Are All Mental Illnesses Related? Cont'd

Our video team recently posted an animation in which former FDA commissioner David Kessler “argues that all mental health issues, including addiction, depression, and overeating, can be explained by ‘capture’—a process where focusing on selective stimuli results in adverse behaviors”:

Several readers find Kessler’s argument to be a little too broad. Here’s Paul Alexander Bravo:

Asking whether mental illnesses are related is like asking whether pie and cake are related because they are two words used to describe food. All things in the universe are related because all that can be said to be part of the universe is, at a minimum, necessarily spatially and temporally related to all that is not itself. But no one can even begin to ask what motivates another human being to behave in any particular way without first knowing what motivates their own behavior, which itself requires truly “knowing” oneself.

A few others, like this reader, disagree with the video’s framing:

FYI, the way this video is done is very dangerous to a severely depressed person. The video concludes with a statement saying, “We’re just wired that way.” The implication (especially to an already suffering mind) is, “Oh well, nothing can be done, might as well give up.”

“Seems like an introduction to a longer series,” another reader offers. He’s not totally off; this video played as an introduction to a panel during The Atlantic’s Summit on Mental Health and Addiction. (Richard Branson’s appearance at the same event sparked a reader debate about whether drugs should be decriminalized.) That panel included Kessler. “Capture is universal,” he argues, offering additional examples:

For readers who still aren’t convinced, Kessler’s Capture: Unraveling the Mystery of Mental Suffering, a 400+ page book on the subject, was released this month. Kessler also did a Q&A about his work with Karen Weintraub of STAT news, which includes this gem:

Anything that’s captured you outside of work?

My first grandchild.

Have any additional arguments for or against capture theory? Let us know. Update from a reader and Zen monk, M. Price:

Is psychology simply going to rename everything the Buddha discussed 2500 years ago and then claim it reinvented the wheel? Mediation, which has specific instructions depending on school, became watered-down “mindfulness,” and now attachment is “capture.” However salient the claim may be, Buddhism rightly points out that without right means, it is impossible to cut attachment asunder and achieve lasting freedom/enlightenment. Something tells me the field isn’t about to convert and then let its patients fly away like little birdies.

Moreover, to claim bipolar disorder, schizophrenia or even unipolar depression are the result of attachment is to ignore all of the genetic biomarkers which predispose to these conditions. The NIMH is specifically working on getting away from these fantastical notions of “single causes” and towards verifiable tests and criteria for diagnoses, which currently do not exist. This problem severely hampers all aspects of management of these conditions.

I think if the director wanted to point out that eating disorders, addiction and OCD in all its foci might in fact be the same condition in different guise, then now we’re talking. OCD, which can be called “greed,” too, if we like, is in my opinion fertile ground for “capture” research, not all of mental illness.

Speaking of eating disorders and addiction, here’s another reader:

As both a smoker and a person who has struggled with disordered eating for the last eight or so years, I can assure you that the mechanisms behind both are incredibly complicated. In the case of the eating disorder, for instance, both restricting and binging/purging are manifestations of my feeling of being out of control—they are maladaptive coping mechanisms for my depression and numerous types of anxiety.

Where do these disorders stem from? In part, likely, genetics; in part, I believe, the extreme academic/social pressure I experienced from my parents and wider community in the county I grew up in—but they are also side effects of a raging case of lifelong ADHD, which was only very recently diagnosed. ADHD is highly heritable and is a neurobiological executive dysfunction, so it seems highly inaccurate to me to call it a result of capture.

Indeed, capture theory, when applicable, seems that way only because it is so broad. It’s like saying that sense perception all stems from “neural processing of external stimuli.” I mean, duh. Your brain picks up certain things and some of them result in mental illnesses, yes, but capture theory sounds to me like a huge overstatement of how closely related this implies mental illnesses to be.

A friend of mine experienced a period of major depression after the death of his father—capture theory? Probably, insofar as he was focused on the loss. Meanwhile, my depression likely stems from constant feelings of inadequacy and inability—also attributable to capture theory, if you consider my preoccupation with my own dysfunction. Yet it seems that my friend and I were struggling in very different ways—he from an outside event and me because undiagnosed ADHD caused me to internalize a great deal of self-loathing. Yes, both are results of “capture” of negative thoughts, but when they are experienced, based in, and treated by such different things, is capture theory really a particularly unifying force?