Seeing the world is up there with one of the greatest pleasures in life. Planning a trip away should be fun: finding a place to stay, exploring, trying new things, relaxation… but having a mental illness can add unwanted complications, which can make it very stressful.
Attitudes to mental illness vary between countries, with severe stigma and discrimination still existing – meaning access to mental health services and medication can be limited in some destinations. Travellers in foreign countries who exhibit aggressive, strange or psychotic behaviour can be arrested or involuntarily detained, leading to rapid deterioration of their mental state.
Unfortunately, you may be prohibited from travelling if you are too unwell to travel. If you have very recently had an episode, you are unlikely to be well enough to travel abroad.
There are lots of factors which can disrupt stable mental health during travel, such as…
- Separation from family, friends and loved ones.
- Time zone changes and jet lag.
- Sleep deprivation and fatigue.
- Disruption of normal routines.
- Travel delays.
- Unfamiliar surroundings.
- Presence of strangers.
- Sense of isolation.
- Language barriers.
- The use of drugs and alcohol.
- Physical ill-health during travel.
- Forgetting to take medication.
- Work or family pressures.
- Stress levels.
- Lack of familiar support systems.
- Adjustment difficulties – more acute for individuals with underlying mental health conditions.
- Large and noisy crowded areas.
- Heat and humidity can lead to increased sweating, which can create complications for those taking Lithium and other medications.
- General stimulation of transport hubs – like airports and stations.
- Extended journeys – known to aggravate pre-existing psychosis.
- Long periods of sitting.
- Culture shock.
- Small spaces.
- Unexpected situations.
- Altered food intake.
Here is a list of some simple tips to hopefully make travelling much easier…
- Planning early is a must.
- Recognise that travelling can be stressful. Travel-related stress has the potential to awaken a pre-existing mental health condition – effective preparation is key.
- Ensure your journey is well thought out. Develop a plan for coping with delays. Recognise potential hazards and plan.
- Arrange international roaming for your mobile phone. Buy the correct adaptor for battery re-charging to prevent becoming isolated.
- Tell loved ones where you are going, leave them your contact details and insurance policy details in case of emergencies.
- Research the destination, country and language so you know what to expect.
- Discuss travel plans with friends/ family/ loved ones and mental health professionals – preferably before booking.
- Find out how to access medical facilities, including mental health ones.
- If fear of flying is a cause of anxiety, many airlines offer specialised courses.
- If you need to arrange a blood test to check medication levels (like Lithium) whilst travelling, research laboratory facilities in the destination before you depart.
- Try to book the most direct route possible.
- Ideally, travel with a friend, family member or loved one.
- Research the type of transport, timing and length of your planned journey. Research the destination details.
- Find out where your nearest British embassy will be, in case you need to contact them.
- Travellers going abroad for long periods of time can learn self-monitoring techniques and stress reduction strategies before their departure.
- Check for predictable difficulties such as traffic and delays, this can help to develop coping strategies.
- Ensure you have access to funds to cover emergencies or unexpected delays. Take more than one means of payment with you.
- If you see a psychiatrist or other mental health professional, schedule a review with them before you go.
- Try to identify a mental health professional at the destination who speaks the same language.
- Find a travel insurance company which specifically covers mental health issues. Make sure to declare all pre-existing health conditions.
- Create a list of what you need to pack to ensure you don’t forget anything. I make a copy of the list, to make sure I pack everything on the way home.
- Consider who to contact if you need help.
- Be realistic, you may think that when you go away you’ll be able to leave your mental illness at home, but that isn’t going to happen. Being realistic means acknowledging there may be hiccups, but that you’ll prepare for them and be strong enough to address them whilst you’re away.
- Pack enough of your regular medication for the total duration of the trip. An additional week or two could be carried in case the medication is lost, stolen or you experience delays.
- Carry it in your hand luggage, in their original containers and make sure they are appropriately labelled.
- Some medications are restricted and even banned in some countries. You can check online for your specific medications.
- A doctors letter or repeat prescription detailing all medication, dosages and diagnosis may be required.
- Make sure you can take your medication out of the UK, that you can take it into the country you wish to visit, and that the type and amount of medication can be taken.
- Due to restrictions on medications in other countries, it can be difficult to replace lost or stolen medication whilst travelling.
- Don’t stop your regular medication during travel, even if your mental health has improved. This can be discussed with your doctor on your return.
- Wherever possible, split medication between bags so that if one goes missing, you still have supplies available.
- Most countries do not provide free healthcare and access to emergency mental health services.
- Therefore, comprehensive travel insurance, covering all activities and destinations, is essential.
- Make sure to declare all past and current mental health conditions.
- Read all details of any policy, including exemptions – ensure that the costs of treatment abroad and medical evacuation for mental health conditions are covered.
- Allow plenty of time to arrive and go through security checks.
- Maintain a regular routine wherever possible – this gives you control over your surroundings and helps you to take medications at the right times.
- Keep in touch with your family, friends and loved ones. If travelling alone, pre-arrange contact via telephone/ skype/email with people back home.
- Take medications routinely and consistently.
- Day-to-day self-care is an important part of managing mental illness and should be continued whilst travelling.
- Carry a list of contact details of any important assistance you might need with you – pharmacies, GPs, psychiatrists, mental health professionals, local hospitals, loved ones. Even if you never use it, it can be a comfort to have.
- Plan for recovery days. Doing too much when you are mentally unwell can be exhausting, sometimes even triggering. Try to schedule days where you can just relax, especially after a big event. Let the other people you’re travelling know that you’ll need these days. If a full day seems like too much, allow yourself a few hours a day – this can seem more manageable.
- Avoid excessive alcohol and illicit drugs.
- If you feel your mental health is deteriorating, seek help and advice early.
- Try practising relaxing or breathing exercises – maybe even carry a calming item.
- Don’t take risks you wouldn’t at home.
- Get enough sleep, eat properly, drink plenty of non-alcoholic fluids.
- Try to maintain a positive attitude, be flexible and try to adapt to circumstances whilst abroad.
- Celebrate your achievements. Living with a mental illness can make you be really hard on yourself. Just as you would celebrate anyone else’s, why not celebrate your own?
- If you, unfortunately, experience exacerbation or re-emergence of your pre-existing condition, seek medical attention when you return to the UK.
I hope even one of these tips can be useful to you if you are planning a trip away! If you have any other suggestions I may have missed I would love to hear them!