Flow: people who are easily absorbed in an activity may have better mental and cardiovascular health

Have you ever lost all sense of space and time when redecorating a room? How about being so focused while playing an instrument that the worries that weighed you down a minute ago just evaporated? Then you’ve probably experienced “flow”.

Flow is a term used in psychology to describe a state of heightened concentration, in which you are completely absorbed in an activity. It exists somewhere between boredom and stress – usually experienced during activities which are somewhat challenging but still meet our skill levels. When we experience flow, we tend to be highly effective, feel in control and forget about time.

Flow is often a positive experience. So could it be good for our mental health? That’s a question researchers, including me, are currently tackling.

Concepts such as flow have been around for a while, take for example the “polarisation of attention”“ which is a state of heightened focus proposed by the Italian educator Maria Montessori in the early 20th century. But the modern, scientific version of flow was developed by the American Hungarian-born psychologist Mihály Csíkszentmihályi in the 1970s.

Work by myself and others has shown how often and in which setting we experience flow largely differs between people, and is partly genetically influenced.

In other words, some people are more prone to experience flow than others, which is partly due to individual differences in genetic predispositions, but also due to factors in our environment. These may include the circumstances of the specific activities we engage in, the distractions we experience and our mental states.

Does flow cause mental health?

It has been proposed that being prone to flow may be associated with many positive outcomesincluding better mental and cardiovascular health. These associations have generally been interpreted as evidence for flow causing such protective efforts.

These proposed benefits of flow have led to the first companies seeing business opportunities and offering flow-promoting training. However, this may be a little premature.

To date, most available research does not allow for any conclusions about causal effects of flow on mental or physical health. That’s because the research has primarily been based on small sample sizes and self-reported data. And both the predisposition to experience flow and mental health problems are partly heritable.

Our specific predispositions will, together with our environment and experiences, influence how we fare in life, including whether we experience flow or mental health problems. But how exactly our genes and environment work together is still mostly unknown.

This implies that the same family factors, including genetic predispositions or early childhood environment, may influence both how prone we are to flow and our mental health. In that case, the associations reported would not be directly causal, but rather be down to a third factor causing both, such as genes or specific childhood experiences.

Enter neuroticism

Another such third factor could be a concept called “neuroticism”. Neuroticism is a personality trait which describes our tendency to be emotionally unbalanced and easily irritated. People with high neuroticism scores are more susceptible to stress and psychological problems, as well as cardiovascular and other somatic diseases.

At the same time, it intuitively makes sense that worry, stress and emotional instability are factors which would keep you from entering flow experiences. So it is quite possible that our predispositions, including neuroticism, would influence both our ability to experience flow and our mental health.

If we then explore the relationship between flow and mental health without considering neuroticism – as most research has done – we would observe an association. But that’s really driven by neuroticism.

Together, this raises the question: can flow really protect against certain health problems? This question was recently investigated by my student Emma Gaston at the University of Melbourne, Australia, and co-supervised by myself and Laura Wesseldijk, a senior researcher in my group at the Max Planck Institute for Empirical Aesthetics (MPIEA) in Frankfurt am Main, Germany. Our paper was published in the journal Translational Psychiatry.

We investigated, for the first time, whether neuroticism influences the observed associations between flow and mental health – and whether family factors such as genetic or early family environment may play a role. Also for the first time, the study tested the reverse; whether mental health problems lead to less flow. This was done using real-life diagnoses from 9,300 people in the Swedish patient registry.

We found that people who were more prone to experience flow had a lower risk of certain diagnoses, including depression, anxiety, schizophrenia, bipolar disorder, stress-related disorders and cardiovascular disease. This is in line with expectations of a protective effect of flow on mental and cardiovascular health outcomes.

However, when considering neuroticism and family factors, flow experiences remained associated only with major depression and (possibly) anxiety, though associations were somewhat diminished. This finding suggests that flow may have some protective effect on those two mental health outcomes, but that the relationship is more complex than thought.

On the other hand, the fact that most of these associations disappeared suggests that being prone to flow didn’t directly cause a lower risk for these conditions. Rather third factors, such as genes, may be a better explanation.

Does that mean we should engage in flow training to reduce our risk for depression and anxiety? No. Research is lacking to investigate if and how we can even manipulate flow and what consequences that would have.

That said, when we are in a state of flow, it is likely that we are spending less time ruminating over our lives or worrying about the future – simply because we are occupied and the experience of flow in itself is rewarding. So if something you love doing makes you lose all sense of space and time, it is likely that it is good for you – at least in that moment.