Migration does increase risk of depression, as documented by several studies. Migration can produce considerable stress on those who are migrating as well as on those around them. Migration may result in losses of social networks, including family and friends; material losses, such as business, career, and property; and loss of the cultural milieu, including their familiar community and religious life. Premigration planning includes reasons for immigrating, duration and extent of planning, premigration aspirations, and beliefs about the host country. The type of migration experience, whether as voluntary immigrants or as unprepared refugees, can have profoundly different effects on migrants’ mental health (Sadock, et al., 2017).
Evidence that Migration Increases the Risk of Depression
The relation between migration and increased risk of depression according to a study of the pattern of depression among Vietnamese in Germany (Wolf, et al., 2017) is tied to self-reported migration-related stressors (MRS) among these Vietnamese immigrants. The five most frequently reported MRS, among the 24 stressor items, were as follows:
- Communication problems in Germany
- Longing for the family in Vietnam
- Difficulties in adapting to the German society
- Ambiguity about what to do in certain situations
- Feeling lonely or isolated in Germany
In particular, it found that among depressed Vietnamese migrants in Germany, a higher number of reported MRS were associated with higher overall depression severity, and the association between MRS and suicidal thoughts was clinically highly relevant. Pessimism, past failure, guilt feelings, punishment feelings, and suicidal thoughts were particularly associated with a higher quantity of perceived MRS.
Wolf et al. (2017) report that in one recent European study, for example, the prevalence rates of depression in elderly Moroccan and Turkish migrants turned out to be significantly higher than in a native Dutch sample. Many of these studies do not merely report increased depression rates but also a higher severity level and prolonged course of depression with less mental health care utilization in migrants.
A 2011 study of Mexican immigrants in the US (Breslau, et al., 2011) found that migrants are at higher risk for onset of depressive and anxiety disorders during the years following migration, compared with family members of migrants who remained in Mexico. In particular, it found that compared with non-migrant family members of migrants in Mexico, Mexican migrants in the US had significantly higher lifetime prevalence of any depressive or anxiety disorder, for depressive disorders as a group and for anxiety disorders as a group. Among the 4 specific anxiety disorders assessed, migrants have a higher prevalence for every type of disorder and this difference reaches statistical significance for 2 disorders, Generalized Anxiety Disorder and social phobia.
Several studies show that schizophrenia is also associated with migration from a developing to a developed country. Apparently, the risk effect is associated with living in an area in which most of the population does not share the same ethnicity. Some of the key studies have involved migrants from the West Indies to either the UK or Netherlands in which the risk of schizophrenia has been found to exceed that in the island from which they migrated and that in indigenous whites in the countries to which they migrated (Thapar & Pine, 2015).
Reasons for Migration Increasing the Risk of Depression
Wolf et al. (2017) state that on the one hand, migration can have a positive effect on mental health, for example, by inducing optimism and hope as well as by leading to an actual improvement of the current life situation. However, moving to another country does not always result in positively perceived changes.
Many immigrants are confronted by an array of obstacles, which increases their risk of depression, such as (Wolf, et al., 2017) (Harrison, et al., 2018):
- Perceived discrimination
- The absence of social networks
- Lack of feelings of belonging
- Sense of guilt for leaving family behind
- Language barriers
- An uncertain resident status
- Selective migration. People in the early stages of an illness such as schizophrenia may migrate because of failing relationships in their country of origin.
- Process of migration. Events relating to the process of migration itself (e.g. physical and emotional trauma, prolonged waiting periods, exhaustion, and social deprivation and isolation) may cause several different kinds of stress-related disorders.
- Post-migration factors. Many factors come into play after migration that could influence the risk of developing mental illness. These include social adversity caused, for example, by racial discrimination and acculturation, in which the breakdown of traditional cultural structures results in loss of self- esteem and social support.
- Social exclusion and poverty are also common problems for migrants. Disparities between aspiration and achievement may also cause stress and depression. Finally, immigrants may be exposed to unfamiliar viruses, which could conceivably affect intrauterine development and predispose to a psychiatric disorder in the next generation.
Breslau, J. et al., 2011. Migration from Mexico to the US and Subsequent Risk for Depressive and Anxiety Disorders: A Cross-National Study. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733092/
[Accessed 12 Sep 2019].
Harrison, P., Cowen, P., Burns, T. & Fazel, M., 2018. Shorter Oxford Textbook of Psychiatry. 7 ed. Oxford: Oxford University Press.
Sadock, B. J., Sadock, V. A. & Ruiz, P., 2017. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. 10th ed. Philadelphia: Wolters Kluwer.
Thapar, A. & Pine, D., 2015. Rutter’s Child and Adolescent Psychiatry. 6th ed. West Sussex: Wiley Blackwell.
Wolf, S. et al., 2017. Migration-Related Stressors and Their Effect on the Severity Level and Symptom Pattern of Depression among Vietnamese in Germany. [Online]
Available at: https://www.hindawi.com/journals/drt/2017/8930432/
[Accessed 12 Sep 2019].