Economists Anne Case and Angus Deaton (2015) coined the term “deaths of despair” to capture the rise of deaths resulting from suicide and substance use among lower class white people in the United States. Their 2020 book Deaths of Despair and the Future of Capitalism identifies social and economic conditions contributing to these deaths, including declines in wages, job opportunities, and marriage rates, as well as the opioid crisis and weaknesses of the American healthcare system. Many scholars have pointed out, however, that deaths of despair have been occurring for decades—even centuries—across many different societies (see Murray 2000; Komro 2018). In other words, ‘despair’ has long been associated with suicidal and other kinds of self-destructive behavior, suggesting that despair itself is a common factor in many kinds of self-inflicted deaths. Yet social scientists such as Lilly Shanahan et al. (2019) observe that the literature on deaths of despair “has neither defined nor empirically assessed its central concept, despair” (854). William Copeland et al. (2020) similarly claim that “despair has not been studied as an independent construct in and of itself” (2). It thus seems that the cross-disciplinary literature would benefit significantly from inquiry into the nature of despair.1

We propose that philosophical research on hope, which has started to have an impact on the social sciences, promises to shed light on the nature of despair.2 Philosophers writing on hope commonly cite despair as hope’s opposite, as the state with which we find ourselves when hope is lost (e.g., McGeer 2004; Pettit 2004; Meirav 2009; Milona 2019; Milona & Stockdale 2021; Huber 2021).3 The assumption that hope and despair are opposites has helped to motivate two central tasks in the literature: how a theory of hope can make sense of the difference between hope and despair, and how hope might prevent people from falling into despair. Yet the focus of inquiry has principally been on hope, with questions of despair playing an auxiliary role.

This paper constructs a systematic theory of despair. We begin with background on the phenomenon of “deaths of despair” in the empirical literature as well as the thoughts, feelings, and behaviors commonly associated with despair. We then examine existing philosophical literature on hope to establish starting points for analyzing despair, including a list of desiderata for any such theory. We build most directly from our own (2018) perceptual theory of hope, though we suspect that much of what we say can be reconciled with nearby theories (e.g., Martin 2014; Calhoun 2018). Our focus is on developing an account of despair rather than systematically teasing out how it fits within various approaches to hope, which are themselves rarely paired with detailed theories of despair.4

Put metaphorically, our proposal is that despair “smothers” or “extinguishes” hope. In despair, hope’s desiderative element is still in place; we desire that over which we despair. The trouble is that the despairing agent sees the prospect of the desired object’s obtaining in an unfavorable light. We understand this way of seeing as an emotional experience, but not one that is sui generis. Instead, we conceptualize despair as a mode of sadness. Whereas sadness in general construes something as a loss, despair construes the loss of reasons to take seriously (e.g., promote, prepare for) that which one desires. An especially attractive feature of this account is that it sheds light on the vexing question of whether hope and despair toward the same thing can coexist, an issue about which philosophers disagree but which is difficult to answer without a theory of despair.5 And crucially, by analyzing despair in terms of a widely studied emotion, our theory may offer useful conceptual resources to social scientists studying deaths of despair.

Case and Deaton (2015) coined the term “deaths of despair” in response to the rise of deaths resulting from suicide, drug overdose, alcoholic liver disease, and other forms of self-destructive behavior. The authors primarily focused on deaths of despair among working-class white people in the United States, leading to an analysis unique to this group’s social and economic circumstances. They observe that this group tends to have a low quality of life characterized by high rates of physical and mental illness, low wages and unemployment, a low social status, less family stability, declining marriage rates, and declining religious participation (Case & Deaton 2020).

Importantly, though, deaths of despair are not just a public health crisis for working class white people in the United States. Case and Deaton (2020) acknowledge that the opioid epidemic, an ongoing public health crisis that is exacerbating deaths of despair, has significantly affected Black communities (cf. El-Bassel et al. 2021). Deaths of despair have also been occurring for decades, and disproportionately, among Indigenous communities in the United States, Canada, and elsewhere in the world without significant mainstream media attention or inclusion in relevant research (Komro 2018; Friedman, Hansen, & Gone 2023). And refugees and asylum seekers are at risk across the world. For example, Human Rights Watch has reported on suicides and attempted suicides in refugee camps in Lesbos, Greece, connecting suicidality to “hopelessness and dangers of life” (Cossé 2017).

Since it appears that certain kinds of suicides involving despair have been a longstanding public health issue across historical periods and cultural contexts, a deeper understanding of despair’s nature may be key to understanding deaths of despair as a more general phenomenon in human life.6 Yet as Lilly Shanahan et al. (2019) observe, despair itself arises in manifold ways. They thus suggest the following taxonomy:

This taxonomy moves us closer to an account of despair by identifying the thoughts, emotions, feelings, and behaviors typically associated with despair. Despair is often accompanied by negative thoughts (e.g., about other people’s intentions), physiological changes (e.g., disruptions to sleep and appetite), other negatively valenced feelings (e.g., guilt and worthlessness), and specific kinds of behaviors (e.g., self-harm). But Shanahan et al.’s (2019) account does not offer a precise definition of despair. It is therefore not clear how the thoughts, emotions, feelings, and behaviors they identify concern despair in contrast to other emotions or states. For example, pessimism about an outcome—or the expectation that the outcome is unlikely to come about—is consistent with hope and the absence of despair. A person can be pessimistic, say, about their job prospects, but nevertheless hold out hope that their prospects will improve. Similarly, experiences of sadness, irritability, hostility, loneliness, and an inability to feel pleasure can all indicate the presence of emotions other than despair, such as grief or anger. And regarding behavioral despair, people can engage in risky, reckless, and unhealthy behaviors for fun (e.g., taking drugs) or out of pressure from peers. Such behaviors do not necessarily mean that a person is in a state of what we would ordinarily call ‘despair.’ Finally, the physiological changes Shanahan et al. (2019) identify are linked to other emotional experiences and states, too. Pregnancy, for example, often involves changes in sleep and appetite regardless of whether the pregnant person is in despair.

Thus, although Shanahan et al. offer a taxonomy capturing the thoughts, emotions, feelings, and behaviors that tend to accompany despair, they have not provided an account of despair’s nature. They have not, in other words, answered the question, “What is despair?” From a philosophical perspective, we suggest that a plausible theory of despair should be able to explain the above manifestations of despair, as well as what we propose (§3) are four key desiderata emerging from insights in the philosophy of hope.

Despair is typically defined in the philosophical literature in contrast to hope, or as the opposite of hope. For example, Trudy Govier argues:

As will become clear, we do not agree with the entirety of Govier’s statement. However, she rightly notices that despair might either be a result of losing hope, or a mental state one has without ever having hope to begin with. In this way, despair is not properly analyzed as disappointed hope, which requires a hope to have existed in the first place (cf. Steinbock 2007: 441). In metaphorical terms, there is a sense in which despair smothers hope, potentially even before it arises. A theory of despair should tell us what exactly this amounts to.

A more specific question about the relationship between hope and despair concerns their compatibility. According to a widespread assumption, a good analysis of hope distinguishes hope from despair precisely by including some feature that rules out hoping and despairing over the same thing (Meirav 2009; Martin 2014; Milona & Stockdale 2018; inter alia). For example, if a person hopes for good weather tomorrow, they cannot at the same time despair that there will be good weather tomorrow. Similarly, hoping that one’s life will improve is inconsistent with despairing that one’s life will improve. But while we think that there is an element of truth here, this assumption may oversimplify actual human experiences. Consider Cornel West’s remarks:

West takes hope and despair to be intricately connected. The idea that despair is a “constant companion” of hope would seem to suggest that the two can co-occur (though we would not say that they are inseparable). West’s remarks may even indicate something stronger: that people committed to justice choose to actively sustain their despair over “catastrophic conditions” of injustice as they hope to make progress toward justice, perhaps to ensure their hopes remain tempered with realism. This is an interesting and provocative claim that we think is worthwhile to pursue, but we remain focused on the more modest possibility that hope and despair may sometimes co-exist.

Jack Kwong (2020; 2022; 2024) has proposed a theory of hope according to which hope is compatible with despair. In his view, to hope is to register a desire for an outcome one sees as possible, where “registering” amounts to “explicitly and consciously entertaining” the relevant desire (2020: 834; see also 2024: 230). To despair, in contrast, is to experience predominantly negative thoughts and feelings about the outcome’s chances (2020: 838–840; 2024: 235). If Kwong is right about the nature of hope and despair, then one can experience hope and despair over an outcome simultaneously. For example, a patient who despairs of ever recovering from cancer might be reminded (e.g., by a loved one or a doctor) about the possibility of recovery; and this event might trigger them to consciously register their desire for recovery which they continue to believe is possible. However, the patient cannot be hopeful about recovering, according to Kwong, since to be hopeful is to have predominantly positive thoughts and feelings about the outcome’s chances. It is thus hopefulness—not hope—that is incompatible with despair.

Kwong offers an intriguing and elegant explanation of how hope and despair can coexist. But we think his theory leaves out important cases of hoping. These are cases which go beyond registering or consciously noting a desire and yet do not necessarily feature generally positive thoughts about the chances of fulfilling the desire (i.e., hopefulness in Kwong’s sense). Suppose, for example, one desires to find a parking spot downtown later this evening and then entertains or notices this desire. Even if one calls this a form of hoping (we are neutral), it is importantly different from the mode of hoping one is in while in the midst of searching for a parking space. In the first case, one desires something that is not (yet or at present) felt as significant to them. Indeed, one can even imagine quickly registering (in succession) a variety of different desires, including the ones believed to be important in the here-and-now. But this activity of registering one’s desires is different from feeling their importance in the way that the person hoping to find a parking spot feels the importance of finding one in the moment. They might not be hopeful about their chances, given the current state of traffic and their past experiences of parking failure. But they’re hoping for a parking spot nonetheless, and this is more than just registering that they have a desire to find parking. Our favored theory, which we describe below, is that such hoping is an experience of reasons (Milona & Stockdale 2018).

We are likewise not convinced that despair can be defined in terms of the mostly negative thoughts and feelings about the desire’s chances. People who tend to focus on threats to what they desire, and the apparently low chances of success, may find themselves beset by nagging worry and pessimism; but having such a broadly negative orientation needn’t involve despair. Similar to emotions such as fear, joy, etc., there is a feeling of despair that is distinct from the thoughts and feelings that tend to accompany it. Despair is thus not reducible to a comparative summary of negative versus positive thoughts and feelings.7 So while we think Kwong is right to question orthodoxy on the question of whether and how hope is compatible with despair, the matter remains open.8

As indicated, a theory of despair should help us to understand its distinctive phenomenal character (which may often be accompanied by other thoughts and feelings as well). As we will argue, the feeling of futility constitutive of despair is a feeling that there is no point in aiming for the outcome one desires—either specific desires (in hoping that p) or all of one’s desires. For example, if an author is in despair about the possibility of publishing a book, they may see no point in continuing to write toward publication.9 Or if a person is in despair about everything, they may see no point in continuing to do anything at all. Despair thus has negative effects on motivation. As Margaret Urban Walker (2006: 57) writes, “often despair or resignation sets in over the fact that ‘nothing can any longer be done’ even when there is something that could still happen.”

Despair saps our motivation because it is bound up with a negative orientation toward the possibility of the desired outcome being fulfilled. But Govier’s (2011: 247) claim that despair involves the belief that there is no possibility of obtaining the desired outcome, or the belief that good outcomes are not possible, is too strong. Ariel Meirav (2009) points out that one might despair of an outcome even if one believes that there is a possibility it will obtain.10 For example, a cat lover might believe it possible for their cat to live until she is 20 years old, but despair that this will occur. They might even strongly desire their cat to live such a long life,11 and believe it physically possible, while experiencing despair rather than hope. A plausible theory of despair should account for cases in which a person despairs of an outcome while continuing to believe in its possibility.

Another key feature of despair is that it cannot easily be controlled; we cannot, simply by an act of will, choose not to despair. (We also cannot choose to despair, if one ever wanted to choose to experience the emotion, e.g., to better empathize with a friend.) This is most obvious in cases of “recalcitrant” despair, when we believe our own despair is unwarranted and yet can’t seem to overcome it. The medical student who is ranked at the top of their class, and who has supportive family and friends, might believe that they will survive medical school (and thus that despair over surviving medical school is unwarranted). But in contemplating the trials ahead, including more years of school followed by residency, they find themselves slipping into despair. Despair is something with which we find ourselves and that we must work through (see Milona & Stockdale 2021).

To sum up, then, a theory of despair should explain (at least) four things:

Once we have a theory of despair that explains these key elements, the hope is that it will illuminate why despair is connected, even if only contingently, with the factors observed by Shanahan et al. (2019; see above).

The term ‘deaths of despair’ is not equivalent to ‘suicide.’ It aims to capture a core emotional experience that seems to be at the heart of a certain class of suicides and other self-inflicted deaths. We see the project of understanding deaths of despair as necessarily interdisciplinary, one requiring empirical work that takes seriously testimony of people’s lived experiences. But our hope is that philosophical work can progress this research further, providing the conceptual resources we need to make sense of a complex public health crisis affecting people from diverse backgrounds and societies. That said, we do not aim to speak for people who have died deaths of despair, or for people who are struggling with despair in their lives. People’s lived experiences of despair will be different depending on who they are, what their despair is about, and their social and cultural locations. But we contend that our theory of despair, combined with philosophical insights on meaning in life, provides a lens through which we might begin to investigate the despair central to deaths of despair.

People who have died deaths of despair through suicide, drug overdoses, alcoholic liver disease, or another self-inflicted means appear in large part to have given up on living. We see this “giving up” either through self-destructive behavior unintentionally leading to death, or through intentionally self-inflicted deaths. Our hypothesis is that the kind of despair at the heart of deaths of despair is connected to a person’s sense of their own life’s meaning.27 Despair can threaten one’s sense of meaning in at least two ways: (1) when the principal object of despair is partly constitutive of what a person takes to be the source of their life’s meaningfulness, or (2) when the principal object of despair is a precondition for finding, constructing, or pursuing a sense of meaning in life. In both cases, despair is experienced as a defeat of reasons to live. People who have this kind of despair might still experience reasons to exist—to continue living in the minimal sense of going through the motions of daily life (cf. Ratcliffe 2013: 602). But they experience a decisive loss of reasons to live in the “full sense”—that is, in accordance with their conceptions of what gives meaning to their lives.

By ‘meaning,’ we refer to agents’ own conception of what makes their life meaningful. We acknowledge that talk of meaning can be difficult to pin down. But given that deaths of despair are understood as a partly socio-political phenomenon, we emphasize an account with an explicitly social dimension that illuminates how people often approach their life’s meaning. In particular, we follow Cheshire Calhoun (2018) who argues that people live meaningful lives to the extent that they spend their time on ends they have reason to value. There are, in Calhoun’s view, a plurality of reasons for valuing ends that agents set, including both public and personal reasons. Public reasons, or reasons for anyone, are “part of a common pool of reasons that can be drawn on to justify the demand that others agree with us in our judgments of value” (33). To borrow Calhoun’s (2018) example, a person who adopts dressage riding as an end can justify their choice of activities by appealing to good exercise, opportunities to socialize, and the dedication, skill, and focused attention required as reasons to value dressage riding. Although the authors of this article have no interest in setting this end for themselves, we appreciate that dressage riding is a meaningful activity for others because they, too, live in societies whose “collective thinking” about what counts as a good reason includes the reasons in favor of dressage riding that Calhoun cites.

Calhoun’s insight that there are public reasons for valuing ends we set helps explain why not just any project can contribute meaning to a person’s life, such as watching every television show ever made or making America’s Most Wanted list. People who set these ends will have a hard time justifying (to themselves and others) what is worth valuing about watching every TV show ever made or being a fugitive. These ends are incompatible with what we (i.e., people who are members of a community) have reason to value. In contrast, the doctor and social activist can appeal to public reasons for valuing their respective paths: the value of giving back to one’s community, saving lives, and making the world a better place. (We say more about the advantage of including such reasons in assessing the meaningfulness of lives below.)

There are also personal reasons unique to people as individuals for valuing ends, such as the symbolic meaning of a project to their life, its connection to their past experiences, and what suits their personalities or natural talents (Calhoun 2018: 35). The doctor and social activist will have personal reasons for pursuing their chosen careers over others (e.g., a fascination with the human body in the doctor’s case). In adopting certain ends (over others), agents construct a concrete normative outlook—a specific conception of what gives meaning to their lives. Agents’ normative outlooks typically include multiple life projects (e.g., career, family, activism, and leisure activities), as well as a way of ranking their values—structuring their time and guiding action in accordance with what is most significant in their lives (Calhoun 2018). A point to emphasize here is that having such projects requires, at least ordinarily, hopes for one’s life. In other words, the valuing that comprises a paradigmatic normative outlook either partly consists in, or entails, having certain hopes.28

How might a normative outlook conception of meaningful living help us to understand life-threatening experiences of despair? Let’s start with a case in which a person despairs over something constitutive of their sense of meaning in life. Take, for instance, the familiar example of a philosophy job market candidate who despairs of being offered a tenure-track position and who has dedicated over a decade to this goal. Being a professional philosopher may well be the most important aspect of this person’s identity (cf. Blöser & Stahl 2017). And despite the fact that their loved ones do not at all understand how they could find reading Kant enjoyable, the job candidate’s family nevertheless see a career in philosophy as a worthwhile end for them to set. There are, in other words, public reasons to set the end of becoming a professional philosopher: the value of teaching important skills, supporting young people as they find their way in the world, and so on.

For someone who sees a career in philosophy as constitutive of a meaningful life for them (i.e. those who have personal reasons for valuing a career in philosophy), job market despair can threaten their sense of meaning in life. This is not to say that the person’s life is doomed, or that people who invest in a career that does not pan out are necessarily at risk of self-destructive thinking and behavior. People whose normative outlooks include other meaning-constitutive hopes will likely continue to find their lives worthwhile in the midst of their job market despair. Loving relationships, passion for arts or sports, and so on can each contribute to many people’s conceptions of what makes their lives meaningful.

We contend that when an agent recognizes other reasons for living as sufficiently strong, their overall sense of meaning in life is not threatened. Because they see themselves as having other reasons to live in the full sense (e.g., to build a family, give back to one’s community, etc.), their normative outlook functions as a source of resilience for them. People may also exhibit the capacity to hope well, in Victoria McGeer’s (2004) terms, which involves forming new hopes or restructuring existing ones when the world proves resistant to some specific hoped-for end being realized. One way in which people can hope well is by having a flexible normative outlook (cf. Milona 2020b: 646–649). For example, the would-be professional philosopher might see that some of the reasons they have for pursuing professional philosophy are reasons for pursuing other projects—ones that also involve contributing in a robust and public way to ongoing political discourse and action (and arguably more so than many other careers). It can be difficult to keep these considerations in view, though easier with the support of others who can help to redirect our hopes. As McGeer (2004) emphasizes, hoping well is a social phenomenon—one that takes place in community with others who support one another in maintaining and restructuring their hopes. When the world leads us to despair, it is often other people who remind us of the meaningfulness of our lives and ultimately pull us through.

But not all of us have the social support and resources we need to redirect our hopes in this way, and there are cases in which an agent’s normative outlook cannot withstand the impact of despair. Consider, for example, a single mother suffering from substance addiction who has lost custody of her children.29 She had hoped to be a good mother and has always considered her relationship with her children the most important thing in her life. But like many people with a history of trauma and a lack of access to effective mental health treatment, she has coped with her pain with alcohol; and, as a result, the court granted custody to her former partner. She is devastated, but throws herself into work as a way of coping with—and finding meaning in—the life she is now living. Even when the most significant reason we have for living our lives is threatened or lost, other meaning-constitutive hopes function as a source of resilience for us. But if motherhood is everything to her, the meaning-constitutive hope to contribute to climate justice may itself be tainted by the mother’s despair. That is, she might begin to see her reasons for pursuing her research as defeated by despair over her relationship with her children. She might think, for example, “what’s the point of being a prominent climate scientist if I don’t have my kids…?” Or, if the mother’s other meaning-constitutive hopes are themselves threatened (e.g., she has become disillusioned with her research program, with not much else going on in her life), the mother’s despair is more likely to threaten her sense of meaning in life.30

Thus theorizing instances of despair in the context of agents’ normative outlooks on the whole, or their own conception of what gives meaning to their lives, may help us to understand why some people’s despair over even particular losses—such as the loss of reasons to pursue a relationship with one’s children—are experienced as a loss of reasons to live.31 Or perhaps more accurately, why the loss of reasons to pursue a relationship with one’s children motivates a felt experience of a loss of reasons to live. In other cases, the principal object of despair seems to be a precondition for finding, constructing, or pursuing a sense of meaning in life. Some people despair over their social and economic circumstances more generally, such as when those who are suffering from poverty, unemployment, housing insecurity, and a lack of access to healthcare find themselves in despair. Having enough money to buy necessities, or to keep one’s apartment, or to access essential healthcare do not constitute people’s normative outlooks. They are, instead, often practically necessary for having and maintaining one.32 Despair thus not only leads people to experience a decisive loss of reasons to take seriously certain meaning-constitutive desires, but to experience a loss of reasons to find (new) sources of meaning in one’s life. Put differently, hope for meaning itself can become smothered or extinguished.

To take a real-world case, consider Camilo Montoya-Galvez’s (2021) reporting on migrant children in Fort Bliss detention facility near El Paso Texas. He found that many children were suffering from despair and self-harm, with 29 youth on a suicide watchlist. Attorney Carlos Holguín visited Fort Bliss and spoke with children there and observed them at “their breaking points.” He explained: “I saw that in the faces of virtually every kid I interviewed in Fort Bliss: A sense of despair and isolation.” One 17-year-old girl from Guatemala suffering from anxiety, insomnia, and increased blood pressure explained: “I used to be able to cope with my anxiety and breathe through it, but now I feel like I’ve given up… I feel like I’ll never get out of here.” Although we don’t have any way of knowing about this girl’s specific hopes and dreams for her life, the very possibility of pursuing meaning-constitutive hopes and dreams likely depends upon her getting out of the detention facility.33 Thus in order for her to even have a chance at constructing or re-constructing a normative outlook, her desire for freedom must be realized.34

In cases like these ones, despair is intricately connected to agents’ social and political conditions; oppression, violence, terror, and experiences of trauma can lead to or exacerbate despair. In earlier work, Calhoun (2007) argues that certain “frames of agency” must be in place for agents to continue taking an interest in leading their own lives, and to be secured against depression and despair. They include having a sense that one’s life has meaning, but also confidence in the efficacy of instrumental reasoning and in one’s relative security from profound misfortune and harm (Calhoun 2007: 198). When one or more of these frames of agency are absent, agents can become depressed or demoralized; and they may fail to see any reasons to reflect, deliberate, and act altogether. They might, in other words, lose the ability to function as an agent. As Katie Stockdale (2021) argues, inasmuch as hope involves exercising agency in some way (e.g., in thought, feeling, and behavior), losing the ability to function as an agent means losing the capacity for hope. We think that even the most serious cases of despair are compatible with having the capacity for hope, which we see as a hopeful sign for people who find themselves in despair. But there is more to say about the relationship between despair as an emotional experience and a loss of the capacity for hope.

We have argued that despair is a distinct mode of sadness through which agents experience a defeat of reasons to live; and, as we have seen, the social, economic, and political conditions of our lives often facilitate those very reasons. Our theory of despair thus complements social scientists’ observation that deaths of despair are a public health crisis, one that is a result of ongoing systemic injustices. Our theory also illustrates the importance of philosophical analysis to the interdisciplinary project of understanding the phenomenon of deaths of despair. Since questions about meaning in life are fundamentally philosophical in nature, we can’t fully understand the kind of despair that manifests as a total loss of reasons to live without addressing them.

We have argued that despair is best conceptualized as a mode of sadness through which agents experience a decisive loss of reasons to pursue a desired end that they believe or feel will not occur. This approach captures key features of despair, including its phenomenology, passivity, and compatibility with relevant modal beliefs. It likewise leads to an attractive understanding of the vexed relationship between hope and despair, an issue central to current debates about the nature of hope. Our project has also been concerned with offering a general account of despair, one suited to capture not only minor cases of despair but also more tragic ones. It thus speaks to the sort of despair involved in “deaths of despair.” Our hypothesis is that the core of such despair is an experience of a decisive loss of reasons to live in accordance with one’s own conception of what gives meaning and value to one’s life.