What causes mental illness?

While I can’t give you all the answers, take a look at this model which helps in identifying and treating mental illness.

The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition, has defined depression as 5 or more of the following symptoms that are present for 2 or more weeks and cause significant emotional distress and/or impairment in functioning:

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  1. depressed or sad mood
  2. short-tempered or easily annoyed
  3. loss of interest or enjoyment in hobbies or activities that was previously enjoyed
  4. feeling of worthlessness or guilt
  5. thoughts of death or suicide
  6. difficulty with concentrating or making decisions
  7. feeling tired or fatigue
  8. feeling restless or slow
  9. changes in appetite such as overeating or loss of appetite
  10. changes in weight such as weight loss or weight gain, and changes in sleep pattern.1 

According to the National Institute of Mental Health, depression occurs due to a combination of genetic, biological, environmental, and psychological factors.2

Genetic vulnerability refers to the inherited characteristics passed on from parents to children that make it more likely that a person will develop a mental illness or addiction.

Biological theory suggests that depression is caused by an imbalance of naturally occurring substances called neurotransmitters (Serotonin and norepinephrine) in the brain and spinal cord.

Depression is said to be almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones (biological)

Psychological and environmental/social factors—such as lifestyle choices ie too much alcohol, past trauma, low self-esteem, substance abuse and loneliness can also play an enormous part in depression.

Treatment for depression consists of participation in psychotherapy, taking antidepressants, or a combination of both. However, many individuals don’t participate in psychotherapy or antidepressants due to factors such as side effects, lack of access/resource, or personal choice.

According to Agius et al 2010, the Stress Vulnerability Model is an extremely useful model for identifying and treating relapses of mental illness. We accept that humans carry genetic and other predisposition to mental illness. However, the question arises as to how stress impacts on a person in order to cause mental illness to develop. Furthermore there arises the issue as to what other effects such stress has on the human body beyond the human brain. 4.

The Stress Vulnerability Model explores the interrelationship between all these factors, and the genetic component which in large part constitutes the ‘vulnerability’ part of the model. Such problems occur in many Psychiatric illnesses, including Depression, PTSD, as well as Schizophrenia.

Vulnerability Factors predispose individuals to develop mental health problems e.g psychosis, clinical depression. Problems are triggered by stress. If vulnerability is high, low levels of environmental stress may trigger distress. Use and effectiveness of coping strategies goes some way to explain why some have problems and others don’t.

Let’s take a look at the model and I’ll share how my vulnerability lead to a psychotic depression:

Look along the bottom where it says Vulnerability – high to low. For me, because mental illness runs in the family (genetic) I have a predisposition to mental illness. I grew up with mum as single carer for four children, I was shy and had low self-esteem (psychological). We moved a lot, I went to more than ten schools and each time I was bullied because of my new accents (social/environmental), then there’s the childhood abuse (psychological), so — I have a high vulnerability to mental illness.

Now look at the left-hand side where it says stressful events: my ex had a baby with someone else, then the breakdown of my relationship, my ex was cheating, I experienced domestic violence, one of his girlfriend’s plagued me for eighteen months, I wasn’t sleeping, I felt suicidal, I was now a single parent and didn’t have any real coping mechanisms other than to bottle it all up. Therefore, you can add up all the stressful events and my arrow is very high, as in the diagram.

Follow that curve in the model and you’ll see how I have an extremely low stress threshold towards mental illness. Hence my psychotic depression, anxiety, panic attacks and anorexia.

While I still have a predisposition to mental illness, there’s been a huge reduction in my stressful events so I now have a higher threshold for stress.

So, back to the chart — Along the bottom line, I’m at the end, on the right ‘high vulnerability’. But along the left side, I’m presently low down on the scale as I have minimum stress at the moment (trace along the chart with your finger). So you’ll see, I’m currently in the mental health category, rather than mental ill-health.

Is this your empty toolbox? Photo by worthpoint.com

I still experience depression and anxiety but they tend to be reactive. I still take medication and I have an extensive toolbox of coping techniques that I can use, when necessary.

I found this model really helpful when working with patients and they liked how it might explain why they developed a mental illness. If you have a mental illness and you wonder why, try using the above chart to see if it’s helpful in determining the how or the why me?

Does this model fit with your ideas? Where would you sit on the graph? Do you think vulnerability needs more explanation? I’d really appreciate your thoughts.

Author: mentalhealthfromtheotherside.wordpress.com

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

42 thoughts on “What causes mental illness?”

  1. Don’t you think it fascinating how we take something subjective, like difficulty making decisions (how difficult is difficult?), then we are able to say quite objectively that five such symptoms equal depression? You know, four don’t but six do. I’m not being funny or anything, but as I have a science background I find this mix of subjective/objective quite difficult to grasp.

    Liked by 2 people

    1. It is fascinating. I get what you mean. But how difficult did you find it 😉 Although it is evidence-based — from thousand’s of studies, unfortunately, psychiatry and mental illness will always be that way (in my lifetime anyway), complex. The good thing was and without question, it gave patients some starting blocks to understanding their illness. Do you what, no one ever raised that issue. Thank you for mentioning it Pete. Caz x

      Liked by 1 person

      1. I managed to get it 🙂 I have a scale myself on how difficult I expect posts to be to read and your’s are usually not so high 😆. But it is interesting that a 1 on one person’s scale might be a 10 on another’s. I know the system is built to take that out, but there must be some.

        Liked by 1 person

      2. Yes. Doesn’t that make sense? We all have different physiologic human systems. Even just take cancer some people can smoke til their 90 and never get lung cancer, others not a day in their life and get it as well. I do believe there is no ‘standard format’ of depression but I do believe depression hits us all on many of these points. Ya know?

        Liked by 2 people

      3. Thank you Lizzy. You’re right, there is no standard in depression and mental health and we just have to use the diagnostic rating scales there is. And the same for treatment, sometimes we had patients on 4-5+ medications until one of them was effective.

        And yes, many people are prone to – at least – mild symptoms of depression.

        Like

  2. I like this post, thank you. I think currently, I myself have PTSD… I’ve had too many massive “life rocks”… happening one right after the other for past 3 years. I didn’t have time to process the first one before something else happened. Was like being punched in the gut continuously. I feel like currently I just have to be silent. Being silent kills me, kinda kills my spirit a little bit. I hold it all together because I have to, I am a mom. And I do believe I can get through it. But I hate being silent. I feel when you speak of things it can help others through?

    As 2020 begins – I am starting to see the sun rise little by little… my life is starting to realign. I fight hard to make things better because I do know eventually they will be. Like a rollercoaster – ups and downs.

    I think this was my period of learning things about people and life.

    But I do think I have PTSD… I have isolated away from people I love and any bad things. I stay away from the internet and Facebook and the news… I am very guarded with people now. I keep to myself – I am friendly and when you are around me I seem very normal… you would never know. But in my own personal life – I am silent. I was never like that. I am not like that… but at this moment it’s my coping skill.

    Too much trauma all at once, so I’m still in the process of learning, accepting and absorbing. I always keep in mind – everyone has their issues and traumas … I know I am not alone there. And I also know life is going to have its ups and downs.

    Currently I am on the edge of the storm – almost out of it. I think I will be stronger and start to come back to life once I rebuild and restabilize my life. I know it’s going to be amazing, once I get through it. I have a good mind set as far as being strong…

    But mental illness does run in my family… kinda? My grandfathers brother committed suicide in his 20’s … and then my moms mom had Alzheimer’s, now my mom does… my grandfather just before he died began having dementia…

    So I am just aware… I remember to make sure to try to keep a small balance, appreciate life itself, and good people and laughter save my life. I try to keep a strong good perspective – I have my moments like everyone else. Sometimes things are too heavy or too overwhelming, that’s where I shut down and isolate currently. I do that to cope. But it never stays that way. I am a fighter for my spirit and strength. Once I have made my life stronger which I am working on, I know I will be back to myself… recently with better events happening – I can feel myself coming back to life.

    Sometimes I worry that all the trauma could cause me to get Alzheimer’s early – since so far been my moms mom, my mother – so I worry sometimes it will come for me –

    And with Alzheimer’s brain trauma from traumatic events makes it worse. I am forgetful and my personality mannerisms and kind of person is a carbon copy of my mother. So it’s a thought … I read everything I can about it. Which can be funny cause I read an article that said drinking olive oil helps… umm ewww lol… but I joked with my sister in law at a restaurant and said maybe I should order a glass of olive oil when they ask what we want to drink lol. (I didn’t, cause eww … but was funny)

    So I loved this post… the one thing about mental illness … is it’s not like a physical medical issue… those have no stigma… but mental health does…

    And so many people have mental issues and problems… it is hard… I myself do not want people knowing I struggle with such massive pain and loss. I have always been the upbeat one, always with a smile and makes others smile.

    And then, I don’t want anyone’s pity or to stay away from me because they don’t know what to say or how to react with me. So I keep it to myself

    So for me that one is hard – mental illness is very hard. The mind is such a incredible thing.

    While I do believe I have PTSD, I cope with it and I am rebuilding – I like to think that I am under construction 🚧 for the next amazing phase of my life… like a caterpillar in the cocoon getting ready to turn into a butterfly 🦋

    I just had to experience some life rocking things, yes they rocked my core, but I survived so far… and I haven’t given up.

    So my spectrum hmm? Well it’s getting better little by little. My smile is coming back slowly. And I’ve learned a lot about myself and I continue to.

    Right now I am in a phase of learning and knowing myself. So what doesn’t kill you does make you stronger.

    Does vulnerability need a explanation? Not really sure what you meant by this? Everyone is different and handles things in their own way or how they know how to… their own biology and life experiences formed who they are. Aren’t we all vulnerable at some point?

    My issues have stories as to why I isolate right now… so I have an explanation. In order to get past something you have to face it and know it before you can move past it or fix it.

    If a faucet is leaking, you have to find where the leak is coming from before you can fix it…

    So doesn’t all of it need explanation? And vulnerability – that’s tough. Because pain or fear is attached to it. It’s all how someone is able to cope.

    I think I’m a pretty strong woman… not perfect – and still working on myself …

    I have a friend who always says clichés lol… she always tells me “you know what makes a diamond?” Pressure

    I hate when she says that but whatever lol … I am definitely a diamond 💎 10 times over!!! Lol ✌️

    I would be curious to know… if someone has a mental illness… could changing the diet specifically around their dna make up… could that help? Or even fix?

    In today’s fast paced and connected world – mental illness seems to be on the rise?

    We have to give our kids good examples and teach them how to have strength through things. I didn’t learn strength until now… so I did need lessons… and that helps me with understanding, compassion and moving forward.

    Anyway – you opened flood gates lol – sorry so long … but I felt my vulnerability did need explanation 😘✌️

    Really loved this post – thank you!

    Liked by 2 people

    1. Hi and thank you for your comments. I feel your pain, really I do. It’s awful when major life events happen one of after another, like they did for you. I can’t possibly know how you feel as fortunately, I still have both my parents.
      I hope that. now you are learning about yourself, you’ll gain more confidence in your coping mechanisms — learn new ones and find out which ones work best for you.

      You sound like a strong lady but I know we all have our limits as to how much we can take before we ‘break’.

      You asked about diet and while there is some evidence that suggest some foods will help stave of dementias, I personally am not sure – how much of these foods would you have to eat for them to actually be useful?

      In this model, vulnerability means we’re more predisposed to mental illness because our parents have it. And if we have one episode of mental illness, we are vulnerable (predisposed) to having another. I hope that’s explained vulnerability in this sense.

      There is a hereditary component to Alzheimer’s. Reseach suggests that people whose parents or siblings have the disease are at a slightly higher risk of developing the condition and that it appears to be passed down through the mother’s genes. I know it might be stressful thinking that you”ll also get Alzheimers too but if it was me, I’d try not to worry too much. The only other thing would to get tested?

      Also, have you seen your GP about your mood yet? He might think it’s not PTSD, it’s possibly a reactive depression? Perhaps it would be a good idea to speak to a professional to get a diagnosis and some counselling – it might help if you talk it all through with some one, in confidence.

      Yes, we do have to teach our kids through good examples and help them develop their own coping skills. It’s sounds like your own strengths will be a good example.

      No need to apologize and no explanation necessary. I hope you continue to strengthen and grow and look forward to hearing about your journey. Caz x

      Liked by 2 people

      1. Oh yes … there were times when I teetered on that breaking point – but in those moments… I think of this… it’s just a moment in time – all things pass… no way was I going to let life take me down like that! I believe things happen for reasons and you take lessons from life… And I have kids who need their mother still… I want to be that example of strength to them… but it’s hard cause I am their strength … but for a moment, I lost mine… I lost all my strength losing people I loved and how things were going – during all that I also had cancer and was getting out of abusive marriage so it was hard… I made it through the cancer, I’m coming to terms with the loss of my family, the divorce is almost finished, and I’ve started to come alive again… slowly – I am the turtle not the hare lol

        But I felt like I was the strength in front of my kids… but losing my family left me without strength and having to learn that really quickly… I never to expected to lose everyone so suddenly one right after the other – was kinda shell shocked ?

        I do have the most amazing people in my life – all my old friends constantly check on me, and new ones have stepped into my life too… so that also rebuilds my strength… which is also why I hate the isolation … I feel is important to have people. I have that, which does give me strength, but I’m still coping… I think I might be coming out of that? I can feel it and I’m starting to speak somewhat (little at a time) This blog helps me sort out a lot and release.

        Yes that did explain the vulnerability aspect – thank you

        I don’t worry too much about Alzheimer’s… I think about it once in awhile but not enough to make me really worry or stress on it… life is going to happen so I’m going to enjoy what I can while I can. But I am fully aware I have a strong possibility.

        I have not spoken to my GP about it. You are right would help and I have spoken to them about setting up an appointment, I am in the process of that currently.

        And I always just assumed was PTSD because I seem to fit all the symptoms … and I don’t know if I would say I am depressed ?? I am a weird one… I use comedy to keep my balance, typically I am a positive person and I’ve been avoiding the bad stuff … anything that is bad or causes pain or heaviness in my own life- I am currently in avoidance of. I only mention my feelings here where I feel is anonymous. Plus I can cry and no one sees me, I like that better. I am private. But yes most definitely a good thing to speak with a trained professional who can maybe help me through these things. I am not very open to medications, but talking might help.

        Thank you very much for the thoughtful and kind response! ❤️

        Liked by 1 person

      2. I can only imagine how you teetered on the edge and I’m happy to read that you’ve been able to pull yourself back a bit. I use that also – and this too shall pass 🙂

        But I can see how you were close to the edge with your parents, abusive marriage and cancer!! You really have been through a lot — and all at once. And yes, I get it. Inside you’re dying and yet you have to carry on and be the support for the children, I certainly know how hard that is and I wouldn’t want to see anyone in that pain.

        I liked reading that you can ‘feel’ that you’re almost ready to come out the other side. Trust me, you will be even stronger and it’s such a great ‘feeling’. I literally ‘felt it’ (getting better) rather than just thinking it – I know this might sound a bit ‘out-there’ and I’m not religious in any way but I did ‘feel it’.

        I’m also happy to read that you are in the process, waiting for the counselling. It could be a lengthy wait but when it is available (even if you’re feeling better) I believe it would still be beneficial. I think everyone should have counselling, lots of people could benefit from it.

        You probably will find you cry in therapy but for me, it was such a release. I felt like a pressure cooker, ready to blow!!

        I too was the ‘happy’ one, the comedian, the fun person, the go to person — now, hubby would say I’m megative but I say I’m a realist – can’t be doing with all this ‘when we win the lottery……..” I’m not so open and trusting anymore, but that’s okay.

        I’m glad you have good people around you too as we all need that support, especially when we have children. We tend to keep strong for them, don’t we?

        You keep looking after yourself, okay. I’m looking forward to readin your blog so I’m going to pop on over there now 🙂

        Caz x

        Liked by 1 person

      1. Aaaww, thank you Lizzy. I’m so happy you like my post. I know how difficult it must be for our military and veterans. Some years ago I I held a Mental Health First Aid (MHFA England) course in a homeless centre for vets in West London and the feedback was terrific. I was there for two days, presenting the course to staff — but my favourite time was out in the garden chatting with the vets and listening to the life journies. I found it heartbreaking that after what they done for their country, they are left homeless. Lizzy, as you mentioned the military, I thought you might like this post?
        https://mentalhealthfromtheotherside.com/
        You take care and thank you once again. Caz x

        Liked by 1 person

      2. Hi. Can’t reply to your post below for some reason. But I mentioned military as I thought that was where the PTSD came from. It’s the only reference I know about. ( silly me ). Anyway thanks for the link!

        Liked by 1 person

      3. Well I am not sure if is PTSD… and I am not in the military. (But I also thank them, as I do have friends and family members who are)

        The reason I said PTSD, is because I have had a lot of MASSIVE mental trauma one right after the other within a 3 year time period. So I never had chances to absorb and process the first thing before the next occurred.

        It was incredibly hard and took every ounce of strength… I am left exhausted and kind of developed ways of coping that are not how I usually am – such as isolation with people and avoidance of anything or anyone bad.

        I have close friends in the military and I had recently called one of them because I also thought PTSD was “military only” type thing… but some of my things were matching. He told me with the trauma I have experienced it is possible, and that PTSD is not just a military condition.

        He said… PTSD is not a term designated only to combat trauma. It is a brain defense mechanism to try and hide and forget mental trauma.

        I do that at this moment… I isolate, and hide.. I also completely avoid anything that is going to cause pain or hurt or too heavy of an emotional response.

        I’m tired and exhausted … etc

        BUT… recently as of lately… good events are “starting” to shine … I survived cancer – which had completely halted my entire life, I got away from an abusive brutal divorce and that is almost over with “legally”, also – I lost my father and my grandparents – one right after the other – along with other family members and friends … and then after my dad died we learned he and my mother had hidden from all of us family and all their friends that she had Alzheimer’s … my mom was my everything … we had to take control over her and I couldn’t even tell her I had breast cancer because they said it could loop her in terror… so I had to go through everything alone and by myself. I had never been so alone “like that” before.

        I DID have wonderful and amazing support through the cancer… my friends and community and people I didn’t even know, were there to hold my hand through that… thank god! ❤️ Got me through some really dark and scary moments

        But anyway… I’ve had a lot of traumatic things that really rocked my life in just “3 years”.

        So I went into a “shell” essentially. Was my coping method.

        I am at the tail end of that, and I can feel peace on the horizon – things are different now … kind of like a new chapter of a book? I fight to make sure I can survive and my efforts and life are aligning finally.

        I miss my family so tremendously – and my mom – that just kills me… I want her back… she’s still here – but Alzheimer’s is a horrific condition – it takes someone away from you, but let’s you still have them there – only to watch them deteriorate in front of you.

        I love that I still have her and did not totally lose her … and now it’s just different … I can still hug her and tell her I love her… But I miss being able to “have” my mom in a mental capacity.

        So that’s why I thought PTSD… so much trauma to my own brain and how I have coped with it. But not because I am military.

        I just wanted to clarify because I definitely honor and respect military and can’t imagine things they see and go through. Mine is just on a more normal person type scale. ✌️

        Thank you though 😘❤️ I am at the end of my massive storm. And I do feel myself coming back to life. Just takes time.

        Like

      4. You’re right, PTSD isn’t only for the military or Vets. Anyway can develop it and you have had a lot happen in a short period of time. And going through cancer without your mum ‘being there’ to comfort you must have been awful. I can’t even imagine.

        No, I just wondered about the military and thoughts perhaps you or your family were from a military background. I too have a lot of respect for them, the things they see and go through.

        I’m glad you can see a brighter future ahead as you certainly deserve it. It will take time, you’ve a lot to process. Just as long as you don’t bottle it up – like you said, you’ve had some amazing people and support around you. I’m happy to hear that.

        I’m here if you ever need to talk 🙂 Caz xx

        Liked by 1 person

  3. I liked working with this theory too, especially explaining to loving family members that even when vulnerability is high a person can endure some stress, some challenges and will be able to stay in the healthy zone. That we don’t need to put vulnerable patients in some sort of a glass box to only look at. It was reassuring to most family members that it is needed to try to manage some things with appropriate steps.

    Liked by 1 person

    1. You’re right. I saw lots of families treating their kids or other loved one like they’ll snap in two. When they can actually endure certain amounts of stress and still stay in the healthy zone. Of course, with more teaching from professionals, patients can identify their own prodromal (the period between the appearance of initial symptoms and the full development) symptoms and take action to stop further development into a full blown episode of mental illness.

      Liked by 1 person

  4. While this only addresses depression and not bi-polar. ( although the depression element is the same ). I can tell you I feel I totally understand the ‘why’ for bipolar. It is clear to me it’s genetic. Inasmuch as I am the ‘poster child in my family’ nearly all of the 8 kids in my family deal with bi-polar and depression. ( two are unmediated bi-polar. One is perfectly fine . That’s 7 of 8 children. My mother dealt with depression but was not aware of it until she hit menopause. I am sure the stress of raising 8 kids had her depressed at times however she found her solace in going upstairs and reading . Being a depression baby there was not only no understanding that this was a treatable illness, there were reasons why her life was stressful both economically and how to equally love 8 kids.
    My mother was singularly the most intelligent person I have known. Both she and my dad raised a full family of highly intelligent children that apparently, after many decades of my syblings saying I was the brightest in my family about 8 years ago I said. Ok you may be right.
    When I was deeply depressed I felt I was a fraud and figured out how to manage social situations so no one would know. On the other end of the spectrum I was so empowered I felt like I could do anything I set my mind to. Both professionally and personally I did just that.
    Net net bi-polar is genetic and filled with many intelligent minds. We try to understand the what is going on and we strive for success putting one foot in front of the other no matter how hard it was .
    Depression I am not sure. It may be situational. How you were raised to prepare you for the adult world or physiological. In America depression kicks in for many during their change from adolescence to an adult. I have read it typically happens in women at about 14-16.

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  5. I had no idea irritability is now a qualifying symptom for depression in adults too. I must say, I easily ticked off more than five boxes even though I’ve not been considering myself majorly depressed lately. For me, slowness, fatigue and a low mood are chronic.

    Liked by 1 person

  6. The list you have for depression…I don’t know why I’ve never gone to the doctor about it. I easily checked off 8 and the other two are off and on. It’s rather alarming. I mentioned to my counselor back in October that I had been so down that I couldn’t remember days at a time. If I was asked what I did during the day I had no recollection at all. I’d answer things like I did the dishes, had coffee, checked facebook…Things that I would just do on auto pilot. My counselor wasn’t concerned at all. I mentioned it to my doctor then. By this time I was generally concerned because I couldn’t seem to find the feelings I had for anything, not even my kids. It felt like I was in my body watching some stranger take over and I was screaming inside but no one could hear me. I could often see myself like I was watching a movie, it was really strange. My doctor told me that if it continues to come back and see him. It had already been nearly a month and I thought maybe it was my medication he gave me for pain. He said that was very unlikely but then didn’t ask any questions or offer advice. I left feeling like I was just crazy and exaggerating my thoughts. I’ve suffered this for most of my life but never had it that bad before (except once as a teen). Because of how no one ever seemed worried about my concerns I figured it was all pretty normal for my circumstances and just kept trying to move forward.
    Thank you for sharing this, it’s very well written and it helped me realize that I should probably go and talk to my doctor again.

    Liked by 1 person

  7. Is this graph specifically for schizophrenia or is it for mental illness in general? I can’t help thinking the curves might look different for specific mental illnesses or for specific people. Humans are such complex creatures. Which is nice when it comes to nuanced experiences but frustrating when something gets misaligned. 😕

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    1. It was specifically for schizophrenia but research shows The stress vulnerability model (Zubin et al. 1977) is an extremely useful model for identifying and treating relapses of mental illness. I get what you’re saying – himans and mental illness itself is complex. We’d done the research and found it fitting to our needs. Our Consultants would always refer to it and we found it useful when working with patients. But, as I’ve said before, this would be one ‘tool’ from our large toolbox that we adopted when needed. Hope this helps 🙂

      Liked by 1 person

      1. Ah, I see. I was just wondering if the curve is steeper for some people or illnesses. I’ve known people who can behave as if they have reached an extreme stress level in response to seemingly minor things (like buying groceries and finding out there was still plenty at home) and then quickly go back to neutral. Of course, maybe that’s just a display to ward off further stressful information or a loud emotive response that actually relieves stress. 🙂

        Liked by 1 person

      2. A quote from you, ‘extremely useful model for identifying and treating relapses of mental illness’. It is a very useful model for those purposes. However, what I find stressful most individuals would find not noteworthy or even enjoyable.

        Liked by 1 person

      3. Your model is great for depression and anxiety however even though the model was first used for schizophrenia I don’t think the model is too useful for schizophrenia. In terms of coping with stressors all that an individual with schizophrenia can do usually is withdraw. Some individuals with schizophrenia are in relatively favorable situations where other individuals are understanding but I hate to say this if an individual with schizophrenia is not among understanding individuals there is basically zip an individual with schizophrenia can do to cope except withdraw. There is the problem also that individuals with schizophrenia even on appropriate dosages of medication quite frequently misunderstand other individuals vis-a-vis which limited contacts with other individuals is frequently a morally correct course of action for individuals with schizophrenia. I don’t think stress causes schizophrenia, however, individuals with schizophrenia can not handle stress. There is a difference.

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      4. I get all this Thomas. Despite only having one long psychotic episode, I understand the need to withdraw. I also worked particularly with patients who had schizophrenia, together with their familes so that they could understand the onset of schizophrenia and the ensuing episodes. I really appreciate what you’re saying and thank you for taking the time to comment. Caz 🙂

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