Dear Dr. Sterling:
I have a simple request. Could you tell me and your readers more about mental wellness? I notice that most of the questions you have answered have been about a particular problem or illness. I would like to know how people stay mentally well? Are there principles of mental wellness? Signed: Wondering About Wellness in Wallingford.

Dear Wondering:
Thank you for writing! You have brought up an excellent topic. Although "mental wellness" is a very complex subject, I think there are some well-established principles that can be discussed even in a short article.

It is important to keep in mind that no one is perfectly mentally well and no one is completely mentally ill. Each of us is a mixture of illness and wellness. We all have different "hot buttons." What might depress or upset one person may not affect the next person. In addition, we all have different "breaking" or "burn-out" points. The best questions we can ask ourselves are "What factors and skills lead to a healthier state of mind?" and "What are our weaknesses and strengths?"

Our baseline mental wellness is determined mostly by our biology. If we are not challenged by genetic or other brain or body abnormalities, we may have an easier time achieving a healthier mental state. However, even if we are affected by biological circumstances beyond our control, we can still develop skills and utilize psychological tools that will help us maximize our potential for enjoying life and reaching goals.

The factors that will help any of us achieve healthier states of mind are self-appreciation, resilience (optimism, perspective, meaning, humor), affiliation, negotiation, curiosity, exercise and leisure activities (reading, board games, playing musical instruments, and dancing). In fact, if we each made a list of our shortcomings in these areas and worked on them proactively, we would each "pump up our mental wellness power" significantly.

Self-appreciation is the ability to not just notice what is wrong with us, but to also notice what is right with us and to appreciate our strengths. Resilience is the ability to deal with and recover from hardship, misfortune, change and shock. The qualities that allow for resilience are optimism, a sense of perspective (seeing the big picture), believing that there is a positive meaning to life, and the ability to laugh at some of the tricks that life plays on us.

Affiliation is the ability to allow ourselves to get close to other people and negotiate give-and-take alliances and friendships and build mutually-supportive social networks. Negotiation is the ability to see that we may not have all the answers and to allow ourselves to learn from others and alter our beliefs based on new data and information.

Exercise, curiosity, and leisure activities have a lot in common, but they are distinct tools and skills that have each been proven to enhance mental wellness. Research has consistently shown that physical exercise protects against depression and that "leisure activities" such as reading, playing board games or musical instruments, and dancing enhance brain functioning and decrease the risk of dementia.

Each and every one of these skills that can increase our mental wellness power can be developed and enhanced by appropriate learning programs and exercises. We now know that no matter how old we are our brain is capable of a certain amount of repairing itself and creating new neurons and new circuits. -- Best wishes, Dr. Sterling.

Posted by:  Ron Sterling, M.D.  Read our Disclaimer.

Our individual biology and the brain structure that we were born with and which develops as we age may be the only limiting factor in how far we can pump up our mental wellness, but within each of our individual structural limitations, there is room to improve our mental fitness. It is not unlike the limitations we each have for how fast we can run or walk or move in some other fashion. We all start with a different body, but we all can learn the skills for quicker movement.

The five factors that I feel are involved in the equation of mental wellness are noted below. You will find links to pages devoted to each factor.

Resiliency researchers and experts might say that resilience is the overriding characteristic which predicts how well we handle challenges to our physical or mental health. In my opinion, no single strength or weakness, on its own, predicts what may happen. For instance, a person with limited resilience may have great affiliation skills and their network of mutual support may get them through some hard times just as well as someone with greater resilience but who has less of a network of mutual support. So, the equation for mental wellness is:

Mental Wellness = self-appreciation + resilience + affiliation + negotiation + mental and physical exercise.

In my mind, the issue for each of us is where do we stand with respect to each factor and do we want to pump up our mental wellness or not? Each of us has that choice. So, to help you kick start your assessment of your strengths and weaknesses and to help pump your wellness up, I offer the following pages and links for your consideration.

Click on the following links to go to pages which are devoted to each of the five mental wellness factors. Links to general mental wellness resources are further down this page.

Self-Appreciation -- the ability to assess both our strengths and weaknesses and to appreciate our unique and individual contributions.
Resilience -- the ability to deal with, recover from, overcome or "bounce forward" from hardship, misfortune, change or shock.
Affiliation -- the ability to allow ourselves to get close to other people and negotiate give-and-take alliances and friendships and build mutually supportive social networks.
Negotiation -- the ability to see that we may not have all the answers and to allow ourselves to learn from others, from experience, and alter our beliefs based on new data.
Mental and Physical Exercise -- exercising our brain and our body.

There are not many general mental wellness resources on the Internet. It appears that the reason for this is that "mental wellness" has been used primarily as a "catch-all" phrase to indicate "preventive" processes and strategies. In fact, the phrase "mental wellness" is so new and so undefined that if you do a search at the National Institute of Mental Health Web site you will not find a reference for mental wellness.

Mental wellness is not just about stress management techniques, although how you handle stress could be called resilience. Mental wellness is a condition related to how well we have developed and utilize the five different mental wellness factors noted above.

Here are a few links to general mental wellness Web sites:

• Wellness and Wellness references.

• Positive Psychology.

• Risk Factors and Protective Factors at 1999 Mental Health Report of the United States Surgeon General.

Dr. Sterling has written several articles on many aspects of depression, including the neurobiology of depression and how stress produces major depression. You can read most of those articles by visiting AllAboutDepression.net.

The Fight-or-Flight and the Relaxation Response.

Dr. Sterling has written two short articles on anxiety disorders, the fight-or-flight response, the relaxation response, and anti-anxiety medications. Those articles can be found at MindMatters.ws. See the following links to learn more about anxiety disorders and anti-anxiety medications.

• Flight-or-Flight Response at The Free Dictionary.

• Stress (Medicine) at Wikipedia.org.

• The Fight-or-Flight Response and the Relaxation Response at MindBodyMed.com.

Lee Iococca, the legendary former Chrysler Corporation Chairman, put it this way: "Everybody says you've got to get ready financially -- no, no, you've got to get ready psychologically!"

How much of a detrimental psychological impact retirement has on any particular person has a lot to do with the circumstances of retirement. Is it forced? Is it due to a disability? Or, has it been planned? A forced retirement that is unexpected and unwanted, can result in feelings of hurt, resentment, anger, and jealousy, which will greatly complicate a retirement.

As much as we all more-or-less dream of retirement as a time of relaxation and no one telling us what to do, the reality of retirement can be feelings of loss, lower self-esteem, boredom, social isolation and, often, more complicated relationships with spouses who may not have seen so much of us while we were employed.

To read a short article about some psychological aspects of retirement or to find more information, please see the following links.

• Dr. Sterling's short article entitled Retirement Repercussions published February 2005.

• From Boston College -- Center for Retirement Research Web Site.

• From FindArticles.com -- Retirement straight talk: the self-discovery that it's not a simple transition but a new phase in life posted February 2004.

• From FindArticles.com -- A healthy retirement posted November 2002.

• From USNews.com, article posted June 14, 2004 -- You call this retirement? -- Today's retirees are defying the stereotypes about the golden years .

• From Aging Today -- Phased Retirement Will Ease Many Into Active Older Years .

• Book -- Don't Retire, REWIRE!.

• Book -- The Psychology of Retirement.

• From National Council on Aging -- "RespectAbility" - New Initiative Will Promote Older Americans As "Untapped Resource" To Help Renew Communities.

• Check the Web site of the 2005 White House Conference on Aging. Such a conference happens only once every ten years.

• American Society on Aging Web Site.

• The Retirement Living Web Site.

• List of retirement communities associated with college campuses. As people begin looking for more meaning and value in retirement, they think about returning to the stimulating environment that they enjoyed decades earlier. Universities and developers, realizing the perpetual appeal of a college campus as well as the numerous resources it can put at the fingertips of retirees, are building retirement communities on or near the school's grounds.

• Check the LaSell Village Learning Community Web site.

• Gary Beene's Retirement Information Center.

• From the United Kingdom -- Age Positive Web Site.

• From Canada -- Ontario Human Rights Commission Web site on Retirement Issues.

Please go to our All About Forgiveness Web page to view links to information, articles, organizations and individuals dedicated to helping us understand the power and the psychological principles of the process of interpersonal forgiveness. Recent research has helped us focus on how forgiveness can contribute to our mental wellness.

Psych Answers is the Web site where Dr. Sterling posts links and answers to questions about mental health, psychiatry and psychotherapy.

Want Advice About Senior Mental Health or Caregiver Support?

SeniorMentalHealth.org is the Web site where Dr. Sterling posts links and answers to questions about senior mental health and caregiver concerns. Dr. Sterling completed a Geriatric Psychiatry Fellowship in June 1999 and is a Member of the American Association for Geriatric Psychiatry.

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