Anxiety may follow you home from Bali, even if you didn’t pack it.

Hi all,

I’m continuing to write and help out where I can, because I feel quite uneasy myself, and really missing home. As a psychiatrist working in private practice I would usually have seen about 15 patients this week by now, and handled a pile of inquiries via phone as well. So having this enforced break in Bali after my flight was cancelled 5 days ago is feeling really surreal, and I am feeling for my patients who have had to move their appointments until I get back.

I have heard that some people have managed to arrive home, but have noticed that the anxiety has followed them there. As a psychiatrist I can understand why, and I know it doesn’t make a lot of sense intuitively. I’m sure these people are hearing lots of comments, which are not helping the situation at all, such as

‘what do you have to be anxious about, you’ve just come home from Bali?’

Returned travelers understandably may have expected to be relieved and grateful when they finally walked in their front door. But instead they may have experienced a range of emotions, good or bad, ranging from mild disappointment to symptoms of trauma and everything else in between.

It is really important to accept it is OK to feel anything you might be feeling when you get home. Only you know and experienced your personal journey to get back in your front door.

As I have been writing about, humans love our structure and certainty. Uncertainty is a fertile breeding ground for anxiety. This structure includes daily routines which work best when they align nicely with our own circadian rhythm, or internal ‘body clock’. When we are on holidays, structure goes out the window in a really beneficial way, and because we don’t have to wake with an alarm clock or fit in with other schedules, we sleep when we want, eat when we want and we feel better for it. However, when we travel home crossing time zones and disrupting sleep (who can sleep on planes at the best of times?) we disrupt our circadian rhythm again, but in a negative way. This has a negative impact on mood and anxiety levels.

It ain’t just post holiday blues, there are known structural connections between the sleep centres and the mood centers in our brain. The good thing is once jet lag or transient sleep disturbance rectifies itself, so should you mood.

But what happens if, on top of all of this, there has been major sadness, disappointment or even illness or loss compounding the situation? What if you have been stranded like I am, annoyed and irritable that I have really no idea what will happen, fed up with comments telling me to enjoy my extended holiday, and then you finally get home? What if, instead of feeling relief and jubilation that you are home, you are teary, on edge and just plain miserable? There may be additional factors, complicating what has already happened with circadian rhythm disturbance that may be making things more difficult for you, including;

  • Nobody at home gets what you have been through. Friends, family and work colleagues only apply what they have seen on the news or have heard from other people, and you can feel they genuinely don’t understand your predicament. This invalidation may make you question your own response, feel deficient in some way, or lead you to holding back or pretending things are fine.
  • You have more FOMO. FOMO, or fear of missing out, may apply if your delays have led to you missing significant events going on for others at home. You may feel inappropriate guilt or anger because this awful unplanned event made you miss something very special to you.
  • As a coping mechanism, and because you felt helpless and uneasy, you may have coped with your extended time in Bali by being somewhat detached from the situation. This is a normal coping mechanism but also occurs when people are anxious. When reality hits you, when you see the credit card bills, or open the mail, all the emotions you may have not experienced while away may come flooding back.
  • If you have been diagnosed with depression or anxiety, you may have inadvertently missed doses of your  prescribed medications due to protracted travel home, or you may have run out while away. These feelings may actually be symptoms of a relapse of your illness and understandable.
  • You are constantly checking FaceBook feeds or news reports as you feel a connection to this situation and you feel inappropriate guilt that you got home. This in an extreme form is akin to ‘survivor guilt’, experienced by those who survive traumatic events and feel guilty that they did. This is complicated when well meaning people remark ‘how lucky were you’ and other things that make people hide their true feelings about their experiences.
  • If your time in Bali was complicated by further adversity, such as illness, theft or violence, you may be re-experiencing the event every time you see more updates, especially if the media at home is sensationalising things. You may feel a need to keep connected to social media as a way of trying to reassure yourself, which is keeping your mind on the past, and not on the healing properties of the present.

So if any of these factors (and I’m sure there are more) sound familiar, first and foremost do NOT beat yourself up for feeling the way you do. I often tell my patients that they feel anxious, depressed, sad, angry, lonely or whatever just because they do. Acknowledging how you feel regardless of whether you feel it is inappropriate or not is your first step to accepting it, then nurturing and healing yourself.

Other practical strategies to try (once again these are general guides and not specific to all cases);

  • Limit or avoid news updates about what is happening in Bali. It doesn’t help to let your mind wander into what is still happening to others. There is a fine line with feeling connected to others who understand, and perpetuating feelings of helplessness and sadness.
  • Connect to 1-2 friends who truly understand and talk to them. But if you feel overwhelmed by sharing, retreat for a while until you feel stronger.
  • Get your circadian rhythm back on track ASAP. Do not stay up late reading updates. Re-establish your normal daily routine. As bad as you have slept the night before, get up at the same time and go for a very short walk, not for the purpose of counting steps but to get some bright sunlight on your face. This will reset your melatonin levels and ensure your sleep cycle returns to normal as soon as it can. Sneak in a coffee or tea on the walk, it may help with motivation!
  • Connect with good memories and times that did happen. Print our photos of smiles, beautiful scenery, a picture of you in a relaxed happy state. All the reasons why you went to Bali in the first place.
  • If these tips do not work in a couple of days, or if you are having worrying thoughts, see your GP as a matter of urgency. You might be going there anyway, for that often needed dose of Bali-belly remedy. Make sure you tell your GP if you are not coping. Key symptoms to report are sleep disturbance, excessive worry, disturbed concentration, and more seriously thoughts of self harm.

This is not a time to think all the feelings you are having are due to you being weak, ungrateful or any other silly idea that may try and pop into your mind. Be kind to yourself, don’t avoid your feelings or excuse them away. Stay grounded. At home.

 

Dr Helen Schultz is a consultant psychiatrist in Melbourne, Australia, generally reachable by air from Bali. Right now she is stranded in Bali, churning out blogs and missing her son like anything. 

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