The nine hallmarks of mental health and wellbeing as a watershed framework for resilient living and healthspan optimization

Mental health and wellbeing are core components of a healthy life. However, emotional stress and mental health problems are on the rise through societies and cause a significant burden of suffering. In the following, we present our watershed framework for optimizing wellbeing and mental health through lifestyle interventions. Emerging evidence also shows that mental health is an important determinant of quality of life. In addition, it may also be a driver of longevity, influencing health outcomes and, ultimately, the overall healthspan. This framework is based on the recognition that mental health is comprised of biological, psychological, and social factors, and that the factors have interdependent relationships amongst them, so that positive changes in one of them can have cascading effects on the others, with the potential to improve the psychological capital of an individual. Our framework consists of nine elements that we consider hallmarks of mental health and wellbeing, structured in three interdependent layers. The first layer is formed by foundational factors, which are essential for wellbeing and mental health, including circadian rhythms and sleep recovery, along with social connections. The second layer, named wellbeing catalysts, encompasses elements of wellbeing that can have powerful positive effects on mental health, including stress resilience, vitality, cardiovascular health, immune health, and the gut-brain axis. The third layer, named as thriving factors, consists of cognitive performance and positive emotions, which are the elements most often associated with a thriving mind. In our framework, we highlight the interactions between the factors and provide a roadmap to structure comprehensive lifestyle interventions aimed at optimizing mental health and wellbeing. Strengthening mental health and wellbeing addresses key biological and behavioral determinants of healthy aging, which are increasingly recognized as critical modulators of longevity trajectories.