My guess:
I think they keep him on anti-depressants. He had that same look during the time before they passed ObamaCare. That was another low point in his popularity and as we all know, the health bill was rammed through to perk up Obama's spirits, not for the sake of the people. When things aren't going well for narcissists they dip into deep depression, try to hide, and often run away. And, I believe those very close to him know it, and keep him supplied with whatever drugs and meds it takes to get him out there and keep some kind of control on him. The rest of the time he is just "allowed" to have fun, golf, take trips, visit with adoring Hollywood types, etc. Nothing too taxing for his fragile psyche.
The country is struggling and the leadership in the WH is, I am sure, fragmented. Who is actually in charge anymore is anyone's guess.
My guess: