Travel presents a great opportunity to explore other countries and their cultures. It also provides an avenue for rest and relaxation. However, travel can pose serious stress which can trigger mental health challenges.
Mental health problems are amongst the leading causes of ill health in travellers and a common reason for medical repatriation. It may occur in travellers with no pre-existing history as well as those with a current/previous history of mental illness.
Several factors have been identified as triggers and this includes: separation from family and friends, sleep deprivation, disruption of normal activities, travel delays, culture shock, sense of isolation, language barriers, drugs and alcohol use, physical ill-health during travel, forgetting to use medications regularly, some type of travels like funeral, volunteer, aid work. Major life events occurring prior to travel such as a birth, death, wedding, divorce, moving or serious illness may also pose a risk. Difficult home or professional life; experiencing recent emotional exhaustion or financial strain, pre-existing psychiatric disease are all important risk factors.
Infections (particularly urinary tract infections in people over 60) are an example of the physical health issues that can radically affect behaviour and mental health. There are clear links between mental and physical health, which makes looking after yourself whilst travelling and while abroad so important.
Tips on how to manage mental health issues during travels
A well-managed or previous history of mental health problems is not a barrier to travel. When planning a trip be aware of the following points:
Before you travel
Check out the travel advice on www.gov.uk/ foreign-travel-advice and www.gov.uk/ knowbeforeyougo
Keep an eye on news reports of any problems in the area you are visiting. Follow Foreign and Commonwealth Office (FCO) on Twitter and Facebook for regular updates
Get comprehensive travel insurance – which includes any pre-existing medical conditions you have, and ensure it covers all activities you intend to undertake. If you do not take out proper insurance, you will normally have to pay the costs of any emergency yourself, including expensive medical bills.
At least six weeks before you travel, check with your doctor what vaccinations and other health precautions you may need to take for your trip.
Take any prescribed medicine with you and keep it to hand, as well as a copy of the prescription. However, be aware that some medications (including prescription medications) may be illegal in the country you are visiting. Speak to your prescribing doctor for advice.
Ensure your passport is valid and in good condition and that you have any necessary visas.
Leave copies of your passport, insurance policy (plus the insurer’s 24-hour emergency number), ticket details, your itinerary and contact details with your family and friends or someone else you trust.
Ensure you got enough funds for your trip. Take enough money for the duration of your trip and some backup funds, such as appropriate travellers’ cheques, prepaid cash cards or credit cards.
Get a good guidebook and get to know your destination. Find out about local laws and customs and follow them.
Be aware of your personal security and take sensible precautions to protect yourself.
Be aware that mental health services are available in the country you are travelling to. Facilities and resources available to those experiencing mental health issues, as well as the understanding of these issues, vary greatly in different countries.
Who would help you if your mental health deteriorated abroad and how would you contact them? keep details of friends, family and/or carers with you when you travel and fill in the details at the back of your passport.
It is a good idea to carry a ‘travelling letter’, which gives a brief description of your mental health needs, diagnosis and, if appropriate, details of any difficulties that could occur and what assistance you might then need.
Consider giving someone Power of Attorney to look after your financial affairs while you are away. You could also consider if you want to give someone the power to make decisions about your welfare or health care in case a situation arises where you are unable or incapable to make decisions for yourself. Ensure your journeys are well thought out and develop contingency plans for coping with delays.
During transit
Be aware that time zone changes and jet lag can disrupt your sleep and mental health.
Make sure you take your medication at the right time during travel and maintain adequate hydration/calorie intake and avoiding drugs/alcohol during travel will reduce travel stress .Engage in physical exercises like walking especially if you are on a long-haul flight.
During trip
Maintain a regular routine where possible – this gives you control over your surroundings and helps you remember to take prescribed medicines at the right time. do not stop your regular medication during travel, even if your mental health has improved – you can always discuss this with your doctor in return.
Ensure adequate rest, hydration and calorie intake, especially if a busy schedule is expected, for example, during a business trip or organized tour.
Pre-arrange contact via telephone, skype, email with close friends and family at home, especially when travelling alone.
Avoid excess alcohol and illicit drugs, and if you feel your mental health is deteriorating, seek help/advice early, either from your travelling companions, family/friends, local mental health services or consulate.
After returning from trip
After travel, some people come home with more than souvenirs. Fortunately, most after-travel illnesses are mild, such as a cold or upset stomach. However, other travel-related illnesses may be more serious, and symptoms may not show up until long after you get home. Seek medical attention if you are not feeling well after your trip, whether you have diarrhea, skin problems, trouble breathing, or other issues. Be sure to tell your doctor about your travel, including where you went and what you did on your trip. This is important as seemingly mild symptoms may worsen a pre-existing mental disorder.
Adeniyi Bukola, Consultant Family Physician and Travel Medicine Physician
Q–Life Family Clinic
