Culture shock: the stages, the signs and how to cope

What is culture shock?

The best-known early description is a 1960 article by the anthropologist Kalervo Oberg. He wrote that culture shock comes from “the anxiety that results from losing all our familiar signs and symbols of social intercourse”. These are the cues you use without thinking: “when to shake hands and what to say when we meet people, when and how to give tips… how to make purchases, when to accept and when to refuse invitations, when to take statements seriously and when not”. Without them, “He or she is like a fish out of water”^[1].

Researchers today often use another name: “The term acculturative stress is now generally preferred over culture shock”^[7].

Culture shock is not a mental illness. The University of Kansas counselling service calls it “a normal process of adapting to a new culture”^[3]. The WHO’s ICD-10 classification lists “acculturation difficulty” among problems related to the social environment: a life circumstance that can affect health, not a mental disorder^[4].

Culture shock is mostly about the new place, and homesickness about missing the old one. Researchers group both under the emotional side of adapting^[8]. For the homesickness and loss side, see our guide to homesickness and migratory grief.

Culture shock examples

Culture shock is usually made of small things. These examples are our own, based on the cues Oberg described^[1] and tasks researchers ask newcomers about, such as “Making friends” and “Getting used to the pace of life”^[9]. They are differences you might notice, not traits of any one country.

• Greetings. Not knowing whether to shake hands, hug, kiss on the cheek or nod, or whether to use first names.
• Tipping. Whether to tip, how much, and when it would be odd.
• Invitations. Whether “come round some time” is a real invitation, and when it is polite to accept or refuse.
• What “yes” means. Whether yes means yes, maybe or “I heard you”, and how directly people disagree.
• Making friends. How friendships start here, and how long they take.
• Paperwork. Banks, visas and doctors’ appointments, and the rules nobody thinks to tell you.

Any one of these is minor, but together they can be tiring. Which ones hit you depends on where you come from and where you have moved. As Oberg put it, “the difficulties which the newcomer experiences are real”^[1].

Signs and symptoms of culture shock

Signs vary a lot. “Individuals differ greatly in the degree in which culture shock affects them”, Oberg wrote^[1]. Common signs include:

• Feelings: feeling homesick, lonely, sad or anxious much of the time, irritable, or crying more often^[3]; anger and hopelessness^[5]
• What you do: a marked change in sleep or appetite^[3]; wanting to depend on people from your own country, or putting off learning the language^[1]
• How you think: difficulty concentrating, or feeling out of control^[3]; feeling out of place, “like you don’t fit into the host country’s culture”^[9]; idealising home, when “only the good things back home are remembered”^[1]
• Your body: more “minor illnesses” such as colds, headaches or stomach pains^[3]; tiredness and physical pains^[5]

If you have physical symptoms, check them with a doctor. “It is natural for people living in a different culture to feel sad and lonely at times”^[3], and the WHO notes that for migrants who feel distress, “For most people, these reactions improve over time”^[5].

The stages of culture shock, and what research found

The best-known model has four stages. It goes back to Oberg, who wrote that people who have watched others adjust “can discern steps in the process”^[1], and to the “U-curve” of Lysgaard (1955): things start well, dip, then recover, as reported by Demes and Geeraert^[7].

Oberg’s stages in his words; the research column summarises studies reported by Demes and Geeraert, and a meta-analysis^[1][7][12].

What are the 5 stages of culture shock?

A popular five-stage version names them honeymoon, distress, reintegration, autonomy and independence. UKCISA uses it, describes it as a “W” curve, and notes that people may go through some phases more than once^[6]. It is often credited to Peter Adler (1975), but we could not check his paper. Like the four stages, it is a description, not a tested sequence.

What the research really shows

Demes and Geeraert call the stage model “somewhat anecdotal in its basis”, though it does “hold intuitive appeal”, and say support for it is “mixed”^[7]. Their own study followed about 2,500 exchange students, average age 17, in 51 host countries, through exchanges of 8 to 10 months. Only 4.9% followed the U-curve. Most fell into groups the authors called “mild stress” (40.6%) and “minor relief” (47.2%): their stress changed only a little. The expected “enchantment”, or honeymoon, group “was not observed”^[7].

So if you skipped the honeymoon, or you are struggling in month 1 rather than month 4, nothing is wrong with you. The authors concluded that “a single overarching description of the course of adjustment over time may be inadequate”^[7]. Their participants were teenagers on planned exchanges, so adults may have a different experience.

Why culture shock happens

Oberg’s answer was the loss of familiar cues. Psychologists today break it into parts.

The ABC model: feelings, behaviour and thinking

Psychologists Colleen Ward, Stephen Bochner and Adrian Furnham describe adapting at three levels: “Affect, Behavior, and (social) Cognition”^[8][9].

The three parts as peer-reviewed papers describe the model; the examples are ours^[8][9].

So part of culture shock is a skills gap, and skills improve with practice. Ward and Geeraert describe this part of the process as “the acquisition, maintenance, and change of cultural behaviors, values and identities”^[10].

Doing well, but not feeling well

Researchers separate “doing well” (sociocultural adaptation: handling daily life) from “feeling well” (psychological adaptation: your mood and wellbeing)^[11]. The two are strongly linked, but they are not the same^[9]. You may have sorted the bank, the job and the bus routes and still feel low. That is not a contradiction.

What makes it harder

A meta-analysis of 66 studies (10,672 people) looked at what goes with doing well in a new culture. Confidence in the language, knowing the culture and contact with local people were each moderately linked with better adjustment. Greater cultural distance, how different the new culture is from your own, went with poorer adjustment^[12]. Openness and extraversion were also linked with better adjustment^[12]. These are averages, not rules about you.

In a meta-analysis of employees sent abroad, “frequency of interaction with host nationals, and family support” consistently predicted better adjustment^[13]. Discrimination matters too. Perceived discrimination, linked with poorer adjustment, was reported as the strongest effect in the 66-study meta-analysis^[9], and “attitudes, policies and prejudice” in a society shape what newcomers go through^[10]. That is not your fault. And several of the biggest factors, such as language, local contacts and knowing the customs, can be built over time.

How to cope with culture shock

There is no quick fix. Most research here is on students and shows links rather than cause and effect. Each step says what evidence is behind it.

If you are an international student

About 7 million people study outside their home country^[19]. Connections with local students seem especially valuable: researchers call them “a critical factor in international students’ successful adaptation”^[11]. KU suggests you “Connect with other international students”^[3], and UKCISA suggests making friends with local students too^[6]. In a review of 14 studies, programmes that taught students what to expect and how to cope “significantly reduced acculturative stress”. Orientation and peer-pairing programmes helped with adjustment, but did not reduce stress^[20]. Your university’s international office and counselling service are good first stops.

Reverse culture shock: when going home is hard

Coming home can be hard too. Researchers call it re-entry stress, or reverse culture shock. People who return “often report heightened levels of stress and lower well-being… including feelings of disorientation, alienation, and depression”^[21]. Home has changed while you were away, and so have you.

In a study of 1,485 high-school students from 45 countries, “acceptance coping predicted lower re-entry stress while avoidance coping predicted greater re-entry stress”. Returning to countries rated as more collectivist and culturally uniform was harder^[21]. In 133 US college students sent home early during the COVID-19 pandemic, the stresses of readjusting predicted poorer mental health, “especially loneliness”, months later. Readjusting is “a process that unfolds over a period of months”^[22].

In 124 people who came home to Pakistan with foreign degrees, reverse culture shock explained about a quarter (23%) of the differences in their wellbeing^[23]. Some people also lose status: one paper notes returnees may see “a decrease in the autonomy and respect they previously enjoyed abroad”^[24].

These studies are mostly of students, and research on adults coming home after years abroad is thin. Practical ideas rather than tested advice: expect some strangeness, give it months, keep a few habits from abroad, and accept the feelings rather than push them away.

When culture shock becomes something more

Across 26 studies of 7,247 international students, acculturative stress was linked with depression (a correlation of 0.41)^[25]. That is a link, not proof that culture shock causes depression.

Doctors may call a lasting reaction to a big change, such as a move, adjustment disorder: “A maladaptive reaction to an identifiable psychosocial stressor”, where failing to adapt causes “significant impairment” in daily life. It “usually emerges within a month of the stressor”, and the WHO notes it can be made worse when family or community support is limited. Ordinary emotional reactions to hard events “should not be diagnosed as adjustment disorder”^[26]. Our guide to situational depression explains it in more detail.

If there are enough signs of depression for at least 2 weeks, it counts as depression “even if there are identifiable life events that appear to have triggered the episode”^[26]. If worry is the main problem, see our guides to stress vs anxiety and social anxiety.

Why therapy in your own language matters

If culture shock is wearing you down, talking to a therapist can help, and you do not have to wait until it feels serious. What research says:

• In an older review, therapy in clients’ own language (when it was not English) was “twice as effective” as therapy in English^[28].
• Therapy adapted to a person’s culture works somewhat better on average^[29].
• Feeling understood matters: clients’ ratings of their therapist’s cultural competence were strongly linked with outcomes^[29].
• Simply matching client and therapist on race or ethnicity brings “almost no benefit to treatment outcomes” on average^[30].

The WHO recommends that services “Adapt interventions to account for language and culture”^[5].

Our summary. What each option offers varies by country and service^[5][7].

On Bliss Therapy

On Bliss Therapy you choose a therapist who speaks your language, by video from wherever you live, with no waitlist. 20 psychologists and counsellors list life abroad, with sessions from €40 (about £33). You can also talk to friends or family, your university’s counselling service, or a doctor where you live. If you live in Berlin or Amsterdam, see our guides to finding an English-speaking therapist in Berlin or in Amsterdam.

Our therapists are based outside the UK and the US, so they are unlikely to be on UK registers or covered by US health insurance. Ask any therapist about their training and their registration in the country where they practise.

When to get help

For most people, culture shock eases over time^[5]. “Sometimes, however, the stress of adapting to a new culture may reach a level in which added support is useful”^[3]. Talk to a doctor or a therapist if:

• you have had a low mood for more than 2 weeks^[27]
• you are struggling to cope with stress, anxiety or low mood, or the things you are trying yourself are not helping^[27]
• it is getting in the way of work, study, family or social life^[26]

If you are having thoughts of ending your life or harming yourself, get help now. If you have just moved, look up and save your new country’s emergency and crisis numbers today, before you need them.