If you have moved to Spain and found yourself feeling low, flat, or disconnected in a way that does not seem to lift, you are not alone. Expat depression is one of the most common mental health challenges I see in my practice, and it is also one of the most misunderstood. People minimise it because they chose to move. They tell themselves they should be grateful. They wait, hoping it will pass on its own.
Sometimes it does. Sometimes it does not. And the longer it goes unrecognised, the harder it becomes to treat.
I am Talí Uribe, a bilingual psychologist with practices in Valencia and Madrid. I have worked with expats navigating depression for over 20 years, and I have lived the experience of building a life in a country that is not your own. This post explains what expat depression actually is, how it differs from ordinary homesickness, what causes it, what the signs look like, and when it is time to get professional support.
What Is Expat Depression?
Expat depression is a form of depression triggered or worsened by the experience of living abroad. It shares many features with clinical depression but has a specific context: the disruption of identity, community, purpose, and belonging that relocation causes.
It is not the same as homesickness, though the two can overlap. Homesickness is a longing for what you left behind. Expat depression is a more pervasive loss of functioning, motivation, and emotional wellbeing that persists regardless of how much time has passed or how objectively well things are going.
Research into expat mental health consistently shows that international relocation is one of the most significant stressors a person can experience. A 2019 study by Sterle and colleagues published in Frontiers in Psychology found that expats report significantly higher rates of depression, anxiety, and identity disruption than non-mobile populations, with adjustment difficulties persisting well beyond the first year of relocation for many individuals.
The fact that you chose to move, that you have a good job, that Spain is beautiful, that other people would love to be in your position: none of this protects you from expat depression. In fact, the guilt that comes from feeling low when life looks fine on the outside is often what prevents people from seeking help.
Expat Depression vs. Homesickness: What Is the Difference?
Understanding the difference matters because the two require different responses. Homesickness is a specific longing. You miss your family, your friends, the food, the ease of navigating a culture you grew up in. It tends to come in waves, often triggered by specific moments like a family birthday you could not attend or hearing your native language unexpectedly on the street. It is painful but it is directional. You know what you are missing.
Expat depression is less specific and more pervasive. You might not be able to point to what is wrong. You wake up without motivation. Things that used to bring you pleasure do not. You feel disconnected from the people around you, including people you love. You go through the motions of your life in Spain but feel like a spectator rather than a participant. The low mood does not lift after a visit home or a holiday. It follows you.
The two can coexist. Homesickness that goes unaddressed and accumulates over months can deepen into depression. Expat depression can also produce intense homesickness as a symptom, making it hard to distinguish the two from the inside.
If you are unsure which you are experiencing, the duration and functional impact are the clearest indicators. Homesickness that disrupts your sleep, your work, your relationships, and your ability to function for more than two to three weeks at a stretch is worth taking seriously as something more than adjustment difficulty.
Why Does Living Abroad Cause Depression?
Relocation removes almost every external structure that supports mental health. This is not obvious until it is gone.
Your social network, the people you could call at short notice, the friendships built over years, the easy social ease of navigating a culture fluently: all of this disappears overnight. Building equivalent connections in a new country takes years, not months. In the meantime, the isolation is real and its effects on mood are significant. A landmark study by Holt-Lunstad and colleagues published in Perspectives on Psychological Science found that social isolation has an impact on mortality risk comparable to smoking fifteen cigarettes a day. Loneliness is not a minor inconvenience. It is a serious health risk.
Your sense of competence also takes a hit. In your home country you knew how things worked. You could navigate bureaucracy, make small talk, understand cultural norms, and get things done without effort. In Spain, even simple tasks require concentration and energy. The constant low-level cognitive load of operating in a second language and an unfamiliar system is exhausting in a way that is easy to underestimate. Over time, this erodes your confidence and contributes to a sense of inadequacy that feeds depression.
Your identity loses its external anchors. Much of how we understand ourselves comes from the roles we play in our communities: professional, friend, neighbour, regular at the local coffee shop. When you relocate, all of these roles either disappear or have to be rebuilt from scratch. The process of rebuilding takes time, and in the interim many people feel a profound sense of not knowing who they are anymore.
For expats in Spain specifically, there is an additional layer. Spanish social culture is warm but slow to open. Deep friendships with locals take years to develop. The expat community can provide connection, but it is also transient. People come and go. Building a stable social foundation takes longer than most people expect, and the gap between expectation and reality is itself a source of distress.
What Are the Signs of Expat Depression?
Depression presents differently in different people, and expat depression has some specific features worth knowing. Persistent low mood that does not lift is the most common sign. This is different from having a bad week. It is a flatness or heaviness that becomes the baseline rather than the exception, lasting most of the day, most days, for weeks at a time. Loss of motivation and pleasure is characteristic. Things you used to enjoy, exploring a new city, cooking, exercise, socialising, stop feeling worthwhile. You do them out of obligation or not at all.
Withdrawal and isolation. You cancel plans, stop reaching out, spend more time alone than you want to but cannot seem to change the pattern. In an expat context this can feel like laziness or introversion when it is actually a symptom.
Sleep disruption. Sleeping much more than usual, or much less. Waking in the early hours with a racing mind. Feeling exhausted despite sleeping.
Difficulty concentrating. Work feels harder than it should. You lose the thread of conversations. Simple decisions feel overwhelming.
Irritability. Depression does not always look like sadness. It can look like short temper, low frustration tolerance, and a sense of being constantly on edge.
Physical symptoms. Unexplained fatigue, headaches, digestive issues, and a general sense of bodily heaviness are common physical expressions of depression that often go unrecognised as such.
Thoughts about leaving. A persistent urge to go home, to give up on the Spain project, not because you have made a clear decision but because your mind keeps returning there as an escape route. This is worth paying attention to. It often signals that something needs addressing, not necessarily that you should leave.
When Is It Time to Get Help?
The honest answer is: earlier than most people think.
Most expats I work with arrive having waited six months to a year longer than they should have. They tried to push through. They told themselves it was normal adjustment. They did not want to admit that something was wrong. By the time they reached out, what might have been a relatively contained adjustment difficulty had become a more entrenched depression that required more time and work to address.
There is no threshold of suffering you need to reach before therapy is appropriate. If your mood has been consistently low for more than two weeks, if it is affecting your work, your relationships, or your ability to enjoy your life in Spain, that is enough reason to reach out. Specific signs that suggest you should not wait include thoughts of self-harm or suicide, an inability to carry out basic daily functions, complete social withdrawal, or a sense that things are getting progressively worse rather than staying the same.
If you are in crisis right now, please contact the Spanish mental health crisis line on 024, the emotional support line on 717 003 717, or emergency services on 112.
How Is Expat Depression Treated?
Expat depression responds well to therapy, particularly approaches that address both the emotional and the existential dimensions of the experience.
In my practice I combine Internal Family Systems therapy with logotherapy. IFS helps you understand the different parts of yourself that are struggling: the part that is exhausted, the part that is angry about having moved, the part that is trying to hold everything together, the part that misses home. Working with these parts rather than against them is a more compassionate and effective route to recovery than simply trying to think your way out of feeling low.
Logotherapy, developed by Viktor Frankl, adds the existential dimension. Depression in an expat context is often partly a crisis of meaning. The life you built, the identity you had, the purpose that structured your days: relocation can dismantle all of this. Logotherapy helps you reconstruct a sense of meaning and purpose that is rooted in your actual life in Spain, rather than in a version of yourself that no longer exists.
Practical elements also matter. Social connection, routine, physical activity, and a realistic timeline for adjustment are all part of recovery. Therapy is not a substitute for these. It is the space where you can understand what is happening clearly enough to take effective action.
A Note on Getting Help in English
One barrier that prevents many English-speaking expats from seeking support in Spain is not knowing how to find a therapist who works in their language. The private system in Spain allows you to contact a therapist directly without referral or waiting lists. You do not need to navigate the public system or speak Spanish to access good psychological care.
For a full guide to finding an English-speaking therapist in Spain, including what credentials to check and where to look, that page covers the complete process.
If you are experiencing expat depression and would like to explore whether working together might help, you can reach me through my contact page. I offer sessions in English and Spanish, in person in Valencia and Madrid, and online from anywhere.
Frequently Asked Questions
Expat depression is depression triggered or worsened by the experience of living abroad. It shares the same core features as clinical depression, including persistent low mood, loss of motivation, sleep disruption, and withdrawal, but has a specific context: the loss of identity, community, and belonging that relocation causes. The guilt of feeling low while living what looks like an enviable life abroad is a distinctive feature that often delays people from seeking help.
Without support, expat depression can persist for months or years. With appropriate therapy it is very treatable. The duration depends partly on how long the person waited before seeking help and partly on the specific factors driving the depression. Most clients I work with begin to notice meaningful improvement within eight to twelve weeks of starting therapy.
Mild adjustment difficulty often does resolve on its own as you build connections and routine in your new country. Depression that has become more entrenched, affecting your sleep, work, relationships, and daily functioning for more than a few weeks, is unlikely to resolve without some form of support. Waiting tends to make it harder to treat, not easier.
Yes. Online therapy is particularly well suited to expats because it removes the geographical barrier of finding a therapist in your area who works in your language and understands your context. A 2022 meta-analysis published in the Journal of Anxiety Disorders found no significant difference in outcomes between video-based therapy and face-to-face sessions for depression and related conditions. Many of my clients experiencing expat depression work with me entirely online.
The first step is to take it seriously rather than minimising it. If your mood has been consistently low for more than two weeks and it is affecting your functioning, reach out to a mental health professional. In Spain you can access private therapy directly without a referral. If you are not sure where to start, my guide to finding an english speaking therapist in Spain walks you through the process.
Author bio: Talí Uribe is a bilingual psychologist (EN/ES) with practices in Valencia and Madrid. She holds IFS Level 1 certification (IFS Institute, 2025) and a diploma in Logotherapy and Existential Analysis (Viktor Frankl Institute, 2022). She has over 20 years of clinical experience working with expats, professionals, and individuals navigating major life transitions.
Health disclaimer: This article is for informational purposes only and does not constitute clinical advice. If you are in crisis or need immediate support, please contact the Spanish mental health crisis line on 024, the emotional support line on 717 003 717, or emergency services on 112.