Community Story: What Moving to the Netherlands Taught Me About My Body
Shilpa is a narratologist, writer and founder of The Bridge HUB. She moved to the Netherlands as an undiagnosed neurodivergent expat and learned the cost of masking firsthand. Now she builds ways across. Affordable Dutch classes. Music lessons for those with passion but not privilege. Storytelling for people ready to tell their own. She is a National ECHO Award nominee. Her belief is simple. Access shouldn’t be a privilege. Everyone deserves a way across. She is a guest writer with IamExpat and contributor for The Hague Online.
Have you ever moved abroad and started feeling unwell in ways you could not easily explain? Perhaps you developed stomach problems, struggled to sleep, felt exhausted after ordinary errands, or became more aware of symptoms you had managed for years. It can be frightening, especially when you cannot tell whether you are dealing with an illness, stress, or both.
I want to be careful with that question. I cannot tell you that moving abroad makes people ill because their nervous systems are “panicking”. I can tell you that migration changes the conditions in which a person lives, and those changes can affect physical and mental health. Research on post-migration stress has found links with poorer health and symptoms such as sleep difficulties, loss of appetite, digestive problems, and headaches. Much of that research concerns refugees or people who migrated under circumstances very different from mine, so their experiences should not be treated as interchangeable with mine. But it raises a question worth asking: what happens to health when daily life requires sustained effort to navigate?
I ask it as an AuDHD person who moved to the Netherlands. I am autistic and have ADHD. I am also a writer, which means I am used to looking for connections between events. For a long time, I looked closely at the events in my life but paid less attention to what it cost my body to get through them.
The Netherlands did not greet me with one dramatic difficulty. The work of adjusting appeared in ordinary places. It was there when I read a letter and had to determine not only what it said but also what action it expected from me. It was there when I planned a journey, checked whether I was going in the right direction, and arrived already tired. It was there in conversations where I understood the words but was less certain about the expectation behind them.
A trip to the supermarket could involve more decisions than it once had. I had to find familiar ingredients or choose alternatives, read labels, manage noise and light, and decide what I could eat. None of those tasks was impossible. That was part of what made the exhaustion difficult to explain. I had done the shopping. Why did it feel as though I had done so much more?
Research on autism describes sensory processing differences, including experiences of overload when sensory input becomes too much. That does not mean every autistic person finds a supermarket difficult or that every difficult shopping trip is a medical event. It does help explain why an environment that looks manageable from the outside may demand considerably more from the person moving through it.
For me, there was also the effort of uncertainty. I could enjoy discovering a new place while wanting the day to be predictable. I could be interested in meeting people and still need quiet afterward. My ADHD and autism did not cancel each other out, and neither made me incapable of adapting. They shaped what adaptation required.
I could arrive at an appointment on time, speak clearly, ask questions, and leave with everything I needed. Someone watching might reasonably think it had gone well. They would not necessarily see the preparation beforehand or the time I needed afterward. I often judged myself by the visible result and dismissed the effort that produced it.
That distinction matters when we talk about health. If we count only completed tasks, we may miss the strain involved in completing them. I was studying, writing, learning, and making a life. I was also sometimes frightened by how tired I felt. I did not yet have a useful way to hold those facts together.
My health history did not begin with migration. For more than twenty years, I took medication for allergies. I lived with IBS and, at times, ate from a limited range of foods because eating felt difficult or uncertain. I had learned to organise parts of my life around symptoms. I want to say this clearly because it would make a more convenient story to claim that I moved to the Netherlands, developed health problems, and later discovered a single cause. That is not my story.
What changed was my understanding of the context around those symptoms. I became more aware of the effort of staying alert: noticing how people responded to me, anticipating difficulties, preparing for changes, and keeping some of my own reactions private. I began to wonder whether I was looking at my body one symptom at a time while overlooking how I was living from day to day.
That question is not a diagnosis. Allergies involve immune reactions to allergens; they should not be explained away as a person’s inability to cope. Stress and anxiety are among the possible triggers for IBS flare-ups, but that does not mean stress caused someone’s IBS or that a new digestive symptom should automatically be attributed to it. Physical symptoms deserve assessment on their own terms.
After I was diagnosed with autism and ADHD, I began asking different questions about my days. Had I been coping with more noise than I realised? Had I missed a meal while concentrating on something else? Was I resting only when I became unable to continue? Was I calling a day “easy” because nothing had gone wrong, even though every step had required attention?
Some of those questions concerned interoception, the perception of internal bodily signals such as hunger, thirst, heart rate, and breathing. Research into ADHD suggests that interoception may differ for some people with ADHD, although findings are not uniform and the studies have limitations. In one systematic review, three of five studies comparing people with and without ADHD found reduced interoception in the ADHD groups. That finding cannot explain an individual person’s symptoms, but it offers a useful reason not to assume that everyone notices or interprets bodily needs in the same way.
I recognised something in that uncertainty. Sometimes I noticed a bodily sensation intensely but could not tell what it meant. At other times, I realised too late that I was hungry, tired, or overwhelmed. I had been told to listen to my body, but listening was not always the problem. Interpretation was.
The distinction changed how I thought about my behaviour. Missing a meal did not always mean I had decided food was unimportant. Needing quiet after a conversation did not mean I disliked the person I had spoken with. Struggling with a changed plan did not mean I was unwilling to be flexible. I needed to understand what had happened before I could decide what would help.
Moving abroad added another layer: I was learning a new social and practical environment while still learning about myself. When I could not understand why something felt difficult, there were several possible explanations. Was I unfamiliar with how a Dutch system worked? Had I misunderstood a social cue? Was I overloaded? Was I tired? More than one answer could be true.
Research specifically about autistic people with immigrant backgrounds is still limited. A 2026 systematic review found twelve eligible studies and identified recurring issues including masking, social exclusion, difficulties with identity recognition, and barriers to appropriate support. It also found strengths and potentially protective experiences. The authors cautioned that direct comparisons between autistic immigrants, non-autistic immigrants, and autistic non-immigrants remain limited. That matters to me: the evidence supports taking this intersection seriously, not declaring that every autistic person finds migration harder than everyone else.
The finding that stayed with me was how easily one part of a person’s experience can conceal another. If I struggled in a conversation, I might assume it was because I was new to the country. Someone else might assume the same. Sometimes that would be right. But what if I was also processing sensory information, monitoring my expression, and trying to work out whether I had understood a social expectation? A single explanation could leave important information out.
I know what it is to appear capable while working hard to appear that way. I could prepare for a conversation and get through it, then spend time afterward going over what I had said. I could be grateful for an opportunity and still find the interaction exhausting. When I kept those experiences to myself, people saw that I had managed. They could not see what managing had required.
That pattern affected the way I sought help. Describing a symptom is difficult when it comes and goes. It becomes harder when you are also trying to decide which details matter and how to explain them in an unfamiliar healthcare system. I felt pressure to make my account clear and concise. Yet sometimes the honest account was: this has happened before, it may be changing, and I do not know whether these things are connected.
In the Netherlands, the huisarts, or GP, is the first point of contact for questions about most physical and mental health concerns. That is practical information, but there is also permission in it. I do not have to decide on my own whether a symptom is physical or psychological before asking for help. I can describe what I am experiencing and let a clinician help assess it.
That is especially important when someone offers a reassuring explanation too quickly. “It might be stress” can open a useful conversation. “It is only stress” can close one. The NHS advises seeing a GP for suspected IBS symptoms lasting more than four weeks and identifies symptoms such as unexplained significant weight loss or bloody diarrhoea as reasons to seek urgent advice. Suspected allergies also merit medical assessment; severe allergic reactions require emergency treatment. Those distinctions matter more than a compelling theory about the nervous system.
Over time, many of the symptoms I had written about in earlier years improved. I am glad they did. I am also cautious about what I claim from that change. My autism and ADHD diagnoses did not cure an allergy. I cannot prove that masking caused my IBS, or that moving to the Netherlands caused any particular symptom. I do not have the evidence to make those claims, and my experience should not become a rule for somebody else’s body.
What the diagnoses gave me was a better set of questions. They helped me notice the relationship between my health, my environment, and the effort of getting through a day. They also helped me recognise that support could take more than one form. Medical care mattered. So did knowing when an environment was difficult for me, allowing time to recover, and being more honest about what I needed.
I began paying attention to what happened before I felt unwell. I noticed whether I had slept, eaten, spent a long time in a busy place, or prepared for an uncertain conversation. Not every symptom followed a pattern. Not every pattern pointed to a cause. But recording those details made it easier to describe my experience accurately, including when I spoke to a doctor.
I also stopped using other people’s ease as a measure of what should be easy for me. If someone else could finish a busy day and go straight to a social event, that told me very little about what my body needed. The goal was not to prove I could endure the same amount of stimulation or uncertainty. The goal was to build a life I could participate in without repeatedly ignoring signs that something needed attention.
There is a social part to this finding as well. Moving abroad is often described as a personal achievement, measured by independence, language progress, work, or the ability to fit in. Those are meaningful things, but they do not provide a complete picture of adjustment. A person can be doing well by those measures and still need help. A person can love the country they moved to and have days when the effort of living there is high.
I have learned not to make gratitude compete with difficulty. I can value the life I am building in the Netherlands and speak honestly about the cost of certain days. I can say that I have adapted in many ways without claiming the process is finished. Change takes me time to understand. Sometimes I know I have adjusted only when I notice that something which once demanded careful preparation has become ordinary.
I began this piece with a question about becoming ill after moving abroad. The responsible answer is not that your nervous system is definitely panicking. It is that migration, neurodivergence, stress, environment, and health can interact, while symptoms can also have causes that require investigation. The research is developing, particularly where autism and migration meet, and no study can tell an individual what is causing their illness.
My finding is more personal, and perhaps more useful because it is limited: I understood my health better when I stopped asking for one explanation that would cover everything. I needed medical care and self-understanding. I needed to take symptoms seriously and notice what daily life demanded of me. I needed to ask what was happening in my body without assuming I already knew the answer.
I moved to the Netherlands and learned new ways to find my place here. I am still learning how to recognise what it takes for me to live well in that place. When my body tells me something is wrong, I no longer want to silence it with a neat story. I want to listen carefully, describe what I notice, and get help where I need it.
Resources
- Psychological and emotional well-being of autistic individuals with an immigrant background: A 2026 systematic review of the emerging research on autistic people with immigrant backgrounds, including its limitations.
- Diminished interoceptive awareness in ADHD: A systematic review: Research on how people with ADHD may perceive and interpret bodily signals.
- Autism and sensory processing: An introduction to sensory differences and overload.
- NHS guide to IBS symptoms and NHS guide to allergies: Information on symptoms and when to seek medical advice.
- GPs in the Netherlands: A practical guide to finding a huisarts and accessing care for physical or mental health concerns.
