For decades, the scientific exploration of human mental health has predominantly treated the phenomena of mental ill-being and mental well-being as separate and somewhat opposing entities. Ill-being has traditionally encompassed clinically defined disorders and subthreshold psychological complaints—essentially the challenges and dysfunctions in mental health—while well-being has been understood as the presence of positive states such as life satisfaction, happiness, and emotional flourishing. However, these dichotomous approaches, which often measure one or the other, miss the nuance and complexity of the interplay between these states. In a groundbreaking Perspective published in Nature Human Behaviour, a consortium of interdisciplinary researchers led by Tamnes, Bekkhus, and Eilertsen critically reexamine this relationship, offering a comprehensive synthesis that challenges the simplistic binary framework that has dominated mental health research.
The researchers interrogate the long-held assumption that well-being and ill-being are poles on a single continuum. Their extensive review spans genetics, neurobiology, developmental studies, psychosocial contexts, societal factors, and clinical observations to depict a relationship that is far more interconnected and complex than previously recognized. Leveraging data from genetic studies, molecular biology, and neuroimaging, the authors reveal that mental well-being and ill-being share a substantial degree of genetic overlap. Rather than existing as independent constructs, there appear to be numerous shared genetic foundations that predispose individuals to both positive and negative mental health outcomes.
While genetics provide a baseline, the researchers emphasize that the biological underpinnings extend beyond DNA sequences. Neurobiological evidence indicates overlapping pathways and networks in the brain that mediate both distress and thriving states. For example, neurotransmitter systems, neural circuitries involved in reward processing, and regions governing emotional regulation do not discriminate straightforwardly between ill-being and well-being; they are involved in orchestrating a spectrum of mental states. This shared biology suggests that improving mental health might be best approached through integrative methods that consider these common mechanisms rather than isolated target areas.
Yet, when turning their examination to environmental factors and societal influences—variables that include upbringing, socioeconomic status, cultural norms, and life experiences—the study identifies divergent effects on well-being and ill-being. These factors can distinctly promote mental flourishing or contribute to psychological distress without necessarily impacting the opposite dimension equivalently. For instance, exposure to chronic stress, social stigma, or economic hardship can exacerbate symptoms of mental ill-being but might not directly diminish well-being in the linear sense, illustrating the complexity of environmental modulation.
The developmental trajectory of mental health adds another layer of nuance. Throughout the lifespan, the interplay between well-being and ill-being evolves, influenced by critical periods such as childhood, adolescence, and old age. The authors propose that different developmental stages embody unique constellations of genetic sensitivity and environmental responsiveness. Early life adversity can imprint long-lasting biological and psychosocial patterns that affect later mental health outcomes, but resilience factors cultivated in these formative years can also bolster sustained well-being, even in the presence of ill-being symptoms.
Importantly, the paper challenges fleeting societal narratives that promote mental health simply as the absence of mental illness or as a mere accumulation of positive emotions. Instead, it advocates for viewing mental health as a dynamic interplay of shared and distinct determinants. This multidimensional perspective underlines that individuals might experience coexistence of well-being and ill-being features, affirming that the absence of one does not guarantee the presence of the other. For example, a person diagnosed with depression might still find meaningful purpose and satisfaction in certain life domains.
Clinically, this reframing holds profound implications. Traditional mental health interventions have often focused narrowly on symptom reduction or eliminating pathology. However, the researchers call for nuanced therapeutic frameworks that simultaneously nurture well-being while addressing ill-being. This paradigm shift encourages integrative treatment goals, emphasizing holistic recovery and not solely symptom remission. It also opens avenues for personalized medicine approaches that identify genetic, biological, and psychosocial profiles to optimize interventions tailored to individual mental health landscapes.
The multidisciplinary approach of the study underscores a critical insight: no single scientific domain can fully encapsulate the complexities of mental health. Cross-pollination of data and ideas from genetics, biology, psychology, sociology, and cultural studies provides a richer, more accurate understanding. The team advocates for continued collaborative efforts and sophisticated methodologies, including polygenic risk scoring, longitudinal cohort studies, and culturally sensitive psychosocial assessments to unravel the nuanced interactions shaping human mental experiences.
A particularly compelling aspect of the research involves the societal and cultural contexts shaping mental health experiences. Global variations highlight that social norms, values, and collective structures strongly mediate how well-being and ill-being manifest, are interpreted, and are managed. The diverse cultural frameworks influence the stigmatization or validation of mental ill-being, the expression of emotional states, and the availability of support mechanisms, further complicating a universal model of mental health.
Moreover, the synthesis presented contends with the impact of contemporary societal changes such as globalization, digital connectivity, and climate crises, which may alter environmental pressures, influencing mental health trajectories differently than in previous generations. Understanding these evolving contextual factors is critical to developing responsive public health policies and preventive mental health strategies that can flexibly address emerging challenges.
The authors caution against overgeneralization or reductionist thinking, emphasizing the importance of considering individual variation and the pluralistic nature of mental health. They stress that mental ill-being and well-being are not merely outcomes but involve feedback loops and bidirectional influences. Positive mental states can serve protective functions, buffering against negative experiences, while chronic ill-being can erode psychological resources necessary for flourishing. This dynamic interactive model calls for research designs and clinical frameworks acknowledging temporality and reciprocal causality.
From a methodological standpoint, the Perspective highlights limitations of prior work that relied predominantly on self-report measures, pointing out the value-added insights from genetic and biological markers. Such multifaceted assessment approaches can capture subtleties missed by subjective reporting alone, enhancing both diagnostic precision and the understanding of underlying mechanisms. Embracing these sophisticated tools will be paramount for advancing mental health research and practice.
In conclusion, this seminal Perspective deconstructs the longstanding artificial separation between mental ill-being and well-being, revealing a complex, interwoven relationship shaped by shared genetics and biology alongside distinct environmental and societal influences. By advancing a differentiated, multidisciplinary framework, the authors provide an enriched conceptual foundation for future inquiry and intervention design. This reconceptualization has the potential to transform scientific paradigms, clinical practices, and public health policies—ushering in a more holistic and effective approach to mental health promotion.
The clarity and depth of this work will likely catalyze renewed enthusiasm and innovation across multiple disciplines seeking to unravel the intricacies of mental health. As mental disorders and positive mental states increasingly impact public health priorities worldwide, this nuanced understanding is a timely and crucial advance. Ultimately, it moves the field beyond dualistic thinking toward embracing the full complexity of the human mind and its capacity for both vulnerability and resilience.
Subject of Research:
The relationship and interaction between mental ill-being and mental well-being, explored across genetic, biological, developmental, psychosocial, societal, cultural, and clinical dimensions.
Article Title:
The nature of the relation between mental well-being and ill-being
Article References:
Tamnes, C.K., Bekkhus, M., Eilertsen, M. et al. The nature of the relation between mental well-being and ill-being. Nat Hum Behav (2025). https://doi.org/10.1038/s41562-025-02319-x
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