Diathesis Stress Theory Explained


The word “diathesis” comes from Greek and it means a disposition or vulnerability is present. When combined with the stress that occurs with daily living, a person can experience psychological, genetic, situational, or biological factors. Depending on the individual’s vulnerability, a wide range of outcomes may occur.

Most people have some level of vulnerability with specific mental disorders. How people stay resilient against them, and why others do not, becomes the focal point of the diathesis stress theory.

Yet when this vulnerability is recognized in some way, the first reaction of the individual tends to be denial. Most people tend to behave normally and continue plodding through their day until the combination of a trigger and stress creates a major event. Then what may be internalized and hidden becomes externalized and can lead to anxiety attacks, mental disorders, or even a severe mental illness.

What Is a Trigger and Why Is It Important?

For a negative event to occur, a trigger must happen. For the diathesis stress theory, the triggering event takes a vulnerable individual and moves them toward a negative outcome.

Triggers can be almost anything. Genetic factors, biological concerns, or environmental concerns can work together in combination to create a trigger that forms the foundation of a mental illness. Stress can act upon those triggers and worsen the experience, which acts upon the vulnerability of the individual.

For a resilient individual who has experienced a trigger, their natural inclination will be to seek out some sort of coping mechanism which will allow them to continue functioning normally. For a vulnerable individual, the natural inclination will be to focus upon the stress that exists for them, which creates a spiral downward into negativity.

Many mental disorders and illnesses, such as schizophrenia, show that individuals suffering from the condition are affected by numerous triggers that are quite similar. By recognizing these triggers before stress can exploit the diathesis that may exist for that individual, a treatment plan has the potential of being developed to create resiliency.

Can Coping Skills Be Developed That Help with Vulnerabilities?

When the diathesis stress theory is being utilized to help individuals who are experiencing a trigger, the goal is the same for that treatment plan as it would be for any other person experiencing a trigger. Coping mechanisms must be put in place that will reduce the stress loads the individual is experiencing.

Because the diathesis stress theory suggests that many triggers are internal, possibly physical, or related to an individual’s emotional state, the goal is to reduce how those triggers react to the environmental stressors that may be present.

This can be accomplished in a variety of ways. Immediate interventions may benefit from medication. Relaxation techniques may help reduce core stress levels so that the triggers can be responsive to standard coping mechanisms. Skill building opportunities that help individuals recognize triggers so they can be avoided can also be helpful.

By initiating coping skills when a trigger occurs, the goal is to reduce the symptoms that a person may experience because of their vulnerability. When proactive measures are taken to avoid potential triggers or stress enhancers, the possibility of delaying the onset of a mental disorder or illness to which someone may be vulnerable becomes the goal.

Avoidance is Not the Same as Coping

Mental illness rates have consistently affected about 20% of the US adult population for more than a generation. More than 42 million people in the United States have an acute or chronic condition that involves their mental health. This may include bipolar disorder, depression, or schizophrenia.

Another 4% of US adults experience a serious mental illness at least once per year.

This is consistent with data that was published by the Centers for Disease Control and Prevention in 2011 that stated 1 in 4 US adults suffer from a mental illness in any given 12-month period.

What is the reason why mental illness and disorder rates are so high? One answer might lie in how we have defined “coping.”

For many people, coping skills involve watching television, getting drunk, listening to music, or cleaning the house. Although exercise can be helpful and shutting the brain off for a while can make someone feel better, the core issue that created a trigger and the stress which enhanced it will still be there.

Many have switched the definition for “coping” with “avoidance.”

Running away from what happens when triggered does not build skills or recognize alternatives. It simply provides that person with a chance to run away. When that person is ready to stop running, the trigger and the stress enhancer return, often with greater force.

Coping involves sorting through the causes that create the trigger in the first place. Is there a physical issue which causes a trigger? An emotional issue? An environmental issue? And what stress is currently present that could enhance that trigger in some way?

By recognizing personal triggers, proactively reducing stress, and identifying key situations that could create a triggering event, it becomes possible to escape from the negative cycle that diathesis can cause.

Acute Stressors Can Cause Acute Triggers

The impact that a particularly stressful event can have for an individual can be highly variable. Someone may be able to withstand the grief of losing someone extremely well, but spiral downward quickly when they suddenly become unemployed. Social, biological, and psychological factors all play roles when determining the individual vulnerabilities that are present.

Acute events that are highly stressful can exploit the vulnerabilities an individual may have and create an acute trigger that leads to a mental disorder or illness. A divorce, the death of a pet, or even a child screaming “I hate you!” can be enough to combine stress and a physiological trigger to create a breaking event.

Even normal milestone events, such getting married, having a child, or retiring can have a negative impact on a person’s mental health. For children, the milestone of reaching puberty can have a similar impact on them.
What may seem normal for someone and be devastating for someone else.

How we understand mental health must change and the diathesis stress theory is a step in the correct direction. Although some may still call these issues “demonic” or treat people with an exploited vulnerability as “weak,” the negative stigma regarding mental health can and must be removed.

Everyone can be affected by the combination of a trigger and environmental stress at any given time.

That is why mental disorders and illnesses are more complex than what they are really given credit for being. Because no single factor can create a specific trigger for an individual, it is unreasonable to expect one specific treatment plan or process to help provide some form of healing.