A city can often be a stressful place for its residents. Fast paced by nature, sleepless by nurture, urban life is a challenge to say the least, especially when we consider hyperconnected, experience saturated, heaving global cities like New York, London and Paris. Scientific research has pointed again and again to the mental health risks posed by city life, including some startling figures from Dutch researchers led by Dr. Jap Peen which indicate the likelihood of anxiety and mood disorders can increase up to 39% in urbanites, while Dr. Mazda Adli, Director of the Mood Disorders Research Group, agrees that urban lifestyles are known risk factors for those predisposed for major depression and schizophrenia. Even those with limited understanding of psychology can understand the pressures of city life and their effect on the psyche; cities offer endless sensory stimulation and a plethora of choices on every corner, and with a growing millennial population and a global entrepreneurship trend, urban citizens can find themselves overwhelmed and unable to disconnect from a rewarding, yet hectic lifestyle. But when we think of tourists and visitors in our cities, we rarely think of stress. They might get lost, ripped off and lost in translation, but they’re on vacation, right? What could possibly trigger a tourist’s mental strife on a trip of a lifetime? Most of us are familiar with Fear & Loathing in Las Vegas but what about the Paris Syndrome?

Originally diagnosed by Professor Hiroaki Ota, a Japanese psychiatrist working in France in the late 80s, Paris Syndrome was better defined by Dr. Youcef Mahmoudia and the Hôtel-Dieu de Paris as “a manifestation of psychopathology related to the voyage, rather than a syndrome of the traveler.” A combination of fear (of cultural and linguistic barriers) and excitement (thanks to the endless adventures to be had and things to see), come together with exhaustion and jet lag to disturb the mental process, manifesting in physical and psychiatric symptoms such as hallucinations, depression, anxiety, dizziness and heart palpitations. Adding to the psychological trauma, some researchers also note disillusion – resulting from the high hopes and romanticized views of the City of Lights – as a contributing factor to disappointment and related depression when tourists touch down at Charles de Gaulle. More interestingly yet, the syndrome is mostly recorded among Japanese tourists – so much so that in 2004, the Japanese Embassy in Paris set up a 24-hour hot line for affected visitors to seek help from. While there’s no strict reason why the Japanese would be particularly susceptible to the syndrome (and Chinese visitors have also been notably struck), it’s likely as simple as the striking cultural, social and lifestyles difference between the Orient and Western Europe that serves as the trigger. Combine that with the image of Paris as portrayed in popular culture, from Moulin Rouge to Amelie, Paris Fashion Week and the endless retellings of Coco Chanel’s life, and disappointment and disorientation could make even the most seasoned of travellers dizzy.

The psychological stresses of urban destinations aren’t limited to Paris, either. Jerusalem Syndrome is defined by similar symptoms, but distinguishable by a religious theme present in the psychosis of those struck by it in the historical city with significance for Christianity, Islam and Judaism alike. Similarly, Stendhal Syndrome, otherwise known as Florence Syndrome, has seen visitors near hysteria when viewing art in the Italian city. However, these experiences and reactions they elicit stand apart from Paris Syndrome, as Jerusalem and Florence arguably hold greater cultural, social and historical significance for the majority of visitors – a deep, emotional and personal reaction can be expected in the context of historical wonders, ancient art and religious landmarks. In that sense, it isn’t unusual to get goosebumps in front of the statue of David, nor tear up at the crossroads of the three major religions. A sense of overwhelming amazement and the dizzying thought process that follows has likely been experienced by the millions of people who have been lucky enough to visit the Pyramids of Giza, the Great Wall of China, the Sistine Chapel or any number of bucketlist destinations.

Conversely, and perhaps most interestingly, Paris Syndrome is characterised by the disparity between expectation and reality and cultural conflict, perceived or real. In this sense, the urban environment can be particularly abrasive when compared with heritage sites, especially when we consider the perils of trying to experience everything a city has to offer on any given day. The issue of urban alienation in touristic or temporary contexts has been addressed in several films, too, from Lost in Translation and The Dreamers to Babel and Vicky, Christina, Barcelona (the latter showing two polar opposite experiences of Americans in Spain). Meanwhile, television and entertainment news continues to portray life in the world’s big cities as a series of exciting encounters, endless experiences and Kodak moments to write home about, putting pressure on visitors to walk a block in Carrie Bradshaw’s shoes, experience Kalifornia like a Kardashian or manoeuvre London like Kate Moss. The compulsion to truly live and breathe what we consider to be the real deal and absorb all the must-sees in the space of a week or two can certainly suck the joy out of a trip and, for the faint of heart and eager of experience, overwhelm the senses. After all, there’s a reason that what happens in Vegas, stays in Vegas.