There are many signs of danger that a family member is experiencing significant stress that requires attention. Occasional difficulties, and even more regular difficulties for awhile during the initial adjustment to the relocation, can be expected. All of us would find the adjustments discussed above to be challenging and sometimes overwhelming, especially at first. However, it would be a good idea to consider a professional consultation if any of the following occur for more than 2-3 months:

1. Any significant change in a family member's usual patterns of behavior or attitudes; for example, a usually cheerful, spirited child becomes combative, argumentative, sullen; an organized, energetic adult becomes distracted, poorly organized, and lethargic.
2. Changes in sleep patterns: difficulty falling asleep, middle of the night awakening, or sleeping too much.
3. Changes in eating patterns: weight gain or loss of more than ten percent of body weight.
4. Anxiety: increased worry beyond usual levels and areas of concern, preoccupation with small details that seem unimportant, ritualistic behavior that someone insists upon to reduce tension, or anxiety attacks (panic, heart palpitations, shortness of breath), refusal to leave the home or venture outside of areas that felt safe previously.
5. Increased use of alcohol or medications to reduce anxiety, sleeplessness, physical pain that is repeated, persistent, and ongoing; this is an indication of efforts to self-medicate to deal with tension or distress.
6. Any change in a child's usual pattern of school performance beyond some initial period of adjustment: deterioration in grades, lack of usual preparation or completing assignments, less interest in school, increased struggles with adults/teachers.
7. Any family member having more social difficulty than their usual patterns of shyness or initial discomfort in new surroundings: withdrawal, avoidance of social interaction, reluctance to engage new people and develop new friends.
8. Other signs of depression: in addition to sleep and/or eating difficulties, loss of energy, loss of interest in usual activities, sad or irritable mood, feelings of worthlessness or hopelessness, loss of sexual interest, any thoughts of suicide.

So You're Going Overseas; J. Stewart Black, Ph.D. & Hal B. Gregersen, Ph.D.; Global Business Publishers; 1998.

Moving Your Family Overseas; Rosalind Kalb & Penelope Welch; Intercultural Press, Inc., 1992.

Women's Guide to Overseas Living; Nancy J. Piet-Pelon & Barbara Hornby; Intercultural Press, Inc.; 1992.

Capitalizing of the Global Workforce; Michael S. Scheel & Charlene Marmer S. Solomon; Irwin Professional Publishing; 1997

The Art of Crossing Cultures; Craig Storti; Intercultural Press, Inc; 1989.