I'm not a professional - just someone older with more life experience than you have. The PhD candidate process is grueling - regardless of your focus - and could really have you (and should have you) challenging your beliefs. Don't underestimate the impact. Further, moving to a new environment in a new country with different norms: huge impact. Perhaps you are simply taking on too much. I moved around frequently when I was your age and yes, the folks back home do go on with their lives without you. And your new friends do not have the history with you. If you were someone who made friends easily when you were younger, I imagine that this "change" can be especially traumatic. 26 is a time when some people are leaving their younger days - life at parties or in bars - behind them and are getting married. Others are leaving the first or second jobs behind them for a career. This is a time when people look for "meaning" in their lives. Do you feel left out of this process? Perhaps you would be better served by a different line of work. After all the bar/restaurant scene (even in small towns) is superficial and transient and if you are basing your self-opinion on reactions in this environment, you will be disappointed. I am assuming that you've checked in with your doctor, has a thorough physical and all. Check back in. If Effexor doesn't work, something else might.