Helping an Au Pair with Depression – without Rematch

by cv harquail on May 11, 2015

It’s more than homesickness. It’s more than a bad day, or a bad mood. It’s depression, and it’s a serious disorder.

Is there anything a host parent can do to help?

HostMomInParadise writes:

83299826_b9691133ea_mI am a host mom in transition. My au pair had been here 8 months and left suddenly, stopping work abruptly and leaving my family. About a month earlier we had had “the talk” — you know, the one where you reset expectations, where you say shape up or ship out. We gave it two weeks and at the end of it she wanted to stay and I had seen sufficient improvement that I could commit to her staying too.

Then, suddenly, she called in sick one morning, and after I had dropped off my child at school, she said she was leaving within the week. She cited medical reasons. And she left two days later. She left 33 calendar days before a huge career deadline. She gave no notice.

I suspected for months that our Au Pair was depressed.

I had been in contact with our LCC, who said the AP had stopped going to cluster meetings and hanging out with the other APs in the cluster.

I gave the AP an extended vacation (15 days at 7 months) and every weekend off, so she could have some time to herself and with her (new, American) boyfriend.

But when I asked the LCC about whether there is any mental health support for APs, she said there is none. She suggested we sit AP down and convince her to seek mental health services on her own and pay out of pocket. I declined: the last thing a depressed girl needs is to be sat down at my dining room table and told she’s depressed and she’s alone in fixing it. I don’t think the LCC actually knew of any ways to help.

Our AP’s health and mood continued to deteriorate. In the end, she complained of sleeplessness and oversleep, pains all over her body, fatigue, and anxious thoughts. (cv’s note: all of these are symptoms of clinical depression in teens.)

Now that I’m in transition, I’m looking back at my experience with AP and feeling terrified of bringing another AP into my home and watching her deteriorate from depression.

What do I do if I see the same things happening again? The LCC never suggested rematch (until our “shape up” probationary talk), and though I’ve read on this site that some host parents will rematch for depression, I don’t want to do that. I think there’s got to be a better way.

What kinds of advice can you give for a host mom who sees signs of depression in an AP?

And how do I personally move on from this experience?


Image: Sad kitten on Flickr


AuPair Paris May 11, 2015 at 6:40 am

God. Well… I have a history of clinical depression, and was forced to take a leave of absence from my MA because of it. Because of this experience, I am fully aware that, when I begin to suspect I’m becoming depressed, I need to see a doctor immediately, go on medication, and call my former therapist to tell her what I’ve done and why. For me, that’s enough.

Without this history, it’s really difficult. A depressed au pair might not know or want to believe she’s actually ill (rather than just “useless”, “lazy”, “stupid” – depression *messes* with you) if she hasn’t already experienced and accepted it. And after that there’s the battle of “but won’t medication totally change who I am as a person?!” and “but I don’t need therapy! I’m not crazy!” This stuff is hard to figure out at the best of times, but when far away from home and any support system, it must be nearly impossible.

I strongly believe that those with a history of mental illness shouldn’t be prevented from working in whatever capacity they wish to (and are capable of – with a Dr’s/therapist’s sign off), but it would be silly to deny that, while in the midst of a bout of depression, with no meds or treatment, it’s really difficult to do your job. If an au pair is in a place where she can’t get any treatment for her mental illness, then the most important thing for everyone is that she goes somewhere that she can be treated… And unfortunately, that probably means rematch for HF and home for AP… How does health insurance work for APs in the US? Can APs not get medical treatment for free?

If the AP can be treated, if she’s doing her job, and it’s not impacting the kids, then just emotional support would be kind. Though I think HPs would have to be careful not to try to become unpaid therapists. It’s like any illness. Support is nice and helpful, but it can’t fix the problem. Only treatment and time can…

Taking a Computer Lunch May 11, 2015 at 7:32 am

As the mom of 2 children who have mental health issues (it’s a myth that retarded children are happy all the time) and the daughter of a clinically depressed parent, I’d say mental health support in the United States sucks. It’s expensive and almost no clinicians offer pro bono treatment (I tried to get help for a trauma victim and a family friend who is a therapist said it would be almost impossible to get someone to take her on as an outpatient).

While I agree with AuPair Paris, that people who live with mental illness should not be discouraged from achieving their goals, APs with a history of depression, bi-polarism, anorexia, or anything else for which a major shift to a new country should think twice before coming to the United States because the medical support will not be here. Therapy is expensive and most providers require payment up front and patients seek reimbursement from their insurance companies. One session at child #2’s therapist would set an AP back for nearly a week’s salary. My insurance will only pay up front for the Camel’s out-patient psychiatric visits in a hospital. If being an AP is a major goal, then come with a game plan and follow it. Good mental health requires a commitment to work toward it.

The only AP I suspected of clinical depression and anorexia was the one with whom we went into rematch after 6 weeks. There were a whole host of reasons, but her behavior got in the way of job at every turn, and as the mom of a medically fragile child with special needs, I just don’t have it in me to provide mental health support past the usual AP adjustment period.

UKAu Pair May 11, 2015 at 8:36 am

I’m with both of you.

If anything’s going to trigger a mental illness, whether first time or relapse, moving across the world to au pair will do it. You’ve got the culture shock, the language, the lack of support network. As AP Paris says, if you have a history of it it’s much easier to see the warning signs and catch it early (although I’d still discourage anyone with a history of mental illness from au pairing in the US, particularly if they know they’re prone to relapse- the medical support just isn’t there, and a full year is much more difficult to get through than, say, 3 months in Europe).

Most importantly, supporting someone with a mental illness is draining, upsetting and incredibly difficult. APs are supposed to make your life easier, and if you find yourself spending hours trying to help her through something, all it’s going to do is make this worse for you. Not to mention the fact that unless you’re professionally qualified you probably don’t have the skills to be able to help someone through something like that if they’re not receiving medical help.

There are very few mental illnesses which won’t have an impact on the children. However they manifest, they will pick up on the symptoms and could (potentially) internalise them and begin causing problems later.

I say this as someone who, like AP Paris, has a history of mental health problems and has also successfully au paired twice, looking forward to the third time: au pairs shouldn’t be au pairing if their mental health isn’t completely under control. If it’s sorted, they have coping mechanisms, they can recognise the warning signs, then they absolutely should have the opportunity to become au pairs, but I’d tend to encourage them to go somewhere where mental health treatment is better, and possibly for a shorter period of time.

NoVA Twin Mom May 11, 2015 at 8:59 am

Another issue at play may be how mental health “issues” are perceived in the au pair’s home country. The one au pair we had that I suspected of having either a tendency toward depression or symptoms of depression was from Germany. Given the way people with mental health issues were treated during the Holocaust, many Germans are still very hesitant to admit that they need mental health treatment. (I realize that things have changed, but the hesitancies remain – even in this country, and while we have a history of treating mental health patients badly as well, it wasn’t as bad as during the Holocaust).

Any suggestions that I may have made that she seek help were NOT appreciated (1) because things were going downhill between us anyway but (2) because of how many people in her country perceive those labeled as needing treatment for mental “illness” she didn’t want to be labelled that way.

So if there’s a way to have the LCC make the suggestion rather than the host family, that might be a way to have some of the power dynamic taken out of the picture and help the situation.

German Au-Pair May 11, 2015 at 1:35 pm

I personally don’t have the experience that we think about the holocaust regarding this subject. Actually, if that were the case we would probably glorify mental illness now, since thinking about the holocaust prevents us from voicing negative thoughts about immigrants as well.
But mental illness is something regarded as either weakness or not a real disease many times. Plus if you inted to work for the state later in your career, you cannot have a history of mental illness. Teachers can work for the schools but the ultimate goal is usually to get the status for working for the state as you cannot lose your job anymore and get a bigger pension (and more salary) but if you want to reach this, you cannot have a history of mental illness. This knowledge would prevent me from seeking help and make my try to figure it out on my own.

Schnitzelpizza May 12, 2015 at 6:09 am

I would second German Au-Pair in that I would not directly link the stigma that is attached to mental health issues in Germany to the Holocaust. We could possibly be behind a bit in overcoming this stigma and I couldn’t say in how far that might be linked to WW2 (the country had to be rebuilt, medicine had to redefine itself, we had to grow together as a country etc.) but I have no possiblity to really compare it with anywhere else. From what I have read I always assumed that mental illness has a certain stigma attached in all over the western world. If someone has a study on that I would love to read it.

What is also true is that there can be practical problems attached to mental health issues. If you want to become a teacher you are aiming to be “verbeamtet” (which is a special status of being a civil servant that comes with many advantages, including a better pay, a higher pension and the highest job safety you can get) but if you have a history of mental health problems it gets difficult to impossible. The same is true for the police, judges, attorneys, some positions in social work…

And maybe, just maybe… we are often (usually? in general?) raised to be efficient, ambitious, industrial. You are expected to be a productive and committed part of wider society. If you suffer from any health issues, even if only short-term, you sometimes can’t. It doesn’t matter if you have a disability, a chronic illness or mental health issues… you are deviating from the path that you are expected to take. You will always be asked to prove that you are able and not defined by your issues. You are seen as weaker, less trust is placed in you… and who wants that? That might be part of the stigma that is attached to mental health problems. Maybe if we were a bit more laid-back that would be different?

Multitasking Host Mom May 11, 2015 at 11:58 am

OP, I comend you for wanting to support an AP that is experiencing a mental health issue. But it is often a bigger problem than something that a host mom can and should handle. My child had anxiety issues and it took a lot of therapy, the help of a couple doctors, and a long period of time to get him to the good place he is now. Also, we have good health insurance and still had to pay for a good amount out of pocket. Most APs have health insurance that only covers emergencies thus they would be paying for all of this on their own. Sometimes in this situation it would be best for them to go home where they would have the support of families and friends and probably access to better health insurance than they could get in the US.

Nana May 11, 2015 at 12:20 pm

What a tricky situation. While naturally you want to be able to help someone, depression is a serious illness that needs to be treated. Not sure what the correct way to do it, would be, but I would try to honestly discuss and plan with the au pair her departure back home, possibly even contacting her parents.

Seattle Mom May 11, 2015 at 1:08 pm

I suspected that our last AP may have been depressed. Her personality was what I considered “low affect” from the beginning- she didn’t really express any emotion in a convincing way. Though she was playful and acted happy with the children, which was enough. Maybe they really did make her happy- I don’t know. But in the last two months she was complaining about abdominal pains and fatigue, and she was less energetic than usual. She also talked about feeling “worried” all the time, she said she was worried that she was sick, but she clearly wasn’t physically ill. She went to the doctor and they did some tests, but there was nothing physically wrong with her.

She continued to see her friends and go out on the weekend, and was fine with the kids, never asked to miss work. So it was enough to keep going for the last 2 months. I did talk to her about it and ask her how she was doing, and I told her that it sounded like maybe she was worried about something and that was making her feel ill. She didn’t disagree, but she wasn’t sure.

If it had been more severe or started earlier in the year we might have needed to make a change.

I do hope she is doing better now that she is home.

JJ Host Mom May 11, 2015 at 2:35 pm

I really appreciate the au pairs who have weighed in on this. It helps to have that perspective.

The thing is, like others have mentioned, the line is very blurry between homesickness and feeling glum because friends have finished their year and gone home and work frustration, especially in cases where things have gotten to the point of a reset conversation, and actual depression. As someone who has battled depression all my life and only recently became aware of it, and as someone who has hosted two au pairs that I strongly suspect were depressed, I can say that it is so hard to recognize actual depression in yourself, much less someone else. And that’s just recognizing it – actually dealing with it is a long road that frankly, no one except for the depressed person and her trained medical team can really help with, unfortunately.

I think in some cases, being abroad can bring out homesickness but then the au pair can work through that and become a stronger person. In other cases, being an au pair can surface and strengthen a depression and other problems that have been simmering beneath the surface since before the person became an au pair. That sort of a thing doesn’t just go away. It has to be dealt with, through medication, therapy, or both.

I think the first step is recognizing when an au pair has crossed the line into depression. In both cases, I let that go on for months and months before I tried to intervene. I gave time off, lent lots of money for extra vacations (which I never saw back) and was so understanding for so long. And in both cases, it got as far as a performance issue before things finally fell apart. And in both cases, in retrospect it affected my kids in a dangerous way. In the last case, one of my kids became a different child altogether within a month or so after the au pair had left. He had persistent behavioral issues for so long that I had pegged him my “challenging” child but afterwards it came out that she just wasn’t nice to him, and he’s been a sweetheart ever since. And in the end, both au pairs would definitely have been better off had they returned home sooner, to friends and family, and had the support to work through their issues.

The other thing at work here is that, like it or not, because of the fact that host families are both families and employers, there is a power dynamic between host families and au pairs that I think will often prevent au pairs from really seeing you as an ally in an emotional situation like this. At least that’s been my experience.

I commend you for wanting to help, but I don’t think you can. Host families can and should support their au pairs through homesickness and fleeting moods but when actual depression is suspected, I think it’s better for everyone for the au pair to be home, surrounded by friends and family and actual medical professionals who can help.

JJ Host Mom May 11, 2015 at 5:32 pm

I forgot that I also wanted to address your question about how to move on afterwards. In my experience it’s been really difficult, almost like dealing with a bad breakup. Because she was great in the beginning and helped us get through some tough times, but things gradually deteriorated over a long time and when she left she wasn’t the same person as when she came and we haven’t talked since she left. So I am both grateful to her and angry at her. I have no advice, other than to say that yeah, in a situation where you cared about your au pair and wanted to do more but the match dissolved anyway, it can be hard to not feel bad about it for a while. Just give yourself time, I guess. I think having a new au pair would help but we’ve decided we’re not going to have any more au pairs, too many bad experiences. But it sounds like you’re expecting a new au pair soon and I bet that will help.

German Au-Pair May 11, 2015 at 2:43 pm

I will say though that starting your stay in the US can be a really positive turn around, too. In retrospective, I believe that I was very close to a depression before I left for the US but living abroad has helped me to learn how to appreciate the little things in life again. At the time I was a bit worried about my constant state of feeling down but I never really thought anything of it. Now that I feel much more positive about life, I see that my state back then was not normal. All those exciting things helped me so much and developing my self far away from home and far away from what had caused the issues was exactly what I needed back then.
So yes, people who have experienced an actual despression may know better about that, but there are many grey areas. Since the OP says she doesn’t believe in rematch as the only option, it could help to talk to an AP who displays warning signs and help her see what an incredible opportunity she has been given.

Anna May 11, 2015 at 4:36 pm

We had an au pair who spiraled into depression shortly after she came to us. She was very passive with the kids, she was in her room all the time sleeping (from 5 pm until the morning!), she was getting really sad and missing home, she was crying repeatedly in her conversations with me, and her performance (while bad to begin with) was deteriorating even more. She admitted she was not happy with our family. I tried to work with her, to make it better, but at the end she was the one who initiated rematch. If she didn’t, I probably would myself soon after. She went to another family and I don’t know how she fared there. Very possibly better; maybe she just hated us and she bit off more than she could chew with our family.

HM1234 May 11, 2015 at 11:52 pm

Yikes! This really resonates with us. We are now on our 2nd experience with depression in our au pairs and we are trying to figure this out too.

The first time was with our first au pair. We saw her becoming more withdrawn, watching TV with us less, communicating less, staying in her room and isolating herself more. Then, one night (shortly after extending for another 9 months and just after giving up a daycare spot), our au pair came home late one Sunday after disappearing all weekend without telling us (not like her previous self). So, we sat down as a family and talked about why this was concerning and she opened up about feeling sad, crying more, basically having every symptom of depression. And then…she admitted to feelings of wanting to leave.

We supported her, talked to her, and looked through her insurance and found mental health coverage. Full benefits up to $1,000 per year. We got her into counseling and she slowly got better, finishing out the year and 9 months with us and we still have a great relationship. It was rocky for a bit, but we got through it and she was grateful.

Fast forward 5 years to our current au pair. She has truly been amazing. Really, no complaints. A dream au pair with teaching experience, enthusiasm, and a great personality. She struggled a bit with our son’s behavior, and we worked through it. She seemed different on our family vacation, but we talked about it. She has talked a little about being sad her best friends would be leaving this summer, but we didn’t think much of it. But then, she sat us down and told us she had been sad for a month or so. Not enjoying things, less patience with the kids, sleeping more, crying all the time, etc.

I quickly recognized she was endorsing symptoms of depression and we tried to support her and reassure her that we had been through this before and that we could get her into counseling through her insurance and get through this. She said she wanted to tell us before she reached a breaking point and wanted to leave. We hadn’t really contemplated that and felt this was out of nowhere after 8 months. We hadn’t noticed her withdrawing or acting very differently as we did with our previous au pair.

She recently had taken a nice vacation with her family and friends, and continued to seem ok. We had also just talked about our next family vacation and bought her non-refundable ticket as well. However, the following day, she sat us down again and said she just wanted to leave. This surprised us completely and we were very hurt that she would do this to our family and our kids without adequate time to find a replacement. We want her to feel better, but were so surprised she wasn’t willing to try to stick it out here. Our LCC didn’t know they had mental health benefits either, but I pulled up the policy and the coverage for APC at least is 100% up to $1,000 per year.

So, now we’re left desperately searching for childcare, piecing it together until we can find someone that will be a good fit with our family. My husband is less forgiving than I am, but in general, we’re trying to maintain a good relationship and support her through this process. That being said, this second experience has totally affected my ability to interview and trust the process. I’m now left scared that this could happen again.

TexasHM May 12, 2015 at 3:54 pm

Not trying to make a judgment here HM1234 but again, your descriptions scream culture shock to me as well. I think it’s important to note that the symptoms list is almost identical for culture shock and depression and I don’t think its a coincidence that so many of us HPs appear to have seen this issue. I would love if one of the HPs in the medical field would chime in on all this!

I noticed that CCAP has A LOT of information on culture shock that they provide to the HFs, the LCs talk about it throughout the year and the APs are taught about it before arrival, during orientation and then its on their “portal” as well. We were with a different agency at the time our AP struggled and our LC was new so we were caught unaware as was our AP and the LC certainly didn’t have the experience to help. One of the articles I read specifically mentioned that awareness was a key factor in mitigating culture shock – ie being aware of the phases and symptoms (HPs and APs and LCs) and taking actions to help combat it.

To be clear – not saying it is preventable or that no APs actually suffer from depression. Just saying that I think its much more likely culture shock and that is why it seems to be so common in APs and experienced HFs. In fact, with our burnout rematch AP I knew almost immediately that we had a problem because the day she arrived she was already complaining about American food and culture. She had zero honeymoon phase and all of our other APs (even the brazilian that was crushed with culture shock later) arrived excited and eager to learn and try new things.

HM1234 May 12, 2015 at 5:51 pm

Ok, so I probably should have disclosed that I’m also a physician (although not psychiatry). Both of my au pairs actually clinically met criteria for a major depressive episode according to the DSM IV (and DSM V) criteria. I agree there are lots of overlaps between culture shock and depression, and we are honestly still skeptical as to whether our current is truly experiencing all of the symptoms she states she is, because we just don’t see it. However, if she is, she meets the clinical definition and I would feel comfortable diagnosing her with a major depressive episode. Regardless, I agree this experience can push someone with a predisposition over the edge into depression. I also think that if caught early and the AP and HP are willing to try, it can be managed in the US with an appropriate counselor. This can also be helpful for culture shock. Unfortunately, our current AP made a different decision, so we aren’t able to help her get through this. I am grateful that the insurance for APC is very good for behavioral health, especially for our first AP. I suppose this is something to consider when choosing a company since it unfortunately is common.

NZ HM May 13, 2015 at 12:51 am

Very similar story here and we attributed it to culture shock. Two of our aupairs completely withdrew for a while and then told us from one day to the next they wanted to leave. In both cases we urged them to take their time and re-think, told them about culture shock, the symptoms and how to overcome it; both of them were unwilling to listen and take on board any advice.

They seemed reluctant to accept the idea that something common was affecting them, that there situation and how they felt wasn’t ‘special’ and individual. Both of them said: ‘I read the information, but, no, that’s not it.’ So they blamed us as a family, our kids, our lifestyle, etc. for things not working out and used us as an excuse for their desire to leave.

For me, the moral, be it depression or culture shock or ‘just’ homesickness: it’s very difficult to help someone if they don’t want to be helped, esp. when you’re dealing with young people who often see themselves as important and unique (and of course they are!) and don’t believe their problems could be common or normal or affecting loads of other people. Pointing out to them what they might be suffering from often doesn’t do any good.

No good advice HOW to deal with it, though, other than to inform about culture shock during matching and as part of the challenge email (“be aware that this might happen…”).

Mimi May 12, 2015 at 6:04 pm

I think what’s hard for many HP is to keep in mind that when APs have problems with culture shock/mental health that they can’t work through, it’s not intentional and not a slight to your family/kids. It can be especially hard in the context of how it interrupts childcare and routines, but continuing a bad situation isn’t in anyone’s best interest. I also think that although the risks for culture shock/depression/whatever are there in the AP program, they are in the minority and there are strategies for screening for them and dealing with them.

MilHostMom May 15, 2015 at 9:01 am

What are some good strategies for screening for mental health issues? Our fourth au pair….whom we liked VERY much, came to me 4 months into her year telling me she was too homesick and sad to continue, and needed to go home. What I subsequently found out was that she may have been suffering from social anxiety disorder, and although she was a lovely girl both inside and out, believed that people perceived her as dumb and boring. I felt immensely bad for her, and we supported her decision to return home….but I was very disconcerted that we had made it that far with her without any idea of what she was struggling with.

Are there any good questions to ask during the matching process? Do any of the agencies offer psychological screenings?

When I asked ours (APC), they responded yes, they offer the DISC profile. However, as I pointed out to them, that is a personality profile, not a psychological exam. In any case, while I felt badly for the au pair and wanted her to get the help she needed, I also had to worry about the impact on my family…which included a very difficult transition for our 6-year old…who was very bonded to her and still cries sometimes about her leaving, and that was 6 months ago! Also, my husband was about to deploy to Iraq, so saying it was bad timing for our family might be an understatement!

Schnitzelpizza May 12, 2015 at 5:41 am

I suffer from depression (and anxiety) as a symptom of hypothyroidism (Hashimoto’s disease). If my thyroid levels are normal/high, I am fine but the first thing to appear as soon as my thyroid levels go down are mental health symptoms – fatigue, low energy irritability, poor concentration, forgetfulness, apathy, anxiety, depression. Even though it’s not a “real clinical depression” but only a symptom of an hormonal imbalance, there is nothing a friend, partner or host parent could do to talk me out of it. And being sat down at the dining room table and be told to seek counceling (and pay for it out of pocket) would be nothing but devestating in such a situation. For me, it would only make it worse as I also suffer from a high level of perfectionism and I would be failing my standards which would make me spiral down fast.

One of my colleagues tried to self-treat her depression by taking days off, passing off work to others, covering up mistakes, lying, drinking… only when she was admited to hospital after an accident (directly related to the drinking problem she ended up with) and really got help did she get any better. Everything she tried helped for a bit, maybe a week or two but only seeing a therapist really made her better. Everything we tried by covering up for her, giving her extra leeway and arranging for internal counceling through our company “social worker” (psychologist) just made it worse. It was even arranged for her to switch departments to see if that would help. But only when she hit rock bottom was she able to accept help. She could not even take care of herself when she got there. No way could she have cared for other people’s children.
Another colleague got herself admited before she spiraled out of control. She noticed she needed help, she got help. She got inpatient therapy for four weeks, another two weeks of out-patient therapy and came back to work. She took medication for another year, saw a therapist once a week and is doing wonderfully now! But she had a family that supported her, an employer that supported her, a network she could rely on and health insurance to cover her expenses. Many au pairs lack all (or most) of that.

I really doubt there is much a host family can do if their au pair really is depressed, other than being supportive which I assume would either mean paying for her therapy or sending her home so that she can be treated. I assume if the depression was mild, it might be possible for an au pair to be treated in the US, but as unfortunately the au pair health insurance does not cover mental health and the au pair stipend really isn’t enough to expect her to cover therapy sessions out of pocket that might likely not be an option. For clinical depression, rematch won’t change a thing. It might be a boost for a very short time (new “honeymoon phase”) but in the long run it won’t help.

Mental health problems partly are so difficult because you can’t see them. Everybody can understand a broken arm, it needs time to heal, maybe a bit of physiotherapy and then you are better. You can see it, you can touch it. Even if you have never broken your arm you can understand and showing sympathy is an accepted social convention. If you have no experience with mental health issues, it’s like an invisible chronic disease – you can’t see it so how can you believe in it? How do you even believe it’s there?

WestMom May 12, 2015 at 10:28 am

A few points.

It is important that APs disclose in their application if they have suffered from mental health issues in the past. I know of a few APs who have hidden this information from their application. In one case, AP had attempted suicide a few years back. She had a great year here, but the mom was shocked to find out that information as part of a casual discussion with her AP. Another AP suffered from depression and was on SSRIs but never told the parents. They eventually found out and she was sent home. I think it is unfair to enter in to a AP contract without sharing this information.

On a personal level, I have a teenager daughter who suffers from anxiety and OCD and who is followed very closely by a psychiatrist and psychologist. I see first hand the impact of living with and supporting someone with a mental illness. It impacts our family life (she gets the bulk of our attention), our work life (all the time we take off or leave early for her treatments), and our social life.

I sometimes wonder if she would ever be able to go on an exchange program or even attend college away from home. I am encouraged that many teens with her condition eventually get better and become productive, independent adults but it does cross my mind that her condition might flare up at any time. I would be very concerned as a parent to see my child with a history of mental illness taking such a big challenge abroad, where she may not be able to get the help she needs.

The level of mental health assistance one can get in this country is fantastic. But it is tremendously expensive. We used to go to a CBT therapist a few years back who now charges $425 per session, no insurance accepted.

What OP describes is an incredibly difficult situation to be in as a host parent. What AP needs is the help of a mental health professional, and possibly medication, none of which is covered on the AP insurance. As a host parent, I think the best approach is to discuss the concerns with AP, and if possible contact the parents to come up with a plan to get AP back home to receive the treatment she needs. Host parents who may offer to do more are tremendously generous and kind and I would admire any effort. But being in this situation already with one of my children, I would not have the mental strength (or budget) to do this for one more person…

AuPair Paris May 12, 2015 at 11:51 am

I’m pretty open about my mental illness, but I wouldn’t disclose it in a job interview – for any job. It’s actually illegal to ask in my country because of (almost certain) discrimination in hiring that will follow, due to prejudices against mental illness. I am aware this is not the case in the US, but I’ve often read people on here being shocked that an au pair wouldn’t disclose something about their health. I understand it must be annoying for an employer to have to deal with an AP who is suffering through a pre-existing condition, and may need to leave. It’s inconvenient and can be upsetting… But I’m not going to open myself up to discrimination in hiring any more than I really, really have to. I think Americans are so used to their own work culture and workers “rights” or lack thereof, that they don’t necessarily take into account how very different it is elsewhere, and how this can influence an AP’s perception of the American system.

I know no one will disagree with me (because most people here are employers and are intimately acquainted with the inconveniences of an AP who becomes ill or leaves)… But I really do want to put the perspective across. I don’t think people realise how much “you must disclose your mental health diagnoses” sounds like “forget about ever getting any kind of job or living any kind of independent life because of that illness! ;) ” to people who have experienced it.

Look, mentally ill people need treatment – of course, of course, of course! But with treatment, mental illness can be controlled. It’s always something to be aware of and pay attention to, but it’s not an employer who should decide that their hypothetical/prospective employee is or isn’t capable of what she says she is, because of an illness that the employee has experienced, understands, and has had medical advice about.

WestMom May 12, 2015 at 12:21 pm

I can see where you are coming from AP, and I agree that in the context of a job interview it is none of the employer’s business whether I have a mental illness, a toothache or I am pregnant. The AP program is not a simple ‘job’. One important aspect is that you integrate a family.

When candidates sign up with the AP program, they disclose if they have a recent or current medical condition and whether or not they take medication. If either are the case, as a host parent I would want to know. And if this information were not disclosed and came to my attention, it would be ground for rematch.

AuPair Paris May 12, 2015 at 12:55 pm

I see where you’re coming from West Mom… But I have experience in a whole ton of client-facing jobs (which I had while ill, before, and after), and although I don’t think of my host-family as “clients” I certainly use many of the same skills to get along with them, be a good housemate, show a good attitude etc, that I had to use when I was working these jobs. One difference is that you can’t get *away* very far when you live in the same house… But I haven’t noticed that being a very big issue!

I just think if one employer is allowed to be a special case, all employers could make that argument. Of course, you are in the US where the info is demanded before you enter into that job. That adds a new dimension, and I would never take any job which asked me for those details (unless I was, you know… Starving to death…). But my point stands – either asking for the info in an interview is morally wrong or it isn’t… And if it is, I think that means that not disclosing it, is ok. (Though then you get into the issues of “lying on a job application” which *is* wrong, as well…)

AuPair Paris May 12, 2015 at 12:58 pm

My original comment should say “no one will agree with me”! I wrote the opposite!

WestMom May 12, 2015 at 1:38 pm

Let me flip the question to you AP. Would you want to know that my daughter suffers from a mental illness? Would that information weight your decision to choose us as a family? If I kept this information from you and her condition were to flare up during your stay, would that be ground for rematch?

It’s unfair to equate AP matching with a job application. Honestly, APs have passed on our family because we had too many kids, because we are not in California, because we want AP to speak French… In return, we have passed on some APs because they were male, too young, or simply because their video was unimpressive. All of these could be perceived as discrimination in the real like job market. I think AP matching is a lot closer to finding a mate!

UKAu Pair May 12, 2015 at 1:46 pm

WestMom, following your second comment, I’d expect to be told about your daughter’s mental illness if it currently requires treatment of any kind, or affects the way I would have to deal with her. If she had recovered then I wouldn’t expect to be told about it, although it wouldn’t affect my decision either way.

exaupair May 12, 2015 at 7:22 pm

On a similar note, does the host parent have to disclose any ‘mental issues’ running in the family before matching the AP? Absolutely.
It works both ways. Being an AP is a job, but a very unusual one, so some ‘unusual’ measures should apply.

Long time ago I almost matched with a really lovely family, nearly booed the flight, references checked ect. I was online hunting for the best flight options, while skyping with the HM, who casually mentioned that one of the children has mild cerebral palsy, as if it wasn’t big deal because it was really ‘mild’. For me that was a deal breaker, partly because I wanted an easy gig, also because I have absolutely no qualifications to look after disabled kids.

It never really crossed my mind to think that backing out of the deal was of the same caliber as discrimination against disabled people or their families. It’s just the specifics of the job, that makes us all more ‘picky’.

p.s. until this day it really makes me wonder why the family wanted to match with me, when they could have someone qualified and experienced with disabled children.

UKAu Pair May 12, 2015 at 1:44 pm

I think au pairs (or prospective au pairs) with a current mental health condition (i.e. currently medicated/seeing psychiatrists etc) should declare it. But past conditions? That’s a whole new kettle of fish.

Should an au pair who became anorexic aged 14, recovered and has been ‘a recovered anorexic’ for the past ten years be forced to declare a history of anorexia aged 24? I can’t imagine many families would be interested.

What about an au pair who was receiving treatment for anxiety as a teenager to deal with exams and home problems, but hasn’t has an issue since then? How about an au pair who was diagnosed with depression following her parents’ divorce but has recovered and been signed off for the past five years?

Personally, I don’t think au pairs should have to report ‘closed book’ cases on their forms. In much the same way as I wouldn’t report the asthma I was diagnosed with when I was 6, because I haven’t used an inhaler since I was 9, I would expect someone who hasn’t had problems for years to declare their mental health history. I think it’s inappropriate, frankly (and I recognise that this is where we may have cultural issues- like AuPair Paris, it is illegal for companies to ask potential employees about their mental health history in my country to prevent discrimination [although that said they’re not supposed to ask about family planning either and in my last interview I was asked when I plan to have children… I reported it]).

To summarise: long-term or current mental illness? Schizophrenia, bipolar: they should be declared. They’re life-long illnesses which require constant medication to keep them under control. Current depression/anxiety/OCD/eating disorder? Should be declared. Past history of depression/anxiety/OCD/eating disorder? I don’t think APs should have to declare them, as long as they’re not going to affect their work.

WestMom May 12, 2015 at 2:05 pm

Agreed UKAP. I actually mentioned ‘recent or current conditions’ in my post. When someone is well into remission, I don’t see any reason to disclose that. Much like bankruptcy… at some point everyone has a chance to have a fresh start.

UKAu Pair May 12, 2015 at 2:18 pm

Sorry, I must have completely missed that!

How would you define ‘recent’? Most medical professionals (in this country, anyway) won’t sign you off until they’re convinced that you’ve made a complete recovery- this can take several months if they’re concerned about a relapse.

AuPair Paris May 12, 2015 at 2:19 pm

Yeah, but for a long time (while working as an au pair) I took medication to prevent relapse. It took a long time to wean myself, despite the fact that I wasn’t actually at all ill at the time. I had relapsed in the past without medication, and had found that immediately going back on medication limited the problem to something like “slightly low for two weeks”, rather than “full-on depressive episode”. So the medication/non-medication line is not that clear (and I don’t like the idea of making fully-functioning people feel like they’re not actually fully functioning unless they chuck out the medicines that help them function. It’s dangerous!)

As for the daughter – I would expect to know if it would affect my looking after her. I don’t include that as “and make sure she takes this medication at 3 every day” – I wouldn’t even ask. (You don’t medicate kids often, for mental illness, but just to make the point…)

Although I also missed the distinction between current and past illness, and I do think it’s relevant, so I understand a little better this position now. But yeah, the whole “currently ill/currently medicated” line isn’t so clear cut for me…

Mimi May 12, 2015 at 2:29 pm

While I agree (in principal) about ‘closed book’ issues, I wonder how most HPs would respond in the context of a relapse for something they didn’t know about? I’m also wondering if disclosing psych issues would disqualify APs with certain agencies?

AuPair Paris May 12, 2015 at 2:35 pm

Also, if your daughter had had depression, no longer did, and then relapsed, I would not rematch, because I know I am capable of helping in that situation. I can understand that someone might if they didn’t feel capable. But either way, it wouldn’t be a matter of “you lied to me! How could you?!” It would be an issue of the job requirements changing to the point that an AP could no longer fulfil them. (In the same way that if a HM found it in month 1 that she was 3 months pregnant, I would rematch because I’m not confident with tiny babies! But I wouldn’t *blame* the HF… The situation would have changed… It happens!)

UKAu Pair May 12, 2015 at 2:54 pm

Mimi, I don’t know the statistics on relapse vs. first time mental illnesses in APs (if indeed they exist), but I think au pairing is stressful enough that it could potentially trigger a mental illness in ANYONE, regardless of history. If anything, an AP who was relapsing would probably be better placed to deal with it than someone who had no idea what they were going through.

American Host Mom in Europe May 13, 2015 at 5:16 am

Interesting discussion! I ask about current medical conditions, and we decided not to pursue a candidate who was an insulin-dependend diabetic because we live in the countryside where an ambulance takes a while to get to…and you never know. I’ve been surprised in a few cases with au pairs who had previous medical conditions that only came up in casual conversation once they were here (like: “Oh, I missed a semester at university because I had brain surgery…”)

I would want to know if an au pair coming to live in my house was on regular medication, from a safety standpoint — so we could discuss where to keep the medication, as I have small children, who don’t always respect the “closed door means don’t enter, and that isn’t your room to go looking for things in.”

Peachtree Mom May 13, 2015 at 9:09 am

I disagree, I think honesty is the best policy. “Remission” or not, I am interested if someone had physical or mental issues in the past. I am interested in the asthma at 6 years old. Just like I am totally honest about our family situation….even to the point of we have a 15 year old cat who sometimes gets sick….and our aupairs are not required to interact with the cat at all. To make an informed choice, you need all the information. We can talk about it and then make a choice. The thought of “well, situations happen, if there is a problem…we can deal with it” does not work for me. I want to minimize potential problems the best I can. Some things I may not see as an issue but something different I may. Let’s figure it out ahead of time. No one wants a rematch. They are disruptive, very expensive and take a huge emotional toll on everyone. Sometimes I get the feeling that aupair candidates minimize the impact of rematches. They are terrible to go through. I feel for the OP scrambling to find childcare, the extra expense and all the other emotional factors. Both the host families and aupairs should be honest about medical issues past and present, family situations and any other factor that could influence making a match. That is fair to all parties.

AuPair Paris May 13, 2015 at 10:08 am

“That is fair to all parties” except for those who have a history of illness who are never given the opportunities they need in life because employers and host families have decided with no knowledge of their (former) condition that they’re not capable of what they and their doctors believe they are.

WarmStateMomma May 13, 2015 at 11:56 am

@ AuPair Paris:

You’re right that a history of mental illness would preclude most families from considering an AP. It’s also true that it’s a double standard for APs to provide this info and not HPs.

On the other hand, being an AP isn’t like taking an accounting job at a big company. My infant and toddler are in the hands of the AP all day long and can really wear on a person who is in the greatest emotional/mental health. It’s not fair to my children to leave them with someone who has mental or emotional difficulties because they are too young to understand, too young to help themselves, etc. A person with those same issues can do perfectly fine in another employment setting, though. The prospective AP *wants* the AP experience but my kids *need* to be physically and emotionally safe.

We endured several months with a depressed AP and I worried a lot about whether my baby picked up on it. Now she’s old enough that I know she would and my child’s emotional health will come before anyone else’s desire to be an AP. That’s harsh but it’s the reality of parenthood.

It’s tricky to decide where to draw the line in terms of disclosure because some things should be private, but AP candidates are asking to be entrusted with my helpless kids and that’s just inherently different from taking a regular job. My secretary’s mental and emotional health is none of my business but she isn’t home alone with my babies for 10 hours either.

TexasHM May 13, 2015 at 12:33 pm

I was trying not to chime in here but I have to wholeheartedly agree with WarmStateMomma and others here. As a HM who had an AP that lied on her application (she says she filled it out honestly and the agency changed it all which I do believe) about several health issues including but not limited to a far previous suicide attempt, having a lump removed via surgery, vision and GI issues I have to say that I was very hurt and angry for a long time that she put me in that situation.

What is happening here is basically you are assuming no host families would take an AP with prior health issues which I don’t personally believe. We have considered APs with all sorts of previous and current medical conditions and we evaluate them on a case by case basis with the focus being on two things – how/if it will impact our kids/us and how/if it will impact the AP having said condition in this country without her support system and good healthcare coverage. I had a close friend in college battle an eating disorder that almost killed her and she is doing great today but still (16 years later) has health issues related to it that I would have to weigh if we decided to have her AP for us.

This is not a typical job so the job interview analogy really doesn’t apply here. This is not a 9 to 5 with benefits. If I were interviewing a roommate you can absolutely bet I would ask about a whole host of things that you can’t ask people when interviewing for a job like not only their health history and background but also things like if they are neat or messy, early birds or night owls, if they do or have done drugs recreationally or otherwise and lots of other things that would not be appropriate in a traditional job interview. At the end of the day, I am entrusting not only my home and vehicles and cell phone but most importantly my children which are irreplaceable and influenced by any presence they interact with so it’s my job as a parent to thoroughly vet and look for any scenario that may impact my children in whatever form, period. If I know the truth and I am willing to take whatever risk that is one thing and on me, if however something is not disclosed and then impacts the kids that is absolutely on the AP and potentially unforgiveable.

We did not rematch on our AP with the health issues but it was a big strain and we did analyze each time something came up if we thought she could 100% do her job as an AP and if the kids would be impacted. We now go through every part of the application during interviewing and explicitly ask about health history and make it clear that it likely would be a rematchable offense if something was not disclosed upfront and that we have had and will consider APs with health history.

AuPair Paris May 13, 2015 at 12:33 pm

Ah well. For me, it’s not in question what parents *will do* to “protect” their kids. It’s what it should be legal and acceptable for humans to do to other humans. Of course parents will do anything for their kids (even if it means incidentally hurting other people who aren’t their kids). That’s why there are human rights which are supposed to be objective. I mean most parents would sacrifice the rest of the world in a heartbeat for their kids. That’s what parenting is. And that’s why employment ethics aren’t based around what parents will do for their children.

I don’t think someone with a history of depression is necessarily a danger to children. I wouldn’t be an AP if I thought that. I know I’m an excellent AP. The kids I look after love me, and I love them, and if it were legal here to ask about someone’s old health conditions in a job interview, I probably wouldn’t be working with them. So I am glad that it is illegal here. I think it is morally wrong for an employer to decide they know better than multiple doctors and psychiatrists about what their employee’s health allows them to do.

Whether you think it’s morally wrong, or just don’t prioritise those ethics when it comes to your children, we’re going to have to agree to differ, and I’ll stay grateful that I work in Europe and not the US.

AuPair Paris May 13, 2015 at 12:39 pm

As for some Host Parents taking APs with mental illnesses – I’m sure there are some! But after years of grueling therapy, digging out all my issues and examining them, pulling my life apart, and putting it back together in order so that I can function, I just don’t fancy laying it all on the table for potential employers to judge. Especially knowing that such a high number of them will judge that I’m not only incompetent, but am actually a danger to their children… Because once I had a terrible, debilitating illness.

Wouldn’t lie on an application, but I wouldn’t work for anyone who asked me for these details either. And if it were in a country where such a thing was illegal, I’d certainly report it.

This works well for all of us – I wouldn’t take a job with you, because I’d think it wrong for you to want to know my medical history, and you wouldn’t hire me for a job, because of my medical history. Everyone is (more or less) happy.

Mimi May 13, 2015 at 12:45 pm

AuPair Paris, while I agree with most of what you’re saying, I think the issue here is the honesty part. Not only being honest on the AP application (within limits), but also being honest with yourself about what your limits are and unfortunately we have all seen instances where a young adult in an AP situation doesn’t have that ability for a variety of reasons.

AuPair Paris May 13, 2015 at 12:51 pm

Well… I agree that one should be honest on a job application. I just question the morality of some of the questions that are being asked, is all. I find them discriminatory.

As for lying to yourself about your abilities… God, most people do that! Ironically, the people who are most brutally honest with themselves about their short-comings are probably depressed! Healthy people have a decent sense of optimistic magical thinking, often! But I do think it’s incredibly, incredibly important to get the opinion of a mental health specialist who knows you and your case before making massive life changes, including changing country for something like that. For the good of the AP, frankly! Which is not the same as just saying “I think I can!”.

TexasHM May 13, 2015 at 1:06 pm

AuPair Paris I think you are very close to this particular issue (rightfully so) but I want to point out that I never said I wouldn’t hire you or any AP with depression in their history. I absolutely would if she showed as you said that she sought help, her doctors say she is in recovery and she understands what happened and can watch for any warning signs in the future. I am very close to this issue myself and actually believe that undiagnosed issues in this area are far more dangerous than those that understand and get treatment (and hats off to them and you).

I think we have now discovered the issue – here the agencies are expected to get full medical history and it is disclosed on the application so yes, I have a huge sensitivity to APs lying on their applications in this area. I personally think it is better for all involved to be completely honest upfront so that if there is an issue the HPs can also assist vs being in the dark but that’s another tangent. :) I do think there is a lid for every pot (even the crazies, I have seen it!) and there is plenty of judgment in the world so that is definitely not my intent. Appreciate your honesty and candor, having the APs voice adds a lot to these discussions.

AuPair Paris May 13, 2015 at 1:11 pm

… Both formerly ill, and beginning to job hunt for the end of my time as an AP. You may be right that I’m a little close to the issue. I stand by my opinions, but I do apologise if I’ve been a little brutal in the way I voiced them.

TexasHM May 13, 2015 at 1:25 pm

My concern was not the opinions stated but the tone. I feared you were perhaps taking some of the opinions personally and perhaps jumping to conclusions that a US host family wouldn’t match with you because of your health history (which I don’t believe for a minute – maybe some but definitely not all) or assuming that US host families think people with depression history can’t be great APs. The tone of this blog (thank God!) is how do we (as HPs and APs) make this experience better and in this case, that was the OP asking how she can prevent a similar situation from happening and you will notice that she too did not want a rematch. I have always enjoyed your perspective and you seem like an awesome AP. Best of luck for your job search and glad you are doing well!

WarmStateMomma May 13, 2015 at 2:01 pm


It’s hard to know which issues we’d be ok with an AP having currently or in the past, and I certainly don’t mean to imply that you are not a great caregiver. Just as pilots are not allowed to fly when they have certain medical/mental health conditions, I would not choose an AP whose specific medical/mental health conditions appeared to create a risk for my kids. I wouldn’t hire someone with physical limitations that would impair her ability to do the physical tasks associated with caring for little ones. It’s not a moral issue but about ensuring that someone is qualified for the job. I reserve the right to discriminate without remorse on this topic, just as I discriminate against AP candidates who don’t share my values or are the wrong age/gender/religion/etc.

FWIW – I really enjoy reading your comments on this blog and hope that you don’t feel unwelcome.

Returning HM May 13, 2015 at 2:45 pm

AuPair Paris, I think you have done an excellent job of articulating an important perspective. In my view, someone who has sought out treatment that has worked in the past – whether through therapy or medication or both, OR who is successfully being treated with medication and is totally stablized, is more likely to have the self-help and coping skills necessary to withstand the challenges of the AP year.

I’ll just add that every single one of my close friends – all very bright, capable women with successful careers, strong marriages, and great parenting skills – takes an anti-depressant or anti-anxiety medication. It could be the kind of women I tend to befriend (the kind of people who seem to do it all and have it all), but I think it’s pretty typical in my profession and socio-economic demographic for women who are in their 40s (dealing with both children and aging parents, on the cusp of periomenopause) to need a little support through therapy or medication. I’ll take someone who knows how to recognize need, ask for help, get help, see the process through to successful completion or longterm ongoing (medication) treatment, over someone who has never been tested and has no idea how he or she will react in a challenging environment.

AP Paris, good luck finding your next job with a lovely family.

AuPair Paris May 13, 2015 at 2:59 pm

Thanks, ReturningHM – that’s a heartening testimonial. I think mental health issues are very, very common. Most of my friends have been through treatment as well, although like you, I wonder if that’s a matter of the friends I choose. Seeking out kindred spirits, or similar!

And thanks to the others too – we can agree to differ on some of our ultimate conclusions, in any case.

Susannah May 14, 2015 at 4:23 pm

I have tourettes syndrome, a brain disorder causing motor and vocal tics. for me, this primarily includes some whistling and a smorgasboard of other very infrequent twitches/sounds that are basically remnants of past tics that hardly ever come up. I’m what would be probably considered extraordinarily open about my tics, i find it’s way easier to explain myself with the weight of a medical condition then because of some other, not likely to be understood, reason. My tics are very mild , and I’ve found they can be managed quite effectively with a healthy dose of sleep, self care, and education of others, as well as a low dose of an SSRI, though I don’t have anxiety/depression issues it helps for some reason. Would I put this on an application. No. I think when people don’t know me first they can become intimidated, thinking that it’s this whole big thing when really it’s just fades into the background of who I am (you can ask my college roommate, it really doesn’t become a problem). Of course I would tell them eventually, long before match, as it is part of the “package” of who I am, but it doesn’t affect my caregiving abilities, and I wouldn’t want the rampant misinformation about TS to dissuade someone from hiring me. TS is never going to be “cured” it’s just not possible, and in my opinion it’s completely unfair to exclude myself from things I’m good at because of my genetics.

TexasHM May 12, 2015 at 10:51 am

Honest question – how can the OP or any of us HPs truly diagnose depression vs homesickness/culture shock? I ask because in reading this post, I heard similar to what we had with one of our APs but I honestly don’t think she was depressed (or maybe I am kidding myself and she was).

For perspective:
She was a great AP whose year ended Dec 26th so she arrived day before New Year’s and her anniversary date was Christmas. She begged us to extend and loved it here and she was great so we said yes (about 3-4 months before her anniversary date – WHY does APIA (agency at the time) send that stuff so early?!). In the few months that followed her family told her they weren’t coming to visit in the second year (they had said they would the first year and then punted to second when she was thinking of extending, then told her they were never coming so she was very upset and felt jerked around, plus she missed them and I think counted on the visit to connect and give her a boost to get through year two without seeing them). Then her best AP friend (also from Brazil) decided not to extend and went home at the beginning of Dec and she took that really hard. Her attendance at dance classes (she LOVED and paid for) became sporadic, then she cancelled, then she stopped making plans (travel or otherwise) even for weekends.

In addition, the Christmas/New Year’s holidays were very big for her and her family so right at the anniversary of her year she was seeing all their facebook posts and was extremely homesick and started only hanging out with Brazilian APs, scaled back to only wanting to eat things she ate in Brazil and almost skipped our Christmas Day to instead attend a traditional Brazilian Christmas Eve party (that would go LONG into the am) until we put our foot down. She also almost opted out of a free thanksgiving trip to another city (one she had said she really wanted to visit in interviewing) to sit around the house with another Brazilian AP for the 5 days – um no. We reminded her of her wish to go there and told her everything she would be missing (inc having an American thanksgiving) and asked her strongly to reconsider after which she decided to go after all (good because our next step was to schedule her to work vs letting her blow her opportunities).

Net/net – Dec 23rd on a drive to the airport I pointed out all the behavior and asked her if she really wanted to be here anymore. She started crying and said she didn’t know she was just so homesick. Two days later (on Christmas) she told us she thought it best to rematch into another part of the country (apparently she told her parents she was coming home and they said she had already committed to year two and just needed a change of scenery). A month later her dad went into the ICU and she left about a week later due to that family emergency and in hindsight, it was the best thing for her and she said as much to me on Skype months later.

Why am I explaining all this? Because she had the symptoms listed above (oversleeping, fatigue, hypersensitive at times bursting into tears for seemingly little things or at odd times, obviously she was sad, withdrew and was anxious). Almost the minute she had a plane ticket home she was cured. I mean telling people she “couldn’t wait” to get home which naturally, hurt us a bit to see the enthusiasm and hear that over and over. Once at home she was her bubbly self. I am no MD but I don’t think she was depressed. I think she had extreme culture shock/homesickness that was exacerbated by her decisions (to withdraw, stop planning, only hanging out with Brazilians and changing diet, etc. As someone who has depression in my family I just hate to jump to the conclusion that an AP is clinically depressed. Just my two cents.

Mimi May 12, 2015 at 11:03 am

Depression isn’t something you can diagnose and treat in your AP and I don’t think that confirmed depression is a rematch issue, I think it’s a leave-the-program issue for all the reasons mentioned above.

I don’t have the experience with depression or mental health issues mentioned by others here, but I agree that APs with a history of depression, or other mental health conditions really should carefully consider the impact being abroad in the US will have on them, not just because the medical support is lacking, but also because the stress of the AP position may trigger problems and there is a potential for a serious negative impact on the children involved and when push comes to shove, a HP needs to first focus on the welfare of their children. Had any of my APs had a serious health issue like this, I would have encouraged them to leave the program to focus on their personal health. I can’t see a scenario where untreated depression would work out in this program and I think it would really diminish the experience for the AP.

If you suspect depression, you need to have a conversation, likely involving the LCC and it’s possible the AP will go home. As unfortunate as that may be (or harsh sounding), IMO it’s likely for the best in the long run for the AP.

JJ Host Mom May 12, 2015 at 10:56 pm

I wonder if you could talk a little about how you think such a conversation would go. I tried variations of “You seem sad lately, do you want to talk?” and “You seem different lately, is everything okay?” and “It seems like something might be wrong, is there anything we can do to help?” and just got defensiveness. And she was basically doing her job so I couldn’t really talk about any performance issues. So then all there is to say is “Hey I care about you and want you to get better, but you aren’t doing so, and in the meantime you’re really bringing down the mood of the household” which is a pretty awful thing to say to someone, especially someone who is already dealing with depression. Even when it’s totally legitimate…especially with respect to the kids, although I confess that it happened so gradually that I didn’t even see the effect she had on the kids until long after she was gone. I ask this because I think one of the reasons I put off dealing with it for so long, in both cases, was because I didn’t have the first clue what to say.

TexasHM May 12, 2015 at 11:06 am

Just thought I would add this reference for emphasis from the Authentic Journeys website:

Social Symptoms
Feeling lonely most of the time (even when around others)
Over identifying or idealizing your native country or culture
Inability to accept anything in the new place
Using stereotypes to judge others
Social Withdrawal – Not feeling like doing anything
Becoming over identified or obsessed with the new culture (forgetting who you are)
Inability to want to learn new things
Inability to relate to or understand others or feeling no one relates to you
Finding it impossible to fit in
Generalizing that all problems happen in the new culture and none happened back home
Inability to feel comfortable in day to day life and daily tasks
Believing that by learning the new culture you are betraying your roots
Feeling disoriented or lost when traveling around.
Missing family and friends (to the point you don’t live life)
Not wanting to understand/ follow new behavior/rules/etiquette in your new culture
Prone to take drugs or drink excessively

Physical Symptoms
Sleeping too much
Not able to sleep enough (insomnia)
Falling physically sick frequently
Excessive concern health/ sanitary needs

Psychological or Emotional Symptoms
Feeling Sad
Mood Swings
Losing touch with yourself
Closing up (not talking to others)
Lack of confidence and feeling insecure
Small problems become big worries (making a mountain out of a molehill)
Being too overcautious in everything/ over thinking
Not feeling safe and secure
Feeling foreign and different (misunderstood)
Taking everything too seriously or not taking anything seriously
Fighting with others
Impatience or unwillingness to try to understand the new surroundings
Imbalanced emotional state

NJmama May 12, 2015 at 6:49 pm

I am not a doctor but it was my impression that culture shock happened at the beginning of the AP year – not several months into it? Not sure.

In the end I don’t know if it matters much what label you put on it. Whether you call it culture shock or depression the upshot is the au pair may need help that we’re not equipped to give.

A couple things I’ve learned dealing with various family members /friends who have mental illnesses (depression, anxiety, addiction, bi-polar)…

1) it’s pretty much impossible to help someone who doesn’t think he/she has a problem. This is the hardest.
2) just because the AP seemed “cured” as soon as she had her plane ticket doesn’t mean she was cured. Mood swings – highs and lows – are not uncommon.

These are weighty issues for sure

Mimi May 12, 2015 at 7:59 pm

Culture shock can happen in the beginning or layer after the honeymoon phase is over. It’s similar for college freshmen; some have a hard first semester, some have a hard second semester.

NJmama May 12, 2015 at 8:37 pm

Good point Mimi I didn’t think of it that way.

SKNY May 12, 2015 at 11:48 am

And i am sorry, I meant to ask if would mess the au pair program. not state. posting from cell phone, in a hurry, in between patients

SeattleHD May 12, 2015 at 12:41 pm

Bit of a rush to judgment on the depression angle.

Does nobody else think that the two weeks off with the new American boyfriend might be a factor?

E.g. find yourself pregnant in a foreign country with minimal health care? Might be best to head home ASAP, and not something you want to confide in a HF you don’t get along with very well.

Not saying it’s the case but it or some other boyfriend related factor is as likely to be the trigger.

Host Mom in Paradise May 12, 2015 at 1:34 pm

OP here. Yeah – I wondered about that. The symptoms of withdrawal / moodiness / sleep issues were going on before the vacation (and hence the vacation). I wonder about how to talk about birth control with an AP from a different culture. I tried to broach the subject with the AP, asking gently if she needed any help with women’s health, and if she felt she was being safe. She said things were fine. But the thought of pregnancy, especially with her symptoms, behavior, and subsequent leaving suddenly definitely crossed my mind.

Julie May 12, 2015 at 3:53 pm

Just in case you are with Cultural Care, you all should know that we have program counselors available to au pairs–LCCs are aware of this and if the au pair is open, we will set up a meeting with a program counselor. The au pair must agree to it and we cannot force it, but please do know that it’s there. I’ve had several au pairs who have been going through rough times speak with a program counselor and it’s been very helpful. For ongoing assistance, we can try to find (if we know about it) local help on a sliding scale so that the au pair can receive additional care.

Au Pair Report Author May 12, 2015 at 5:13 pm

Thanks to TexasHM for listing the symptoms of culture shock. I think the reason so many host moms are coming forward with stories about depressed au pair is because it is extremely difficult for many au pairs to adapt. Aside from the inherent challenges of living with strange family, there are all the difficulties of missing those back home and dealing with the reality (vs. the fantasy) of what the au pair experience is like. I was an au pair in France many years ago, and I remember crying in my room many times, feeling horribly lonely. This was before Skype or even cheap international phone calls, but communication with people at home can make it even more difficult. When I was an au pair counselor, I usually recommended that families choose an au pair who at least had lived away from home for a significant amount of time–and prior international experience is even better. This doesn’t mean it will necessarily be easy, but at least the au pair would then have a better sense of what she is getting into. I was trying to find the post that mentioned $1000 of mental health coverage for insurance, but can’t find it and don’t remember the name of the program. That coverage would be a strong argument in favor of choosing that program because then host parents could help the au pair seek professional health whether the problem is culture shock or clinical depression.

Taking a Computer Lunch May 13, 2015 at 7:03 am

We’ve talked about cycles in the AP year before and individual reactions to the Culture Shock (it’s going to happen – the question is, Is the AP strong enough to deal with it and move forward?). I expect tears on the first day. To me, that’s normal. The AP orientation is exciting and then the day after it’s over, the AP is alone with a strange family that she’s (usually) never really met before. It helps that DH and I have both lived abroad, and can recognize the feelings and are willing to talk explicitly about how they’re okay.

We’ve also talked about how, three months in, APs seem to go through a second round of culture shock. The newness has worn off, they’re settling into a routine, and yet nine months seems like such a long time to continue working day after day. It’s not like school. At this point, I encourage APs to develop their friendships, exercise, find a hobby that will introduce them to Americans.

And then, one after one, their best friends leave. AP friendships are really intense, because they’re born out of similarity of experiences. If the friends leave well before the last 8 weeks in the AP year, then it can be really hard – especially if she’s shy and doesn’t have a lot of AP friends. Try to bring her back into the family fold with a family game night, a picnic, or something that helps give her something to do in the vacuum left by a best friend’s departure. If the family is taking another AP, then encourage her to form a friendship with that person and introduce her to the community.

And then, finally, there are the last 8 weeks. I’ve written about it enough elsewhere. It’s an emotional roller coaster, and it’s important that the HF stay calm and reassure the AP that the grief in the constant goodbyes is normal.

Now, the majority of APs deal with their feelings just find. Once they weather the initial culture shock, they don’t become depressed in a clinical way. I don’t say, “You seem sad,” when I know a friend has left, I say “It’s really hard to say goodbye to someone with whom you’ve been so close. I know you’re going home to the same country, but your cities are so far apart that it will never be the same again. It’s just part of adulthood, really. People are going to come in and out of your life – you’ll stay in touch, get together from time to time, but saying goodbye is really hard.”

I also tell my teary APs on their first day, “You think this part is hard, but believe it or not, it will be worse on the day I drive you to the airport to say goodbye. We’re going to have a great year together, and it’s okay to feel really homesick now.”

And now that I have teenagers, I’m really grateful for the 11 APs I have hosted. They’ve really prepared me for the ups and downs of raising teens.

But finally, there are some APs who cannot weather the culture shock, the departure of friends and their own impending departure. It’s too overwhelming. At that point, it really helps to have a good LCC who is willing to call and check in.

Host Mum May 14, 2015 at 5:30 pm

As a person who suffers from bouts of mild depression (whenever I don’t exercise enough and work too hard basically) I can understand where Paris Aupair is coming from – I feel its my business, there is a lot of discrimination and no way would i disclose it in an interview. I would be kissing my chances goodbye. The girls who have been depressed previously likely can recoginise their symptoms and have strategies, its the ones who never have experienced it that will be in denial and refuse help.

Depression is very, very common. In my case Im sure its mostly chemical, a healthier lifestyle fixes it. I have taken SSRI from time to time but am able to wean off quickly once I fix the stressors in my life. Again, not disclosing that in a job interview, as unless my boss has the same experience they are going to assume “major uncontrollable depression”, wheras I know what it is and how to fix it..

Lots of my aupairs have been very sporty at home but give up when they go overseas, I imagine their bodies and brains miss the “good” chemicals and stress relief being physcially active gives them. We have had a depressed aupair, but she shut down and wouldn’t talk to us. She rematched to a milder climate and got better from what I could see from facebook.

I agree, helping a young person who is experiencing their first episode away from home is going to be difficult. Not talking about it wont help though, your support agency should be able to source information sheets in the aupairs home language from the internet? If they cant or wont get help, or severe, yes going home to family is probably the best idea. Stigmatising people who have previously been depressed is not though.

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