What is wellbeing?

People use the word wellbeing in many ways. In research, it has a more exact meaning: how your life feels to you, and how well you are doing in it. It is about the presence of good things, not only the absence of problems.

This page explains the two main sides of wellbeing and what flourishing and languishing mean. It also covers a popular model called PERMA, and how the WHO-5 works. The WHO-5 is the short wellbeing check in our MindCheck.

Feeling good and functioning well

Researchers who study wellbeing have long followed two traditions:¹

• Hedonic wellbeing is about happiness. It focuses on pleasant feelings, enjoyment and avoiding pain.
• Eudaimonic wellbeing is about meaning and growth. It focuses on how fully a person is living and functioning. The word comes from an old Greek idea of a good life.

The two overlap a lot, but they are not the same. A relaxing afternoon may feel good without feeling meaningful. Caring for a sick parent may feel meaningful but rarely feels pleasant. Both kinds of wellbeing matter.¹

A review in The Lancet split wellbeing into three parts that are often measured in surveys:¹⁰

The example questions are ours, written to show the idea. For the first part, see Life satisfaction. For the third, see Meaning and purpose.

Psychologist Carol Ryff built an influential model of the "functioning well" side. It includes things like purposeful engagement in life, using and growing your talents, and knowing yourself. Her review of decades of work found growing evidence that this kind of wellbeing goes along with lower disease risk and a longer life. Resilience, the ability to keep or regain wellbeing in hard times, is a recurring theme.⁷

Flourishing and languishing

Sociologist Corey Keyes described wellbeing as a range, from languishing at the low end to flourishing at the high end.²

• Flourishing means having a lot of positive feelings and functioning well in life.
• Languishing means having little of both. Life may feel hollow, flat or stuck, even if the person does not have a mental illness.
• Most people are somewhere in between, which Keyes called moderate mental health.

In a national survey of 3,032 U.S. adults aged 25 to 74, about 17% were flourishing, about 57% were in the middle and about 12% were languishing.² People who were languishing were about twice as likely as people in the middle to have had major depression in the past year. They were nearly six times as likely as people who were flourishing. Languishing also went along with poorer emotional health, more limits in daily activities and more lost workdays.²

Later work found that adults who were free of mental illness and flourishing missed the fewest workdays. They also had the lowest risk of heart disease and the fewest chronic illnesses as they aged. Yet only about 1 in 5 adults was flourishing.³

Wellbeing can change

Wellbeing is not a fixed trait. When the same U.S. adults were surveyed again 10 years later, about half of those who had been languishing had improved. About half of those who had been flourishing had declined.⁴ People whose wellbeing rose had a lower risk of mental illness at the second survey. People whose wellbeing fell had a higher risk.⁴

Wellbeing may also matter for recovery. Researchers looked at people in the same survey who had a mental illness in 1995. Those who kept or gained high wellbeing over the next 10 years were far more likely to have recovered by 2005. People whose wellbeing stayed low were less likely to recover.⁵ The authors noted limits: the data were old, and they could not account for every factor that affects recovery.⁵

These studies show links, not proof that raising wellbeing prevents illness. Still, they support a hopeful idea. Treatment that eases symptoms is important. So is building the good things in life. You can work on wellbeing even while you live with a health condition.

The PERMA model in brief

Psychologist Martin Seligman proposed a model of flourishing in 2011 called PERMA. It names five building blocks of wellbeing that are separate but connected:⁶

Researchers later built a short questionnaire, the PERMA-Profiler, to measure these five areas. It was tested in more than 31,000 people. It shows a profile across the areas rather than one overall score.⁶

PERMA is one useful map, not the only one. It can help you notice which areas of your life feel full and which feel thin. Then you can choose one small step in a thin area. Our pages on everyday habits, meaning and purpose and finding connection have ideas for each.

How the WHO-5 works

The WHO-5 Well-Being Index is one of the most widely used short wellbeing questionnaires. It was first published in 1998 and has been translated into more than 30 languages.⁹

It asks how often, over the last two weeks, you have felt cheerful and in good spirits, calm and relaxed, and active and full of energy. It also asks whether you woke up feeling fresh and rested, and whether your days were filled with things that interest you.⁸

1. Answer each question from 0 (at no time) to 5 (all of the time).⁸
2. Add the five answers. The total runs from 0 to 25.⁸
3. Multiply by 4 to get a score from 0 to 100. Higher scores mean better wellbeing.⁸

What the score means. WHO says a score below 50 (a raw total below 13) suggests poor wellbeing. It also signals a need for further checking for a possible mental health condition, such as depression. It is a screening result, not a diagnosis.⁸

How well it works. A review of 213 studies found that the WHO-5 has strong validity. It works well as a screening tool for depression. It tends to pick up depression when it is there and not flag it when it is not. It is also useful for tracking change during treatment.⁹

What a low score can mean. A low score can reflect a hard few weeks, poor sleep, pain, grief, stress or illness. It can also be a sign of depression. If your score is low, try our depression check-in. If it stays low for more than a couple of weeks, talk with your doctor.

You can take the WHO-5 on its own with our Well-being check, or as part of MindCheck. Repeating it every few weeks lets you see whether your wellbeing is steady, rising or falling.

Why wellbeing matters for health

Wellbeing and health are closely linked, and the link runs both ways. Older adults living with heart disease, arthritis or chronic lung disease tend to report lower wellbeing and more low mood.¹⁰

Wellbeing may also help protect health. A long-running study followed older adults in England for about eight and a half years. About 29% of people with the lowest sense of purpose and meaning died in that time. Only about 9% of those with the highest sense died. This held after the researchers accounted for age, other background factors and people's health at the start.¹⁰ This kind of study cannot prove cause, but it adds weight to taking wellbeing seriously.

Common questions

Is wellbeing the same as happiness?

Not quite. Happiness is one part of wellbeing, the feeling-good side. Wellbeing also includes meaning, growth, relationships and how well you are functioning.^1,6

Can I have good wellbeing if I have a mental illness?

Yes. Illness and wellbeing are related but separate. Some people living with a mental health condition still have meaningful relationships, purpose and moments of joy. Building wellbeing can be part of recovery.⁵

When to get help

Low wellbeing is common during hard times, and it often lifts. But see a doctor or mental health professional if:

• Your WHO-5 score stays below 50 for more than a couple of weeks
• You have low mood or lose interest in things most of the day, nearly every day, for two weeks or more¹¹
• You feel hopeless, worthless or numb, or you have changes in sleep, appetite or energy¹¹
• You cannot keep up with work, home or caring for yourself

Older adults may feel flat or empty rather than sad. Aches, pains and tiredness that do not get better with treatment can also be signs.¹¹ See Signs and symptoms of depression and Depression in later life.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.