Beyond Relocation: We need to acknowledge the emotional impact of migration

Psychiatrist Dr Sabina Rao of Sakra World Hospital, Bangalore, spoke to Sriranjitha Jeurkar from the White Swan Foundation about why moving within the country can be stressful too, and how one can be prepared.

We don’t always think of migration as being stressful or as affecting us emotionally. Is that true?
I think people look at migration more from a practical standpoint - they see it as a practical change in location without keeping in mind how much they have invested into the society they are living in, the social structures they have become dependent on. This is more so when a spouse or a parent moves to a city to be with their partner or son, and don’t have a job there. Everybody thinks it’s for the better. Parent often leave behind 40-50 years of stable friendships and relationships. Suddenly, they are lonely. They don’t know anyone, and it’s a significant culture shock to them.

What brings the culture shock? After all, they are moving within the country…
I don’t think people are anticipating the magnitude of change. They think they’re moving within the same country, how different could it be? I think people are more prepared when they’re moving abroad. I have had clients who have moved to a different country. That, they’re all set - it’s going to be cold, I won’t know anyone, I won’t understand the accent - you don’t expect the exact same features when you move cities. And that is exactly what they experience. But when moving within India, they are unprepared. 

What about young people who are, say, on their first job and move to the city? How do they experience the migration?
I think it’s a two-pronged thing. On one hand, they’re very excited because they’re starting a new job, some of them are paid very well. Many of them are excited to move out of a small town and into a big city. But they are not prepared for enormity of the city. In its chaos, it’s very lonely. The strucuture of their jobs helps to some extent. But I have found in my practice that they get into very chaotic relationships. These are very young people in their early twenties unhealthy relationships. They has dispensible money which can be used on alcohol and drugs and they may turn to that to cope. The loneliness, the anxiety of fitting in, the fallback becomes smoking and drinking. 

I have had so many patients who’ve lived in joint families till they moved to Bangalore. And for many people it’s not an easy flight back home. You can’t just go back because you’re feeling sad and lonely. Going from complete support - emotional, financial - to being on your own. And now figure out who you are, in this IT city, on your own. 

The other issue is of emotional maturity. Many of them come straight out of college, they come straight to work and are trying to make friendships at work. And they look at their job as the place of their social environment also. Everyone will not necessarily make their best social relationships at work. In fact, sometimes I wonder if they should be making their best relationships at work, where they are trying to be analytical; and you may want to be emotional in your social life, and you’re trying to mix those. In multiple instances, I’ve had patients coming in wanting to quit their jobs because the relationships they were in had not worked out. 

Is there something about the anonymity of the city that frees you up to do what you wouldn’t do back home?
A hundred per cent. I’m also surprised at how many people are in live-in relationships. One would think that in the cultural context, live-in relationships are not socially accepted.

And what happens, when you’re in a live-in relationship and back home, you have a family that doesn’t get that - it’s almost like living two different lives?
Absolutely, and there’s a whole bunch of young people doing that. And I’m not sure they’ve thought it through. First, this is someone who is still adjusting to living in a new city. And then perhaps they’ve never been in a relationship before. Not only do they think they’ve fallen in love, they also move in with this person. And I have met quite a few people who have moved in without even a conversation about what this move means for them. I’m not sure they have thought it through. And then one partner finds out that the other never intended to get married. And to this person, it’s come as such a shock, that sometimes there are thoughts of suicide. But there was not mature conversation to base their assumptions on. 

There’s so much migration happening now - if you look at any workplace or locality, you’re bound to see so many people who have come to the city from somewhere else. Does this make it easier or harder, knowing that there are other people like you who’re new to the place, the culture?
I would say a chunk of the population finds a way to fit in and move on, but there’s always a small percentage that - despite having a lot of people from the same culture and place - miss home, miss the food, which is a big thing.

Does moving make you more vulnerable to certain kinds of mental health issues?
I think depression and anxiety would clearly be illnesses resulting from migration. Substance abuse would be another. And this is in the range of 20-30 age group. A lot of confusion, and the saddest thing about people moving is that they genuinely don’t have time to find ways to divert their minds from work. They’re working 10-12 hour days, so even if you suggest to them, why don’t you spend an hour hanging out with friends or exercising, they genuinely don’t have the time. By the end of the day all they want to do is have a cup of tea and go to bed. They’re going home and watching movies or youtube videos, or rushing off to the gym. So not only are they coming into situations they didn’t expect, they don’t have the time to do anything about it.

If you’re moving, what can you do to make the move less stressful for yourself?
You might as well look at it as moving countries - what would you do if you were? What kind of language do they speak, what kind of clothing do they wear, what is the culture of the place, what kind of foods do you get, what is the cost of living, if I want to look for people from my culture, where will I go, how will I find ways to stay motivated? I think we need to acknowledge that moving is not necessarily an adventure. Any new thing you do is stressful - marriage, having a baby, buying a house, building a house - and that includes moving. We need to acknowledge that moving does bring some stresses, it’s not going to be only fun. The reality is you’re moving to a place that’s very different from what you’re used to.

If you think about it, when you’re moving to a college in the US, your seniors give you a list of things to bring, things to see, places to go, what to expect. We don’t have such a resource for moving within India. So you may want to get in touch with people you know who’ve moved to that place before. The onus is on them to get in touch with them and have a chat about what to expect.

How do you know that you need help?
Unless you’re essentially a loner, you probably enjoy company, are enthused about work. When that starts to be not exciting, you’re not enthusiastic about getting up to go to work, that’s a sign. Do you suddenly feel like going out to hang out with your friends is worth avoiding? Stop for a moment and ask, is there anything you can do to get your mojo back? Go to a gym, or a dance class, or something else that works for you…

What about spouses? Many women move because of marriage, their husband is likely the only one they know in this new city, and he’s off to work and they’re alone at home...
And usually many of these women have a little child or two to care for, so they can’t leave the house to go anywhere. And it’s very likely that in-laws or parents who were so supportive back home haven't come with them. So maybe they can take the initiative to find a social structure  - a social gathering in a religious place, a yoga center, a park or someone’s house. Attempt to find a couple of people you think you will connect with. They may not turn out to be the best of your friends, but at least you are beginning to have some connection. Otherwise, it’s a setup for depression, anxiety or social anxiety. So make the effort to find a social structure for yourself.

What about elderly people? Is it harder for them?
I think this is the biggest challenge, because they have had 50-60 years of the same company. There are a few places they can visit - elder enrichment centers, but then financial constraints exist. Many elderly people don’t have the means or don’t feel comfortable spending that money. That leaves them isolated in the houses. What they can do is walk down to their nearest park, or religious place. Most people live in apartment complexes, so at least go down for a walk. They should look for  ways to support themselves socially and not just depend on their child or daughter-in-law. 

This story is from Beyond Relocation, a series on migration and how it impacts our emotional and mental health. Read more here:
1. Organizations must help employees transition: Maullika Sharma
2. Moving was all of these: a challenge, and adventure and an opportunity to learn about myself: Revathi Krishna