Expats Like Us
A podcast series exploring life as a U.S. Expat in Mexico. Topics include preparing to move to a new country, navigating your new home and finding your passion as a retiree.
Expats Like Us
My Mental Health Journey as an Expat
Life abroad comes with its unique set of challenges, a truth I've come to know intimately since moving to Mexico. From the sun-soaked beaches to the bustling street markets, this vibrant country offers a wealth of experiences, but adapting hasn't been without its struggles. Through candid conversations with Dr. Kitzia Ruiz Navarro, a psychiatrist from Playa del Carmen, we shine a light on the mental health hurdles many expats encounter, including my own battle with insomnia and depression. We discuss the pressures of cultural acclimatization, the crucial role of community, and the necessity of accessible English-speaking mental health resources that can often be a lifeline for those feeling isolated in their new surroundings.
As we weave through the fabric of expat mental wellbeing, we tackle the interconnectedness of anxiety, depression, and sleep disturbances, and the additional strain a language barrier can impose. Dr. Kitzia and I unravel the layered complexity of these issues, offering insights and real-life anecdotes on the significance of seeking professional guidance. The episode also journeys into the sensitive topic of retirement, addressing the quest for renewed purpose and the emotional upheaval that can accompany such a major life change. We wrap up on a lighter note with our "que padre, que malo" segment, balancing the serious discussion with a glimpse into the everyday joys and challenges of life in Mexico. Join us as we approach these compelling topics with honesty, empathy, and an eye towards hope and healing.
We are incredibly thankful for engagement and stories from our listeners, who have found their own sense of 'home' across the globe. Stay tuned as we continue to share the wisdom and wanderlust of those who've charted their unique international courses. We'd love to hear your comments and questions. Email them to expatslikeus@gmail.com
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Welcome to Expats Like Us. When I quit my job and retired to Mexico, I was so looking forward to everything I associated with this part of the country Great weather, great beaches, great food and all the time I needed to enjoy it all. So I did. The first year was so exciting. We made so many friends and did so many things and had tons of new experiences. Going to the beach, drinking margaritas, trying new restaurants, navigating all the strange Mexican systems took up most of our time. The second year, however, I began to have some problems. To make a long story short, the beach wasn't new anymore, the margaritas didn't taste as good as they once did, and I was having increasing trouble sleeping at night. If you've ever experienced an extended period of insomnia, you know how awful that can be. I soon found out that what I was experiencing was more complicated than just insomnia. My guest for this episode is one of the people who helped me through this tough period. This episode is one of the people who helped me through this tough period. Doctora Navarro is a psychiatrist in Playa del Carmen. I am so excited she agreed to be on this podcast and I hope my story and her advice can help other people who may be experiencing some of the same feelings that I had. I know it helped me. Following her interview, I will have a list of some mental health resources that are available in English for expats throughout Mexico. So stick around.
Speaker 1:Welcome to Expats Like Us exploring the world of US expat life in Mexico. In each episode we'll meet new people and hear their personal stories. We'll also learn more about the expat life and get a few tips on everything from making your move to settling in and living your dream. Let's dive in. I'm your host, bob Bussey. Today I'm thrilled to be talking with psychiatrist Dr Kitsia Ruiz Navarro. Dr Kitsia lives and practices in Playa del Carmen. She's trained as a surgeon and holds degrees in effective and bipolar disorders and psychiatry from Ramon de la Fuente National Institute of Psychiatry, and she's certified by the Mexican Council of Psychiatry. Dr Kitsia describes herself as proudly Mexican, originally from Mexico City and happily from Playa del Carmen. She's also a leader and a fighter for social issues. I met Dr Kitsia after experiencing chronic sleeplessness, which turned out to be a symptom of depression in my case. Thank you, dr Kitsia, and welcome to Expats Like Us.
Speaker 2:Thank you very much. It's a pleasure to be here with you today.
Speaker 1:So tell me what first interested you in a career as a psychiatrist.
Speaker 2:There's something in humans that make us being us and no one else, and it's not the brain, it's not the heart, it's not our background, and since the beginning, I had a lot of interesting to understand. What was that? Unfortunately, by the time pass, I understood that there is no answer with that, but the mystery of the brand, it's something that makes me wake up every morning and do my job, like, like and that's it. I I always say that the mind is like a universe, a big, big universe, and we only know only like a start we can see with a telescope and that's it. So a lot of things to, to, to, to research, to understand, and every day something new in my practice, and that's what I like a lot about psychiatry.
Speaker 1:So how long have you been practicing?
Speaker 2:Like about 18 years.
Speaker 1:Oh, okay. Yes, a lot of years, a lot of years, and there's still just as much mystery involved in the human mind, as there was when you started.
Speaker 2:Yes, but the more I know, the less I think I know Like.
Speaker 1:So Playa del Carmen, where you practice and it's nearby where I live, it's a relatively young international city with residents from all over the world living here. Do you find that this environment lends itself to any mental health issues that may not be so prevalent in other places?
Speaker 2:Yes, playa del Carmen has something very peculiar and it's different. I always say that there is Mexico and Playa del Carmen, or Mexico and Quintana Roo. Quintana Roo is a place that was built by immigrants, not only international immigrants, also by people of other places of Mexico. So it's very difficult to find a sense of community here and most of people arrive here alone and loneliness is something that by sure it's like a risk factor for mental disorders. So it's not easy to get used and to get involved and make this community that at the end, we need to have community. So, yes, people can stroll a lot by the time they arrive here, especially after certain months.
Speaker 1:Yeah, I've never thought about that, but this area it's a young place, basically it's. You know, Quintana Roo became a state in the 70s sometime, so there's nobody that has five generations of family and support structure here. I've never thought of that before.
Speaker 2:And Playa. It's a place that people come and go Like they can come work, stay like a couple of months and then leave and they go to a different place. So it's a very unstable place to settle.
Speaker 1:Right. So describe your clientele. Are they primarily immigrants from other countries? Are they native Mexicans or is it a mix of both?
Speaker 2:I think it's a mix of both Some days and it's something I like a lot at my job, because some days I only see Mexicans, but other days I can begin with the Russian, and then with the Spanish, and then with the Italian and then with the Chinese, so it's very interesting. At the end of the day, it's a very multicultural, very cosmopolitan city, so I see people from almost all the world Right. I see people from almost all the world.
Speaker 1:Right.
Speaker 2:So there is no difference between being a forgain immigrant, like coming from USA or Canada, and coming from Mexico City or Monterey. At the end, everybody's an immigrant here.
Speaker 1:Right, right. I've never thought about that. I look from being only here for three years now, you know. I look and say oh, this, this, this person is, is a native here, but not many people are.
Speaker 2:No, actually, actually I'm an immigrant. I'm an immigrant. I have been 12 years living here. I'm from Mexico City, so so, yes, we're everybody's immigrant.
Speaker 1:Yeah, okay. So I've heard that there are some problems or disorders that anyone can suffer from, but maybe they're more prevalent in the expat or immigrant population. And why is this? You may have touched on that Is the support structure.
Speaker 2:Yes, like according to the city, and coming to a new place with a different language, different culture. I think that anxiety and adaptative disorders are some of the things that I see the most Like all this. I mean not depression, not anxiety, but is the stress about coming to a new place with new people, with new job, with new culture. It's the stress of coming to a new place with new people, with new job, with new culture, and there is no like a different prevalence from other place in the world.
Speaker 1:Actually, Like we know that anxiety and depression are the most common psychiatric disorders in the world. So when you say adaptive disorders I guess I didn't know that term really that's when you have a major change in life. Is that what that is?
Speaker 2:When you have a major change, exactly. You have a major change in your life and you can have symptoms that are compatible with a depression or with an anxiety disorder, but they are not as intense to give medication or they don't interfere in your functionality as a depression or anxiety disorder can do.
Speaker 1:Okay, well, everybody that we talked to on this podcast has adapted to some big changes in their life. Yes, and mostly just in the last few years.
Speaker 2:Yes, especially when you come here to a new place and you begin your retirement.
Speaker 1:Right.
Speaker 2:Not only moving to a new place, it's also that.
Speaker 1:It's a double change.
Speaker 2:It's your work, life changes and your home changes Exactly. From one day to another, you stop with your routine of 25, 30 years and the first months I always say that it's like a honeymoon. It's like you're in the place you dream all your life. You have the beach, you have the sun, you have a beautiful weather. And by the month's passes it's like and now what? So it's very easy to lose the purpose in the days Right, and that's a risk factor for depression and anxiety. It's like now, what am I going to do?
Speaker 1:I remember you very well telling me the exact words the honeymoon is over.
Speaker 2:Yes, and it's when we began to see anxiety, depression, and another thing that is very common here, especially after retirement, is like alcohol abuse also. You can begin the party at 11 in the morning and end at 2 am in the morning, yeah, because you feel that you're on vacation, so it's very easy also to get involved with alcohol, right? And it's another thing that I see a lot like a lot of alcohol abuse.
Speaker 1:I bet, yeah, I see it too. I'm not a psychiatrist, but I can diagnose it, you know.
Speaker 2:in my head.
Speaker 1:So I know that there are people who move here that begin to feel what they may describe as anxiety. Can you describe what anxiety is, where it comes from and what it feels like, and what's the difference between anxiety and depression?
Speaker 2:I have a very short like short long story to describe anxiety. Anxiety is like living in a hurry, with a feeling that someone is behind you, that you need to to end things very fast, and with the feeling that you are uh, that you are forgetting to do something, like being worried about almost everything and also small things and you're not able to focus in one situation. It's like that's anxiety or that's living with anxiety. What happens with anxiety is that we get used to that, like someone that lives some people have anxiety exactly, exactly because they are going to the next thing.
Speaker 2:And we get used to live like that until something changes in our body and we begin to struggle in our days. We lose our functionality, for example, with panic attacks where we're not able to sleep, and if we don't sleep by sure we are going to feel terrible the next day. If we have a lot of nights without sleeping, I mean life can be a disaster. Or if you stop eating or you are so irritable that you don't want to be with anyone or you're just fighting with everybody everywhere, like those are the most common symptoms of anxiety. Also, like being worried about small things. It's like, ah, I need to go and pay my CFE bill and go into the bank and pay the bill. It's like something extremely big. It's like we began to see things bigger than they are. We are thinking all the time in the worst scenario in the future. We feel that we can think what other people is thinking, or we take things very personal, like that's society like in general, I think as an immigrant, there's an additional factor that goes with that.
Speaker 1:Like I have to go pay my SEFE bill, but I don't know Spanish, you know?
Speaker 2:Exactly.
Speaker 1:The things that we talked about on this podcast with people about things they have to adapt to. That's. One of the main things is paying your bills and doing that sort of thing and the bureaucracy that you deal with with the government and everything. It's extra hard for immigrants because they don't know the language.
Speaker 2:Let me explain you something. Don't feel so bad because, also as a Mexican, when we arrived here are very difficult things. I mean, quintero works very different than other cities in Mexico. As you said, there is a lot of bureaucracy, a lot of bureaucracy, and even though we speak Spanish, it's something difficult for us to get used to that.
Speaker 1:Right, I had a friend. We went to get our driver's licenses renewed the other day and they wanted her to. They started asking her questions about like a driving test, and it was in a dialect of Spanish. She's a native Spanish speaker but she grew up in the United States and it was in a dialect she didn't understand and, oh my God, that was. That's some stress and anxiety right there.
Speaker 2:Yes.
Speaker 1:She did end up getting her license, but and they didn't ask me quite they knew better than to ask me questions in Spanish, because that wouldn't have worked out at all yes, this, it's difficult and, as you said, it's like something more.
Speaker 2:I mean you have like more stress right, right.
Speaker 1:So I've heard that often people think they're suffering from anxiety, but maybe they're suffering from depression. What are the differences between the two and what are some symptoms people might have that may be signs of either anxiety or depression, and what are the differences?
Speaker 2:Most of the times, anxiety and depression comes in a combo. Okay, that's just how our brain works. I already explained what anxiety is, but when we keep that levels of anxiety very high, in one moment we're going to begin feeling like sadness that it's there all the day, almost every day. You have motivation. We like you can eat more or eat less. You can also have sleep disturbances. You stop enjoying what you used eat less. You can also have sleep disturbances. You stop enjoying what you used to enjoy.
Speaker 2:You abandon yourself and in a very advanced moment you can also have suicidal thoughts and, on the other hand, you can begin having depression and in a certain moment you're going to have some symptoms of anxiety right right and the reason is how our brain works between adrenaline and serotonin and a lot of like more technical things, that it's going to be a little bored, but but but most of the time they come together would you say that anxiety is?
Speaker 1:would anxiety be maybe considered a precursor to depression, something that you know?
Speaker 2:most of the time, if you don't have like the right treatment? Would anxiety be maybe considered a precursor to depression? Yes, most of the time, if you don't have the right treatment for anxiety at a certain moment, you're going to feel depression. And let me make a pass here we are humans and we have emotions and we can have good days and bad days and we can have griefs and we can have stressful situations, that in certain moments we're going to feel sad. But feeling sad sadness is not depression. I mean depression also comes with other symptoms and as the same as anxiety. When we are not able to do the things that we need to do, when our functionality gets like damaged, it's when we talk about depression, not only sadness. Sadness is not enough.
Speaker 1:In my personal situation, my main symptom that brought my attention to anything was insomnia. I couldn't sleep, and it's like you just said. You know, you go a night without sleeping, that's a problem, but you go a whole bunch of nights without sleeping, it's a. It is quite a thing to deal with, right? But the way I saw it, my lack of sleep was what was causing me anxiety, which was something I really didn't understand, you know, until I talked to you and talked to doctors about it. I went to several medical doctors looking for something to help me sleep. I was looking for some kind of pill that would put me to sleep, and it didn't help. I didn't find anything like that. You know, I didn't have any luck, anything like that. You know, I didn't have any luck. And then one of them referred me to you and it turns out that the underlying cause of my sleeplessness was actually a form of depression. So I do I, you know.
Speaker 1:You know, my experience with this is probably better than I do but do you find that many of your clients go through that similar journey?
Speaker 2:Yes, sleep disturbances is one of the first symptoms when our brain is not able to repair all the changes that we can have when we suffer from depression or anxiety, and why we just pay attention to the sleep pattern. Because if we don't sleep the next day we can feel terrible, not only mental but also physical. So most of the time we go to the doctor asking for something to sleep, thinking in our fantasy that by the time we sleep we can feel better. And yes, yes, but there are symptoms that we need to take care about. There are sleep disorders, like in psychiatry. There are also psychiatrists that specialize just in sleep disorders and it's another world inside psychiatry but they are not as common as we think, like when we talk about insomnia. Most of the time insomnia it's a symptom of anxiety and depression, a primary disorder of the sleep. It's not so common as we can think, but it's something we have or we can identify better than other symptoms that we can have when we have anxiety or depression.
Speaker 1:Right, right. So in my case, treatment involved counseling and medication for about six months. It also involved finding a worthwhile purpose in my retirement, which actually is one of the key themes to this podcast that we're doing right now. This is we kind of talk with you. Know, we go in a roundabout fashion. We don't say, are you depressed? But we say so, what is your passion in life? And that's what we try and encourage amongst, amongst expats. Um, so my symptoms eventually went away and I was back to my old self. And do you find this is the case with most of your clients?
Speaker 2:no, no, you were like a very good patient, and, and, and you followed instructions and you and you did what, what I suggested you to do, and that's why you succeed so fast and in a very short time period, like you, began paying attention to your sleep pattern, to your diet, making exercise, going also to psychotherapy and finally you got your purpose in this new city, in new circumstances, and that's why you succeed. I hope everybody were like you.
Speaker 1:That would be the ultimate goal. Right is to have more people that come through that on the other end.
Speaker 2:Believe it or not, there is a lot of resistancy to make changes right, like like. Remember that as humans, we are always going to do what we know how, what we have been doing all of our life. But sometimes we forgot that we're in a different moment of our lives and we are still moving in the same direction, thinking that everything is going to change and it's just about time. So it's very important to begin taking the risk to do the things different so you can have different results, and not everybody can understand that so easily as you did. That's why you succeeded so fast.
Speaker 1:Very good, thank you. So if someone thinks they're suffering from symptoms of anxiety or depression, where should they turn for help? What's the first thing they should do?
Speaker 2:I think that any approach to a certificate medical health care, mental health care it's like they can identify what you need, like if you need to go to a psychiatrist or you need just therapy or, most of the time, both of them. What we need to be careful about living here is that you can find a psychologist in any corner of the city, but you need to be sure that they have the right certifications right right because sometimes there's another thing, like it's very peculiar from this place and it's like something that I call the shanty shanty.
Speaker 2:Here you have, or you can find, like a lot of magical thoughts about energy, about ayahuasca, about chamanes, like and it's very common that people go there before coming right.
Speaker 2:They're looking for the crystals to solve their problems rather than psychotherapy or whatever exactly something I hear a lot every day is like I'm coming here because you're at my last option, I've had done all the alternative therapies. Nothing works, so just go into a professional. It doesn't matter if it's psychologist or psychiatrist, if it's something, if it's an ethical professionalist, he or she can refer you to the treatment that you need okay, very good, if you had advice for anyone thinking about retiring and moving to Mexico, like I did.
Speaker 1:I retired young. I retired earlier than most people retire. But if they're moving to Mexico, or anywhere in the world for that matter, what would your advice be and what are some things they may not be thinking about?
Speaker 2:Okay, okay, before talking about retire, I will give an advice. Don't forget to enjoy your life by the time your retirement comes, because unfortunately, I also see a lot of stories of people that their dream was like retire and coming here to Rivera Maya and achieving that goal. They didn't pay attention to the health, to the family, to relationships, and now they are here in the place they wanted to be, but alone and sick.
Speaker 1:Right.
Speaker 2:Oh, yes, yes, Thinking of retirement. It's perfect. I plan about that, but don't forget to enjoy the road to go there. That's my first advice Don't forget to live every day. And once you retire, it's like we need to understand that at the end it's a grief, it's a different moment of our life and when we have a grief it's valid to feel what we need and what we want to feel we are not only like stop seeing our friends, our community, of all our life. We're also like moving to a new place. So we need to be compassionate with ourselves. So, yes, we're going to feel sadness and sometimes we're going to be like very happy, and sometimes we can cry and it's OK. It's OK not to be OK. Yeah, right, and living that process and give up, give ourselves to, to, to, to, to close like that cycle of our work and productive life and begin something new, it's new. I always say that retirement is like going to school the first day of school.
Speaker 1:Yes, yeah, you're starting something brand new that you don't even know what you're going to learn or what you're going to do yet.
Speaker 2:Exactly, but as children we are not so complicated and we are always open to learn new things. So it's the same attitude that we can have in the retirement, like I'm going to let the life to surprise me and I'm going to be open to learn how this new adventure in life goes without pushing the things. And that's it Like don't try to do what you used to do before your retirement.
Speaker 1:Right, right, I would agree with you and I learned a lot from you, and you are one of my most admired people that I've met since I moved here. I just want to say that, so, so, one of the things that we do, we have a lighthearted tradition on this podcast and we call it uh K padre, k malo, and it's like we ask our guests one thing that they love about living in this area and they love about Mexico or Quintana Roo, or whatever, and the other one is Que Malo, something that not necessarily that they hate, but something that they're still adapting to is the way that we like to say it. So could you give me a Que Padre and a Que Malo?
Speaker 2:Okay, a Que Padre is that there's no traffic. Well, there is more than 12 years ago that I arrived here, but it's like I can go from one place to another without being hours in my car. Like that's a que padre.
Speaker 1:Unlike Mexico City right.
Speaker 2:Mexico City. You can stay three hours in your car just going from one place to another. So so that's a que padre and a que malo. It's a very hard question yeah and I'm going to explain you why. I'm sure you want an answer from me, but but if I just pay attention to the que mal, I'm not going to be able to enjoy the good things that I have here.
Speaker 1:You won't be able to enjoy the Que Padre yes.
Speaker 2:And I know that moving from Mexico City to here, there were a lot of things that I'm not going to have. But you can have everything, at least not at the same time.
Speaker 1:Right.
Speaker 2:Or maybe the Kemalo. It's like that cultural life that you can have in Mexico City, like museums, theater, like concerts, like a lot of things. I think that will be the Kemalo, but it's not so Kemalo. Yeah, I have other things here.
Speaker 1:I completely understand what you're saying, because we used to love, you know, plays and concerts and that kind of thing, and it's just not something that's here.
Speaker 2:You cannot move to a new place like thinking all the time in all the things you left Right, right.
Speaker 1:Things you don't have.
Speaker 2:If not, you're not going to be able to adapt to a new place. So, yes, there are a lot of Kemalos, but they are small Kemalos. There are more good things than bad things.
Speaker 1:Right. That's why you're here, I would totally agree. Well, thank you so much, dr Kitsia Ruiz Navarro, for sharing your insights with us on expats like us.
Speaker 2:Thank you. To you, it was a pleasure to be here and congratulations for this space and to share experiences with other expats.
Speaker 1:Very good. Thank you so much. Thank you to you. Bye-bye, bye.
Speaker 1:From my personal experience, the best mental health care begins with your own medical doctor. That's how I was referred to, dr Kitsia. It's a great place to start. Here are some more mental health resources available in English for expats in Mexico and around the world.
Speaker 1:Ola Therapy is a team of international and multidisciplinary therapists. They're based in Mexico City and work primarily with the international community. They offer therapy in English and Spanish. Their services include individual therapy, couples therapy, family therapy and working with children and teens. They are an inclusive service as well, being LGBTQ plus friendly and welcome people from all walks of life. You can find them at holatherapymx that's H-O-L-A-T-H-E-R-A-P-Y dot M-X BetterHelp, where you can tap into the world's largest network of credentialed and experienced therapists who can help you with a range of issues, including depression, anxiety, relationships, trauma, grief and more. With their therapists, you get the same professionalism and quality you would expect from an in-office therapist, but with the ability to communicate when and how you want. They're found at BetterHelpcom.
Speaker 1:Onlinetherapycom is based on Cognitive Behavioral Therapy. They're a dedicated online-based team of consultants, therapists, cognitive behavioral therapists, practitioners and support staff that work collaboratively to help people in need of emotional support. You can find them at onlinetherapycom. In each episode of Expats Like Us, we're going to teach you a new Mexican slang word. This is something you may not find in your phrasebook or your online Spanish class or your Spanish app or wherever you're learning your Spanish. Instead, this is a term used primarily by Mexican Spanish speakers. Today's word is Naco.
Speaker 1:Naco, how do you spell that?
Speaker 2:N-A-C-O.
Speaker 1:N-A-C-O Naco. What does that mean?
Speaker 2:Naco is basically a person who is not well-educated, ghetto, clumsy, doesn't know what's going on.
Speaker 1:Okay, very cool. Don't be a NACO. Don't act like you're a NACO.
Speaker 2:Exactly.
Speaker 1:All right. Gracias to Erica Kowalski from Mi Vida Margarita. We'd love to hear your thoughts on today's topic. Just look up Expats Like Us on Facebook or send us an email at expatslikeus at gmailcom. You can also see the video version of today's discussion and all of our discussions on our YouTube page. Follow, like, subscribe and leave us a review. Thank you to today's guest, dr Akitsia Ruiz Navarro, for sharing her insight. Thanks also to Chris and Erica Kowalski and Sherry Bussey. Most of all, thank you for tuning in to Expats Like Us and thank you for interacting with us on social media. Next time, we'll bring you for tuning in to Expats Like Us and thank you for interacting with us on social media. Next time, we'll bring you more firsthand information about your international move. We'll see you again in two weeks. Until then, remember our homes are not defined by geography or one particular location, but by memories, events, people and places that span the globe.
