You are functioning, but are you flourishing?

2 days ago

9 min read

A four-level check-in with your mental health

Have you ever stopped to ask yourself how well you are doing mentally?

Not just when you are overwhelmed, anxious, or going through a difficult phase, but as a regular check-in, perhaps once a day or at least once a week?

We have so many ways to assess our physical health. We check our blood pressure, do blood tests, go for routine health check-ups, and pay attention when something in our body doesn't feel right. But when it comes to our mental health, how do we know where we stand? Is there a scale or a benchmark that can help us reflect on our current state?

As a psychologist, I have often been asked questions such as, “When should I seek help?” or “How do I know whether what I am experiencing is just a difficult phase or something I need to pay attention to?”

This article is an attempt to make that reflection a little easier.

The goal is not to diagnose ourselves, but to pause and understand where we might be on the spectrum of mental well-being and, more importantly, what we can do to move towards greater well-being, flourishing and thriving.

For physical health, we have well-established health checks. For mental health, there are several frameworks that help us understand well-being, distress and functioning.

One useful framework is Corey Keyes' work on the Mental Health Continuum, which includes the concepts of flourishing and languishing. Another is the Mental Health Continuum Model used in military and organisational settings, which describes movement from healthy functioning through distress and impairment to clinical illness.

Drawing from these established ideas, I have simplified them into four broad levels of mental health functioning for the purpose of this article, so that they become easier to understand, reflect upon and use as a personal check-in.

This is my practical adaptation of these ideas, not a diagnostic or clinical assessment tool. It is intended to help us pause, reflect on our current level of functioning, and recognise when additional support may be helpful.

Because mental health is not simply about being “well” or “unwell.”

Sometimes, we are struggling.

Sometimes, we are functioning despite our struggles.

Sometimes, we are doing well.

And sometimes, we are genuinely flourishing.

So, where are you today?

A simple analogy between physical and psychological health

Physical Health	Psychological Health
Feeling physically fit and capable	Feeling psychologically engaged and capable
Occasional tiredness, stress or lack of energy	Occasional stress, worry, sadness or low mood
Feeling sluggish or less energetic for a few days	Reduced motivation, concentration or emotional energy
Persistent physical symptoms	Persistent emotional, behavioural or cognitive difficulties
Difficulty carrying out normal physical activities	Difficulty carrying out normal daily responsibilities
Significant illness or inability to function normally	Significant psychological distress or impairment

How do we actually know where we are on this continuum?

Mental health is not an “either you have it or you don't” situation. We can move up and down depending on what is happening in our lives, how we are coping, the support we have, and even the circumstances we are going through.

You may be going through a difficult time and still be functioning well.

You may be getting everything done on the outside while feeling emotionally exhausted on the inside.

You may not be struggling with any obvious symptoms, yet feel disconnected, stuck or simply not quite yourself.

And you may be in a phase where you feel energised, connected, purposeful and genuinely engaged with life.

These are different points on the mental health continuum.

As you read through the four levels, I invite you to pause at each one and look inward for a moment.

If you paused and honestly checked in with yourself today, where would you find yourself?

Four Levels of Psychological Well-Being: From Struggling to Flourishing

The four levels described in this article are my practical adaptation of established ideas about mental health and well-being, informed by Corey Keyes' work on flourishing and languishing and the Mental Health Continuum Model used in military and organisational settings.

Sociologist Corey Keyes introduced the idea that mental health is not simply the absence of mental illness. His work also highlighted flourishing and languishing as ways of understanding positive mental health and well-being.

The framework I am using here is intended as a reflection and awareness tool, not a diagnostic instrument.

Level 1 – Flourishing / Functioning Well

→ Maintenance & Self-Optimisation

In this state of flourishing, you would be able to manage normal responsibilities, start and complete tasks, focus well, have motivation and interest, recover from stress normally, make decisions and move on, experience flow or engagement, and have zest.

You are active, emotionally balanced, and able to take on daily challenges without significant distress or procrastination.

In Level 1, your mind is like a well-tended garden in spring. The soil is rich, plants are blooming, and a sudden sunny spell or light rain only makes the garden grow stronger.

The Goal: Maintaining resilience, optimising personal growth, and creating a safety net for life's inevitable stressors.

Therapy/Guidance Format: Coaching, mentorship, or periodic check-ins.

Best Practices to Stay Here

Mindful Habits: Regular meditation, journaling, continuous learning, and prioritising physical health (sleep, nutrition, movement).
Social Infrastructure: Nurturing strong social connections and community ties that act as emotional buffers during tough times.
Growth Orientation: Utilising life coaching or executive coaching to focus on future goals, values alignment, time management, and skill optimisation rather than treating emotional pain.

Being in Level 1 and in a flourishing state does not mean being happy all the time or not experiencing stress. Sadness, frustration and stress occur in life. However, being at this level means having the capacity, tools and zest to navigate through challenges with resilience and grit.

Shifting between levels is natural. It may happen due to internal or external factors, and the goal here is proactive maintenance.

Practices like journaling, mindfulness, and maintaining strong social bonds can help keep our mental reserves full so that we are better able to manage life.

Rather than traditional clinical therapy, people in this stage may benefit from coaching — working with a guide to set goals, improve productivity, and build long-term resilience and adaptability so that when stress hits, they can bounce back more effectively.

Level 2 – Struggling / Early Warning

→ Proactive Fine-Tuning

A person may be functioning well, but they may experience mild or temporary distress.

In this state, procrastination may increase, concentration may become difficult, and motivation may decrease. Even ordinary day-to-day tasks may seem difficult. You may seek distractions such as your phone or other substances to manage distress, experience irritability or anxiety about things that were normal for you before, have sleep disturbances, experience decreased enjoyment, or want to do something but find yourself unable to get started.

In Level 2, your mind is like a garden affected by a sudden gusty windstorm. The trees and plants bend and lose a few leaves. It creates friction and mess, but the roots remain stable, and the garden can recover once the storm passes.

The important distinction from the previous level is:

“Life is still happening, but functioning is becoming harder.”

In this stage, self-care, social connection, rest and early professional support can help.

The Goal: Prevention and swift adjustment.

Therapy Format: Early professional support or a few “tune-up” sessions, depending on the concern.

When you are in the Struggling phase, you don't necessarily need a total life overhaul — you may simply need a brief tune-up.

Seeking professional support at this stage can help identify what is creating friction before it becomes more difficult to manage. A therapist can help you identify the immediate stressor, untangle minor cognitive loops, refine your boundaries, and give you practical tools to help you move back towards flourishing.

Level 3 – Languishing / Survival Mode

→ Consistent Restorative Work

At this level, a person may be doing things just because they have to. They may feel as though they are just existing in survival mode.

In my practice, I have heard people say, “I just get through the day, but I don't live it anymore.” That is typical of the languishing phase.

A person in this phase might find it difficult to maintain normal routines. Getting up early in the morning with a lack of motivation and getting through the day can become difficult. There may be significant withdrawal from day-to-day activities, no motivation to start new ventures, major focus or concentration issues, deterioration in responsibilities, loss of interest in meaningful activities, problems with relationships, being immersed in distraction, and feeling dissatisfied at the end of the day.

Sleep issues may become more prominent, and functioning may require a lot of effort and energy.

In Level 3, your mind is like a garden that has been in prolonged drought. The ground is dry and cracked, growth has almost completely stalled, and the garden is simply trying to conserve water to survive rather than produce flowers.

The Goal: Deep recovery and breaking out of “survival mode.”

Therapy Format: Ongoing, regular sessions, depending on the nature and persistence of the difficulties.

Languishing is a state of chronic disinterest and depleted reserves, and it can take time to recover from this phase. Here, a person may need regular therapy and a lot of support.

It isn't just a temporary bump; it can feel like a persistent fog.

At this level, therapy shifts from a quick “tune-up” to a consistent, supportive partnership. Regular sessions can help rebuild routines, process underlying stressors, restore emotional resources, and gradually transition the mind out of survival mode.

Level 4 – Distressed / Significant Impairment

→ Multi-Disciplinary Clinical Intervention

This is the most severe level, where professional clinical assessment and intervention may be necessary, particularly when there is significant functional impairment, severe symptoms or safety concerns.

There may be severe impairment that affects not only the individual but also their ability to manage relationships, work, family responsibilities and daily life.

This level may be characterised by severe depression, panic, persistent inability to function in daily life, or exhaustion that requires formal medical or clinical intervention.

Being at this level can affect all aspects of a person's life, including work, family, relationships, social functioning, safety and even basic needs.

At the most severe end there may be:

inability to care for oneself
severe deterioration in functioning
severe substance use
psychotic symptoms
suicidal thoughts or behaviour
risk of harm

The important point we need to understand is that Level 4 shouldn't simply mean “an affected person's behaviour is affecting other people.”

Someone can be psychologically healthy and still have a difficult impact on others occasionally. And someone can be severely depressed while affecting relatively few people because they have withdrawn.

So we can define Level 4 primarily around significant functional impairment and/or safety concerns, with effects on others as one possible consequence.

Level 4 is like a garden affected by fire or a severe natural disaster. The ecosystem is overwhelmed. Self-watering won't work anymore; it requires external emergency responders to put out the flames and clear the debris before new growth can even begin.

The Goal: Crisis stabilisation, symptom relief, and functional recovery.

Therapy/Guidance Format: Psychiatric Evaluation + Regular Clinical Therapy + Medical Support, when indicated.

Best Practices for Help

Integrated Care: Combining clinical psychotherapy (e.g., CBT, DBT, trauma-informed therapy) with medical evaluation.
Psychiatry & Medication: Consulting a psychiatrist for medical assessment when severe symptoms significantly interfere with daily functioning or engagement in therapy. Medication may be considered when clinically appropriate.
Community & Support Systems: Involving close family, trusted loved ones, or support groups to assist with daily responsibilities while recovering.

At Level 4, the impairment goes beyond typical burnout or sadness — it can severely affect the ability to carry out basic daily functions and deeply impact a person's life.

Self-help strategies or quick check-ins are no longer enough. Recovery at this level requires a comprehensive, compassionate support system.

This may mean working with a psychiatrist for medical management or, when appropriate, medication to help stabilise symptoms, paired with consistent clinical therapy to process deep-rooted distress.

In some severe situations, particularly where there are significant safety concerns or an inability to care for oneself, hospital-based care may be necessary.

Seeking this level of structured care is not a failure; it is a necessary step towards recovery, just as you would seek medical care for a serious physical illness or injury.

A Quick Look at the Four Levels

Level	State	Primary Support Model	Core Focus
Level 1	Flourishing	Coaching & Self-Care	Goal setting, habit building, and maintaining resilience
Level 2	Struggling	Early Professional Support	Early intervention, course correction, and boundary setting
Level 3	Languishing	Ongoing / Consistent Therapy	Breaking out of survival mode, restoring energy, and rebuilding routine
Level 4	Distressed	Psychiatry + Clinical Psychotherapy	Symptom stabilisation, medical support, and intensive recovery

A Final Thought

I wrote this article with a simple intention — to help us become a little more aware of our inner and mental well-being.

I often think of the mind as a garden. A garden does not need someone tending to it every minute of the day. But it does need regular care, attention and nurturing.

Our mental health is much the same. We don't have to constantly monitor ourselves or worry about whether we are doing well. But periodic check-ins can help us notice when something is changing and give us an opportunity to take care of it before things become overwhelming.

When we tend to our mental health regularly, we build the emotional reserves that help us navigate difficult periods in life. When we keep postponing that care, small weeds can slowly grow unnoticed. And when a major challenge or crisis comes along, we may find that we have fewer reserves to cope and recover.

We already understand the importance of maintaining our physical health. We exercise, eat well, rest, and go for health check-ups when needed. Our mental health deserves the same kind of attention.

We don't need to strive for a perfect mind or a life without difficulties. We simply need to keep tending to our inner garden.

With the right care, a garden can flourish. And so can we.