Dear Dr. Siman, Thank you very much for your help in my situation with my au pair. After we read your comments, my wife took her to a another doctor.  He was concerned and sent her to a psychiatrist and she told us that our au pair needed to go home.

Apparently she was having delusions and was very ill, mentally. She was a very sweet girl, and the doctor said the move and the culture shock may have been too much for her and she slipped into a "psychosis" and she explained she could not be in charge of children.

We wanted to help her and get her treatment here, but our agency said no, and they put her on a plane within a few days. She was medicated for the flight. We have not heard anything from her family yet, but we are hopeful that she will be okay!

Again, thank you so much!! Grateful Dad

Hi GeorgeM.,

Thank you for your question.  It is a concern for any host parent to find that their new au pair may have emotional problems or issues adjusting to their new surroundings.  You have a valid concern - is she depressed or is there something else going on?

First, let's take a look at her personality before she arrived.  She sounds full of energy and excitement about her new role as your au pair.  On arrival, she was, as you observed, "great the first few days."  What could have happened between then and now?

It very well may be that your au pair is suffering from Culture Shock.  This is a phenomenon that occurs when an au pair enters her new culture and experiences unpleasant adjustment symptoms that can range from simple fatigue to a full-blown depression. All au pairs can experience culture shock to varying degrees when they first arrive and most of the time, within a few weeks, most will adjust quickly and move on to meet the new challenges of their job.

However, a significant number of au pairs never adjust and they continue to have problems with sleeping, fatigue, refusal to speak English and they can even manifest physical symptoms such as headaches, minor colds, stomach problems and eating disorders. 

Since your au pair seemed fine when she first arrived, I would call your counselor and have a meeting with her and the au pair.  Tell the counselor your concerns and have her confirm your observations.  If your au pair is suffering from culture shock, the counselor may be able to help with the au pair's adjustment problems.  If not, you may want to request a medical exam, to rule out the presence of a clinical depression.

I also suggest that you read Edina Stone's article on culture shock, "Is Your Au Pair Experiencing Culture Shock or Depression?" where she lists the major symptoms of both depression and culture shock and suggestions that can help.

If your au pair continues to experience issues adjusting and does not seem to be capable of caring for your children, call the agency and seek help right away.  You want to ensure the safety of both the au pair and your children, by seeking professional help in a timely manner.

Since your doctor checked her out, she may be fine in a few weeks since he/she did not see any clinical signs of depression.

Your au pair is very young and it is the first time she has been away from home. She may be very homesick, a very common symptom of culture shock.  Maybe she needs more time adjusting - but just be vigilant and don't hesitate to call the agency if your au pair's sleeping habits continue. or worsen  Oversleeping can be a sign of depression.  If your au pair is depressed, she needs to receive medical care immediately.

Dr. Siman