Transforming towards global sustainability requires a dramatic acceleration of social change. Hence, there is growing interest in finding ‘positive tipping points’ at which small interventions can trigger self-reinforcing feedbacks that accelerate systemic change. Examples have recently been seen in power generation and personal transport, but how can we identify positive tipping points that have yet to occur? We synthesise theory and examples to provide initial guidelines for creating enabling conditions, sensing when a system can be positively tipped, who can trigger it, and how they can trigger it. All of us can play a part in triggering positive tipping points.

Recent work on positive tipping points towards sustainability has focused on social-technological systems and the agency of policymakers to tip change, whilst earlier work identified social-ecological positive feedbacks triggered by diverse actors. We bring these together to consider positive tipping points across social-technological-ecological systems and the potential for multiple actors and interventions to trigger them. Established theory and examples provide several generic mechanisms for triggering tipping points. From these we identify specific enabling conditions, reinforcing feedbacks, actors and interventions that can contribute to triggering positive tipping points in the adoption of sustainable behaviours and technologies. Actions that can create enabling conditions for positive tipping include targeting smaller populations, altering social network structure, providing relevant information, reducing price, improving performance, desirability and accessibility, and coordinating complementary technologies. Actions that can trigger positive tipping include social, technological and ecological innovations, policy interventions, public investment, private investment, broadcasting public information, and behavioural nudges. Positive tipping points can help counter widespread feelings of disempowerment in the face of global challenges and help unlock ‘paralysis by complexity’. A key research agenda is to consider how different agents and interventions can most effectively work together to create system-wide positive tipping points whilst ensuring a just transformation.

We identify key actors and actions that can enable and trigger positive tipping points towards global sustainability.

Childhood maltreatment is one of the strongest predictors of adulthood depression and alterations to circulating levels of inflammatory markers is one putative mechanism mediating risk or resilience.

To determine the effects of childhood maltreatment on circulating levels of 41 inflammatory markers in healthy individuals and those with a major depressive disorder (MDD) diagnosis.

We investigated the association of childhood maltreatment with levels of 41 inflammatory markers in two groups, 164 patients with MDD and 301 controls, using multiplex electrochemiluminescence methods applied to blood serum.

Childhood maltreatment was not associated with altered inflammatory markers in either group after multiple testing correction. Body mass index (BMI) exerted strong effects on interleukin-6 and C-reactive protein levels in those with MDD.

Childhood maltreatment did not exert effects on inflammatory marker levels in either the participants with MDD or the control group in our study. Our results instead highlight the more pertinent influence of BMI.

D.A.C. and H.W. work for Eli Lilly Inc. R.N. has received speaker fees from Sunovion, Jansen and Lundbeck. G.B. has received consultancy fees and funding from Eli Lilly. R.H.M.-W. has received consultancy fees or has a financial relationship with AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Ferrer, Janssen-Cilag, Lundbeck, MyTomorrows, Otsuka, Pfizer, Pulse, Roche, Servier, SPIMACO and Sunovian. I.M.A. has received consultancy fees or has a financial relationship with Alkermes, Lundbeck, Lundbeck/Otsuka, and Servier. S.W. has sat on an advisory board for Sunovion, Allergan and has received speaker fees from Astra Zeneca. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, Janssen; and research grant support from Janssen. A.J.C. has received honoraria for speaking from Astra Zeneca, honoraria for consulting with Allergan, Livanova and Lundbeck and research grant support from Lundbeck.