Ulysses syndrome: the immigrant's chronic stress (symptoms and treatment)

You left looking for a better life and instead you find yourself fighting to survive every day: alone, far from your loved ones, afraid, exhausted, with headaches and unable to sleep, with the constant feeling that you "can't go on". If you recognize yourself in this, maybe you aren't "ill": maybe you're going through Ulysses syndrome, also known as the immigrant syndrome of chronic and multiple stress. It isn't weakness or madness: it's the response of a healthy person to extreme circumstances.

Living through too many adversities at once and far from home takes its toll. According to the World Health Organization, migration in harsh conditions is an important risk factor for mental health. In this article I explain exactly what Ulysses syndrome is, why it's named that way, which stressors cause it, how it shows up, how it differs from depression and from migratory grief, and how it can be addressed and treated.

What is Ulysses syndrome?

Ulysses syndrome is the set of symptoms that appear when a person experiences extreme, chronic and multiple stress during the migration process. It was described by psychiatrist Joseba Achotegui, who called it "the immigrant syndrome of chronic and multiple stress". The central, and very important, idea is this: it isn't a mental illness. It's the reaction of a healthy person to an extreme situation; the problem isn't the person, but the circumstances they have to endure.

That's why it's said that Ulysses syndrome sits "on the border" between health and disorder: it's intense suffering, yes, but as a logical response to a hostile context, not as a sign that something is wrong inside you.

Why is it called "Ulysses syndrome"?

The name comes from Ulysses (Odysseus), the hero of Homer's Odyssey who, after the Trojan War, spent years wandering the sea, facing danger after danger, alone and far from his homeland, Ithaca, with a single longing: to return home. Like him, many migrants live through one adversity after another —loneliness, the struggle to survive, fear— missing the place and the people they left behind. The name captures that loneliness and that endurance in the face of continuous suffering.

The causes: the migrant's stressors

Ulysses syndrome doesn't appear because of one single thing, but from the build-up of major stressors lived all at once and over a long time:

• Loneliness: the forced separation from loved ones, especially when you can't bring your family over or return. Unwanted loneliness is one of the cores of the syndrome.
• Grief over the failure of the migration project: when, after enormous effort, opportunities don't arrive and the feeling of having failed sets in.
• The struggle to survive: the difficulty of covering the most basic things —food, a roof, papers, decent work.
• Fear: of the dangers of the journey, of helplessness, of having no rights or of being deported.

On top of that, all of this is amplified by the language barrier, culture shock, the lack of a support network and, sometimes, discrimination.

Who does Ulysses syndrome affect?

Ulysses syndrome can appear in any migrant, but it's more likely the harsher and more prolonged the circumstances are. It especially affects those who have emigrated alone and can't reunite with their family, those living without papers or in precarious jobs, those who don't speak the language of the host country and those who can't find a support network. It doesn't depend on the person's strength: it depends on how many stressors pile up and for how long. That's why two people in the same city can experience migration very differently depending on the conditions around them.

Symptoms of Ulysses syndrome

The distress of Ulysses syndrome shows up in four main areas:

Ulysses syndrome or depression?

Ulysses syndrome is often confused with depression and, sometimes, the symptoms are simply medicated. But there's a key difference: in depression, the suffering comes "from within" and persists even when conditions improve; in Ulysses syndrome, the suffering is proportional to the adversity and tends to ease when the situation improves (network, papers, stability). Even so, if it isn't addressed, sustained stress can end up developing into depression or an anxiety disorder. That's why a good professional assessment matters so much: to avoid confusing one for the other.

Ulysses syndrome and migratory grief: how they relate

Migratory grief is the normal grieving process for everything you leave behind when you emigrate: family, language, the land. Ulysses syndrome is, in a way, its extreme version: it appears when conditions are very harsh and stressors pile up, so that grief can no longer be worked through and becomes chronic and overwhelming. To understand the emotional foundation of all this, it helps to read about migratory grief and how to overcome the loss of your country.

How to address and treat Ulysses syndrome

Because the problem is above all the circumstances, treating Ulysses syndrome isn't (only) about medication, but about reducing the stressors and supporting the person emotionally. What helps a lot:

• Breaking the loneliness: looking for a network, community and bonds that make you feel accompanied.
• Covering the basics and finding resources: social, legal and community support for work, housing and papers.
• Psychoeducation: understanding that what's happening to you is a normal reaction to an abnormal situation —not madness— already brings a lot of relief.
• Looking after your body and sleep: sleeping, eating and resting are the foundation for sustaining stress.
• Psychological therapy: to put words to the fear, guilt and grief, reduce the stress and recover a sense of meaning.

Doing therapy in your own language is key. That's why, if you live far away —for example, you're a Spanish speaker in the United States—, online therapy in Spanish lets you work on it with a psychologist who understands you culturally and linguistically. The American Psychological Association and the National Institute of Mental Health remind us that chronic stress is treatable and that the right support makes the difference.

When to seek professional help

If for weeks or months you've felt overwhelmed, if anxiety, sadness, insomnia or headaches won't let you function, or you notice you're "holding on" with no end in sight, it's time to ask for help. Ulysses syndrome can be addressed, and you don't have to do it alone.

In my practice I support people who live far from their country and carry an enormous amount of stress in silence. We work on the fear, the guilt, the loneliness and the tools to sustain and reduce that stress, with online therapy in Spanish or Catalan, wherever you live. If you recognize yourself in this, get in touch for a first assessment with no commitment.

One important message: if you're overwhelmed it isn't because you're weak, but because you're carrying too much. Asking for help is the first step to stop doing it alone.