Are You Struggling, Surviving, or Thriving?

According to the World Health Organization, mental health exists on a spectrum – and when someone is in a state that is considered optimally healthy, they are able to fully realize their own potential. Upon this spectrum exists three psychological states ー struggling, surviving, and thriving ー with each one representing how mentally healthy a person is feeling at that point in time.

To take a deeper look at it, these three states can be broken down into one of five categories: being in crisis, struggling, surviving, thriving, or excelling. Understanding the differences between each zone ー and being able to discern which one you are currently in ー can not only enhance your knowledge of mental health, it also can help you discover ways to improve your own well-being. Read on to learn more about the Mental Health Continuum, its components, and how to move forward from struggling and surviving, to thriving and excelling. 

One of the most widely-accepted theories in understanding mental health is the Mental Health Continuum Model, proposed by Dr. Corey L. M. Keyes ー an American psychologist and sociologist specializing in positive psychology and mental health ー in 2002 in his study: The Mental Health Continuum: From Languishing to Flourishing in Life. He postulated that psychological health lies on a spectrum, wherein there are five different zones, each representing whether an individual is living with a “presence” or an “absence” of mental health. He summarized them into this model, as outlined below: 

This zone is characterized by a total absence of mental health ー a sense of worthlessness and hopelessness. Individuals in this zone experience serious mental health challenges and negative emotions. For instance, they can feel extremely anxious, with low mood, exhaustion, and a sense of absenteeism ー the feeling when one lacks motivation to show up, whether that’s to work or elsewhere ー which can trigger the desire to escape from life challenges, or even suicidal thoughts. It’s believed that those in this zone also tend to have to deal with numerous physical issues, such as unhealthy sleep patterns, atypical circadian rhythms, unusual weight loss, and numbness ー the loss of bodily sensations such as being insensitive to pain. As a result, being in this zone can be destructive to one’s normal daily functioning, causing various issues from excessive negative self-talk to severe mental health issues.

This zone is characterized by a low presence of mental health ー a sense of agitation and tiredness. People in this zone often feel reluctant to get out of bed in the morning, and have little self-awareness ー they tend to have ruminating anxious and depressive thoughts that can be challenging to manage. Although people in this zone might have a slightly better physical state than those in the “in crisis” zone ー since there’s a little presence of mental health ー they can still, at some points, still experience sleep and appetite issues, as our bodies and minds are always tied together. It’s also common for “struggling” individuals to have lower self-esteem and self-confidence, and leaving these feelings untreated can develop into more negative issues. 

This is characterized by an average presence of mental health ー neither too high nor too low. Although these individuals are "not sick", it doesn't necessarily mean that they are healthy and feel fully satisfied. In this zone, people tend to experience a lack of fulfillment. For example, they may find it difficult to get excited about things in life, losing pleasure in activities they used to enjoy, and believing that "every day is just the same." It's also common for them to lack excitement in their career, to a point where they work hard only to pay the bills, trapping themselves into the cage of the “Cult of Busyness” just to fit into the norms of society. Although being in this zone usually won't result in serious health impacts, it can still generate negative emotions that lead to worries and frustrations. This, in turn, may lead to stagnant and empty feelings that are likely to originate from the inside ー which tend to cause dissatisfaction in life, and act as an impediment to living with joy.  

The presence of mental health becomes stronger in this zone, which can eventually give rise to a greater sense of meaning and significance. According to Dr. Daniel Brown, a Chartered Psychologist of the British Psychological Society, “thriving” can happen when an individual experiences growth and development, generating more positive feelings that can make one feel more fulfilled and content with life. Where those in the “surviving” zone are simply not sick, people in the “thriving” zone are healthy ー in other words, they tend to maintain a positive attitude, cope with challenges effectively, and handle stress well. Owing to this healthy psychological state, those who belong to this zone are likely to have better physical health and social well-being ー all of which are interconnected, in the sense that these three factors (biology, psychology, and social) can all contribute to our mental health, as illustrated in Dr. George Enge’s Biopsychosocial Model. 

In the healthiest zone, the presence of mental health reaches its highest level, provoking a sense of purpose, mastery, and mattering ー and together, these factors empower an individual to experience their greatest psychological state. This usually means that they can realize their full potential, achieve self-actualization, and enjoy positive emotions beyond happiness, from feeling cheerful and joyful to feeling energetic and hopeful. “Excelling” people tend to be highly motivated. For instance, they tend to seek out new opportunities, believing confidently that they can overcome obstacles. Due to this curiosity and the strong desire to improve, they view challenges as a way to learn ー and in doing so, easily reach the flow state as they keep exploring new things in life. The “excelling” zone is also similar to the Japanese “Ikigai” way of living: having a meaningful and authentic reason to keep moving forward.

Dr. ​​Keyes's model centers around the idea that mental health appears on a continuum ー from "in crisis" to "excelling" ー through which we tend not to stay permanently in one zone. Rather, we usually jump from zone to zone without following a rigid framework, depending on how mentally healthy ー or mentally struggling ー we feel at that time. It's also important to note that the Mental Health Continuum is only one psychological model. Other psychologists suggested that there are two continuums ー "mental health" and "mental illness" ー to determine one's mental health. This is known as the Dual Continuum Model, proposed by Dr. Gordon Allport in 1937. 

Good mental health can help you reach the “thriving” and “excelling” zones, but when you lose some of it by experiencing life’s downs more than ups, you can leave those healthy zones, and fall into the neutral “surviving” zone. While practicing self-care can eventually bring you back to the flourishing parts of the spectrum, staying in the “surviving” zone for too long can leave you more vulnerable and at risk of developing mental health issues. When these struggles are left untreated and neglected, it can potentially push you to the “struggling” zone, or even make you fall into the “in crisis” mode ー which can negatively harm your overall state of well-being. 

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Ignoring your mental and emotional health may ignite mental health issues ー so don’t wait until a couple of seemingly insignificant sparks grow into a wildfire. It's also wise to take note of those around you, since social support is critical for protecting one against mental health challenges. For example, if you suspect that someone among your friends or family might be mentally struggling, show your concern and let them know that you care. Mental health is an essential aspect of life, and so is the healthy function of our bodily systems. It might be easier said than done, but the first step towards achieving better mental health is cultivating positive thinking and believing that you can thrive.

Dr. Keyes coined two terms and associated each one with a positive and negative zone:

• Languishing: This is an absence or limited presence of mental health. People in the “in crisis”, “struggling”, and “surviving” zones are known as languishing individuals. 

• Flourishing: This is a presence of mental health. Those in the “thriving” and “excelling” zones are called flourishing individuals. 

These terms have been widely used in positive psychology to describe a person’s state of psychological well-being. It can be wise to check in with yourself at regular points throughout your life, to ponder which one of these types of people you are at that time, or where on the continuum you’re finding yourself. Are you languishing and struggling with your mental health, or are you flourishing and living your life to the fullest? If you’re languishing, remember that you are not alone, and that there are always people who can help you, be that friends, family, or mental health professionals. If you’re in the “in crisis” zone, a therapist can pull you out of the darkness. If you’re in the “struggling” zone, a counselor who you feel comfortable working with can be a great support system to you. And if you’re in the “surviving” zone, why not seek advice from a coach to figure out what you really want in your life? 

After all, there is no true health without mental health, and it’s just as important as our physical health. You deserve to be the best version of yourself, and you do have the power to flourish ー so if you’re just struggling or surviving, it might be time to take the plunge and actively consider how you can thrive and shine instead.

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All of the content on our website is thoroughly researched to ensure that the information shared is evidence-based. For more information, please visit the academic journals and other resources that influenced this article: Mental Health: Strengthening Our Response; Corey Lee M. Keyes - Department of Sociology; The Mental Health Continuum: From Languishing to Flourishing in Life; The Mind–Body Relationship in Psychotherapy: Grounded Cognition as an Explanatory Framework; Psychologists Find the Key to a Thriving Life; Leveraging the Biopsychosocial Model; Ikigai: The Japanese Secret to a Long and Happy Life - Goodreads; Mental Illness and Mental Health: The Two Continua Model Across the Lifespan.