Missing the gap (day 112)

Yesterday I listened to a Stanford lecture on depression.  It was a link from the Open Culture blog (which I highly recommend).   The lecture was an hour long and fairly engaging but throughout I couldn't shake the feeling that the facts we currently hold to be true are in fact quite brittle.  He kept saying "it's not a matter of just getting over it...there are real physical obstacles, physiological changes...".   The experiential gap there is so massive that it's really hard to believe him.   I cannot picture a mental state that I couldn't affect by doing something different...however small.  I can't imagine not being able to bootstrap myself out of a situation.  It's almost like in hearing his presentation I lost touch with the idea of free will (which I know is a problematic concept but let's just say free will with a very small f).  Surely there remains in a depressed person a small gap where something different could happen?   It seems that the manipulation of neurotransmitters is a pretty coarse tool, and not a sustainable one.   It seems that by saying 'it's not their fault, they can't do anything about it' we confirm the helplessness they feel.  The professor in the lecture anticipates my reaction and says we would never say something like that about a diabetes patient.  He has a point except he's relying on an arbitrary definition of disease.   There are lots of diseases that weren't diseases just 5 years ago - especially diseases of the mind or behaviour.  To be clear, I have no qualifications to be saying anything categorical about depression.  I just want to believe in personal agency for change and I'm suspicious of the language we use around depression.

The same applies to alcoholism.  The accepted fact is that an addict is an addict for life, there are recovering addicts but they can never take a drink again because they can't control it.  They appeal to a higher power, etc, etc.   I know it is useful to draw a strict boundary between drinking and not drinking, to help break the habit.  But is it sacrilegious to think an alcoholic could ever return to normal social drinking patterns?  It seems so.   A quick search on google points to circular definitions - "if you are able to go back to social drinking, you were not an alcoholic to begin with".  It's suspicious.  Again I have no deep knowledge in this area, just wondering how something can be such a one way street.

On the other hand, lately there's been lots of talk about the plasticity of the brain and how much we can change.  We've come a long way from the story that was around when I was young when neurons died every day and were never regenerated.  Every day you became less smart.  At least now we know that the brain is a bit more resilient than that.   So how does one resolve the plasticity with the unequivocal statements of inability to change?

A song for this post.