Supriya Ghosh (Editor)

Ulysses syndrome

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The Ulysses syndrome (Immigrant Syndrome of Chronic and Multiple Stress) is an atypical set of depressive, anxious, dissociative and somatoform symptoms diagnosed in migrants facing a multitude of chronic, extreme stressors deriving from the difficulties of the migration process. The syndrome is named in relation to the ancient Greek hero, Odysseus (Ulysses is the Latin equivalent) who suffered involuntary migration and travelled for 10 years through the Mediterranean to come back home from the decade-long Trojan War. The hardships of his journey are compared to the ones of contemporary migrants, who have to struggle with intensely stressful, novel situations in isolation and with little help. Scarcity of their resources makes it impossible to cope with and successfully adapt to unfamiliar environment of the receiving country, which in turn leads to experiencing a range of detrimental symptoms.

Contents

Causes

Immigrants face multiple losses of physical and symbolic kind – loss of loved ones, job, social support of home country, status and identity among others. Migratory grief process that arises because of that losses is partial, as the subjects of grief do not entirely disappear, recurrent and experienced by not only migrants themselves, but also their families back in the home country. It may produce such an intense stress levels that they exceed adaptive capacity of human beings and lead to a failure of acculturation process and existence of depressive symptoms among migrants.

Extreme stressors that hinder ability to overcome the process of migratory grief include:

  • separation from family and homeland
  • dangers of migratory journey often undertaken on crowded rafts and boats without life jackets, combined with the fear of arrest and deportation afterwards
  • social and cultural isolation, partially stemming from lack of access to cultural and religious institutions language proficiency
  • lack of opportunities to acquire appropriate migration documentation, obtain work permit, find non-exploitative, quality job and gain access to housing and health services
  • sense of failure of the immigration goals, amplified by the pressure to earn enough money so as to provide for family back in the home country
  • racial discrimination and prejudice faced in the receiving country
  • low proficiency in the language of receiving country that is main element of assimilation process, enabling to successfully adjust to a new country

    • Migratory mourning and extreme stressors influencing its course are believed to more strongly affect middle-aged and elderly people than younger ones, mainly due to larger loss of status within both family and society as well as less mobility, lower likelihood of encountering people outside of the home country community through school or work and less access to the new country’s mainstream culture. Moreover, older immigrants face significant difficulties in learning novel, receiving country’s language, which may substantially impair their ability to understand and interact with the new culture.

    Symptoms

    Symptoms of the syndrome include migraines, insomnia, recurrent worrying, tension and nervousness, irritability, disorientation, fear, fatigue, sadness, gastric and osteo-physical pains, low self-esteem, increased tobacco and alcohol consumption and decreased productivity. Lack of social support for the immigrants as well as inappropriate diagnosis and treatment in line with Western medical model may additionally aggravate symptoms.

    Diagnosis

    Symptoms of Ulysses syndrome are very often falsely recognised as signs of depression, adjustment disorder or other mental disorders, which results in unnecessary treatment of suffering immigrants that may only lead to strengthening of existing stressors and further exacerbation of their health. Unadjusted application of standard diagnostic criteria to multiple cultural groups that, for example, believe in the existence of the spiritual world unlike Westerners, may fail to see cultural characteristics of the immigrant for what they are and incorrectly attribute them to mental disorder.

    Ulysses syndrome differs from:

  • depression, as its symptoms do not include apathy or thoughts of death. Immigrants, unlike people suffering from depression, have the motivation to go forward and struggle in order to reunite with their families and have a better life, despite their current difficulties and do not lose their interests, but try to maintain their social and professional activities.
  • Adjustment disorder, which is defined as a worse state of the individual than would be anticipated given the nature of their stressor and total inability to cope with it, whereas Ulysses syndrome is characterised as a natural response to multiple extreme stressors. Substantial deterioration of social activity, which is present in adjustment disorder, does not occur in the case of the syndrome.
  • Post-traumatic Stress Disorder in their symptomatology and nature of stressors – disturbing thoughts or feelings about traumatic events as well as distress and avoidance to trauma-related cues does not occur in Ulysses syndrome, but does in PTSD, whereas stressors such as social isolation, lack of opportunities or discrimination and prejudice are common for the syndrome and not for the PTSD.

    • References

    Ulysses syndrome Wikipedia
    (Text) CC BY-SA