Ulysses syndrome is a specific stress disorder of immigrants . It is associated with the multiple experiences of mourning that these people face, as well as with the difficulties they must overcome to adapt to the new context.

In this article we will describe Ulysses syndrome, its main symptoms and its most common causes . In order to do so, we will rely mainly on the work of Joseba Achotegui, the psychiatrist who coined the term by which we refer to this disorder.

What is Ulysses Syndrome?

The Multiple and Chronic Stress Syndrome, more frequently known as “Ulysses Syndrome” , is a set of symptoms that derives from serious stressors associated with migration. One of the factors that most contribute to its appearance is the scarcity of economic resources that many people in this situation face.

The usual nomenclature of this syndrome refers to Odysseus, a hero of Greek mythology who was known as “Ulysses” in the Roman world. According to the Iliad and the Odyssey, the two main epic texts of Ancient Greece, after participating in the Trojan War Ulysses sailed for 10 years going through great difficulties before arriving home.

The term was coined and popularised in the 1990s by Joseba Achotegui, who is currently a lecturer at the University of Barcelona and directs the support programme known as the “Psychopathological and Psychosocial Care Service for Immigrants and Refugees” or “SAPPIR”.

Although this syndrome can affect people of all ages, the available evidence reveals that is more common in the elderly and middle-aged . This is probably due to factors such as fewer opportunities for socialization and greater difficulty in learning the new language or adapting to a different culture.

Main symptoms

The symptoms present in people with Ulysses syndrome may vary depending on the particular case, but they have been related to four categories of psychological disorders: anxiety, depression, dissociation (disconnection from physical and emotional experience) and somatoform disorders (physical symptoms of psychogenic origin).

In the depressive area, the presence of feelings of sadness associated with the perception of personal failure, low self-esteem and thoughts related to guilt and, rarely, to the desire to die, stand out. According to Achotegui, specific symptoms are influenced by culture; for example , guilt is more common in Westerners than in Asians.

The experience of anxiety, also very relevant in this syndrome, manifests itself in symptoms such as recurrent and excessive worry (similar to that of generalized anxiety disorder), tendency to irritability, psychological and physical tension or feelings of fear. Insomnia is favoured by anxiety and poor living conditions .

Achotegui includes in the spectrum of somatization symptoms and signs such as headaches, present in three quarters of the people diagnosed, and fatigue, associated with lack of psychological motivation. It also highlights the tendency of Asian people to present symptoms of a sexual nature or that of North Africans to chest discomfort.

Other problems that often appear in people with Ulysses syndrome are low self-esteem, decreased overall performance, excessive use of substances such as tobacco and alcohol, or painful symptoms of gastrointestinal, bone and muscle.

Causes of this syndrome

Ulysses syndrome has been related to the mourning process, which consists of adaptation to psychologically significant losses . People who emigrate become partially separated from their usual environment, family, friends and even their identity as citizens of a particular region of the world.

When the demands of the new situation are perceived as excessive for the migrant, chronic symptoms of stress and other related psychological disorders can appear that negatively influence well-being and adaptation to the context. This chain of events is what is generally known as Ulysses’ syndrome.

The feeling of socio-cultural isolation is considered a key factor in the appearance of the syndrome. In this sense, the lack of knowledge of the language or the differences in values are relevant, but also the prejudices and discrimination for ethnic and cultural reasons to which immigrants from many countries are systematically subjected.

In cases where the migration process has been carried out illegally, the fear of possible consequences (in particular detention and deportation) is an additional stressor and one with a particularly high potential to foster a state of chronic emotional distress.

On the other hand, the Ulysses syndrome is also favoured by the marked difficulties that a large number of immigrants experience when trying to legalise their situation, when looking for work or when accessing basic services such as housing and medical care. The frustration of the personal and economic expectations of the person is also relevant.

Bibliographic references:

  • Achotegui, J. (2005). Borderline stress and mental health: the Immigrant Syndrome with Chronic Multiple Stress (Ulysses Syndrome). Northern Journal of Mental Health of the Spanish Society of Neuropsychiatry, 5(21): 39-53.
  • Achotegui, J., Morales, M. M., Cervera, P., Quirós, C., Pérez, J. V., Gimeno, N., Llopis, A., Moltó, J., Torres, A. M. & Borrell, C. (2010) Characteristics of immigrants with chronic immigrant stress syndrome or Ulysses syndrome. Spanish Society of Neuropsychiatry, 8(37): 23-30.
  • Díaz-Cuéllar, A. L., Ringe, H. A. & Schoeller-Diaz, D. A. (2013) The Ulysses Syndrome: Migrants with chronic and multiple stress symptoms and the role of indigenous linguistically and culturally competent community health workers. Retrieved from www.panelserver.net/laredatenea/documentos/alba.pdf on 27 July 2017.