Health

Homesickness is no longer classified as a disease, yet it causes both anxiety and depression. The pandemic has magnified the grief and loss of distance and separation. By Melanie Cheng.

A pandemic of the homesick

Millions of Australians unable to travel due to the pandemic are homesick.
Credit: Imaginechina-Tuchong / Alamy

The first night of my general practice rotation to country Victoria was long and sleepless. I was a medical student and the clinic receptionist had offered to put me up in a spare room of her family home. It wasn’t so much a house as a homestead – she lived with her husband on a large dairy farm. The room I was staying in, which had once belonged to her daughter, was still decorated with pink curtains, a patchwork quilt and a clan of moth-eaten teddy bears. Thankfully I couldn’t make out any of these kitsch furnishings in the darkness – I could barely see my own hand as I waved it in front of my eyes. The silence, too, was dense. Every so often I made a few throat-clearing sounds just to be sure my ears were still functioning.

Until that night, most of my life had been spent living in apartment blocks in Hong Kong. I was accustomed to noise and people and lights. Without them, I was anchorless – an astronaut drifting through space. But even in the midst of my homesickness, I knew that what I was experiencing was not unique. As I lay there staring into the blackness I remembered stories about Hong Kong emigrants who, on moving to places such as Canada and England, had listened to recordings of traffic noise to get to sleep.

Much later, when I was working in community health, Greek and Maltese migrants told me about adjusting to life in Melbourne in the 1960s. They spoke of hard work and family and heartache. But it was when they spoke of home that I saw a shift in their faces – a sudden liveliness in their eyes as if, rather than the inside of my consulting room, they were seeing the beloved features of their childhood stomping grounds. I was surprised to discover that many of these same patients had never been back to their home countries, even for a visit. Their recollections were as perfectly preserved and unchanging as the photographs that now adorned the walls of their homes in Australia.

These days, I see a much younger cohort of patients, many of whom are also far away from home but whose memories of the countries they’ve left are still bright and sharp and fresh. These young people grew up believing the world to be a small, well-connected place. In contrast with the migrants of the 1960s, they left home on the assumption that they could return for important events such as weddings and funerals. Flights were plentiful and inexpensive. Long-distance relationships were a real possibility. And then the pandemic hit.

It was a medical student by the name of Johannes Hofer in 17th-century Switzerland who first suggested that the experience of missing home was a form of illness. He even invented a term for it by combining the Greek word for homecoming, nostos, with the Greek word for pain, algos. The symptoms he attributed to this new condition of nostalgia included poor sleep, reduced appetite and heart palpitations. The most effective treatment for the condition, he claimed, was to return the afflicted patient to the home they longed for.

Early research into nostalgia focused on mercenaries and soldiers. Over subsequent decades, as countries expanded their territories and as populations became more mobile, nostalgia became a more prevalent disease, affecting a more diverse population. It was later, in the 1750s, that the English word, homesickness, finally emerged – initially in a church hymnal, before finally being included in the Oxford English Dictionary. Homesickness continued to be considered a medical illness until as late as World War II, when it was still listed in the surgeon general’s manual.

While modern medicine no longer classifies homesickness as a disease, contemporary research suggests that homesickness, especially when severe, can give rise to mental health conditions such as anxiety and depression. Never have I been more aware of this association than during the Covid-19 pandemic. I think of the Australian student who sought my help in applying for a travel exemption. She wanted to return home to the Middle East to see her elderly father before he underwent major, lifesaving surgery. I think of how she was rejected by Australian Immigration not once, but twice. And I think of how, over the course of the ensuing weeks, I watched her mental health deteriorate – each rejection inflicting a more devastating psychological blow. I don’t like to contemplate what might have occurred had her third application been declined. Thankfully, mercifully, that didn’t happen. I haven’t heard from the patient since she left, but sometimes I like to imagine her safely reunited with her family.     

As of June 2020, there were 7.6 million people living in Australia who were born overseas. No doubt a significant proportion of them have experienced episodes of homesickness in the past 18 months. I’ve seen quite a few of them in my practice: sisters separated from brothers, parents separated from children, lovers separated from partners. Many have expressed a feeling of helplessness as key milestones such as births and anniversaries roll by, unshared and uncelebrated.

Time doesn’t stop for the pandemic. Babies arrive, people get married, everybody gets older, some people die. Those who remain far away are left with few ways to mark the occasions. In this sense, homesickness bears similarities to grief – loss is a huge part of it. As the Vietnamese–American novelist Viet Thanh Nguyen writes: “While the distance to return to our lost country was far but finite, the number of years it would take to close that distance was potentially infinite. Thus, for displaced people, the first question was always about time: When can I return?”

Unlike Hofer’s mercenaries, whose symptoms resolved on returning to the Alps, in my case and in the cases of many of my patients, the homes we yearn for no longer exist. During the time we have lived overseas, buildings have been torn down, political situations have changed, the people we have been missing have moved away or died. And yet, our homesickness remains. Like a stubborn little knot inside our throats. It is this longevity, more than anything, that has surprised me most about my own homesickness. I’ve lived in Melbourne for more than 20 years; I’ve laid down roots, I’ve created my own family. But even now, as little as an image or a smell or a song can have me pining, once again, for Hong Kong.

The American writer Alice Walker reportedly said that “there is a point at which even grief feels absurd. And at this point, laughter gushes up to retrieve sanity.” There is no doubt that homesickness, like grief, gets easier with the passage of time. This has certainly been true for me. Of late, I’ve even been feeling a kinship with my old Greek and Maltese patients, because like them I now greet a memory of home with warmth and fondness as well as longing. This is a good place to be. Not quite home, but a good place nonetheless.

This article was first published in the print edition of The Saturday Paper on Sep 4, 2021 as "Homesick and tired".

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Melanie Cheng is a doctor, writer and The Saturday Paper’s health columnist.