You’ve been looking forward to your vacation for months — but a few days into your trip, you find yourself feeling tired and listless, without the energy or enthusiasm to go out and explore. You don’t want to do anything, you don’t want to interact with anyone, and it takes everything you have just to get out of bed. For people traveling with depression, this scenario might sound uncomfortably familiar.
If it does, you’re not alone. Depression is one of the most common mental health problems, affecting more than 300 million people worldwide, according to the World Health Organization (WHO). This includes plenty of travelers. “Mental health issues are among the leading causes of ill health among travelers,” notes WHO, “and ‘psychiatric emergency’ is one of the most common medical reasons for air evacuation, along with injury and cardiovascular disease.”
If you’re struggling with depression, it doesn’t necessarily mean that you can’t travel, but you may need to take a little extra care and preparation to ensure that your trip goes smoothly. The following tips can help make traveling with depression a little easier.
Assess yourself honestly before traveling with depression
Before you book any flights, take stock of whether you’re really ready to leave home. “Make sure your depression is well controlled,” advises Dr. Sarah Kohl of TravelReadyMD. “Typically this means no medication changes or flare-ups within the last three months.” If you see a doctor or therapist for your depression, he or she can help you assess your fitness for travel.
Know your options
Mental health problems are not handled the same way in every country. “Be aware of how mental health conditions are perceived at your destination, as this can influence the kind of care you receive,” says Daphne Hendsbee, communications and marketing specialist at the International Association for Medical Assistance to Travelers (IAMAT). “Is forced admission (without the patient’s consent) the norm? What are the psychiatric facilities like? Is appropriate treatment/medication available? Can I find local mental health professionals that speak my language?”
If your depression is severe and there are few resources to help at your destination, you might want to reconsider your trip.
Make a contingency plan
Once you’ve decided to go, develop a plan for what you’ll do if travel depression strikes. This might include figuring out the best way to get in touch with your therapist at home, looking up English-speaking mental health professionals in your destination, or opening an account with an online counseling service such as Talkspace or BetterHelp. It’s also a good idea to look up the emergency number in the country you’re visiting.
Many travel insurance policies exclude mental health conditions from coverage. However, you might want to consider purchasing a “cancel for any reason” policy so you can call off a trip without penalty if your depression flares up before you’re scheduled to leave.
Manage your medications
If you’re on antidepressants or other medications, make sure you have more than enough for your trip (in case you lose a pill or have to stay a few extra days). Always pack medications in your carry-on, not your checked bag.
Do not change your medication dosages before or during a trip without your doctor’s knowledge. “You may have been feeling great for months … but that’s no reason to start adjusting your doses,” says Dr. Kerem Bortecen of NYC Surgical Associates. “You should only make adjustments under the careful supervision of your primary care physician or psychiatrist.”
International travelers should keep in mind that certain medications — including many psychotropic drugs used to treat depression — are restricted or even banned in some parts of the world, notes Sheryl Hill, executive director of DepartSmart.org. She recommends consulting with your local travel clinic to figure out how your destination handles the drugs you’re taking. It may be necessary to pack your medications in their original labeled bottles, along with a doctor’s note. IAMAT has a useful guide to this issue, and you can find country-specific information at the website of the International Narcotics Control Board.
If you’re taking special medications such as anti-malarial drugs for your trip, check with a doctor or pharmacist to make sure they are safe to combine with your antidepressants.
Plan your trip wisely
When traveling with depression, many people find that stress can bring on symptoms or make them worse. If you’re not an experienced traveler, start small — like a weekend road trip or a quick flight to a nearby city rather than a two-week trans-Atlantic trip spanning multiple countries.
No matter where you’re headed, advance planning can help reduce stress. Dr. Irene S. Levine, co-publisher of GettingOnTravel.com and a psychologist and professor of psychiatry at the NYU School of Medicine, recommends starting your trip preparation well before departure, including “making prior arrangements for things to go smoothly at work, making sure your home is secure, and packing for the trip … so all the tasks aren’t left for the last minute. This will help minimize pre-trip stress and anxiety.”
Dr. Levine also suggests working some downtime into your itinerary and coming home at least a day before you have to go back to work to allow for an easier transition back into everyday life.
Finally, try to work around anything you know might set off travel depression. “Does lack of sleep trigger symptoms of depression? Plan ahead so that you schedule enough time for rest and recuperation,” says Dr. Jana Scrivani, a clinical psychologist. “Do the stress and anxiety associated with travel itself trigger symptoms? Learn how to practice relaxation skills such as diaphragmatic breathing and progressive muscle relaxation.”
Set realistic expectations
Some people find that exploring new places helps their depression symptoms, while others discover that the stresses of jet lag and being in a strange place actually make things worse. It’s important not to embark on a trip with unrealistic expectations that everything will go perfectly or that you’ll be able to escape your depression completely. Such expectations simply add more pressure and exacerbate your symptoms.
“For some people, traveling gets them out of their normal routine, and this is a positive thing,” says Dr. Scrivani. “Sometimes those folks are able to maintain positive gains they’ve made to their mood once they return home. [But] travel is not a cure for depression. We can’t spend our lives on vacation, and either our triggers come with us, or will certainly be waiting there once we get home.”
Stick to a routine
While part of the fun of travel is breaking out of your everyday routine, that lack of structure can sometimes cause problems for people traveling with depression.
“Particularly when you’re on a long trip, the fact that you can end up losing track of what day it is (let alone what time) makes it quite hard to feel grounded and stable when your head starts to do some telltale unraveling,” says Tabby Farrar, a travel blogger at JustCantSettle.com who has dealt with depression. “Forcing yourself to get up at about the same time every day, eat breakfast, just those normal things you’d be doing at home … can be a huge help in making yourself feel a bit more ‘normal.’”
Take care of your body
Eating healthy meals and exercising regularly — from walking around town to doing stretches in your hotel room — often have beneficial effects when traveling with depression. So can getting the right amount of shut-eye. “Sleep hygiene is directly related to your mood,” says Dr. Bortecen. “Get seven to eight hours of sleep every night, do not oversleep, and get acclimated to your time zone as soon as possible. Don’t nap during the day or stay awake all night.”
Dr. Bortecen also warns against drinking alcohol: “There’s always the temptation to let loose on holiday, but it’s important to remember that alcohol will act as a depressant, so determine your limit beforehand. … For some, this may mean one glass of wine with dinner. For others, it may mean abstinence.”
Set small goals
Sometimes travelers with depression put too much pressure on themselves to see all the local sights and constantly have a great time. But if you’re struggling with a lack of energy or motivation, that can just make things worse.
“A [common] symptom of depression is anhedonia, or the inability to experience pleasure,” says Dr. Scrivani. “Oftentimes, people with depression will stop engaging in activities that they once enjoyed because they no longer experience any pleasure from them. When traveling, if you notice that this is happening, set small, reasonable goals for yourself … like heading out to a museum for an hour. Chances are, once you have behavioral momentum, you’ll want to do more. If you don’t, be gentle with yourself and acknowledge that meeting that one goal is a win.”
Use your support system
Whether it’s a companion on your trip or a therapist at home, it’s important to have someone you can talk to when you’re traveling with depression. “If you’re really struggling, a familiar face on a video call or a voice at the end of a payphone can be the little boost you need to feel better again,” says Farrar.
Dr. Nadeen White, a physician and travel blogger at The Sophisticated Life, notes that depression-focused support groups can also be helpful, such as the Depression Support Group or Safe Haven on Facebook.
Get a little space
If you’re feeling blue and just not up for that walking tour or temple visit, don’t force it — instead, give yourself permission to take a little vacation from your vacation.
Says Farrar, “There’s often pressure to interact with other travelers, try something new and exciting every five minutes, and not waste a single second. [But] sometimes if you have depression you really do need that downtime you’d be having at home. … It’s totally okay to check out of your dorm room and into a private space, and to say no to the hiking trip when you could just be chilling out on the beach again.”
Be patient with yourself
Travel can be stressful and exhausting at times even if you aren’t traveling with depression, so don’t be too hard on yourself if you aren’t able to do everything on your itinerary. “Above all else, be kind to yourself,” says Dr. Scrivani. “Remind yourself that you may have symptoms, but you have a proactive plan in place to cope with them. … Celebrate the small victories that can be so much more difficult to manage when you’re feeling depressed.”