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Sarah Gonzalez: The pandemic and more than a year of isolation from friends and family has taken a toll on many people's mental health. Almost overnight, routines changed. For some, it felt and still feels like living the same day over and over.

Speaker 1: Do you ever have Déjà vu, Mrs. Lancaster?

Speaker 2: I don't think so, but I could check with the kitchen.

Sarah Gonzalez: Some who are lucky enough to work from home had been initially grateful for the flexibility, but as the lines between home and work blurred, burnout started to seep in, and it goes beyond that. Some Americans have slipped into feeling stuck or unfulfilled or apathetic, and a recent article in the New York Times tried to get at this quote, "Sense of stagnation and emptiness, as if you're muddling through your days, looking at your life through a foggy windshield," that feeling the Times identified as languishing. You told us about it too.

Speaker 3: My mental health was changed over the past year. I've been extremely introspective. I've been taking great care of myself as far as healthy diet, daily exercise, but I'm sort of languishing about what's next career-wise and job-wise for me.

Speaker 4: I just started to take time to actually remind myself that I'm getting a lot done. Also that as a working mom and a person of color, like there's no time for languishing, so we just have to get on with it, and that's the approach that I've been taking.

Speaker 5: I am very lonely, and I feel like there's something wrong with me emotionally and socially. It's difficult to keep from giving up.

Speaker 6: This pandemic is sort of pointing out to me that my life is somewhat nearing its end, not in a suicidal way. Not at all like that, but my career kind of went away and starting a new one at 61 seems iffy.

Sarah Gonzalez: Thank you to our listeners for sharing what they've gone through and are still going through. I'm joined now by Corey Keyes, professor in the department of sociology at Emory University. Professor Keyes has been researching the concept of languishing since the early 2000s. Professor Keyes, welcome to The Takeaway.

Professor Keyes: Great to be here.

Sarah Gonzalez: First, what is languishing?

Professor Keyes: Well, as you mentioned in the intro, it is this sense of feeling stuck, stagnant, empty, but some people describe it as a piercing void in their soul. That description is really apt for what I'm calling the absence of good mental health.

Sarah Gonzalez: The absence of good mental health, in the hierarchy of mental health conditions, where does this fit in?

Professor Keyes: Well, my research has focused on the presence and absence of good mental health, and I use the word flourishing to denote that people are mentally healthy when they meet the criteria for flourishing. When they feel interested in life or happy and satisfied with their life, but also when their life has purpose, they're contributing things of worth and value. They feel integrated. They're confident that they can express their ideas and opinions, they're accepting of themselves and others.

That is what I call good mental health or flourishing. Languishing is the absence of feeling anything good about life or interest, and it's the absence of a sense of purpose, belonging, contribution, acceptance of self and others, and mastery, and it's not mental illness. It's what I would call the absence of good mental health.

Sarah Gonzalez: It's not mental illness. How is this different from something like diagnosed depression?

Professor Keyes: Well, depression is the presence of severe sadness, and it does include, when you diagnose depression, a loss of interest in life. That's one thing that overlaps with languishing, but to be depressed isn't just about being sad, it's also that suddenly you started to function rather poorly. You're sleeping too much or too little, you're eating too much or too little, concentration has gone by the wayside. Languishing is this sense that life just has no meaning and you don't feel anything, good or bad. It's right in between depression and flourishing. That's why we call it the middle child.

Sarah Gonzalez: So, it's not mental illness, it's not something like depression, but apathy and dullness and maybe feeling like a lesser version of yourself are part of it. What should people who are experiencing some of these symptoms be on the lookout for? Is this something to really worry about?

Professor Keyes: Well, yes, and this is the point I've been trying to make to public health systems around the world because this group gets ignored, and yet, we find that in our research that people who are languishing have almost as high of a risk of suicidality as people with depression, and if they've never had mental illness in their life, if they're languishing and they stay there too long, their risk for becoming depressed or anxious increases dramatically.

In addition, if you're languishing throughout life or as we get older, languishing becomes a serious risk factor for premature mortality. If you're working age and employed and languishing, you miss almost as many days of work as those who are depressed. My argument has been that public health systems need to recognize languishing as a serious issue and prevent it from becoming full-blown depression and anxiety, and we need to focus on helping more people flourish.

Sarah Gonzalez: Then, are you saying our healthcare systems currently do not take languishing seriously? Is languishing something that our healthcare system even treats?

Professor Keyes: Not at all.

Sarah Gonzalez: Oh.

Professor Keyes: In fact, quite a few people who are languishing, our data show, try to get help from the current health system for physical problems but also quite interestingly for mental and emotional reasons. In our studies, we found people who didn't meet the criteria for depression or anxiety but were languishing, and they showed up for help for mental, emotional reasons nearly as much as people who met the criteria for depression.

My worry is that they're showing up to this system where we only diagnose mental disorders, and they walk away with no diagnosis, and so they're led to believe nothing is wrong with them. My recommendation is that there's a growing group of people who practice what we call life coaching. I think life coaches are far more able and better equipped and have the experience to deal with what I would call languishing.

Sarah Gonzalez: Do we have any idea how many people are affected by this absence of good mental health as you put it?

Professor Keyes: Yes, in some countries, it is the most prevalent group. For instance, about five years ago, in Canada, there was a large study that used my measure, and we found the highest rates of flourishing in Canada are over 70%, but then, if you were to go over to South Korea or Japan, the prevalence of flourishing was down to about 30%, while almost 40% to 50% were languishing. That is, they had the absence of good mental health. There's huge differences by country, and even in the United States, among college students, we found that less than half of US college students are flourishing and almost 40% have the absence of good mental health or are languishing.

Sarah Gonzalez: You've told us that languishing can lead to more severe conditions like anxiety. With more vaccines being distributed and some states loosening pandemic restrictions, can regular socializing or getting back to our old routines help?

Professor Keyes: I would hope so, and there is this particular study that I've been very fond of, and it was called "A Tuesday in the life of flourishers," and every Tuesday, they thought they would call up their participants and ask them if they engaged in any of these six basic activities, "Did you exercise today? Did you play? Did you socialize? Did you learn something new? Did you engage in a spiritual activity? And did you help another person?"

If you did more of the following five, "played, socialized, learned, some spiritual activity, and helped another person," if you did more of those things, you are much more likely to have a better day, and as you engaged in more of those five activities, you were much more likely to move towards flourishing if you weren't. That's the good news. Now, for some reason in this study, exercising more didn't lead to a better day or it wasn't conducive to flourishing. I think that's just a problem of framing, when I asked my students, do they schedule exercise and do they treat it as work? Yes, it's the first thing they do in the morning, and they try to get it out of the way [crosstalk].

Sarah Gonzalez: Yes. There's too much pressure attached to exercising or there can be. Play definitely feels a little bit more like just go out and have an hour of fun time for yourself.

Professor Keyes: Exactly. I think those five activities are something we could be doing today before these restrictions loosen up.

Sarah Gonzalez: Corey Keyes is a professor in the department of sociology at Emory University. Corey, thank you so much for joining us.

Professor Keyes: Thank you, Sarah.

Sarah Gonzalez: If you or someone you know is having suicidal thoughts, please call the National Suicide Prevention Lifeline, 1-800-273-TALK, that's 8255, or text HOME to the Crisis Text Line at 741741.

Speaker 7: I'm calling from Edmonds, Washington. My mental health has been greatly impacted by [unintelligible 00:11:14] mental health, which has been affected in a very negative way over the last 15 months or so.

Speaker 8: My mental health has fluctuated during the pandemic. Although there have been some very challenging times, overall, it has been for the better. The social conditions surrounding the pandemic have required everyone to be kinder, to extend unusual grace to others, and to exercise patience and gratitude. I think this is a good thing and has resulted in character growth for me personally.

Speaker 9: This is John from Omaha, Nebraska, and yes, some days are worse than others, but I have also some anxiety about going back to the office and being around people, so I feel caught between feeling depressed and being isolated, but fearful about getting back to normal social activities, so I pretty much just stay where I'm at, and it's kind of depressing.

Speaker 10: After this past year, I was feeling really stuck in the last month and decided to do something about it. I started exercising again, meditating, eating better, and accepting that it's been a hard year for almost everyone. I'm really very lucky to be healthy, have a wonderful family and lots of good friends. I feel especially lucky to live in a beautiful and safe place. This is Lou from Falmouth, Massachusetts.

Speaker 11: Very interesting that the pandemic came along and forced closing and forced us to make a dramatic shift in our lives. For me, that shift was forced on me, and I don't think I would've made some of the choices to slow down my life, which have almost been a breath of fresh air. Mike Keating. Massachusetts.

Speaker 12: In one word, flourishing. I'm much more focused on what matters and living life with purpose because who knows what tomorrow or even later today may bring. Thank you for asking. Sunshine girl, S-U-N-S-H-I-N-E girl, which is my childhood nickname, and I'm bringing her back.

Speaker 13: During the coronavirus pandemic, I have been full of fear. I'm fearful of the vaccine. I'm fearful of the illness. I'm fearful of uncertainty. However, I recognize this fear is not a mental illness. It is a normal reaction to what is happening. I would be worried about you if you were not depressed or anxious.

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