Living or studying abroad is no small feat: you may be thousands of miles away from home for months at a time, perhaps outside your own country (and, according to our interviewee, ‘on another planet') for the first time. Your usual support systems and coping mechanisms may suddenly be absent, and sometimes Skype just doesn't cut it! For many years, Sandro Rosseti, M.D., a Florentine psychiatrist, has been a referred psychiatric physician for several of the American universities in Florence. In addition, Dr. Rosseti is the director of the Italian Institute for intensive short-term dynamic psychotherapy and a long-time TF reader. He took some time talk with TF about the importance of putting your mental health first while studying abroad.
What is the principal reason that students seek your professional advice?
It's important to note first off that any time you face something you're not familiar with, especially thousands of miles and a few time zones away, a reasonable amount of anxiety is common, and the amount obviously depends on how well you deal with change. There's something I like to call ‘backpack syndrome,' and it refers to the fact that any pre-existing problems will not disappear when you change your environment-anzi. The stresses can be exacerbated when most or all of your usual support systems are no longer present. That said, one of the most common reasons I see students is that they already have a condition.
However, they often have neglected to let anyone know, least of all a professional, so I often see a student when he or she has reached a ‘crisis point,' which is something that should be avoided at all costs. Next in rank are depression and anxiety, oftentimes after prolonged homesickness and difficulty adjusting or managing time. This can be a new experience for students, but propensity for depression varies from person to person. When you add sleep deprivation, overexcitement and school anxieties, clinical depression can occur, and any other issue just becomes that much worse.
How can students deal with the anxiety of spending prolonged periods abroad?
The most important step is to first acknowledge the problem! So often people think that time, a change of location or new friends can make their problems disappear. In some ways this is true, but, for example, depression can often be mistaken for homesickness and the sadness, listlessness or difficulty socializing that can come with it. If these symptoms persist for weeks on end, and the student has trouble concentrating, getting out of bed, is over- or under-eating regularly; and if the student allows this to continue, depression only gets worse: I'll see a student quite late in the process, and treatment becomes much more difficult.
My most important advice to those with a pre-existing condition is to contact the student life office for a professional contact immediately upon arriving. The staff there will refer you to a specialist, and you'll feel much better knowing beforehand who will treat you if you need help. Odds are you will have no trouble adjusting and can continue just as you do at home, without any help. However, knowing whom you would be talking to is immediately helpful; the student is less likely to try to cope alone with anxiety, depression or another condition until it is too late.
Do students ever come to you because they are overwhelmed?
Anxiety often occurs when students feel the ‘so much to do, so little time' pressure, especially when academic performance is tossed in. I encourage students to realize that they don't have to do it all at once. Three months, six months-it's a long time! Take it easy.
Do you believe in culture shock?
Oh yes! We are different. Wherever you come from in the States, Great Britain, Europe and what have you; Italy is another planet and Florence is another galaxy! The way Italian men relate to women is different; the way Italian women relate to men is different. This is a Renaissance town, too, but Florentines live here, and here is where the usual discourse about alcohol and acceptable behavior comes in.
From a psychiatric standpoint, I'm not here to make moral judgments or tell students how to make a bella figura: that is their own responsibility, and order is the responsibility of pub owners and, sometimes, the police. Students should know that. However, as far as alcohol goes, our two cultures are very different. My principal concern is that students do not begin using alcohol as medicine. If you have social phobias, depression or any other condition or impulse that is causing you to drink to numb your mind, you need a prescription, not a Pinot. Go talk to a professional immediately, even if you need to talk about one of your friends whom you believe is ‘overmedicating' in any way.
Any last words of wisdom?
In any given year, we send a maximum of three or four students home for mental health reasons. If you are in a large program of 500 students, maybe more, it's easy to get lost. I want students to know that there are abundant resources that must be available to them-by law. The student life office is a comprehensive, friendly resource that will know where to send you, so consult, consult, consult! Be realistic, be honest with yourself and make your health your absolute primary concern. You are here to have an eye-opening, life-changing and, above all, fun experience. Don't let that go to waste just because you feel like there is no one to talk to.