A few months ago, I decided to go ahead and book an overseas vacation. I hoped that it would give me something to look forward to, and that it would help to finally put a dent in the anhedonia and apathy that have been such a challenging part of my depression. I decided to go to Italy because it was already high on my list of places I wanted to go, and being a Western European country it seemed like it would be pretty easy logistically. Travelling was always a passion for me, so the notion of travelling for mental health made at least some sense.
Now, as the 3-week trip draws to a close, it’s time to review the good and the bad.
Pros:
- I was having a really hard time just before I left. Knowing I’d soon be able to get away from it all gave me that faintest glimmer of hope to keep on going.
- Present moment focus: It took about a week to really ease into this, but I was able to keep myself mostly in the now for a pretty good chunk of the time.
- It was good to have a break (mostly) from all things work-related. I despise my new employer and I really need to consider whether it’s worth the agitation.
- It was also good to have just a general shift in focus and environment, a way to sort of press reset.
- My energy wasn’t too bad, and I was out and about each day all morning and for the early part of the afternoon.
Cons:
- Too much choice is a bad thing. I was quite lost when it came to picking out restaurants to eat at, so my go-to became supermarkets. Still good food, but I didn’t get the real Italian culinary experience.
- I’m naturally good at organizing. So it really highlighted a deficit when I struggled to figure out how to structure each day. In the end I managed ok, but it was frustrating to have the feeling of looking at my guidebook and my notes and just totally drawing a blank.
- Negative interpersonal experiences: from perv-y hostel guy to being ignored by staff at a cafe, this trip has definitely not helped to restore my faith in humanity
- The anhedonia firmly stayed put. Many of the things I saw that would normally be considered amazing and beautiful came with an attitude of bland indifference.
- My lithium-related lack of coordination was worse than usual, and I managed to wipe out, sprain my ankle, and scrape myself up.
- I am frequently having the feeling that the ground underneath me is vibrating or rocking. I wonder if it might be due to overstimulation or anxiety (even though I don’t feel anxious emotionally). If it continues when I get home I’ll go see my doctor about it.
So, what’s the final assessment? Is travelling for mental health something that actually works? I think while on the trip I did as well as could be expected. Even though I hoped travelling would counteract the anhedonia a bit, realistically I knew that external circumstances would be unlikely to accomplish that. Probably the biggest thing was knowing I would have an escape from my world, which helped me get through a really rough September. Now I head home feeling ever so slightly more able to face my world again, and that at least is a good thing.
Travelling with mental illness: Things to consider
Here are a few things you might want to consider when planning your travels.
Insurance
Make sure you get travel medical insurance. Consider shopping around for a policy that will cover an exacerbation of your pre-existing mental illness.
In 2007, I had planned to do an organized tour across China, Mongolia, and Russia with a couple of friends. Around two months before our planned departure, I ended up in hospital with psychotic depression following a suicide attempt. So much for that trip.
It was the one time I’d ever purchased trip cancellation insurance. I made a claim, but the insurance company came up with excuses to deny it. I’ve never bothered purchasing cancellation insurance again. If you have a pre-existing condition, check if the trip cancellation policy will cover that. This article in Forbes warns that you typically can’t get pre-existing condition waivers for depression and anxiety, so it may not be worth bothering with trip cancellation insurance.
Flights
If you’re struggling with your mental health, airports are probably going to be pretty stressful. Be prepared with music to drown it out or things to soothe you. If you have extra as-needed medication, have that on you.
Medication
Speaking of medications, keep those in your carry-on so you still have them if your checked luggage doesn’t arrive the way it should. If you’re travelling on sleeper trains, keep your meds close to you. I had stuff stolen from my backpack on an overnight train in India, but luckily, my meds were in a bag snuggled up next to me.
If you’re flying or crossing borders, keep your meds in their original labelled bottles from the pharmacy. Don’t bring quantities much larger than what you need for your trip. Even then, border officials may not be impressed that you’re bringing pills into their country; in Uzbekistan, they were puzzled by all my drugs and really had no idea what they should be doing about them. Lack of English posed a problem there, and I certainly didn’t know how to say antidepressant in Uzbek.
The US CDC offers tips on travelling abroad with medications.
Hydration
If you’re going somewhere hot, make sure you keep up your fluid intake. If you’re sweating a lot, or if you’re vomiting or having diarrhea, you need to replace electrolytes. The easiest way to replace sodium is to chow down on a bag of potato chips.
This is extra-important if you take lithium. When you lose sodium and potassium through sweat/vomiting/diarrhea, your body hangs onto more lithium than usual, and you can start to get side effects. Loading up on water alone will further dilute your electrolytes. So drink lots of water, but make sure you’re consuming sources of sodium and potassium (e.g. bananas, coconut water) as well.
Wishing you happy and safe travels!