International travel can be stressful for a range of reasons, but it’s important to recognize that it’s stressful for every traveler and not solely for those struggling with mental illness. The stressors for one individual may not affect another quite as much, but given the overall stress of travel pre-existing psychiatric disorders can recur and latent, even undiagnosed, problems may become apparent for the first time.
Mental illness is an under recognized public health concern and travelers are often unable to access adequate emergency psychiatric care when traveling away from their own physician and support system. Travelers with mental health concerns often encounter the additional burden of dealing with stigmas, negative attitudes, and behaviors toward their illness.
If you know you have a mental illness, or you’re traveling with someone who does, the following outlines important steps to take to prepare for a successful trip abroad.
1. Know how travel could affect your mental health
Your mental and physical health prior to and during your trip will determine how well you are able to cope with what happens on the trip. Some factors to consider and discuss with your physician include the following:
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Current sleep levels and expected levels of sleep while traveling
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Reason for traveling (leisure, business, or family responsibility, etc.)
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Life events occurring at the same time (births, deaths, divorce, moving, etc.)
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Professional and/or work situation (job changes, promotions, project status, etc.)
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Financial events (selling or buying a house, bankruptcy, financial strain, etc.)
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Medications, changes in medications, and new medications with psychiatric effects (such as anti-malarial drugs)
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Type and length of travel
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Travel destination (politically unstable or war-torn areas, returning to a place of psychological trauma, etc.)
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Culture shock when you arrive
Every traveler is unique and what effects you may not be a problem for others, so take the time to look at the factors that could affect your health while traveling.
2. Ensure you’re fit for travel
Many people with pre-existing mental illnesses are able to fly and travel without difficulty, but a good assessment of your fitness to travel is advisable especially following any changes in your medication, any recent illness or hospitalization, or major life changes. The availability of culturally compatible mental health services varies widely from country to country.
Prior to making your travel plans, speak with your mental health care provider about your travel plans and any concerns you have. A one-time prescription or change to your current medications may be enough to alleviate the anxiety and emotional stress that is common to travel.
See also: 4 Tips to Create a Simple, Effective Travel Medical Portfolio to take with you.
3. Have on hand the tools you need
Passengers with mental illness traveling by air are required to be in a stable condition to travel alone. In other cases, an appropriately trained escort with access to medication to calm the traveler may be necessary. Liaison with airport medical services ahead of time to ensure the best possible travel experience.
As a person living with mental illness, you know what tools help you best. Make a checklist ahead of time of all the things you want to bring with you and cross them off as they are packed. Be sure to separate those you need inflight into your carry-on if you plan to check a bag.
See also: What’s in your Travel Medical Kit? and have the essentials you may need on your trip.
4. Have adequate medication and documentation for customs
It’s important to have an adequate amount of medication to cover your entire trip plus a few days in case there are unforeseen changes in your travel plans such as a flight cancellation due to severe weather. If you run out, refills may not be available. In addition, the laws regarding the use of illicit substances can be severe in some countries.
Use these tips to travel with your medications:
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Determine ahead of time whether you can travel with your medication to your destination
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Carry your medications in their original containers
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Have a letter from the prescribing physician indicating that the medicines have been prescribed for medical reasons
You may have to check with the country’s embassy or with a physician specialized in travel medicine to find out ahead of time if you’ll be facing problems at customs and be prepared.
See also: Our Checklist for Traveling with Medications for more information.
5. Be aware of the risks and your triggers
Travel is often associated with an increase in sexual activity – even unprotected sex – as well as other activity that could affect a traveler’s level of risk or how their medications are working. Different environments and weather patterns such as high temperatures and increased sweating could lead to toxicity even when the traveler is taking the usual dose, for example. Reduced sleep and changes in time zones could have a negative impact on the traveler’s level of awareness and even cause confusion about when to take certain medications.
Doing some research ahead of time will help ease the risk levels, but being aware of the factors is one step toward minimizing the risk.
6. Seek support abroad
Travelers who typically have support options back home should seek the same type of support when they’re traveling. For example, currently sober patients can seek out local Alcoholics Anonymous meetings depending on the length of their stay and the stability of their sobriety.
It’s important to recognize that travel is destabilizing and so having those supports on hand may be key to staying healthy while on your trip. Keep your doctor’s phone numbers handy in case you need to call during your trip.
7. Buy travel insurance
While travel insurance plans specifically exclude reimbursement or coverage for any loss caused by or resulting from nervous, mental, or psychological disorders, some (not all) plans include the caveat that the exclusion does not apply to medical expense and evacuation benefits. This means that you won’t be able to cancel your trip as a result of your mental illness, but you can seek medical attention for an injury or illness that occurs while traveling and have the coverage you need.
While travel medical plans may not cover losses due to your pre-existing mental health condition, you’re just as likely to be injured or become physically ill as any other traveler and having the coverage you need for those incidents is critical.
8. Take care post-travel too
A traveler should always take care to notice any changes in their health after they return. Physical symptoms could be a sign of a disease picked up during your trip. Mental symptoms could indicate a higher-than-normal level of stress that may need to be accounted for in the dosages of medication you’re taking.
If a traveler experienced a high level of stress on their trip or a traumatic experience, it’s important to get in touch with his or her mental health care provider. Symptoms could occur months or even years after an event and knowing about the potential for symptoms is key. If there’s is any doubt about a possible reaction to a traumatic event, a psychiatrist referral may be warranted.
Useful resources
Travelers with mental health questions can find useful resources with the International Association for Medical Assistance to Travellers (IAMAT), including the following:
Travel and Mental Health downloads
Plus, joining IAMAT entitles members to access doctors and clinics who are mental health practitioners and speak your language. See the information about IAMAT doctors and clinics for details.