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Migration and Mental Health: Understanding the Psychological Impact of Moving Countries

2025年3月12日
讀畢需時 11 分鐘

已更新：1天前

Originally published 12 March 2025 · Updated 20 September 2026


Woman walking along an everyday city street with pedestrians, shops and public transport

Moving country can make surprisingly ordinary parts of life require thought again.


How directly should I say this? Is that person being distant, or is this simply how people communicate here? Should I ask for help, or wait to be offered? Why did something that would once have been understood immediately seem to land differently?


These may seem like small moments. Yet they tell us something important about migration. Much of what helps us move through everyday life is knowledge we barely notice while we are living somewhere familiar. We know how to read a room, how institutions work, how friendship tends to develop, how disagreement is expressed, and what other people are likely to understand without much explanation.


After moving, some of this becomes less automatic.


For someone newly arrived, the effort involved may be obvious. For someone who has lived in another country for ten or twenty years, it may be much harder to see. By then they may speak the language fluently, have close relationships, know the system and feel established professionally. It is sometimes only when looking back that they realise how much they had to learn.

What Changes When We Move?

The most visible change in migration is geographical. We leave one place and begin living somewhere else.


The psychological changes are often less obvious.

A person may expect to miss family and friends. They may be less prepared for missing the ease with which they once moved through daily life: knowing how to speak to a doctor, how formal to be with a colleague, what to bring when visiting someone's home, or how to tell whether a new friendship is becoming close.


There may also be changes in how other people know us.

Someone who was established professionally may become a newcomer again. A person who was articulate and quick in one language may need more time to find words in another. Family members who once shared everyday life may now know it largely through calls and messages.


Much depends on why someone moved, what they left, what they arrived to and what has happened since.


A person moving for a job they wanted may experience the transition very differently from someone who left because remaining was unsafe. A person can feel pleased about the life they are creating and still be caught unexpectedly by what they miss.

When Ordinary Life Requires More Attention

It can be difficult to identify exactly what is tiring about adapting to another environment.

Is it speaking another language?
Having to pay closer attention to people's reactions?
Not being sure whether something unfamiliar is cultural, personal, or simply particular to this situation?
Or is it the accumulation of small moments in which we have to think about things we once simply knew?

Someone can be functioning very well while this is happening. They may be working, studying, parenting, developing friendships and dealing with the same responsibilities as everyone else. What may be less visible is the extra layer of noticing and interpretation running alongside those activities.


Consider something as ordinary as speaking in a meeting.

A person may know exactly what they think. What takes effort is deciding how to say it here. How directly can they disagree? Does confidence sound the same in this workplace? Was the pause after they spoke meaningful, or are they reading too much into it? Would they even be thinking about these questions in a workplace they had known for years?


Person checking directions on a smartphone while waiting at a busy city bus stop

Repeated across many situations, this kind of attention can become tiring.


Some of this sustained effort is described in psychology as acculturative stress.

For some, the difficulty is feeling unable to adapt. For others, something more subtle is happening: they are adapting constantly and have become so accustomed to doing it that the effort itself is difficult to see.

Learning What Difference Means

Living in another cultural environment can also make us more aware of things we previously took for granted.


We may discover that what we thought of simply as “being polite,” “being close,” “showing respect” or “speaking honestly” was shaped partly by the environments in which we learned those things.


This does not usually happen through one dramatic realisation.

It happens through encounters.


Perhaps someone interprets our quietness as a lack of confidence when, to us, it communicates respect. Perhaps we experience another person's directness as harsh before gradually realising that it carries less interpersonal weight in that setting. Or we learn that something we initially attributed to cultural difference has very little to do with culture at all.


That last possibility matters.

Becoming more experienced across cultures does not mean becoming better at explaining people's behaviour through culture. Often it means becoming more careful about doing so.


Over time, a person may become more comfortable asking what something means rather than assuming they already know. They may notice their own expectations more readily. They may have more ways of communicating when the first one does not work, and become better at recognising when adjustment is useful and when they would rather hold their position.


Intercultural research sometimes discusses these kinds of capacities under intercultural competence. One recent UK study with Chinese international students looked at areas including understanding of self and others, attitudes, communication and cognitive skills in relation to psychological adaptation. Its focus is narrow, but it raises an interesting question: what do people learn through repeatedly having to understand and communicate across unfamiliar contexts?


Instead of asking only how successfully someone has adjusted to the environment around them, we can also notice what they have become more able to see, understand and negotiate.

When Competence Does Not Travel in the Way We Expect

One of the more unsettling experiences after moving can be knowing that you are capable while finding it harder to feel capable.


Someone who rarely had to think about how they came across professionally may begin rehearsing what they want to say before a meeting. They know their field. They know what they think. What has become uncertain is how strongly to say it, how disagreement is received here, whether their humour will work, or whether hesitation in another language is changing how confident they appear.


The ability itself may still be there. What has changed is the context in which other people recognise it and in which the person is accustomed to expressing it.


Language makes this particularly visible.

A person can know exactly what they mean and still sound less precise than they are. They may understand humour they cannot yet reproduce. Their emotional vocabulary may be much richer in one language than another. They may have spent years developing a professional voice and then find that, in another language, they sound younger or less certain than they experience themselves internally.


Other people may therefore be meeting only part of what that person can do.


Something similar can happen outside language. A parent who once knew how to navigate schools and healthcare may need help with basic procedures. Someone who could read social situations easily may become less certain about what other people expect. A professional may discover that qualifications or experience carry different weight in another system.


There can be a particular frustration here because the person remembers what it feels like when these things are easy.

I know I can do this. Why doesn't it feel like me when I do it here?

Over time, many people find new ways of expressing abilities that were already there. They may learn how authority works in a different professional culture, become more spontaneous in another language, or find ways of communicating warmth, humour or disagreement that feel increasingly their own.


New capacities can develop alongside the old ones.

Something that once felt like a personal quality: I am confident, I am articulate, I am good with people, may turn out to depend partly on language, familiarity, relationships and whether the environment knows how to read us.

Relationships Across Distance

Relationships continue after migration, but they no longer develop within exactly the same shared life.


The people who have known us longest may know very little about the ordinary world we now inhabit. They may know the job title but not the workplace, the names of friends but not what those friendships feel like, the city but not the particular places that have become important to us.


Newer relationships can contain the opposite gap. Someone may know our present life intimately without knowing the earlier versions of us that family or old friends remember.


At times, this can create an unusual experience of being known in parts.

Care, money, responsibility and family expectations can stretch across countries. Someone may feel more independent in one part of life while becoming more responsible for family in another. Calls home may carry affection, obligation, worry and ordinary conversation all within the same relationship.


These experiences can gradually raise questions that go beyond migration itself: who knows which parts of us, where we feel most understood, and what we mean when we call somewhere home.


I explore that territory more fully in Feeling Between Worlds: Why Home Can Become a Question Rather Than a Place.

Missing What We Do Not Want Back

People are sometimes surprised by what they miss.


It may not be the country in any simple sense.

It can be the sound of a language around them. Food that required no searching. A particular kind of humour. Being able to see someone without arranging a visit months ahead. The professional role they once occupied. A version of themselves that seemed easier to access there.

This can feel confusing when leaving was a decision they still believe was right.

If I don't want to move back, why does this still affect me?

Perhaps because attachment does not operate like a decision.


Choosing a different life does not make everything associated with the previous one emotionally finished.


Research on migratory grief has begun to examine interpersonal, material and more abstract losses associated with migration, although the evidence remains limited.


In practice, the word grief will fit some people's experience and not others.

Sometimes missing is enough.


Quote: “A person may miss something deeply without wanting to restore the life in which it belonged.”

What Are We Adapting To?

So far, I have been describing much of adaptation as something happening in the interaction between a person and a new environment.


The environment itself deserves closer attention.

Imagine two people who are equally skilled at navigating cultural difference. One has secure immigration status, stable housing, financial resources and a workplace that values their previous experience. The other is living with uncertainty about whether they can remain, cannot find work at their previous professional level, and repeatedly encounters discrimination.


It would tell us very little to compare how well they are “adapting” without understanding those differences.


Racism, insecure housing, financial pressure, immigration uncertainty, difficulties having qualifications recognised and barriers to services can all become part of the psychological context of migration.


A person can become extremely skilled at navigating an environment that remains difficult to live in.


This is also why I would be cautious about turning intercultural competence into another expectation placed on migrants. Greater understanding and flexibility can help someone navigate many differences. They cannot resolve insecure immigration status, discrimination or an environment that repeatedly excludes them.

When Migration Becomes Part of a Mental Health Story

Moving country does not, by itself, tell us what will happen psychologically.


Loneliness or uncertainty may be particularly noticeable in the early period after moving and become less prominent as relationships and familiarity develop. Existing difficulties with anxiety or depression can sometimes become more pronounced during a major transition. Experiences of trauma may have occurred before leaving, during the journey or after arrival.


And sometimes the difficulty that brings someone to therapy has very little to do with migration.

This is one reason broad statements about “migrant mental health” need care.


An international student, someone relocating for work, a person joining family, a refugee fleeing conflict and someone seeking asylum while living with prolonged legal uncertainty have all experienced migration. That shared fact tells us very little on its own about their psychological experience.


What becomes clinically useful is understanding how migration sits within this person's life.


A person might initially come to therapy because they are exhausted at work. As we understand more, we may notice how much energy is going into monitoring language, proving professional competence or navigating expectations that still do not feel intuitive.


For someone else, the same work exhaustion may be much better understood through workload, perfectionism, neurodivergence, family pressures or something else entirely.


Migration becomes useful psychologically when it helps us understand more of the person. It becomes less useful when we begin using it to explain them.

From Adapting to Building a Life

There may come a point when adaptation no longer feels like quite the right word.

The street that once required Google Maps is now the route taken without thinking.

There is a café where someone knows what we usually order.


Barista serving coffee to a customer in a familiar neighbourhood café

A friendship that began after moving now contains years of shared history.

We know which colleague to ask, which train carriage is quieter, what to bring to a neighbour's house, where we go when we need some space.


These details are small, but perhaps that is the point.

A life has been accumulating.


The person is no longer only learning how an existing environment works. Their presence has also become part of that environment. They contribute to workplaces, friendships, families and communities. New traditions develop. Old ones change. Some practices are kept deliberately; others disappear without much thought.


Earlier, someone may have wondered, How do people do things here?

Later, the question may become, How do I want to do this?


Experience across different environments can leave a person with more than one possible way of understanding or approaching something. That does not mean they are permanently caught between alternatives. Sometimes it gives them more room to choose.


Not every part of that development needed to be difficult, and difficulty does not acquire value simply because something was learned from it. But it can still be worth recognising abilities that have developed quietly through years of living, relating and making decisions across different contexts.

Returning to a Familiar Place

Migration can also change our relationship with the place we left.

Returning may bring an expectation of familiarity. Often there is familiarity, but perhaps not quite in the form we remembered.


Friends have had experiences we were not there for. Family routines have continued. Neighbourhoods change. We notice things we once took for granted because we now have another context with which to compare them.


And other people may notice changes in us.

Sometimes this is comfortable. Sometimes it produces an unexpected sense of distance. At other times it makes something feel more precious precisely because we now encounter it differently.


For some people, returning begins to raise a different question: what do I mean by home now?

What Has Migration Meant in This Particular Life?

Two people can move between the same countries at a similar age and come away with very different experiences.


What became unexpectedly difficult?

What did you have to learn that you had never previously thought of as something that could be learned?

Did you become less confident somewhere you had once felt capable?

Are there things you can now do across different environments that you rarely think of as skills?

Which ways of adapting still feel useful, and which have become tiring?

And when you look at what is difficult now, how much of it actually belongs to migration?


Sometimes migration helps connect experiences that previously seemed unrelated. Sometimes it becomes one strand among many. Sometimes, after exploring it, we realise that it is not where the difficulty sits.

Exploring Migration in Therapy

Migration does not need to be the reason someone comes to therapy for it to become relevant there.


Questions about confidence, exhaustion, relationships, identity or feeling stuck can sometimes look different once we understand what changed through moving and what the person has had to learn since.


At other times, migration remains background rather than explanation.


In my own practice, I may ask about culture, language, relationships or migration history when they seem relevant. Sometimes they become important to how we understand a difficulty; sometimes they do not.


For someone who has spent years adapting, there may also be value in asking questions that are not only about what has been difficult:

What has this required from me?

What have I learned to do?

What do I still find myself adjusting around?

And what do I want the life I am building now to have room for?


Individual Psychological Therapy

If some of these questions connect with what you are experiencing, you can find out more about my approach to Individual Psychological Therapy.


Online psychological therapy is available in English, Cantonese and Mandarin.


About Dr Tiffany Leung

Dr Tiffany Leung is an HCPC-registered Counselling Psychologist and Chartered Psychologist with over 14 years of clinical experience in the UK and Hong Kong. She works with adults experiencing a range of psychological and mental health difficulties, with particular experience in trauma, intercultural identity and migration, neurodivergence, emotional regulation and complex relational experiences. She offers online psychological therapy in English, Cantonese and Mandarin.


References for Migration and Mental Health

 
 
 
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