Greg Thorkelson, MD with Ryan Reagan, PhD(c), LPC

It was somewhere in there—one of those unnumbered days that we all just lived through; Adam Grant published and op-ed in the New York Times introducing the term “languishing” to a larger audience. And then it was in articles everywhere, and so perfectly tailored to this moment. The sociologist Corey Keyes is actually credited with identifying the phenomenon, supplanting earlier articles that described what we were feeling as “collective grief.”  Initially, there was some truth to this, we were grieving a way of life, but what should we call the months that followed? Is grief a suitable metaphor for an event that has not ended?

In 2000, Psychology underwent one of those occasional re-orientations that happen in every field.  Invariably, these get referred to by somebody in the field as a revolution, like the “behaviorist revolution” and the “cognitive revolution.”  It may be too early to say that Positive Psychology is a revolution, though somebody probably has.  Nonetheless, it was a pretty seismic shift, and it probably has had a larger cultural footprint that many realize.  This is important to this week’s topic for the Nexus Mental Health Blog—languishing.  

One of the main objectives of Positive Psychology is to better understand and promote human flourishing. Without going into great historical detail, this was one of the original aims of Psychology. Until this century it had been largely neglected since Maslow and his pioneering work on the study of human needs.   Enter the pandemic—an event that suddenly made us acutely aware of our human needs—social, spiritual, material.  What else could you call a state where life is so abruptly suspended? Time felt suspended, opportunities contracted, everything felt like it was wilting.  

Languishing is the opposite of flourishing.  It should also be pointed out that languishing is closer to a state than a specific mood.  This is an important distinction for both clinicians and anyone who believes they may be suffering from languishing.  It is important because it shares an overlap with the features observed in depression.  The course of treatment may be different as a result.  Second, there is a silver lining here. One of the shifts that came with positive psychology and its focus on flourishing was the realization that states can be cultivated.  The treatment for languishing is to cultivate the opposite state—flourishing.    

Symptoms and Signs

Corey Keyes, the researcher who coined languishing has described it as “the absence of mental health.”  It is also the case that the person is not mentally ill, but rather lacking a positive orientation toward life.  Since the study of this phenomenon is relatively new, research is only beginning to illustrate the scope of the problem.

By one account, those who met the criteria for languishing were three times more likely to develop PTSD.  It is conceivable that many will develop an episode of major depression, which was already associated with languishing prior to the pandemic.  Those with pre-existing mental illness are at an increased risk for relapse and exacerbation of symptoms.  In other words, languishing can compound the symptoms of depression and anxiety disorders.

It should also be recognized that this phenomenon will likely fall disproportionately on younger adults.  The sudden loss of college routines, employment, and socialization have significantly increased isolation and anxiety.  Young people often do not have the financial resources and may not be employed in professions that could readily adapt to economic downturns.  It is also true that the pandemic hit young adults in a major developmental window, one in which autonomy and individuation are major goals.  

The symptoms that have been identified with languishing include loss of motivation, feelings of aimlessness, lack of purpose, boredom, and difficulty focusing or concentrating.  The French word ennui is closely related—a broad dissatisfaction with life.  The criteria also bear a resemblance to what psychologists used to call dysthymia, a persistent low grade depressive state.  The difference with major depression and languishing is the intensity of the symptoms.  Major depression is “cannot function” whereas languishing is “going through the motions.”

What Can You Do to Counteract Languishing?  

There are a number of things that can be done to help alleviate the symptoms of languishing.  You may have noticed in the above description that languishing has a breadth to it, it is like a disposition or worldview saturated in pessimism. This would be an indication that there is not a single cure all prescription.  These phenomena require a kitchen sink approach.   You may have to try multiple things to chip away at this state.  In fact it may be helpful to develop a system or routine that builds in multiple opportunities for growth and development.

Medication/Therapy

In this country we tend to treat everything with medication, but medication has limited efficacy with some phenomena. Take grief for example, we are unable to simply medicate away the feelings of loss, and if we try, they resurface.  Languishing appears closer to one of those categories of problems that used to be called existential.  These are problems related to meaning and purpose in life.  This is where therapy can be particularly helpful.  For those that are spiritually inclined pastoral counseling may also be worth considering.

Find a Hobby/Outlet

During the pandemic there were countless articles of people who took up baking, home improvement projects, and other arts.  The point of these activities is that you can experience a state that positive psychologists call “flow.”  Flow state is described as “optimal functioning.”  Artists and athletes will sometimes describe getting lost in their practice or “being in the zone.”  What they are likely experiencing is a heightened degree of mindfulness.  When the body and mind are in sync with a singular focus, it is very difficult to even consider the other things we typically worry about.

Meditation

There are different approaches to meditation, mindfulness is one of the most popular. There is now substantial research to support the benefits of this practice.  Some may be turned off by the “spiritual” aspects of the practice, and it is true that many faith traditions have meditation practices.  For those less inclined to that path there are secular approaches.  Jon Kabat Zinn’s Mindfulness Based Stress Reduction program (MBSR) is a good place to start.

Gratitude

Research supports that acts of gratitude increase optimism and hope.  One of the interventions that Martin Seligman recommends is writing a gratitude letter to someone important and then deliver in person.  That may sound like a bit much, but it can be an incredibly powerful experience for both the giver and the recipient.  You certainly don’t need to go to that level of performance to express gratitude daily.  One researcher recommended putting a few rubber bands on your wrist as a reminder to say something positive to somebody—this could be as simple as “hey, I just wanted to let you know that I really appreciated...  Then move the rubber band to the opposite arm.  

Changing Routine

This one is helpful for boredom.  Go to a new restaurant or park.  This also fits with taking up a new hobby.  The purpose is to expose yourself to new activities and information.  If you are developing a mindfulness practice this is a great way to apply.  Place yourself into a new environment and try to hold your awareness on the newness of the experience.  What do you notice about the environment?

Savoring

Savoring is another way to apply mindfulness.  Savoring is basically the mindful application of pulling into awareness things that are pleasant.  This can be especially powerful when applied to accomplishments.   The pandemic was emotionally taxing.  In the presence of such a pervasive amount of suffering it is easy to lose sight of accomplishments.   There was a recent article in the New York Times addressing the topic of resilience.  Resilience generally cannot be seen until after the adversity passes.  Savoring is the willful practice of “man that was awful, but…”

Diet and Exercise

One of the things that invariably comes with difficult times is indulgence.  There is a reason for that stereotype—eating a container of ice cream after a breakup.  Food can bring comfort, but it can also tip into emotional eating. It also seems to be true that people tend toward foods rich in calories when emotional eating and that can easily lead to weight gain if you are also not exercising. This will make it more difficult to find motivation at a later time.  

It is also well known that exercise can perform about as well as antidepressants in cases of mild to moderate depression.  You do not have to go straight to the gym.  Start with a few days of walking here and there and get accustomed to being active again.  You may start to notice that mood gets dragged along with it.

Speaking of indulgence—public health officials are also concerned about the increased consumption of alcohol.  The isolation of the pandemic means that there was also a lot more drinking alone.  This has long been recognized as one of the high-risk factors for developing a substance use disorder.  Alcohol also has the downside of being a depressant and since we are talking about languishing—a negative mood state it should be avoided.  

Connection

We are social creatures by nature.  Some of us require less socialization.  There is some research to support that extroverts had a difficult time adjusting to the sudden isolation and loss of social outlets.  Extroverts typically derive energy from social exchanges.  For people that lean in this direction the loss of social outlets can be particularly sapping of motivation and energy, and may go unnoticed since we can remain connected through other means.  Unfortunately, for some of us zoom meetings and zoom happy hours get old pretty quickly.  

Fortunately, the pandemic restrictions are starting to ease, and this provides the opportunity to reconnect and explore new possibilities.  For example, joining a social group builds on two of the strategies here—changing routines and connecting.  You get two points for that one.

Celebrate Accomplishments

And that brings us to the final point.  This was no easy time, and we should take inventory of what we managed to accomplish.  Restraint, resistance, and “holding it together” consume vast amounts of emotional energy.  As space opens up that energy can be channeled into a positive direction.  And when the positive emotions return you will have something to savor. You get points for that one too.  

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