Mental fitness promotes mental health through lifestyle change. As described by Drew Ramsey, MD, it offers a non-stigmatizing, strength-based approach that helps patients reconnect with meaning, purpose, and vitality. This guide outlines the nine tenets of mental fitness and how to integrate them into psychiatric care.

Based on an interview with Drew Ramsey, MD, published in the September 2025 issue of The Carlat Psychiatry Report. Inspired by principles from his book: Healing the Modern Brain: Nine Tenets to Build Mental Fitness and Revitalize Your Mind (HarperCollins, 2025).

1. Self-Awareness

• Encourage journaling to improve mood, memory, and executive functioning.
• Reflect on whether specific activities that are working well.
• Identify patterns and triggers that affect mental health.

2. Nutrition

• Assess food security, eating habits, and the patient’s relationship with food.
• Introduce Mediterranean-style dietary shifts supported by evidence.
• Avoid intensive nutrition counseling in active eating disorders.

3. Movement

• Frame as “movement,” not “exercise,” to reduce pressure.
• Explore joyful options: dancing, walking, or recreational sports.
• Recommend 15–40 minutes/day of light aerobic activity.

4. Sleep

• Teach the importance of sleep for learning, memory, and mood.
• Review caffeine intake, light exposure, and bedtime routines.
• Explain concepts like the glymphatic system and circadian rhythm.

5. Connection

• Ask about social supports and isolation.
• Normalize connection through community, art, faith, or service—not just close relationships.
• Recommend low-pressure steps (e.g., sending one message, attending one meeting).

6. Engagement

• Encourage cognitively stimulating activities: puzzles, books, mentoring.
• Reconnect patients with hobbies that offer meaning.
• Pair with other tenets (e.g., a walking book club = engagement + movement + connection).

7. Grounding

• A 90-minute walk in the woods reduces ruminative thinking .
• Suggest practical exposure: breaks outdoors, walks, houseplants.
• Cite benefits like reduced rumination and improved attention and immune function.

8. Unburdening

• Make space to process trauma if it blocks recovery.
• Use journaling or therapy to externalize unresolved issues.
• Normalize that healing from trauma is a part of mental strength.

9. Purpose

• Explore what gives the patient fulfillment or a sense of contribution.
• Don’t push “finding your passion”—focus on meaningful engagement.
• Frame purpose as protective for long-term mental health.

Tips for Clinical Integration

• Start by affirming what patients are already doing well.
• Share evidence to motivate small changes.
• Set collaborative goals—avoid tackling everything at once.
• During acute episodes, prioritize movement, sleep, and connection.
• Stay flexible and nonjudgmental; don’t overwhelm the patient.