[HN Gopher] Vitamin D and Omega-3 have a larger effect on depres...
___________________________________________________________________
Vitamin D and Omega-3 have a larger effect on depression than
antidepressants
Author : mijailt
Score : 815 points
Date : 2026-01-29 10:35 UTC (12 hours ago)
(HTM) web link (blog.ncase.me)
(TXT) w3m dump (blog.ncase.me)
| vegancap wrote:
| I found this to be the case. Tried Sertraline for a while, gave
| me headaches and made me feel sick. Then as part of a new gym
| plan, started taking Omega 3+VitD daily, and I just felt a sense
| of calm and peace after a few weeks. The massive uptick in
| exercise probably also helped. I also felt quite an extreme
| uptick because I was a vegan for 10 years, and found out I had
| basically zero Omega 3 in my blood. I suspect one of the main
| reasons my mental health declined was due to the lack of Omega 3.
|
| Disclaimer, not saying vegans should stop being vegans, just make
| sure you find a good supplement, and make sure you understand the
| difference between EPA/DHA Omega 3.
| dvh wrote:
| > as part of a new gym plan
|
| There's your answer
| vegancap wrote:
| Possibly, deffo would have been a big factor. Anecdotally
| though, I forgot to take these supplements for a while
| recently, just got out of the habit, and definitely felt
| worse again for a bit. But, could have been a
| coincidence/something else
| serpix wrote:
| Omega 3 comes from algae, which might be okay for some vegans.
| hshdhdhj4444 wrote:
| What vegans would not be ok with algae?
| buddhistdude wrote:
| algerians
| Kichererbsen wrote:
| @buddhistdude - thank you :) made my day!
| tefkah wrote:
| Unlikely any vegan would have any moral qualms about algae,
| given that they're not animals. Maybe you were thinking of
| oysters/clams/bivalves?
| quietbritishjim wrote:
| I think they meant their vegan diet didn't naturally have
| Omega 3 in it if they didn't take supplements; not that they
| couldn't take the supplements once they realised it.
| augusto-moura wrote:
| Or fish oil
| vegancap wrote:
| Yeah I took that for a while, and did slightly improve
| things. Only problem I had at the time was those were super
| expensive in the UK. Maybe that's changed now
| hshdhdhj4444 wrote:
| All my nutrient numbers improved when I became vegan because
| nearly every one in the US/UK is deficient in VitD, Omegas and
| B12.
|
| Fortunately today's vegan communities are much more aware of
| this so I started taking these supplements right up front and
| all my blood markers improved dramatically since when I
| consumed meat/dairy.
|
| It's annoying to hear some push back against this when it's as
| simple as taking relatively safe supplements (just make sure
| you talk to a doctor, and not a social media influencer, about
| how much you should take, and if you get a chance to regularly
| check your bloodwork don't miss out).
| johnisgood wrote:
| Why did you become a vegan if apparently even non-vegans are
| deficient in B12? Do you supplement B12? Since B12 is mainly
| found in meat, and B12 deficiency is irreversible.
| tefkah wrote:
| why do you think the reason for them becoming vegan has
| something to do with B12 levels? likely they became vegan
| for different reasons, became much more aware of the
| importance of B12 and started taking a supplement.
|
| every vegan should supplement b12, so they probably do too
| johnisgood wrote:
| > All my nutrient numbers improved when I became vegan
| because nearly every one in the US/UK is deficient in
| VitD, Omegas and B12.
| pseudalopex wrote:
| > Fortunately today's vegan communities are much more
| aware of this so I started taking these supplements right
| up front and all my blood markers improved dramatically
| since when I consumed meat/dairy.
| johnisgood wrote:
| Yeah but that sentence does not refer to why the person
| switched to being vegan, the first one does. In any case,
| let us not beat the dead horse there. :P Supplement B12
| and it is fine.
| vegancap wrote:
| My cholesterol improved massively, but over time, a few, such
| as Omega 3 suffered. But those were ultimately my own fault,
| wasn't managing it properly. So, I'm absolutely not
| suggesting there's an issue with veganism, this isn't really
| why I fell out of it. So I do want to stress I wasn't
| suggesting people should steer clear of Veganism, just
| something to be mindful of. Oh, and my cholesterol
| immediately shot back up again when I stopped being a vegan.
| So, swings and roundabouts with every diet/lifestyle, I
| guess!
| brushfoot wrote:
| > I was a vegan for 10 years, and found out I had basically
| zero Omega 3 in my blood
|
| I see your disclaimer, but just for more context, vegans can
| get Omega 3 without taking pills per se. Flax seeds are an
| excellent source. I often add a spoonful to a bowl of oatmeal
| or as a pancake topping along with fruit sauce and granola.
| pydry wrote:
| Flaxseeds are probably the most flavorless things I've ever
| tasted.
|
| Chia seeds taste ok but you need to prep them by soaking
| which is a pain (or experience bloating).
|
| All other seeds have more omega 6 than omega 3.
| grvdrm wrote:
| Funny - I feel the opposite about chia. Soaked and plumped
| is when I hate them. Dry on salads/etc. or just submerged
| in an active bowl I'm eating is when I like them most - the
| crunch adds texture to what I'm eating.
| canucker2016 wrote:
| Grind the flaxseed before eating them so your digestive
| system can access more of the nutrients in flaxseeds.
|
| from https://www.bhf.org.uk/informationsupport/heart-matters-
| maga... : Eating ground flax seeds gives you
| more benefits than whole seeds, as whole seeds remain
| undigested and pass through the system.
|
| from https://www.peoplespharmacy.com/articles/must-you-grind-
| flax... Most people can't chew flaxseeds
| effectively, so they grind them first or swallow them whole.
| (They are tiny.) Nutrition experts do recommend grinding them
| first to release the fiber and the beneficial fatty acids.
| Flaxseeds are helpful for constipation and may lower
| cholesterol as well. Ground flaxseed goes rancid
| easily, however, so it should be kept in the freezer until
| you are ready to use it. If you buy it ground, you wouldn't
| have to use the blender or coffee grinder to break those
| seeds up before you have breakfast.
| mistercow wrote:
| Flax seeds are a very tedious and inefficient way to get
| omega-3 as a vegan, particularly because they contain ALA, a
| short chain omega-3, which our bodies are extremely
| inefficient at turning into long chain fatty acids.
|
| Just get an algae oil based DHA+EPA supplement.
| the_pwner224 wrote:
| Flax seeds & other seeds provide ALA but not EPA & DHA. You
| need all 3.
|
| The body has some ability to convert ALA to EPA & DHA, but at
| extremely low rates (particularly for DHA) - it's not a
| consideration in practice.
|
| So no, eating seeds will not fulfill your body's
| requirements.
| Aurornis wrote:
| > Then as part of a new gym plan, started taking Omega 3+VitD
| daily, and I just felt a sense of calm and peace after a few
| weeks. The massive uptick in exercise probably also helped
|
| I would bet that 95% of that improvement or more was due to the
| exercise.
|
| Your anecdote is common: People start taking Vitamin D or fish
| oil as part of a bigger plan to have a healthier lifestyle and
| then they attribute success to the pills, not the lifestyle
| changes.
| vegancap wrote:
| Possibly, but anecdotally, I went through a period of
| forgetting to take them again recently, and definitely felt
| worse again. Sleep started suffering, felt lower energy
| again. But, could have been a coincidence/something else
| entirely
| seba_dos1 wrote:
| I wouldn't bet so eagerly on these lifestyle changes being
| achievable without these pills.
| brushfoot wrote:
| And better than taking pills for the former, add hemp hearts or
| flax seeds to your cereal. One serving of hemp hearts has 10
| grams of protein and 12 grams of Omegas 3 and 6. Flax seeds are
| lower in protein but an even better source of Omega 3 in
| particular.
| cube2222 wrote:
| I'm not an expert, but I've done a bunch of reading on this
| previously, and also skimmed the article which also mentions
| some parts of this.
|
| First, when taking omega 3 supplements, you generally care
| about increasing the ratio of omega 3 to omega 6. Hemp hearts
| have much more omega 6 than omega 3, so they're not very
| effective for improving the ratio.
|
| Second, hemp hearts contain ALA, while what you generally want
| to improve is EPA and DHA (this is also covered in TFA). The
| body can convert ALA to EPA and DHA, but it's not efficient.
|
| So all in all, if Omega 3 for the article's stated benefits is
| what you want, this is not the way. I recommend looking into
| eating more fish, or if you want a vegan route, algae-based
| supplements. [0] is a decent source from the NIH about foods
| and their Omega 3 content, split by ALA/EPA/DHA.
|
| [0]: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-
| HealthPro...
| brushfoot wrote:
| The ratio of Omega 6 to 3 needs to be below 4:1 to be a good
| source of Omega 3, and hemp hearts are at 3:1, so they're
| listed as a good source of Omega 3.
|
| Flax seeds are even better just for Omega 3 at 1:3, but hemp
| hearts have other benefits, like more protein, which is why I
| called them out. That said, I eat a fair amount of flax seeds
| as well.
| cube2222 wrote:
| Just to reiterate, both of those (hemp hearts and flaxseed)
| only contain ALA, while what you're generally looking for
| is EPA and DHA. TFA also explicitly mentions it's only
| talking about EPA.
|
| This is not to say that they're unhealthy of course.
|
| EDIT: see the sibling comment by code_biologist, it's much
| more comprehensive than what I've written.
| brushfoot wrote:
| Your body converts ALA into EPA and DHA, however, so
| plants are fine sources of both.
| code_biologist wrote:
| Never going to advocate against eating whole foods if they
| taste good! But beware, the ALA omega 3 fat in flax and plant
| sources is not the DHA and EPA omega 3 fats used by animal
| cells, and so it's not as potent as what's in fish.
|
| _The main problem with ALA is that to have the good effects
| attributed to omega-3s, it must be converted by a limited
| supply of enzymes into EPA and DHA. As a result, only a small
| fraction of it has omega-3 's effects -- 10%-15%, maybe less.
| The remaining 85%-90% gets burned up as energy or metabolized
| in other ways. So in terms of omega-3 "power," a tablespoon of
| flaxseed oil is worth about 700 milligrams (mg) of EPA and DHA.
| That's still more than the 300 mg of EPA and DHA in many 1-gram
| fish oil capsules, but far less than what the 7 grams listed on
| the label might imply._
|
| https://www.health.harvard.edu/heart-health/why-not-flaxseed...
|
| Also, beware of omega 6 fats. Seed oils (corn, soy, canola)
| used in commercial food products are incredibly omega 6
| dominant in terms of polyunsaturated fat content. Consequently,
| the ratio of omega 3 to omega 6 fats we consume has plummeted
| as food production has industrialized. Omega 3 fats are
| precursors to generally anti-inflammatory signaling compounds,
| whereas omega 6 fats are precursors to pro-inflammatory
| signaling compounds. The bias in fat intake leads to more pro-
| inflammatory signaling in the body, and a lot of alt health
| types have alleged this is a major causative factor in the
| obesity epidemic.
|
| This is important for depression, because chronic brain
| inflammation as a cause of depression was one of the going
| hypotheses at least a decade ago when I last looked into all of
| this. Upping omega 3 intake is an intervention that can address
| chronic inflammation, which is potentially why it improves some
| cases of depression.
|
| Pretty much nobody in the west needs more omega 6s these days.
| I hear even farmed salmon eat primarily corn and soy based
| feeds these days, meaning their fat ratio is skewed much more
| heavily toward omega 6 than wild salmon and fish.
| r1ch wrote:
| Please do not take 5000mg/day of Vitamin D. The author confuses
| IU and mg which is very dangerous.
| Aldipower wrote:
| That would be 5g. At this point everyone should notice that
| something is off. :-D 5000 mg of vitamin D3 = 200,000,000 IU
| (200 million IU)
| xi_studio wrote:
| More often written as 200,000 IU as 5000mg of D3 is not
| written as 5,000,000mcg
|
| The author simply (and terrible mistaking) typed [mg] instead
| of [UI] in the first paragraph: if readed entirely, the
| author correct this typo in every other sentence
| Xunjin wrote:
| Still it needs proof reading and definitely a BIG WARNING
| that anyone who reads the article should first talk with
| their doctor before trying any "recommendations". Some of
| these "recommendations" could literally kill someone.
| hermannj314 wrote:
| I bought the once weekly 50,000IU bottle on Amazon and am
| currently taking 4 a day and I am ignoring all growing
| signs of vitamin D toxicity because I read this guys blog
| and never once ever decided to consult another source,
| including later paragraphs in that same blog because
| there was no warning. Without a warning, you should
| blindly follow all medical advice you read online.
|
| That is that pathway to death you are worried about?
| deltoidmaximus wrote:
| I was going to say, wouldn't following through on this
| mistake require you to not just spend a ton of money on
| pills but also take tons of them a day? I'd like to think
| this would give even the dumbest of people pause just
| because of the practicality aspect.
| fc417fc802 wrote:
| You might be surprised. Medical journals that specialize
| in reporting one-off cases have some wild articles.
| amai wrote:
| Why didn't the author notice? AI slop?
| dec0dedab0de wrote:
| doctors prescribe vitamins in MG, but they're sold in IU.
| It's an easy mistake to make.
| AdamN wrote:
| People don't always realize:
| https://www.chemistryworld.com/news/university-fined-in-
| caff...
| ndarray wrote:
| Wow that must be hell
| cloudhead wrote:
| So 5000 IU is the recommended amount?
| Liquix wrote:
| 5000 IU is very high, might be beneficial during the winter
| for folks with very fair skin. but most probably shouldn't
| take that much every day
| HPsquared wrote:
| That's equivalent to about 10 minutes of sun exposure. Not
| very much when you look at it that way.
| zelphirkalt wrote:
| That comparison doesn't work. Only 10-20% of the vitamin
| D we intake is delivered through food and the body cannot
| process more sourcing from food. Even if you take more
| you will not benefit in an unlimited way, processing
| more. The skin is much better at generating/making/doing
| it.
| smallerfish wrote:
| The skin is definitely much better, but a higher than
| "recommended" dose is definitely (anecdata) effective at
| bringing up and maintaining the measureable Vitamin D3
| level in your blood if you are under the recommended
| range. It's an important metric to track in your regular
| blood tests.
| graemep wrote:
| I think you mean for those with very dark skin, not fair?
| bloak wrote:
| You mean very dark skin?
|
| It's my understanding that northern Europeans evolved fair
| skin in order to cope with the lack of vitamin D in their
| diet.
| Liquix wrote:
| yes, i had it backwards - thanks for the correction.
| Flatterer3544 wrote:
| You got it backwards, it would be more beneficial in areas
| with few hours of sun for darker skin folks, since they do
| not absorb as much Vitamin D as fair skin folk do.
| cies wrote:
| absorb or create?
|
| i understand it as: absorbing is in the intestine,
| generating D happens in the skin when exposed to the sun
| zelphirkalt wrote:
| According to what I read in a newspaper article, the
| recommended dose is much lower, at 800.
| moritzwarhier wrote:
| According to the internet, it is way higher, probably over
| 9000.
|
| Edit because the comment might be to shallow for HN: I
| sympathize with the struggle against depression and, after
| first-hand experience, share the skepticism against the
| widespread prescription of antidepressants and the methods
| of evidence presented for it.
|
| Very serious and important topic.
|
| Regarding Vitamin D, I am also supplementing in the Winter,
| but I have not read the article, which says it has an
| estimated reading time > 10min. I use one 1000IE (0.025mg
| according to the package) tablet a day max.
|
| I'll bookmark this discussion page to read TFA later maybe.
| voisin wrote:
| It's important to take Vitamin D, as a fat soluble
| vitamin, with dietary fat during a meal. Something about
| bile production and absorption.
|
| Also important to take it with Vitamin K.
| moritzwarhier wrote:
| Yes, I remember that and have Vitamin D+K combo tablets
| with calcium.
|
| Seems like it would be best to increase time spent
| outdoors though.
| energy123 wrote:
| There's likely significant individual variation in
| bioavailability. I would start with 2-5K/day, then
| measure and iterate.
| lossolo wrote:
| I was taking 2x2000 IU with almost no sun exposure and then
| did bloodwork. My level was 77.8 ng/mL. The lab's reference
| ranges listed 30-50 ng/mL as optimal, 50-100 as high, over
| 100 as potentially toxic, and over 200 as toxic.
| dns_snek wrote:
| I don't know why this is downvoted, I had a very similar
| experience a while back. I took 4000 IU/day for about 4
| months, insignificant sun exposure and ended up at 60 ng/mL
| (lab listed normal range as 30-40).
|
| My starting levels were unknown but I assumed they were low
| given my usual sun exposure and some low-energy symptoms
| (which resolved a couple of weeks after I started taking
| it). I discontinued VitD then and now I only take 1000
| IU/day in the winter.
| johnisgood wrote:
| It depends. I have MS and I take 10k IU. My cousin who also
| has MS takes 20k but gets regular blood tests for it.
| neRok wrote:
| This was linked on here a couple of months ago: [The Big
| Vitamin D Mistake
| [2017]](https://pmc.ncbi.nlm.nih.gov/articles/PMC5541280/)
|
| > A statistical error in the estimation of the recommended
| dietary allowance (RDA) for vitamin D was recently
| discovered; in a correct analysis of the data used by the
| Institute of Medicine, it was found that 8895 IU/d was needed
| for 97.5% of individuals to achieve values >=50 nmol/L.
| Another study confirmed that 6201 IU/d was needed to achieve
| 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.
|
| > This could lead to a recommendation of 1000 IU for children
| <1 year on enriched formula and 1500 IU for breastfed
| children older than 6 months, 3000 IU for children >1 year of
| age, and around 8000 IU for young adults and thereafter.
| Actions are urgently needed to protect the global population
| from vitamin D deficiency.
|
| > ...
|
| > Since 10 000 IU/d is needed to achieve 100 nmol/L [9],
| except for individuals with vitamin D hypersensitivity, and
| since there is no evidence of adverse effects associated with
| serum 25(OH)D levels <140 nmol/L, leaving a considerable
| margin of safety for efforts to raise the population-wide
| concentration to around 100 nmol/L, the doses we propose
| could be used to reach the level of 75 nmol/L or preferably
| 100 nmol/L.
| js2 wrote:
| Multiple previous discussions:
|
| https://hn.algolia.com/?q=vitamin+d+mistake
|
| Vitamin D is a favorite topic around here:
|
| https://hn.algolia.com/?q=vitamin+d
| maximedupre wrote:
| With K3! Otherwise you're fucking yourself up.
| sowbug wrote:
| Oh dear, here we go again.
|
| IU, not mg.
|
| K2, not K3.
| consp wrote:
| Isn't the oral intake pretty much negligible anyway? I remember
| getting a vitamin d supplement in a syringe (to be put on
| bread, from a physician) containing a very large dosis.
|
| I'm not stating the dosage is wrong. Looks like it is anyway.
| moritzwarhier wrote:
| It is easily possible to overdose on oral Vitamin D tablets
| and damage your body.
| voisin wrote:
| Source? There have been many articles on HN showing the RDA
| to be ~10x too low (something like 5,000 IU) and that the
| daily safety limit to be significantly higher than that
| (something like 30,000 IU).
|
| Edit: for clarity I am not saying it is impossible to
| overdose on oral tablets, but rather that with most tablets
| 400 IU to 1000 IU and the safe limit so much higher than
| these, it seems like it would be extremely unlikely for
| someone to be taking 30+ tablets daily. Not impossible, but
| not easy either.
| perching_aix wrote:
| That's a bit of a non-sequitur, isn't it? The debated
| point is how oral intake as a delivery method can pan out
| specifically (and _its_ limits), not the dosage limits of
| Vitamin D in general. Think consuming a drug vs injecting
| it.
| moritzwarhier wrote:
| > Source? There have been many articles on HN showing the
| RDA to be ~10x too low (something like 5,000 IU) and that
| the daily safety limit to be significantly higher than
| that (something like 30,000 IU).
|
| First: the RDA and the safety limit are not the same, and
| an RDA in a country being too low does not mean that the
| maximum safe dose is wrong.
|
| And it certainly does not mean that there is a higher
| risk in under-dosing than overdosing when taking the RDA
| (which already includes recommendations for supplementing
| if you spend most of your time indoors).
|
| I'm not a scientist, so I only know what physicians told
| me and what's explained in news publications or by
| consumer advocacy non-profits.
|
| Here are a study (which I didn't read) and the NHS's
| advise on Vitamin D toxicity:
|
| https://www.ncbi.nlm.nih.gov/books/NBK557876/
|
| https://www.nhs.uk/conditions/vitamins-and-
| minerals/vitamin-...
|
| The study says:
|
| > Most cases of vitamin D toxicity resolve without
| serious complications or sequelae. However, in some
| instances, severe hypercalcemia can lead to acute renal
| failure requiring hemodialysis. Cases of permanent renal
| damage due to vitamin D toxicity are rare.
|
| Which sounds good, but I don't think it supports that
| there is no risk of oral Vitamin D overdose.
| neRok wrote:
| The first link makes the problem sound like it can happen
| to anyone, but then when you tease out the details;
|
| * Toxicity resulting from lack of monitoring is
| frequently seen in patients requiring high doses to treat
| ailments like osteoporosis, renal osteodystrophy,
| psoriasis, gastric bypass surgery, celiac, or
| inflammatory bowel disease.
|
| * Patients who are on high doses of Vitamin D and taking
| inadvertently increased amounts of highly fortified milk
| are also at increased risk for vitamin D toxicity.
|
| * According to the latest report from America's Poison
| Centers (APC), there were 11,718 cases of vitamin D
| exposure recorded in the National Poison Data System.
| More than half of these cases were in children younger
| than 5 years.
|
| * The clinical signs and symptoms of vitamin D toxicity
| manifest from hypercalcemia's effects.
|
| * Clinical management of vitamin D toxicity is mainly
| supportive and focuses on lowering calcium levels.
|
| * Isotonic saline should be used to correct dehydration
| and increase renal calcium clearance.
|
| A lot of those point to people drinking too much milk!
| (enriched milk)
|
| * People with osteoporosis thinking "I better drink more
| milk for strong bones" when they are already on
| supplements/medicine.
|
| * Kids drinking lots of milk and presumably not drinking
| any water - hence the dehydration.
|
| PS: There are a lot of people out there that don't drink
| any water, and stick to juice or milk or soda, etc. They
| are not always fat, but that doesn't mean they don't have
| issues.
| moritzwarhier wrote:
| I've read the article by now and I like it. It's
| balanced, more so than the comment section made me think.
|
| And my takeaway is not that everyone should be taking 10k
| IE, but it's a great reminder to be more consistent in
| taking my Vitamin capsules in winter.
|
| I'm still standing by my point that it's "easy" to
| overdose on Vitamin D. Like the article already mentions,
| one should remember possible kidney issues and not take
| insane doses of it.
|
| What the recommended daily intake should be, I don't
| know.
|
| The whole reason I'm commenting on this is I used to take
| one of the "top" antidepressants on this list.
|
| And I am a skeptic of antidepressants, that doesn't mean
| I deny all positive effects in people who are prescribed
| them, of course.
|
| For what it's worth, it's also easy to overdose on
| Venlafaxine. It's still considered safe.
|
| Just an example to make clear that my comment was not a
| critique of taking Vitamin D in general.
|
| I don't find the article's main point surprising though.
| That's the reason I'm taking Vitamin D, too. Doesn't mean
| that it's impossible to overdose, and this point is also
| important, because many people still think that it would
| be impossible to take too much of an vitamin or mineral.
| Thankfully, high-dose Vitamin A / retinol supplements are
| not as widespread.
| ifwinterco wrote:
| Why would you not be able to overdose orally? It's not
| like it stops absorbing past a certain dose, and there is
| such a thing as too much (especially if vitamin k2 is
| lacking)
| bulbar wrote:
| I do know somebody taking way more than 30k/day though.
|
| Seems to be a thing in conspiracy theories "they try to
| hide those simple tricks from you (drinking bleach,
| ivamectin, 100k D3, ...)
| seba_dos1 wrote:
| It may not be that crazy in fact, unless it's prolonged.
| Don't take 30k/day for several months without
| supervision, but doing that for a single month is
| unlikely to harm you if you start from deficiency. Some
| people may need even more than that.
|
| In any case, keep your blood levels in check. It's cheap
| and easy. There are even services you can order to have
| your blood sample taken at your home.
| ndr wrote:
| I would say it's almost impossible with typical packaging.
| What makes it easy?
| abelitoo wrote:
| Oral has felt very effective for me. I take a daily
| supplement that has roughly 100% of the recommended daily
| dose of everything. I split it in half.
|
| For D3, it is 25mcg / 1000 IU / 125%
|
| After splitting in half it's 12.5 mcg / 500 IU / 62.5%.
|
| I take with some fat-containing food to allow ir to absorb
| which is usually breakfast (yogurt, some nuts, some kind of
| fruit, oats), and it's a night and day difference in my mood
| (how easily I can control my temper if already agitated, how
| easily I brush off annoying stuff, takes the intensity off of
| my reactions and mood during conversations).
|
| I did a blood test before starting, and if normal is between
| 30 - 70, I was at 10. Dr prescribed megadose of D2, followed
| by daily D3, but I skipped on the megadose and went straight
| to D3 -- makes me wonder if a megadose would build up my
| stores since D is fat-soluble and make it so I could miss a
| day and not notice.
|
| All of the above is anecdotal from me, a self-professed cave
| dweller, but it's been a couple of years now, and I still
| notice the difference. Also, what I heard from people in
| Boston is that 90% of them are on a vitamin D supplement. My
| friend from there laughed at me when I was raving about it,
| saying "yeah, literally everyone here is on it".
| zelphirkalt wrote:
| Only recently again I read in the newspaper, that most products
| are overdosed. There is a typical number that the vitamin D
| products usually show, and in the article it said, that only up
| to 800 IU is safe, and everything above is an overdose. There
| are many products out there with 2000 UI or maybe even more.
| Beware.
|
| EDIT: Wow, the HN-local doctors at it again. Imagine getting
| downvoted for sharing information from newspaper article (and
| honestly labeling that info as such), that probably was written
| by someone consulting medical professionals. But hey HN will
| know better!
| weird-eye-issue wrote:
| Misinformation. Do more research.
| AndrewDucker wrote:
| If you have useful information to share, please do so.
| Telling people "Do more research" adds nothing to the
| conversation.
| viraptor wrote:
| Neither does "I read in the newspaper, that most products
| are overdosed" to the honest.
| woadwarrior01 wrote:
| Examine.com's page on Vitamin D has a table on tolerable
| upper levels segmented by age ranges.
|
| https://examine.com/supplements/vitamin-d/
| spoiler wrote:
| While (I think) I agree with you on the facts here, I don't
| think this type of dismissive comments are that useful
| either.
|
| Can you give the replyee some pointers, for example? Link
| to articles or studies that show a different view?
| weird-eye-issue wrote:
| Just Google it. There's tons of research on this so I
| don't know why I need to provide a specific link when
| this is common knowledge.
|
| But also here is something to think about: your body will
| produce more D3 than that by being in the sun for just
| several minutes. So if you consider such a low dose of D3
| an overdose then you better steer clear of the sun!
| johnisgood wrote:
| The problem with "Just Google it" that you can find a lot
| of bullshit on this.
| weird-eye-issue wrote:
| You can find scientific papers on Google if you know how
| to use it.
| johnisgood wrote:
| I do, but surprisingly a lot of people do not.
| zelphirkalt wrote:
| You can find scientific papers on a lot of search
| engines, not only Google.
|
| The problem with that is, that you still need to know how
| to interpret any results and statements within the
| supposedly scientific papers. If you are not a
| statistician, you might overlook methodology mistakes. If
| you are not an expert in the matter of the paper, you
| might not realize some side condition, that makes some
| statement or result of the paper irrelevant for your
| individual situation.
| weird-eye-issue wrote:
| Another overly verbose worthless comment from you. Why do
| you continue spewing text like this as if you're actually
| helping anybody?
| zelphirkalt wrote:
| > But also here is something to think about: your body
| will produce more D3 than that by being in the sun for
| just several minutes. So if you consider such a low dose
| of D3 an overdose then you better steer clear of the sun!
|
| This is another superficial statement, that displays
| shallow-at-best understanding. Staying in the sun and
| producing via the skin, and intake via food are 2
| separate pathways. You cannot just make wild assumptions
| about one of those pathways from stuff you know about the
| other pathway.
|
| And actually: Yes, you shouldn't stay in the sun for too
| long without proper protection. Having the sun shine on
| your skin is not some inherently healthy thing. It too
| comes with acceptable dosage and overdose. Symptoms of
| overdose are commonly known as getting a sunburn.
| weird-eye-issue wrote:
| Thanks for clearing that up for me.
| nilslindemann wrote:
| Hi, Mr. wolf language.
| krona wrote:
| Being at the beach (in summer) for a half an hour will
| produce 10,000 and 25,000 IU for the average european.
|
| See: Vitamin D and health: evolution, biologic functions, and
| recommended dietary intakes for vitamin D (293 citations)
| zelphirkalt wrote:
| So? What's your claim here? Are you claiming that our skin
| works the same way as our digestive system? That would be a
| ridiculous claim. And fyi, many people get a proper
| sunburn, if they stayed in the sun for 30 min straight
| without protection, at least in summer. So your 30 min
| statistic doesn't really tell us anything about something
| being healthy or not.
| krona wrote:
| I've given you everything you need to find out for
| yourself. Your incredulity on this is a self-confession.
| zelphirkalt wrote:
| What you have given is rather a comparison, that doesn't
| stand up even the slightest scrutiny, and an improper
| citation. I am not gonna read a whole paper on a whim.
| Cite properly, with proper hyperlink, and at least a page
| number, and I will consider looking at it.
| SoKamil wrote:
| Could you cite that claim from the paper?
| poizan42 wrote:
| Not OP, but the paper says on page 8
|
| > An adult in a bathing suit exposed to 1 minimal
| erythemal dose of ultraviolet radiation (a slight
| pinkness to the skin 24 h after exposure) was found to be
| equivalent to ingesting between 10,000 and 25,000 IU of
| vitamin D (Fig. 6).
|
| Doesn't say 30 minutes, but it may be 30 minutes
| depending on your skin colour and the local strength of
| the sun.
| zelphirkalt wrote:
| I think the OP's interpretation of this is wrong. Just
| because someone was found to have an equivalent of
| ingesting so and so much, after UV radiation, doesn't
| automatically imply that it a good idea to ingest any
| amount of vitamin D. Ingestion is different from exposing
| skin to UV/sun. The paper probably doesn't state, that
| ingesting that much will make a person absorb that much
| from that ingestion, nor does it state, that ingesting
| some equivalent amount will be safe and without side-
| effects.
|
| So the paper may be well researched or whatever, but the
| interpretation of it is questionable.
| poizan42 wrote:
| I can't make any assesment on the quality of the paper as
| that is far outside my expertise, but as far as I can
| tell from a quick skim it does indeed make the claim that
| recommendations for supplements should be significantly
| increased.
|
| From the abstract:
|
| > The safe upper limit for children can easily be
| increased to 2,000 IU of vitamin D/day, and for adults,
| up to 10,000 IU of vitamin D/day has been shown to be
| safe. The goal of this chapter is to give a broad
| perspective about vitamin D and to introduce the reader
| to the vitamin D deficiency pandemic and its insidious
| consequences on health that will be reviewed in more
| detail in the ensuing chapters
|
| The full article is available on researchgate[1]. Direct
| link to PDF [2].
|
| [1] https://www.researchgate.net/publication/226676251_Vi
| tamin_D...
|
| [2] https://www.researchgate.net/profile/Michael-
| Holick/publicat...
|
| EDIT: I just looked up the author, Michael F. Holick.
| Apparently he is one the people who identified calcitriol
| in 1971. I know appeal to authority doesn't prove
| anything, but it might be prudent to at least consider
| his findings.
| lynx97 wrote:
| Before I take medical advice from a newspaper, I might as
| well ask my local esoteric nut.
| Ensorceled wrote:
| Can you provide a link to the newspaper article at least
| while whining about the downvotes?
| zelphirkalt wrote:
| I would like to, but I cannot, since it is a region-local
| newspaper that comes as actual paper, that only has a paid
| online offer, to which I have no access, nor could I post a
| link to that. If I went through recent paper form
| newspaper, I could get a photo of the text in German, but
| then I would (A) need to spend that time, and (B) need a
| place to upload pictures, without having to make an
| account, and only then get back to you with a link. To be
| honest, I am too lazy to do that, just to justify a comment
| on HN.
| freedomben wrote:
| That's not unreasonable, but then you also didn't really
| "cite" your source. Even without photographing the paper,
| giving the name of it, article title, or author would go
| a long way.
|
| I think the downvotes are harsh btw and in general HNers
| have gotten too reflexively downvoting IMHO.
| Ensorceled wrote:
| Understandable, but you wrote all of that and you still
| haven't even named the newspaper.
| turtlesdown11 wrote:
| perhaps citing a source would be helpful
| Xunjin wrote:
| It's unbelievable crazy what the author suggests, even say
| "10,000 IU if you're feeling daring / have darker skin / live
| in less sunny climates.".
|
| Just a simple look at the side effects of high dosages:
|
| Safety and side effects
|
| Taken in typical doses, vitamin D is thought to be mainly safe.
|
| But taking too much vitamin D in the form of supplements can be
| harmful and even deadly. Taking more than 4,000 IU a day of
| vitamin D might cause: Upset stomach and
| vomiting. Weight loss and not wanting to eat.
| Muscle weakness. Not being able to think clearly or
| quickly. Heart rhythm issues. Kidney stones and
| kidney damage.
|
| https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...
| smallerfish wrote:
| To my understanding Vitamin D is regularly underdosed.
| Several points:
|
| 1) There are lots of studies that correlate Vitamin D
| production with sunlight exposure. For example,
| https://pubmed.ncbi.nlm.nih.gov/20398766/ this one lands on
| 1/4 of a MED = 1000 IU. Of course now we have a MED
| definition problem, but we're roughly talking single digit
| numbers for a white person in midday sun in NYC to reach 1/4
| of a MED.
|
| 2) If you also supplement with Magnesium, a lot of your side
| effects go away. Vitamin D3 depletes Magnesium absorption.
| Bender wrote:
| FWIW just anecdotally I took 160,000 IU per day for a few
| months along with 800mcg to 2mg of K2 MK-7 and about double
| the suggested amount of magnesium _citrate_. I slowly
| titrated up to that amount over a few months. I am not
| suggesting anyone else do that as I had a specific purpose
| _slow action TPA when combined with many protease so to
| speak_ but just my own experience I did not have any of those
| issues. I don 't know how they came up with them so I figure
| they are just guessing like they did with the toxic level of
| selenium _which has a funny back story_. I am back down to
| 5000 IU a day. Years later still none of those issues. But
| that is just me.
|
| I did have one issue related to magnesium however. If I did a
| very high dose of magnesium taurate _and a couple of other
| chelated forms_ I would have trouble catching my breath after
| physical exertion similar to chronic high doses of iodine.
| Not the end of the world but it was unnerving.
|
| Don't anyone else do what I do. I experiment on myself more
| than scientists experiment on mice minus the whole dissection
| bit. I am just continuing some experiments from the 1900's
| but as I understand it AI will be learning all of those soon.
| Fascinating stuff really.
| leetrout wrote:
| I respond well to magnesium oxide and magnesium citrate in
| capsules but the chelated magnesium gives me heart
| palpitations or makes them more frequent if I am already
| having them. I hadn't noticed shortness of breath since the
| palpitations would have outweighed that.
| ncasenmare wrote:
| Hi, I'm the author of the main blog post. Just wanted to
| say that's a fascinating experience, 160,000 IU a day! I
| mean, _I 'm_ not going to try that, but that's good to hear
| that 5,000 IU/day for years has been working fine for you.
| Thanks for sharing!
| ncasenmare wrote:
| Hi, author of the blog post here! Thanks for your concern. I
| do still stand by my claim, since more recent peer-reviewed
| studies have shown that up-to-10,000 IU is safe. As written
| in the post:
|
| > McCullough et al 2019 gave over thousands of patients 5,000
| to 10,000 IU/day, for seven years, and there were zero cases
| of serious side effects. This is in line with Billington et
| al 2020, a 3-year-long double-blinded randomized controlled
| trial, where they found "the safety profile of vitamin D
| supplementation is similar for doses of 400, 4000, and 10,000
| IU/day." (though "mild hypercalcemia" increased from 3% to
| 9%. IMHO, that's a small cost for reducing the risk of major
| depression & suicide.)
|
| So why then does Mayoclinic, etc, all say 4000 IU is the
| limit? I think because policy is decades behind science (this
| happened with trans fats), and also policymakers are much
| more risk-averse. (this is why in California, thanks to Prop
| 65, up until ~2018, there used to be a warning in every
| coffeehouse that coffee causes cancer.)
|
| But thanks to your comment, I will edit the intro to note
| what the official max safe dose is, and that more recent
| peer-reviewed research shows it's too low!
| gavinray wrote:
| I've been taking 20,000iu of Vit D daily for years, split
| into 10k AM/PM
|
| Regularly have my Vit D levels checked and they are always
| within the upper bounds of healthy reference range
| mezzode wrote:
| It depends on the person, as a sample size of one I was on
| 5,000IU and my levels were still on the low end (almost still
| deficient), and my calcium levels were still safely on the
| low side as well. Ultimately people should be getting their
| levels checked before and after to see exactly what the
| effect on them is
| josalhor wrote:
| I also noticed that. Opened issue:
| https://github.com/ncase/blog/issues/4
| ncasenmare wrote:
| Hi, author of the blog post here! Yes thank you for catching
| this awful typo, it's fixed now! I _did_ write "4000 or 5000
| IU of Vitamin D" _everywhere else_ in the article -- main
| text, conclusion -- just my luck that the one place I mess up
| is right at the very start.
|
| (Do not take 5000 _mg_ , that's 200,000,000 IU. You'd have to
| chug dozens of bottles per day)
| barbazoo wrote:
| Let's hope the LLMs haven't picked it up yet and are
| suggesting it to everyone already. :)
| s-daveb wrote:
| Hi, I'm curious about medicine in general and I'm
| considering going back to school.
|
| what formal education do you recommend so that I can better
| understand this data?
|
| It's clear you've dealt with anxiety before, but this
| analysis is super thorough!
|
| And thank you for quickly fixing that mistake - that could
| have really harmed someone.
| mixmastamyk wrote:
| Colon Blow: _" It would take over 30,000 bowls. [ a giant
| pyramid of cereal bowls shoots up from under the man, who
| yells in terror as it rises ] To eat that much oat bran,
| you'd have to eat ten bowls a day, every day for eight and
| a half years."_
|
| https://snltranscripts.jt.org/89/89ecolonblow.phtml
| RandomTeaParty wrote:
| Is "IU" another case of xkcd 927?
| grumbelbart2 wrote:
| No, it's to make it easier to dose different kind of
| biologically active substances. They can have significantly
| different "recommended weight to eat of this per day", IUs
| make that sort-of comparable and easier to remember.
|
| https://en.wikipedia.org/wiki/International_unit
| sowbug wrote:
| The usability issue with IUs is that people are used to
| scales measuring weight and containers measuring volume,
| but an IU is different for each substance.
|
| Another issue is insulin syringes are labeled in "insulin
| units," which hapless folks reasonably assume can be
| abbreviated "IU."
|
| If you are measuring out a certain number of IUs, and your
| calculator or formula hasn't asked you which substance
| you're working with, you're gonna have a bad time.
| sschueller wrote:
| If you don't have an underlying condition it is way better to
| get the Vitamin D from the sun in 10-30min increments per day
| after which you are saturated for the day. Overdose is not
| possible via the sun (excluding sun burns of course).
|
| > A single, optimal sun exposure session might produce the
| equivalent of 10,000 to 25,000 IU from a supplement, but it
| will not keep increasing with more time in the sun. That's your
| max per session.
| arethuza wrote:
| From NHS Scotland:
|
| _" In Scotland, we only get enough of the right kind of
| sunlight for our bodies to make vitamin D between April and
| September, mostly between 11am and 3pm."_
|
| https://www.nhsinform.scot/healthy-living/food-and-
| nutrition...
|
| Personally I found that taking Vitamin D supplements made
| quite a bit of difference - and I spend a fair amount of time
| outside (~3 hours each day).
| matsemann wrote:
| And in Norway we often don't see the sun during certain
| months, due to it only being up for a few hours in the
| middle of the day (when we're working). And even if I was
| outside I would be covered in clothes.
|
| We have a saying here to take cod liver oil all months
| ending with R (in Norwegian that's September to Februar) to
| get both omega 3 and the vitamin D.
| pjc50 wrote:
| .. how do you calibrate this against a cloudy sky? It's
| pretty dark up here at 56 degrees north, and on top of that
| it's been overcast for days.
|
| It also sucks a lot when it's dark before starting work, dark
| after leaving work, and during the day rather cold to be
| exposing skin to the sun.
| INTPenis wrote:
| Agreed, but I live in Sweden so I take vitamin D supplements
| every winter.
|
| During the spring, summer, fall months I barely need it since
| I'm outside so much with my dog.
| Ensorceled wrote:
| This is nonsense advice for pretty much anybody that is
| shovelling snow right now.
| bflesch wrote:
| Why don't you just travel to the south during winter? /s
| austinjp wrote:
| Check local/national advice. In many places it is officially
| advised to take vitamin D supplements, especially in winter
| or if you have a darker skin tone.
| bflesch wrote:
| Your suggestion sounds a bit detached from reality of many
| people.
|
| In many countries it is physically impossible to get enough
| vitamin D from the sun, even if you go out naked.
|
| Also did you ever notice that the cheap apartments in many
| places are facing north and do not have a balcony, and of
| course do not have a private garden? Now you are reduced to
| going to a park which in the "cheap" areas is also not a good
| spot to chill for 30 minutes.
| mixedbit wrote:
| In winter, even on a sunny day, only tiny fraction of your
| skin is exposed to sun. 10-30 min of sun when you are wearing
| tshirt and shorts is much different from 10-30 min of sun
| when you are wearing long sleeves, gloves, and a scarf.
| pbhjpbhj wrote:
| It's not really the exposed skin that's the issue. At
| higher latitudes the ultraviolet (UVB) gets scattered by
| the longer path through the atmosphere and so even if you
| were naked you still wouldn't be getting enough.
| RobotToaster wrote:
| > it is way better to get the Vitamin D from the sun in
| 10-30min increments per day
|
| spoken like someone who has never lived in the UK
| nimonian wrote:
| Next time I get sunburn I'm calling it a vitamin D overdose
| francisofascii wrote:
| I would argue to do both in the winter, since sunlight has
| other benefits than just Vitamin D synthesis, like
| mitochondrial health and better circadian signaling for
| better sleep quality.
| theptip wrote:
| Don't guess; just get your vitamin D levels tested. It's $20,
| you can just buy it a la carte.
|
| For some people even in sunny areas, 5000 IU might be needed
| to get you in-range. This is highly individual.
| koakuma-chan wrote:
| I used an LLM to summarize and it told me 5000 IU.
| phoronixrly wrote:
| Wow, so what value is there in LLM slop exctracted from
| already dubious self-medication advice?
| perching_aix wrote:
| They're saying that it successfully filtered out the bit
| where the author told people to overdose by 40000x. I guess
| that's the value.
| phoronixrly wrote:
| There would be value if it _pointed out the mistake_
| instead of hallucinating a correction.
| pulvinar wrote:
| GPT5.2 does catch it and warns to not trust anything else
| in the post, saying no competent person would confuse
| these units.
|
| I wonder if even the simplest LLM would make this
| particular mistake.
| naasking wrote:
| IU was correctly used everywhere else in the article
| except that one place with the mistak, so the LLM didn't
| hallucinate a correction, it correctly summarized what
| the bulk of the article actually said.
| nialv7 wrote:
| yes, once i saw that i stopped reading. if the author can't get
| that right i am not going to trust anything else they say.
| Aurornis wrote:
| That's a large enough error that it calls the rest of the
| writing into question, in my opinion.
|
| Also, be careful taking 5000 IU/day of Vitamin D. I did this
| for a few months and it was enough to send my blood levels over
| the top of the range, even in winter.
|
| Too much Vitamin D is not good for you. The supplement fans
| have gone too far in recommending too high of dosages. My
| doctor said she's seeing a lot of people with excessively high
| Vitamin D levels now that it has become popular.
| seba_dos1 wrote:
| It's usually pretty hard to get to toxic levels though, most
| people that don't live in a particularly sunny climate won't
| get anywhere near there on 5000 IU/day.
|
| Just test your blood levels before you start and then after 3
| months or so. It's quick and cheap, and the only way to know
| whether the dose is right.
| Aurornis wrote:
| > It's pretty hard to get to toxic levels though, most
| people that don't live in a particularly sunny climate
| won't get anywhere near there on 5000 IU/day.
|
| No, that's literally what I was doing when I reached the
| excessive range: 5000 IU/day in winter with an indoor job.
|
| This commonly repeated idea that everyone is deficient and
| you can't overdose on 5000 IU/day is wrong.
|
| > Just test your blood levels before you start and then
| after 3 months or so. It's quick and cheap, and the only
| way to know whether the dose is right.
|
| Literally what I did.
|
| Every time I explain this online it seems like the
| supplement people ignore what I wrote and just parrot the
| same "5000 IU/day and everyone is so deficient you can't
| overdose" myth.
| seba_dos1 wrote:
| > No, that's literally what I was doing when I reached
| the excessive range:
|
| That doesn't make it easy for most people. In my case it
| was barely enough to move the needle, but that's not how
| it will be for most people either.
|
| > you can't overdose on 5000 IU/day is wrong
|
| Of course you can (though it would usually have to be
| really prolonged to actually cause you troubles, and even
| then it's mostly due to calcium rather than vit D
| itself). The vast majority of people won't, but you don't
| know whether you're in that group or not until you test
| yourself.
|
| > Literally what I did.
|
| That's good, but my post obviously used plural "you" as a
| general advice.
|
| (BTW. There's no evidence of toxicity below blood level
| of 150 ng/ml, but there are many guidelines that consider
| levels way below that, such as 50 ng/ml, as "too high"
| already)
| redhed wrote:
| It can also be at non-toxic levels but still cause
| arterial calcification.
| globular-toast wrote:
| Even 5000IU a day is huge and will likely result in calcium
| buildup.
| legulere wrote:
| > A 2014 systematic review concluded that vitamin D
| supplementation does not reduce depressive symptoms overall but
| may have a moderate benefit for patients with clinically
| significant depression, though more high-quality studies were
| determined to be needed.
|
| https://en.wikipedia.org/wiki/Vitamin_D#Depression
| nayroclade wrote:
| The meta-analysis cited in the article is from 2024 and
| specifically mentions the Shaffer et al. 2014 review cited by
| Wikipedia as being low quality:
|
| > Some of the available reviews, owing to the limited number of
| trials and methodological biases, were of low quality (Anglin
| et al., 2013; Cheng et al., 2020; Li et al., 2014; Shaffer et
| al., 2014).
|
| https://pmc.ncbi.nlm.nih.gov/articles/PMC11650176/
| afpx wrote:
| Therefore what to do? I have seen these Hacker News vitamin D
| ads appear every few months for the past 15 years, or so. I
| always seem to have a vitamin D deficiency, so it reminds me
| to take supplements. I take them for a few months, hoping to
| see a change, but I don't feel any benefit. Then, I forget to
| take the supplements until the next time I see an ad. How to
| know if they're actually doing something useful?
| phoronixrly wrote:
| Until you see an article like this which calls for '5000
| _mg_ ' of supplementation, decide that you didn't take
| enough and overdose...
|
| HN and dubious self-medication advice go hand-in-hand.
| Please consult a medical professional instead of a bunch of
| ad-tech devs.
| mrguyorama wrote:
| Remember when HN had an entire year of articles about how
| we should all be on microdoses of various hallucinogenic
| and psychoactive substances for "peak performance"?
|
| Good times.
|
| HN is as bad at medicine as it is at everything else.
| phoronixrly wrote:
| No, I was here just for the year in which they ended
| COVID with vitamin D. With the weekly (n=5) articles
| garnered with blog posts from randos swearing by it...
| Palomides wrote:
| you could make a decision informed by actual information,
| i.e. your blood levels
| legulere wrote:
| If you're not in the respective fields it can be pretty
| difficult to distinguish good from bad research. I am not
| able to do so.
|
| If you (or your close ones) don't suffer from depression,
| then I guess it's best to ignore it until scientific
| consensus has formed. That will for sure show up on
| wikipedia. As far as I can see as a layperson there is a lot
| of correlation with Vitamin D that breaks down in
| interventions and Vitamin D is recommended mostly for babies
| and elderly people. On the other hand I see Vitamin D pushed
| as a miracle drug not unlike Vitamin C used to some decades
| ago and regular reports of overdosing of supplements leading
| to organ failure.
|
| If you're suffering from depression, you should talk to your
| doctor. They will be able to help you to weigh potential
| benefits with risks
| running101 wrote:
| Chia seed and flaxseed high in omega3
| grvdrm wrote:
| + great for fiber. I load up chia as much as I can throughout
| the day.
| code_biologist wrote:
| Chia is awesome for making pudding out of random liquids. I
| have to restrain myself from eating a batch of coconut milk
| cinnamon chia pudding in a single sitting.
| freehorse wrote:
| ALA, not EPA, though, and it is unclear how much of it is
| converted then to EPA in the body. Afaik only EPA has shown
| antidepressant effects.
| b800h wrote:
| Can I just add: In addition to this, if you struggle with anxiety
| or have some sort of ADHD, then try cutting out caffeine
| _entirely_. Not just switching to "decaf" (which isn't), but
| cutting out tea and coffee, and switching to an alternative like
| Barleycup.
|
| Doing this has had a massive positive effect for me, and combined
| with decent nutrition and daily exercise, has been wonderful.
| grvdrm wrote:
| Fascinating.
|
| Can you describe what else you tried? Other supplements? Any
| other non-food/supplement techniques like journaling,
| breathing, etc.? Any therapy and other similar human
| interventions?
|
| After all those - is it / was it still the case that cutting
| caffeine drove the best outcome?
| parag0ne wrote:
| Not OP but I'll share my experience. For me, I have to quit
| caffeine for those to even become an option. Otherwise I get
| my short burst of productivity then everything shuts down
| after and I don't want to do a thing, everything feels
| "impossible" or like it doesn't matter at all.
|
| Things like journaling / breathing / etc calm the nervous
| system while caffeine stimulates it. I would say caffeine is
| counterproductive to those practices.
| grvdrm wrote:
| Thanks for sharing.
|
| I briefly quit caffeine once but it as well before any
| realization of anxiety. So, hard to extrapolate forward
| from that experience.
|
| What feels different to me (compared to you) is this:
| sometimes I'll drink 2 cups of coffee in the morning and be
| awake but useless. Sometimes totally productive. Caffeine
| in some form is there - recently sometimes substituting
| coffee for a Celsius.
| b800h wrote:
| I am OP, and I can confirm exactly this line of thought.
| Once I had given up caffeine, I was able to start using
| methods like Pomodoro and Eisenhower grids, and they
| actually worked.
| bamboozled wrote:
| I love coffee so much, I'd prefer to deal with the anxiety, and
| I do suffer from it.
| ramon156 wrote:
| You can also get decaf beans, or try to see if you can get
| used to tea. I do both right now and I feel a lot better
| buddhistdude wrote:
| Or the addiction just makes you think that this is good for
| you when actually you'd feel better without it?
| bamboozled wrote:
| It's the smell, texture and taste of coffee I love, not
| really the caffeine. I tried decaf, doesn't taste the same.
| majkinetor wrote:
| Find better decaf. Caffeine has no taste.
| tripledry wrote:
| How long would you say it takes to feel the effects after
| switching? I did this a couple of years ago and as far as I
| remember the only real effect was my energy levels were more
| stable.
|
| I gave it maybe 2-3 months and decided it's not worth it.
|
| Tempted to give it another shot!
| b800h wrote:
| I think some of the positive effects are very quick (better
| sleep) whereas others take longer to materialise. My wife
| commented after maybe 2-3 years that I had become much more
| organised. I think that happened because I came off caffeine
| and then adapted over time to having a different brain
| chemistry, so I learned techniques to organise myself that I
| wouldn't have stuck to had I carried on consuming caffeine.
| binsquare wrote:
| I did the same thing and experienced the same effect.
|
| I'd add that my ability to sleep naturally was negatively
| affected as side effect of medication. I tried a various combos
| to induce sleep and found the best solution to just be...
| exercise.
|
| No caffeine, exercise, sleep lead to a significantly reduced
| anxiety and more.
| parag0ne wrote:
| Agreed, anyone that already struggles with something like this
| should quit caffeine. My life is so much better off of it, but
| I struggle to stay off of it because I'm addicted to the 2hr
| productivity boost vs the all-day steadiness when you're not on
| caffeine. Things that improve for me were: No sense of urgency
| for every single thing. Significantly improved confidence. Word
| things better and speak better in general. No hard crash later
| in the day. All my scattered thoughts become cohesive. No more
| random heart palpitations.
|
| All of these likely got better due to the overall effect of
| decreased anxiety and not making ADHD worse. I'm not myself
| when on caffeine. Nikola Tesla quit all caffeine/other
| stimulants for a reason.
| b800h wrote:
| The silly thing is that when I drank caffeine, the hit from
| it would make me overcreative. Yes, I might do more, but it
| probably wasn't what I was supposed to be doing - I'd pursue
| some new and exciting thing with tremendous fervour, before
| realising later that it was a load of nonsense.
| xenospn wrote:
| As someone from the Middle East, just thinking about not
| drinking coffee makes me lose my will to live. It's like asking
| me to wear sunglasses on a cloudy night.
| voidUpdate wrote:
| I wish I could cut down on my caffeine intake to help my ADHD.
| Unfortunately, I already have basically zero caffeine intake
| (apart from diet coke sometimes)
| b800h wrote:
| Exercise is another good thing to do on a daily basis. It
| prevents me from self-medicating with alcohol.
| jofzar wrote:
| > Not just switching to "decaf" (which isn't)
|
| Going to argue here, this is wildly bad advice. Decaf
| practically has no caffeine, it has 2-7 mg from what I can tell
| which is less then chocolate. 2-7mg is like impossible to
| notice and might aswell be water with how little there is.
| dddw wrote:
| Agree, althouh quiting it altogether might simply help with
| establishing the new habit.
| charles_f wrote:
| But replacing it with decaf is also easier to get into.
| dddw wrote:
| Yeah, some people need to go cold turkey. Or... Help them
| out by replacing their coffee with decaf without them
| knowing. ;D
| haght wrote:
| Very true! I recently found out that i am extremely sensitive
| to caffeine, and one cup at 6 pm makes me unable to fall asleep
| at night until 4 am. Trying to cut off the caffeine entirely
| now.
| b800h wrote:
| Yes, I'm sensitive to it, and a slow metaboliser. A lot of
| people will be in the same boat and not realise it.
| marginalia_nu wrote:
| Downside with going completely off caffeine is you get _so_
| tired and unfocused and it lasts for ages.
|
| I tried doing this for almost a full year, and while the
| improved sleep and generally improved mood was fantastic, and
| even toward the end it was so much harder to get any focused
| work done.
| b800h wrote:
| I have to say that I don't find this at all. I've been off
| caffeine for years, and I'm perfectly able to focus without
| it.
| marginalia_nu wrote:
| Stimulants (of caffeine is one) are the de-facto treatment
| for ADHD, not entirely unlikely caffeine is keeping me
| subclinical.
| b800h wrote:
| Some stimulants are a treatment for ADHD. Caffeine is not
| one of them, and whilst there are suggestions it can act
| as a short-term treatment for some people, it's not
| recommended.
| marginalia_nu wrote:
| Actual ADHD meds aren't available to me, so it'll just
| have to work.
| cameronh90 wrote:
| I think my average level of _useful_ focus is just simply
| higher with caffeine. I was off it for three years, which is
| well beyond the time it would take to lose any tolerance, but
| never really reverted back to the same level of focus that I
| get with caffeine.
|
| I'm not sure my overall focus over time is higher with
| caffeine, but it does allow me to nudge more of it into the
| useful part of my day. However I'm a fast metaboliser of
| caffeine, and it doesn't impact my sleep at all, so could be
| that there's a genetic component to one's experience here.
| driverdan wrote:
| > if you struggle with anxiety or have some sort of ADHD
|
| Those are two different things. Cutting out caffeine can help
| with anxiety but not ADHD. It's the opposite for ADHD,
| stimulates help significantly.
| Aurornis wrote:
| This is not true. Caffeine is not necessarily helpful for
| ADHD. It has a different mechanism of action from ADHD
| stimulants. They are not interchangeable. Not all stimulants
| help ADHD.
|
| Also there's a growing trend of diagnosing every focus
| problem as ADHD when many patients might have focus problems
| secondary to another condition like anxiety. It's sadly all
| too common to find someone who believes they have ADHD due to
| TikTok self diagnosis or even a lazy doctor's diagnosis but
| their core problem is actually anxiety. For these people,
| stimulants of any kind can actually worsen focus even if then
| provide a short term perception of helping due to the energy
| boost.
| ivm wrote:
| Tea, especially green tea, doesn't have the same caffeine
| bioavailability as coffee - otherwise people would abuse it
| just as much as coffee.
|
| I'm quite sensitive to caffeine, yet I can drink green tea all
| day without noticing much effect, while even a light coffee or
| a caffeine pill is clearly noticeable. I can also drink tea
| before going to sleep without any problems.
| Aurornis wrote:
| > Tea, especially green tea, doesn't have the same caffeine
| bioavailability as coffee - otherwise people would abuse it
| just as much as coffee
|
| You can absolutely get high doses of caffeine from tea if you
| really want to. It comes down to the type of tea, how much is
| used, and how strong it's brewed.
|
| There is nothing special about tea that breaks the rules of
| caffeine. It comes down to the content of the leaves,
| quantity, and extraction into water.
|
| > while even a light coffee or a caffeine pill is clearly
| noticeable
|
| Caffeine pills generally have really high dosages, FYI. Even
| light coffee drinkers can be caught off guard by how much
| caffeine is in a typical off the shelf caffeine pill.
| ivm wrote:
| _> There is nothing special about tea that breaks the rules
| of caffeine._
|
| There's definitely something special, just poorly studied:
| typical "how much caffeine is in X?" tables show tea having
| caffeine levels similar to coffee, but I never feel the
| same effects.
|
| _> Caffeine pills generally have really high dosages,
| FYI._
|
| I use 200 mg tablets split into quarters for doses of
| 50-100 mg. Yet, they produce a much milder curve than
| coffee (which I no longer drink) and, as a side effect,
| cause no gastrointestinal side effects!
| Aurornis wrote:
| > typical "how much caffeine is in X?" tables show tea
| having caffeine levels similar to coffee,
|
| I have never seen a caffeine comparison table that shows
| tea and coffee at the same level.
|
| It's common knowledge that typical coffee brews are in
| the range of 2-5X higher in caffeine content than typical
| tea brews.
|
| Tea is widely used as a lower caffeine alternative to
| coffee.
| ivm wrote:
| Quick search shows various infographics: green tea at
| 20-35 mg, black tea at 45-50 mg, espresso at 45-75 mg,
| and instant at 60-80 mg on average. The day I feel
| anything close from a cup of black tea to what I get from
| an instant coffee or a quarter of a pure caffeine pill, I
| might start trusting those numbers, but for now I see
| them as nonsense that tries to present as science.
| seba_dos1 wrote:
| There are also other ingredients in coffee and tea that
| may affect caffeine's effect (L-theanine in tea for
| example). Same with energy drinks, these will have a
| different effect even with the same caffeine intake due
| to presence of taurine.
| volkk wrote:
| i thought that the mechanism in green tea is that it has
| l-theanine that helps with caffeine jitters/spikes. a bunch
| of people drink coffee + theanine which gives a much calmer
| high.
| dec0dedab0de wrote:
| Counterpoint, purposely adding caffeine in the form of
| different mushroom coffees has greatly improved my ADHD
| symptoms.
| __turbobrew__ wrote:
| I am in the middle of trying this out. When I first stopped
| caffeine I had better sleep and very vivid dreams every night.
| I also feel better as I think coffee was making my stomach too
| acidic which was causing me other indigestion problems, not to
| mention that coffee was nuking my teeth as well with acid.
|
| Im on week 3 of no coffee now, I will maybe give it a month or
| two more to make a judgement call if I want to continue with
| coffee or not.
|
| It is unfortunate as I really enjoy coffee, but it causes some
| issues for me with anxiety and stomach problems.
| charles_f wrote:
| I cut coffee for over 6 months, and one of the most significant
| thing it did for me is that, when I resumed, I noticed that
| caffeine actually helped me feel more awake and alert (while I
| didn't notice any effect when taking a lot of it before
| stopping cold-turkey)
| daoboy wrote:
| My physician prescribed Vitamins D and B12, so a quality Omega 3
| is the only supplement I currently purchase.
|
| After an absurd amount of trial and error with every over-the-
| counter, trendy supplement over the last couple of decades (and
| lord only knows how much money), these are the only ones that
| seem to make a subjective difference on my quality of life and an
| objective difference in my bloodwork.
| Iolaum wrote:
| Your body makes Vitamin D when in sunlight. Could it be that
| sunlight - and the whole being outdoors situation - is the thing
| that helps rather than vitamin d levels?
| rini17 wrote:
| There's a research that winter sunlight in northern latitudes
| just does not convert precursors to vitamin D. Even when it's
| shining, no matter how long you are outside.
| 7952 wrote:
| And I guess you need uncovered skin which can be tricky in a
| cold winter.
| NoPicklez wrote:
| It could be, but the same effect can be observed in people who
| dont change their outdoor habits but take vit D and omega 3
| supplements
| xi_studio wrote:
| Sunlight alone don't help, it helps just because our body makes
| Vitamin D during the sunbathing process.
|
| So sunbathing is one of many way of integrating Vitamin D in
| our body not THE way.
| account42 wrote:
| Well if you'd be so kind to move the earth so that we get
| enough sun during winter then that'll solve the problem.
| notTooFarGone wrote:
| What drove you to write this comment? There are enough
| countries where sun is an exception in winter and this is a
| valid problem.
|
| Comment is neither helpful nor is it funny.
| Ensorceled wrote:
| It's going to be sunny this morning, but also -14 and also I'm
| too far north for adequate Vitamin D synthesis in winter. But
| thanks for the advice.
| zipy124 wrote:
| In most northern countries like the UK, there is simply not
| enough UVB in the winter to make any Vitamin D through
| sunlight.
| dennis_jeeves2 wrote:
| Interesting point, there is at least one theory out there which
| says that neither sunlight nor Vitamin D is necessary if an
| individual is really healthy. The ones that feel better on the
| Sun and/or Vitamin D are people who are at least mildly
| unhealthy and it's of form of addiction where the individual
| ought to keep taking something to just not feel miserable.
| Liquix wrote:
| can vouch for a diet high in fatty fish along with
| supplementation of D3 + cofactors (K2, A, magnesium, zinc,
| copper, boron). sample size of one but noticeably improves mood
| and energy levels.
|
| recent evidence [0] suggests there's not much of a link between
| serotonin and depression, and therefore the effects of SSRIs are
| either placebo or an as of yet unexplained mechanism of action.
| IMHO it seems much more likely that modern lifestyles (excessive
| screen time, poor diet, lack of socialization, no connection to
| nature, no spirituality, etc) have more of an effect than
| serotonin levels.
|
| [0] https://pubmed.ncbi.nlm.nih.gov/35854107/
| shimonabi wrote:
| Over the last few months, I've increasingly come to believe that
| depression is not caused by a chemical imbalance. After trying
| ten different antidepressants with no success, I found far
| greater improvement by changing my patterns of thinking.
| meindnoch wrote:
| Yeah, I call bullshit. Tried both, and SSRIs are a godsend.
| lynx97 wrote:
| Can confirm. Since I take 20000 IU vitamin D every sunday, my
| winter depression is gone.
| rustyhancock wrote:
| These are always tricky, vitamin D deficiency and low fat diets
| clearly cause depressive symptoms.
|
| Does that mean vitamin D treats depression in general?
|
| When most people talk of depression they aren't even using
| talking about major depression.
|
| We live in a world that in many ways is comfortable but crushing.
| Is that depression? Or just harmful levels of understandable
| unhappiness? Are they different?
| nxobject wrote:
| Be careful - many studies in the Vitamin D meta-analysis
| *enrolled patients already taking antidepressants.* [1] Reporting
| effect sizes without specifying "on which population?" is
| misleading.
|
| (As an aside, Cohen would be the person _not_ to tell you to
| assign qualitative values to effect sizes. They are as arbitrary
| as any other threshold used by working statisticians.)
|
| [1] https://www.cambridge.org/core/journals/psychological-
| medici...
|
| EDIT - that is, _please_ don 't draw the conclusion that you can
| substitute supplements for antidepressants. The meta-analyses
| don't seem designed to examine that hypothesis, and I doubt
| anyone would ever participate in a such a trial. In general (and
| as a working biostatistician), I would be very, very, very
| cautious applying estimates of average effect to myself, you, or
| any other individual person in a field as murky as psychiatry.
| That's why even the stingiest American health insurance plans
| still have an incredibly large range of antidepressants in their
| formularies.
| GenBiot wrote:
| Based on your own citation, this is untrue. The citation you
| have linked is a meta analysis of 31 trials, many of which
| specify no medication use at recruitment.
|
| You are however correct about population being important (which
| is a big reason meta analyses can be very useful).
| nxobject wrote:
| I said "many", not "all". (Many don't indicate, either.)
| ncasenmare wrote:
| Hi, author of the blog post here! Thanks for bringing this up
| -- it wasn't my intention to say one should _replace_
| antidepressants with vitamins (the conclusion even says
| "(Don't quit your existing antidepressants if they're net-
| positive for you!)", but you're right that the intro may give
| that impression. I'll edit the intro to say you can stack, not
| substitute, regular antidepressants.
|
| > many studies in the Vitamin D meta-analysis _enrolled
| patients already taking antidepressants._
|
| Yes, and that's even more encouraging, that there's still
| effects of Vitamin D on major depression even if already on
| antidepressants! This suggests we can "stack" the
| interventions.
|
| Table 1 of the meta-analysis (
| https://pmc.ncbi.nlm.nih.gov/articles/PMC11650176/ ) shows the
| raw sub-group analysis. There were 9 studies on patients using
| antidepressants, 13 on patients who weren't, the rest were
| Mixed or Not Reported (...how do 6 studies just _not report_
| that?) Anyway,
|
| Effect size of Vit D for people on antidepressants: -0.54
| (-0.85, -0.23)
|
| Effect size of Vit D for people NOT on antidepressants: -0.28
| (-0.40, -0.16)
|
| Both negative. Weirdly, the effect of Vit D seems to be a bit
| stronger for people _on_ antidepressants, but the difference
| isn 't statistically significant at the p<0.05 level (P
| subgroup difference is 0.23)
|
| (As for why those effect sizes, -0.54 & -0.28, are lower than
| what I (and that meta-analysis itself) report, -1.82, that's
| because the majority of RCTs for any group used far less than
| 5000 IU. Table 2 in that paper shows the effect (with 95% CI)
| for various dosages.)
|
| I'll lightly edit my blog post to emphasize _stack them, don 't
| substitute_. Thanks again for your comment!
| zahlman wrote:
| > Yes, and that's even more encouraging, that there's still
| effects of Vitamin D on major depression even if already on
| antidepressants! This suggests we can "stack" the
| interventions.
|
| I think the point here is that such a study selects for
| people where their antidepressants are already known not to
| work very well for them, or they wouldn't be interested in
| participating.
| trhway wrote:
| then it would suggest why depression gets worse in colder and
| less sunny part of the year. That even has its own name -
| Seasonal Affective Disorder (SAD).
| cardanome wrote:
| With depression it is important to find the cause of it.
|
| You might be depressed because you life objectively sucks. Then
| you symptoms are good and healthy and a signal to make changes in
| your circumstances.
|
| You might actually have a good life but still feel depressed
| because there is a chemical imbalance in your brain. (Very
| simplified). That is when drugs come in.
|
| It might be just a seasonal thing and you need to go outside more
| and take some supplements.
|
| You might have some other undiagnosed issue. You might have ADHD,
| autism and other things that cause you to struggle and develop
| depression as a side effect.
|
| So find out what works and what doesn't work for you.
| ajkjk wrote:
| That's the sorta standard socially accepted way of thinking
| about this. but uh... to a lot of people it doesn't ring quite
| true.
|
| For example: if your life objectively sucks, why aren't you
| doing anything about it? Some people whose lives suck fix their
| lives, and other people get depressed and do nothing; what's
| the difference? And: all of us know somebody who appears to
| have a good life and therefore their depression is presumably a
| chemical imbalance thing _but_ if you 're being honest the
| vibes in their life are a bit off, actually, like you can tell
| they're not _really_ getting everything they need out of it,
| that they 're clearly good at masking (for example people who
| are clearly not thriving in their relationships) .... in which
| case sure medication could help but you can't shake the feeling
| that facing the reality of their life would help a lot more.
|
| However! Questioning this stuff becomes a bit of a moral
| minefield. "Believing" in the chemical imbalance theory is part
| of why it's medically helpful. If your life has sucked for
| years and you could find no way of fixing it and then SSRIs
| helped, then you basically need to believe that it really was a
| chemical imbalance, because believing that it might not be
| threatens to take away the thing that's making your life work.
| So much so that I would bet at this point there are already
| readers of this comment who are ready to angrily reply to my
| preceding paragraphs, because the model I just described
| threatens their existence. (If so, wait a sec and read the
| rest...)
|
| On the flip side, for some people _not_ believing in the
| chemical imbalance model for some particular case might be
| important. Maybe they _want_ to feel responsible for their life
| being bad, so they will be motivated to do something about it,
| and being happy due to drugs would make them feel complacent
| and okay with years passing by at a shitty job or something. Or
| picture someone whose parent has gone their whole life unable
| to take them seriously as an adult, which as a result means the
| child and parent have a bad relationship, and then picture the
| parent complaining about depression and taking medication for
| it. This can be really infuriating: the child thinks about the
| parent, "your life sucks because of the tension created by not
| treating people around you with respect, and you're so
| incapable of recognizing this even when it's told to your face
| regularly that you're taking drugs to feel better despite not
| fixing the problem". Now ascribing depression to medical
| problems seems like avoidance, and having people write off your
| frustrations and say that you're just depressed and need to
| take a drug for it is frustrating.
|
| Just saying: the two narratives really get tangled up. I don't
| really know what to do about it, but I do think that some harm
| is done by harping on the concept of a "chemical imbalance". A
| lot of the issue is avoided if you just think of the drugs as
| _helpful_ but don 't choose any model (with its moral
| implications) for what exactly it is they're helping with. Just
| treat them as a tool for making you feel better.
|
| Also, I suspect that people who have an intuitive aversion to
| mental health drugs are probably way overindexing on that
| intuition. I definitely did this for a long time, as did some
| friends I knew growing up. Turns out whatever your issues you
| can sometimes just deal with them sooner than later if you
| accept that doctors might be onto something. (Actually I think
| the reason people get stuck avoiding medication for so long is
| precisely that they feel like they're not _allowed_ to be
| skeptical of them... which makes them kinda plant their feet in
| the ground and refuse to be open to it. That 's kinda why I'm
| typing this long comment, to tell anyone reading that it is a
| reasonable thing to feel. And now that you know that maybe try
| them anyway..?)
| xnzakg wrote:
| The problem with the "your life objectively sucks" option is
| when you end up too depressed to actually bother doing anything
| and just give up. That's another case where drugs can help.
| citrin_ru wrote:
| > You might be depressed because you life objectively sucks
|
| The problem with this that to a bad situation different people
| react differently - some trying to do what they can to improve
| the situation or at least don't make it worse and some give up
| and let situation to slip and become worse and worse (becoming
| a self fulfilling prophesy). It's not a choose one makes I
| think (it's likely a biological predisposition) but the
| difference is still exists.
|
| People prone to depression genuinely believe the main (only)
| reason for a depression that the life sucks and as a result
| they avoid medical help and don't do anything which could help
| them.
| tock wrote:
| You mean relatively sucks. Else every single human ancestor
| would have to be super depressed too given the standard of life
| in the past.
| cardanome wrote:
| Objectively in the sense that there are actual causes in you
| life that distress you and cause your symptoms instead of
| thinking your life is shitty because you are depressed. Of
| course being able to determine if it is your depression
| talking or if things are objectively bad isn't easy and
| people often need outside help from a therapist for that.
| Plus it isn't really clear cut in practice.
|
| On a sidenote, I know that knowing that it is "just your
| depression talking" is also a pretty hard pill to swallow and
| not always helpful. Personally I have a lot of fears that I
| know are irrational but that doesn't make them any less real.
|
| And even if your problems are external, sometimes you need to
| focus and your inner self first, find some strength and help
| so you can tackle the external problems later. But for other
| people "working on yourself" can be avoiding the actual
| problems they need to work on.
|
| And yes happiness is always relative.
| sambuccid wrote:
| I guess there are different types of "life sucks" that can or
| cannot contribute to depression, my current understanding is
| that a lot of it depends on whether you feel you have some
| control over the situation or if you think you have
| absolutely no power over it
| citrin_ru wrote:
| Isn't people in the past had less control? There were dying
| from infections and not only had no vaccines and drugs they
| didn't understand how infections are spread. They also
| suffered from various natural disasters not having a
| protection a modern civilization gives us.
| sambuccid wrote:
| I don't know enough about how people lived in the past
| but I would tend to agree with you that they might have
| had less control than us on many things. But what I meant
| was that it depends on how much control you *think* you
| have rather than the control you actually have. So I
| think a lot of it is about perception, in 100 years time
| people might wonder why we weren't all depressed because
| we had a life expectancy of "just" 80/90 years, but for
| us it's just normal and expected
| the_pwner224 wrote:
| According to Victor Frankl (psychiatrist concentration camp
| survivor, author of Man's Search for Meaning) being in a
| shitty situation without any control over it isn't
| necessarily bad. Humans can still be mentally okay in the
| face of extreme unavoidable suffering like in the camps.
| The key thing is that you need to have some purpose /
| meaning in life (often a loved one or dependent).
| zug_zug wrote:
| I don't think that's true. I think that just shows how
| disconnected we are.
|
| We tell ourselves that we must have "better lives" than say a
| native american in the year 1000AD, but there's no reason to
| think that.
|
| I think odds are that maybe the native american was happier
| -- having a small group that you spend time with outdoors
| every day, getting extensive exercise, having a clear sense
| of purpose, eating healthy fresh food every day, never once
| thinking about politics or bills or global warming. I bet
| they liked their life more than a depressed divorced
| accountant in our modern society, even if we have more
| material wealth or health access.
| BeetleB wrote:
| Most people's lives objectively suck. Most of them are not
| depressed.
|
| Pinpointing problems in your life as the cause of your
| depression is a trap.
| jillesvangurp wrote:
| This stuff is complex. There are no magic potions or hacks that
| work for everyone. No amount of positive thinking can fix
| physiological issues that you have because of some underlying
| condition. But it's quite possible to create new issues as a
| side effect of being depressed, stressed, chronically
| exhausted, etc. So, working on those issues is probably smart.
|
| And each of those things can be caused by physiological issues
| as well. You might feel stressed because you don't sleep well.
| You might sleep poorly because you suffer from e.g. sleep
| Apnea. Which in turn might be because of a mix of physiological
| and other reasons (diet, weight, alcohol abuse, etc.).
|
| Or you might be working too hard, which makes you stressed and
| causes you to lose a lot of sleep. Different causes that have
| similar results. Including long term physiological results.
| Your brain can actually get damaged if you chronically abuse it
| or neglect it. Many "between the ears" type problems are
| actually physiological.
|
| Root causing your issues enables you to deal with them properly
| instead of fighting the symptoms.
|
| Anyway, I take vitamin D and a few other things. Getting
| yourself checked out regularly once you hit middle age is a
| good idea. There's a lot of stuff that is long term lethal that
| a checkup can detect early. And some of it is fixable. I have
| the usual cardio vascular challenges that many people struggle
| with because of a combination of genetics, age, and life style.
| And indeed a vitamin D deficit.
|
| I was also recommended to consume more omega-3 as well. Eat
| salmon. Work some flax/chia seeds in your breakfast. I put flax
| seeds in my yogurt and use it as a thickener in sauces as well.
| You have to grind it to dust for it to get absorbed properly.
| Dirt cheap and it doesn't mess with flavor/texture too much. I
| keep a jar of ground flax seeds in my fridge. Takes 2 minutes
| to top it up every 1-2 weeks or so with some freshly ground
| seeds.
|
| But I'm also aware that me being a stressed startup founder has
| health consequences that a few pills and suplements won't fix
| for me. I need to actively make sure I get my rest and sleep. I
| deal a lot better with stressful situations when I'm well
| rested. And I seem to be better at avoiding getting in to those
| as well. And I feel happier. Sometimes the best thing I can do
| for my company is having a proper weekend or going to bed early
| enough that I can get my 8 hours of sleep. You can survive on 4
| hours (been there done that), for a while. But most people are
| not at their peak performance if they do that. And it's not
| good for you to work yourself to exhaustion all the time.
| isoprophlex wrote:
| Because it's common to hate on antidepressants, I've always
| personally had a bias against them.
|
| For the past 15-20 years, november thru february are basically a
| writeoff due for me due to seasonal affective disorder. Cold
| showers, exercise, no alcohol, strict sleeping rituals. Vitamin
| d. I can still sleep 11 hours and feel like reheated cat shit.
|
| Enter citalopram. "It will take up to six weeks to dial in" they
| said. Within four days I felt like the inside of my head was
| designed by Apple in their glory days. My mind became an orderly,
| well lit, tastefully designed space... instead of a dimly lit
| crack den. I'm more emotionally available, no longer tired, less
| cranky. I felt cozy. I could cry with joy because I could finally
| understand emotionally why people like the Christmas season.
|
| I won the SSRI lottery I guess, the side effect are sweaty feet,
| vivid dreams and a dry mouth. That's all.
|
| This just goes to show that for me, they're extremely effective.
| sheikhnbake wrote:
| Same for me with buproprion. Night and day difference. Made me
| wonder how different my life would be if I had been diagnosed
| appropriately when I was a kid.
| mvcosta91 wrote:
| "God, I see what you're doing for others, and I want that for
| me."
|
| I had a very similar experience, except it killed my libido, so
| I chose to endure the suffering of Winter rather than live with
| emotional numbness.
|
| Still, I strongly recommend it for people flirting with the
| abyss. It was life-changing for me while I was raising an
| autistic 2yo during the pandemic.
| rco8786 wrote:
| > except it killed my libido
|
| Similar experience. Apparently pretty much ubiquitous with
| SSRIs
| isoprophlex wrote:
| i'm sorry this happened to you, this was of the reasons i
| held off trying them for so long. ubiquitous indeed, also
| on this front I got lucky...
|
| please people, take my post for what it is: anecdotal
| evidence. SSRIs can basically give you any possible side
| effect, including destroying your libido.
| bflesch wrote:
| hm
| rco8786 wrote:
| I don't relate at all to the latter part of your
| question, so by process of elimination it must be the
| former :)
| michaelsshaw wrote:
| Libido can be supplemented with Wellbutrin. Works great, even
| better than before.
| sixtyj wrote:
| I have switched to lamotrigin, it helps to balance mood as I
| had bad mood in months with less sunshine. Lamotrigin is not
| an antidepressant, previously it was used for epilepsy
| stabilisation but now it is prescribed for mood swings. (This
| is not a medical advice.)
| deskamess wrote:
| It is still prescribed for epilepsy. I am actually hoping
| for some medication stories if anyone/someone they know has
| ADHD and epilepsy. It's for a juvenile, but your stories
| can be for any age. Or pointers to any resources about the
| combo.
| bflesch wrote:
| I have no experience about antidepressants myself so please
| excuse my stupid question.
|
| When I hear people say "it killed my libido" I always think
| about the fact that hyper-sexuality can be a trauma response,
| and if your body is healing the hyper-sexuality is most
| likely also reduced.
|
| It's like when you have a disease and then read the side
| effects of a medication and notice that a lot of the side
| effects are basically also something that can happen when
| your overall condition is improving but still some people
| report them as adverse effects and then these are added as
| side effects to the package label.
|
| For example you take antibiotics but bacteria can have toxins
| in their body, and when the bacteria disintegrate you get
| more sick from the released toxins. It's called the
| Herxheimer effect: https://en.wikipedia.org/wiki/Jarisch%E2%8
| 0%93Herxheimer_rea...
|
| When I started methyl-B12 supplementation I also had
| inflammation in sinuses for weeks but it was just from my
| immune system starting up again and being able to attack
| long-standing inflammation. Someone else would've put
| "fever", "headache" and "stuffed nose" onto the side effects
| medication label of methyl-B12.
| subscribed wrote:
| Stupid question - why do you keep suggesting that having a
| libido equals hypersexuality?
|
| Is this your trauma speaking, or do you automatically
| associate _any_ sexual needs with a pathology?
|
| You've done it twice in this thread alone.
| hu3 wrote:
| I'm not whom you asked. But it's a resonable association
| for some cases.
|
| But I understand that it would have been better to ask
| and not associate because it's a fraction of the cases.
| WarmWash wrote:
| If I told you that I often have a fire in my fireplace,
| it would be incredibly strange if you suggested that
| pyromania can be a trauma response.
|
| Either OP is confused about what libido means, or has
| some kind of heavy shame around sexuality.
| hu3 wrote:
| Yeah, I agree with your sentiment.
|
| Sex is awesome and liberating! Should be anything but
| shamed.
| toxik wrote:
| That is not what this was. You have been firing your
| fireplace, now you put on a sweater and you suddenly
| don't want to fire so much. Maybe that's not bad, but a
| return to normal. That was the proposition. Is it true,
| who knows. Case by case question.
| butlike wrote:
| I didn't read their comment as insinuating libido is 1:1
| to hyper-sexuality. I read it as: "consider if you have a
| libido, and depression, you may also be hyper sexually."
|
| The situation is PersonA has determined they need an
| anti-depressant. So one thing is 'wrong.' It stands to
| reason that they may be using sex as a painkilling
| mechanism. After all, sex feels great. When the anti-
| depressant kicks in, the body may determine it doesn't
| have to use that painkilling method anymore, hence, the
| decreased libido. It doesn't mean having a libido is bad,
| it means that the person potentially was overdriving it.
| bflesch wrote:
| Thanks for reframing it. That's what I was trying to say.
| jonasdegendt wrote:
| > I had a very similar experience, except it killed my libido
|
| Did you, as well as the other people seconding this, have any
| libido left in the first place? I got on Sertraline because I
| was depressed, and it actually brought my libido back, by
| virtue of just bringing me back to a better emotional
| baseline.
|
| All to say, if it had affected my libido, it'd have been a
| NOOP anyway in my case.
| kranner wrote:
| > All to say, if it had affected my libido, it'd have been
| a NOOP anyway in my case.
|
| Wouldn't a "NOOP" be the opposite of a "Nope"?
|
| Sorry for the pedantry, but this forum seems an appropriate
| place for this.
| toxik wrote:
| That's the point, killing an inexistent libido is a no-op
| cael450 wrote:
| Villazodone was created partly to address that. Once I
| switched to that, I had no libido-related issues again.
| larrywright wrote:
| Speaking from personal experience, people react to different
| SSRIs differently. I took a popular one that had significant
| side effects without a whole lot of benefit, and so I stopped
| it and didn't try anything else for 10 years. Then I spoke to
| a psychiatric nurse practitioner who suggested trying several
| others until we found something that worked for me. I had
| (incorrectly) assumed that if you had e.g. sexual side
| effects from one SSRI, that you'd have them for all. That is
| not the case.
| wincy wrote:
| I spent $300 on high lumen output light bulbs. 28 200W
| equivalent LED bulbs and 2 LED corn bulbs. Just a TON of
| light. Depending on severity either run it all day (late
| January and February tend to be the worst months), but even
| 10 minutes in the morning helps substantially. Just a lot of
| light. You can get hung up on high CRI and full spectrum but
| just do it badly first, then if it works worry about
| perfecting the setup. I just kept buying more bulbs and as I
| bought, I felt better and better.
|
| Edit: this was the blog that gave me the idea, it comes up on
| hacker news a lot. https://www.benkuhn.net/lux/
| krzat wrote:
| If a drug has an 1% chance of 100% effect, it will look pretty
| weak in those studies.
|
| IMO it's pretty clear that depression is a symptom of many
| independent issues, so it's really lame that we don't have a
| more accurate way of diagnosing it.
| compounding_it wrote:
| The goal is to tackle it in every way. The medicines are
| supposed to be supportive and not the solution. More often
| than not people treat it as a solution.
|
| Thats why they are eventually tapered and discontinued once
| you are able to be on your own.
| petesergeant wrote:
| Yah. Measuring the effects of these drugs with a single effect
| size number is ridiculous. They work exceptionally well for
| some people (myself included). It seems as well that SSRIs work
| much more reliably on anxiety disorders than on depression.
|
| Getting on them can be a ball ache (or entirely painless;
| escitalopram was easy on and easy off, Wellbutrin was a
| nightmare to get on, but also easy off), but entirely worth a
| shot for anyone symptomatic.
| compounding_it wrote:
| As someone who tried citalopram escitalopram and sertraline,
| along with venlaflaxine and fluvoximine, I would suggest doing
| a pharmacological test for psychiatric medications.
|
| I am an intermediate metabolized for the first three and the
| ones I was on most long. It did not suit me and made my orgasms
| go from 'wtf' to 'that's it?' And they are still not normal 2
| years after discontinuation.
|
| I am still depressed and anxious to the point of serious
| consideration of these medicines to save myself, but you can
| save yourself the experimentation by doing a simple test and
| avoiding those medicines.
|
| Anxiety depression panic attacks are something I wish more
| people studied along with sexual health.
| anonymous344 wrote:
| look my other comment for niacin
| ghusto wrote:
| The hate on antidepressants is not because they're not
| effective, but rather that they're abused by psychiatrists.
| Ideally, a professional will prescribe them as a necessary
| helper to becoming (more) mentally healthy whilst tackling the
| root cause. Most of the time however, it's more of a "here,
| take these indefinitely".
|
| It's like if we took sleeping pills every time we had trouble
| sleeping. Having said that, I just realised I have the
| impression that's exactly what people do in the USA?
| isoprophlex wrote:
| you're not wrong that pharmaceutical crutches are overused.
| but as an outsider to these problems my 'ambient impression'
| was always one of _haha antidepressants are for suckers_.
| well, in my specific case, so what if i 'm a sucker...
| they're super effective in fixing what appears to be a
| defective winter brain.
| michaelsshaw wrote:
| > It's like if we took sleeping pills every time we had
| trouble sleeping. Having said that, I just realised I have
| the impression that's exactly what people do in the USA?
|
| I'm not sure if it is common but I've definitely taken my
| fair share of my dog's trazodone.
| darvid wrote:
| after being prescribed Mirtazapine, then Trazadone I
| realized I don't think I've had restful sleep as long as I
| can remember. I need a sleep study done probably but until
| that the quality of life from taking something that has
| virtually no negative side effects for me is insane.
|
| meanwhile people are like "just take magnesium or melatonin
| lol"
| larrywright wrote:
| Nobody should take this as medical advice, but from my
| own experience, nothing has made a bigger difference in
| my sleep quality than supplementing with magnesium
| glycinate. I didn't even start taking it for that purpose
| - I was taking it for something else and quickly noticed
| that it made the quality of my sleep significantly
| better. The only side effect from it is that sometimes I
| have strange dreams (not nightmares or anything, just
| odd).
|
| Everyone should check with their doctor, but it's an
| inexpensive supplement and the effects (if any) show up
| pretty quickly, so IMO it's worth a shot.
| hypeatei wrote:
| > like if we took sleeping pills every time we had trouble
| sleeping
|
| Yes, that's normal in the US. I have multiple family members
| who take Ambien (zolpidem) before bed every night.
| lazide wrote:
| Which knowing the side effects of Ambien is pretty bonkers.
| lotsofpulp wrote:
| I know zero people that have ever taken Ambien.
|
| https://www.cdc.gov/nchs/products/databriefs/db462.htm
|
| Seems like daily users would be less than 10%.
| paufernandez wrote:
| Agree. But sometimes there is no "root cause", the brain is
| still a mystery. If you had been depressed even when you knew
| there was nothing to worry about, you would see it
| differently, because then you deduce that the black cloud is
| produced within.
|
| Chemistry trumps psychology. Good enough chemistry enables
| cognitive treatments. But to fix the wrong chemistry you need
| chemistry.
| citrin_ru wrote:
| If you view a world at a certain angle there is always
| something to worry about: 1. World in not perfect, it
| doesn't confirm to how we want it to be (and could not even
| in theory given that different people want it to be
| different) 2. The future cannot be predicted with 100%
| accuracy so even if all is perfect today you can worry that
| it will turn bad in the future.
|
| When looking at the same reality one persons sees the
| situation as OK and another as a an endless and hopeless
| disaster it is hard to tell who is right. A depressed
| person would tell that most people around him are wrong and
| are optimistic only because they don't understand how bad
| all is.
| ajross wrote:
| This is the "people with anxiety should just stop being
| worried" attitude that failed to help for centuries.
| Whether or not you believe SSRI's are clinically
| effective, denying the existence of mental health
| disorders is not helping.
|
| No, anxiety and depression aren't simply a matter of
| perspective.
| citrin_ru wrote:
| My point is that it's hard if not possible to objectively
| tell if the situation you are in is good or bad. And I'm
| not trying to deny anything.
| IAmBroom wrote:
| So your point is explicitly off-topic to the subject
| matter (read the title above). Gotcha.
| Forgeties79 wrote:
| > A depressed person would tell that most people around
| him are wrong and are optimistic only because they don't
| understand how bad all is.
|
| Or because of a legitimate chemical imbalance or some
| other cognitive issue they can't control alone. Right?
| jodrellblank wrote:
| > " _There is no convincing evidence that depression is
| caused by serotonin abnormalities_ "
|
| - https://www.psychologytoday.com/us/blog/insight-
| therapy/2022...
|
| and
|
| > " _the etiology of depression is incredibly complex,
| the narrative that it is caused by a simple "chemical
| imbalance" persists in lay settings. We sought to
| understand where people are exposed to this explanation_
| "
|
| - https://pmc.ncbi.nlm.nih.gov/articles/PMC11752450/
|
| and
|
| > " _Onset of depression more complex than a brain
| chemical imbalance. It 's often said that depression
| results from a chemical imbalance, but that figure of
| speech doesn't capture how complex the disease is.
| Research suggests that depression doesn't spring from
| simply having too much or too little of certain brain
| chemicals._"
|
| - https://www.health.harvard.edu/mind-and-mood/what-
| causes-dep...
|
| and
|
| > " _Analysis: Depression is probably not caused by a
| chemical imbalance in the brain - new study_ "
|
| - https://www.ucl.ac.uk/news/2022/jul/analysis-
| depression-prob...
|
| (These are not thoroughly checked articles, they're the
| first few search results; however claims that depression
| _is caused by_ a chemical imbalance ought to be able to
| show where that idea originated, how the imbalance is
| measured in patients, where that hypothesis is supported
| by evidence, why antidepressents don 't fix depression in
| half of patients, and several more suspicious things).
| Forgeties79 wrote:
| I didn't say it was simply that. You're twisting my words
| and these studies to discount all of behavioral health.
| jodrellblank wrote:
| Yes you did. No I'm not.
|
| (I've written paragraphs and paragraphs thinking through
| some of my views in this thread. You wrote three words
| naming a thing which doesn't seem to exist. If you want
| more engagement, engage more. What words am I twisting?
| Where did you say it was anything more detailed than
| that? What behaviour that people "can't control alone"
| are you talking about?)
| Forgeties79 wrote:
| I did not and I am telling you I do not believe that it
| is that simple. You do not need to waste time arguing
| against your incorrect interpretation of my comment. If
| you need me to say I could have phrased it better, sure,
| I could have phrased it better. But I am now telling you
| exactly what I mean and think so we don't need to do this
| song and dance.
|
| For emphasis: I do not think it is simply/exclusively
| "chemical imbalance."
| jodrellblank wrote:
| But why do you think it is _at all_ "chemical imbalance"
| when that doesn't seem to be an actual thing? What
| evidence convinced you? What measurements were taken on a
| human brain to diagnose the imbalance?
| 16bitvoid wrote:
| That's incredibly reductive. I'm sure some people's
| depression can boil down to a matter of perspective, but
| it's naive to extrapolate that to everyone with
| depression.
|
| I'm incredibly optimistic and am content with my position
| in life. My default state is being mindful of the present
| and I don't think about things too far into the future. I
| very rarely ever feel stressed out over things in life.
|
| However, none of that changes the fact that I feel
| completely empty and find no joy in things. Interests are
| nearly non-existent, emotions dialed to 1, and the only
| thing I'm motivated to do is lay in bed staring at the
| ceiling... unless I'm on sertraline.
|
| Admittedly that's just anecdotal, but I worked in a
| clinical neuroscience lab researching treatments for
| severe treatment-resistant depression (read: people who
| tried so many options including CBT that they even tried
| electroshock therapy). The _only_ thing that helped those
| subjects was a regimen of personalized neuroimaging-
| guided transcranial magnetic stimulation for 10 minutes
| every hour for 10 hours every day for a week. Even then,
| it wasn 't permanent. Some saw improvement for months,
| others only weeks.
|
| For some people, it's not just a matter of "perspective".
| kanbankaren wrote:
| > I feel completely empty and find no joy in things.
|
| Maybe the idea that we should find joy and feel full is
| wrong?
|
| We are on a random planet circling a random star in an
| unfathomable Universe.
|
| STOP looking for meaning and you are liberated. The quest
| for meaning by itself might be exhausting and makes you
| feel depressed.
| 16bitvoid wrote:
| Who said I'm looking for meaning? I'm not.
|
| It's not as liberating as you might think. A joyless
| existence is either suffering or nothingness. A life
| without meaning, either internal or external, is one
| where nothing is meaningful with no motivation thus one
| of crippling catatonia til death.
|
| All I can say is just that it doesn't feel good and if
| you can't feel good about anything, your calculus of your
| life inevitably leads to the conclusion that existence
| isn't worth it.
| trilogic wrote:
| There is only one cure/hack for Nihilism or similar...
|
| Go somewhere where you need to work physically you az off
| to afford daily food. You will be so exhausted eventually
| that: 1 you will not have any energy left for thoughts. 2
| If you have any energy left, you will give it to
| angriness which will lead to other circumstances which
| are none related to find the meaning of life.
|
| Ignorance may lead to happiness and friends :)
| 16bitvoid wrote:
| I think a lot of people are conflating depression with
| "bad thoughts". That's just one possible symptom, usually
| as a result of a combination of both anxiety and
| depression.
|
| I didn't have anxiety, just depression. I rarely thought.
| I existed on autopilot. I was physically exhausted on a
| daily basis as a division 1 athlete in college. Often
| went days without eating either because I simply forgot
| to eat or forgot to make time for it between classes and
| training. Didn't change anything.
|
| I think something people are forgetting is that
| motivation is either driving you toward something you
| want _or_ driving you away from things you specifically
| don 't want. A complete lack of motivation means I wasn't
| motivated to do anything to get something, _but also_ I
| wasn 't motivated to anything to avoid something either.
| I wasn't motivated to eat to avoid hunger pangs. I wasn't
| motivated to quit my sport to avoid routine physical
| exhaustion. Instead, my empty autopilot existence just
| freely acted on the expectations of those around me as a
| proxy for motivation.
| trilogic wrote:
| Interesting reply thanks. I would say though, If I were
| programmed or a program or whatever you name it... I
| would realize the under statement:
|
| If One can't be happy with what One have now, One will
| never-ever be in any circumstances.
|
| This is not your case certainly but is connected with the
| autopilot (meaning we don't get to choose.
| moron4hire wrote:
| Yeah, most folk get the causation backwards. They think
| having meaning in life will pull you out of depression.
| It's the other way around. You have to get pulled out of
| depression to be able to find meaning in your life.
| trilogic wrote:
| Realizing that some "chemical reactions" can change your
| destiny then further learning that when you want
| something, all the universe is bound to conspires in
| helping you to achieve it.
|
| This one came out good :)
| sameesh wrote:
| If its not just a matter of perspective and only
| medication can help, etc, then why do we call depression
| a "psychological" or "mental health" concern? Why isn't
| it just considered a neurological disease?
| thewebguyd wrote:
| Depression is increasingly starting to be seen as a
| neurobiological disorder as we learn more.
|
| In my own opinion, we need to stop viewing "mental
| health" as a separate class of conditions from
| general/physical health. A mental illness is a
| health/medical condition just like any other and shifting
| our views and diagnostic criteria in that direction would
| do a lot to remove the stigma associated with mental
| illness.
|
| Someone with depression has a chronic illness, not a
| temporary "it's just in your head" condition.
| seba_dos1 wrote:
| Not sure what your point is, many mental health concerns
| are caused by neurological diseases.
|
| In case of depression in particular, it appears to be a
| label given to a big bag of various issues you may have
| causing similar symptoms.
| citrin_ru wrote:
| I'm not telling it's a matter of perspective, my point is
| that I see no objective metrics to tell apart if the
| situation is bad so it's one expected to be depressed and
| when the situation is good (so only medication / therapy
| would help). And it makes discussions around this topic
| harder.
| sfn42 wrote:
| Depression and pessimism are not the same thing.
| arghwhat wrote:
| > Chemistry trumps psychology
|
| To nitpick: The mind is applied biochemistry. Psychology
| intervenes in the chemistry, like many other activities do.
| The goal of that is to solve the root cause so that your
| future levels will be maintained at the right level,
| instead of just forcing the level by sourcing the
| respective chemicals externally.
|
| A good rule of thumb in biology and particular any kind of
| hormone production and balance is "use it or lose it" - if
| you start regularly receiving something externally,
| internal production will scale back and atrophy in
| response, in many cases permanently.
| Roark66 wrote:
| >A good rule of thumb in biology and particular any kind
| of hormone production and balance is "use it or lose it"
| - if you start regularly receiving something externally,
| internal production will scale back and atrophy in
| response, in many cases permanently.
|
| There are ways to "hack it".
|
| For example, ~6 months ago I started trt (testosterone
| replacement). It was the best decision health wise ever.
| I feel way better psychologically, first time in my life
| I managed to stick with cardio training for so long
| (before 3 months was the most). There are other benefits
| too.
|
| So what about the "loose it" part? Well there is a
| hormone called HCG one can take a twice a week to trick
| one's balls into producing some natural testosterone. Its
| use prevents atrophy and infertility.
| fwipsy wrote:
| Psychology can change neurochemistry but only in certain
| limited ways. Many people are on antidepressants long
| term because that's the only thing that works for them.
| Taking antidepressants is already stigmatized enough.
| People should just do what makes them feel best over the
| long run. Your rule of thumb does not trump hard-won
| personal experiences.
|
| We don't really know how SSRIs work, but there's some
| evidence that it's through desensitizing serotonin
| receptors, not directly addressing the lack of serotonin.
| If so, "use it or lose it" doesn't apply; long-term
| adaptation is the point, and SOMETIMES does persist after
| quitting.
| pixl97 wrote:
| >A good rule of thumb in biology and particular any kind
| of hormone production and balance is "use it or lose it"
| -
|
| Very basic and very often wrong rule, so take it with a
| grain of salt.
|
| Insulin for example is the opposite. "lose it then use
| it" would be a general rule for type 2 diabetics where
| insulin resistance commonly due to weight gain is the
| primary problem. Losing the weight leads to better uptake
| and usage. For a type 1 "lose it then use it" you
| typically lose the ability to produce insulin to an an
| autoimmune disorder, then are stuck using insulin for the
| rest of your life.
|
| The body itself typically attempts to main homeostasis,
| but at population scales this is something that is going
| to have a massive range of ways it shows up. Evolution,
| at grand scales, doesn't care if you survive as long as
| enough of your population survives and breeds. At the end
| of the day you might just be one of those people that was
| born broken and to work properly you need replacement
| parts/chemicals. A working medical system should be there
| to figure out which case is which.
| jodrellblank wrote:
| The parent commenter describes seasonal Winter depression.
| If the problem was brain chemistry, wouldn't it be with
| them from birth until treatment? Who has Seasonal Type 1
| Diabetes, or Seasonal Dwarfism, or Seasonal Missing-an-Eye-
| From-Birth? Depression generally isn't something children
| have from birth, it's something adults get temporarily.
|
| A few HN submissions recently are in the style " _thinking
| about doing the thing is not doing the thing. Planning the
| thing is not doing the thing. <etc etc>. Only doing the
| thing is doing the thing_". Comparing a brain to a large
| software project with bugs hiding in it, in that vein
| giving the computer 11 hours of 'sleep' each night is not
| debugging the code; overclocking or undervolting the CPU is
| not debugging the code; installing the latest updates and
| patches is not debugging the code. 'knowing there is
| nothing to worry about' is not debugging the code. Only
| debugging the code is debugging the code. Reading a badly
| explained idea on an internet comment and dismissing it
| with a mocking "thanks I'm cured" isn't debugging the code.
| Saying "I've tried everything" isn't debugging the code.
|
| A more specific example, if you are going on a
| rollercoaster and you are experiencing physical and mental
| symptoms of worry - nervous, anxious, angry at the person
| pushing you to ride, twitching and trying to back away,
| eyes looking around searching for an exit, coming up with
| excuses to do something else instead, nervous shaking,
| dread tightness in the chest, affected breathing,
| perspiring, gritted teeth, etc. etc. then washing over all
| that with " _I know there is nothing to worry about so this
| must be a problem of brain chemistry_ " seems a clearly
| _incorrect_ conclusion.
|
| Such a person clearly _has_ a worry. Quite likely one that
| 's out of proportion (e.g. "rollercoasters kill thousands
| of people every day!"). Possibly one that's completely
| incorrect (e.g. "going more than 10mph makes people's
| insides fall out!"). Quite likely a less clear and less
| obvious one - which could be anything, e.g. they saw a
| documentary about a rollercoaster which behaded a child and
| that's their only thought about rollercoasters; they saw a
| show about fighter pilots pulling high-G maneouvres and
| passing out and think that will happen to them on a big
| rollercoaster; they see the rollercoaster track and support
| flexing and don't understand that a some flexibility
| doesn't mean weakness; they went to a theme park as a child
| and older children bullied them into riding a scary ride
| and they wet themselves and figuratively died of shame and
| buried the memory; they were pushed into learning to drive
| at 15 by their wicked stepfather and this is pattern
| matching to the same kind of experience; etc. etc.
|
| Saying "there is nothing to worry about, rollercoasters are
| safe enough and you know it, so your brain chemistry must
| be broken" isn't debugging the problem. It isn't even
| explaining the problem. Why would broken brain chemistry
| particularly affect them at a theme park, or in Winter, and
| not the rest of the time? How was this broken chemistry
| identified and measured and quantified and that hypothesis
| proven?
|
| Likewise, just because the parent poster has tried sleeping
| and exercising and taking Vitamin D, doesn't address that
| humans evolved in Africa, connected to oceans and trees and
| tribal living, and not commuting to a fluourescent lit
| beige box filled with strangers writing JavaScript while
| being bombarded with news items about wars and genocides
| and stories of how everyone else is having a wonderful
| Christmas, earning more money than you, with a cost of
| living crises always on their mind, etc.
|
| > " _Good enough chemistry enables cognitive treatments._ "
|
| Drugs can force people to carry on with a life that's
| making them miserable when they have no other available
| options to find out why and fix it. That isn't evidence
| that "there is no root cause"(!). Any more than turning it
| off and on again can let you get on with your job, but that
| doesn't show there's no root cause for a program locking
| up.
|
| > " _then you deduce that the black cloud is produced
| within._ "
|
| And you have a lifetime of your prior experiences affecting
| your mood. When you remember that your aunt hit you when
| you swore at the dinner table, or you saw someone slip on
| ice and fall over and break their wrist, or watever, every
| life learning experience is "the mood is produced within".
| Noaidi wrote:
| > If the problem was brain chemistry, wouldn't it be with
| them from birth until treatment
|
| Ha, of course it can be! Our brain chemistry is not
| stable through our life! Many children are born with
| epilepsy, but some people develop it later in life.
| epilepsy, like all neurological disorders are nature AND
| nurture, genes AND the environment.
|
| Using your roller coaster analogy, there very well may be
| genes that control; how much fear someone experiences
| when riding a roller coaster. The problem society has is
| telling people that they all should be able to not have
| feear riding a roller coaster and if youa re too afraid
| to ride a roller coaster you should take xanax.
| jodrellblank wrote:
| > " _Our brain chemistry is not stable through our life!_
| "
|
| Citation requested. Because, y'know, it's not like your
| leg muscles suddenly don't work from age 40-50 and then
| start working again and we say it's because of unstable
| "leg chemistry". It's not like your stomach, liver,
| kidneys, <organs> suddenly stop working after you lose
| your job or your life partner and we say it's both
| inexplicable and because of a deficit of "body chemicals"
| and nod agreement with each other that "body chemistry
| isn't stable" through a lifetime.
|
| These are just unsatisfyingly crappy non-explanations.
|
| And quick attempts to assume that Doctors,
| Neuroscientists, Psychiatrists, Psychologists must have a
| better detailed knowledge of brain chemistry and I'm just
| falling for nonsense seems to find that they actually
| don't, and they don't agree that "brain chemistry" is a
| good explanation, and it can't be measured in a patient,
| and the idea isn't strongly supported by evidence, and
| even the mechanism of action of "drugs which correct
| brain chemistry" isn't agreed on, and when given to
| people to "correct brain chemistry" it often doesn't make
| the problem that was blamed on brain chemistry go away.
|
| > " _there very well may be genes that control; how much
| fear someone experiences when riding a roller coaster._ "
|
| I will lump "genetics" in as another pet-hate
| unsatisfyingly crappy non-explanation that people tag
| onto whatever they want so they can stop thinking about
| it further. There probably are many genes which affect
| how much fat bodies store, or burn, or food cravings, or
| what constitutes hunger, or production of various leptins
| and grehlins and insulins and stomach acids, but that
| doesn't mean "I'm obese because of my genetics" is any
| kind of explanation at all. Or "I have this personality
| because my parents and grandparents had it, it's genetic"
| is an explanation. Downe's Syndrome is a good use for
| genetics as an explanation. "I have a macro-scale set of
| vaguely related behaviours, symptoms and body effects and
| no clear cause, it's my genetics" isn't.
|
| Even if you have sequenced your genome, and have some
| specific gene that is associated with extra fat storage,
| genes can be turned on and off through a lifetime by
| behaviours and environment. Having a gene from birth
| doesn't mean it's being expressed and is therefore
| causing a specific problem, or that the problem can't go
| away and can't be fixed. ( https://www.cdc.gov/genomics-
| and-health/epigenetics/index.ht... )
|
| > " _The problem society has is telling people that they
| all should be able to not have feear riding a roller
| coaster and if you are too afraid to ride a roller
| coaster you should take xanax._ "
|
| I agree with this. Society likes assuming everyone is the
| same. Imagine if we collectively noticed that Adrenaline
| gives people "a burst of strength" and decided that daily
| exercise, individual strength training plans, gym visits,
| were all too much bother and that ageing adults were
| suffering from "an imbalance of Adrenaline" and when they
| struggle to carry their massive haul of groceries in from
| their car they should carry an auto-injector of
| Adrenaline to help their chemical deficiency.
| Noaidi wrote:
| > Citation requested. Because, y'know, it's not like your
| leg muscles suddenly don't work from age 40-50 and then
| start working again and we say it's because of unstable
| "leg chemistry".
|
| Ohhh, leg chemistry, good choice! You know that leg
| "chemistry" is control by neurotransmitter release, yes?
| So you must have never heard of Familial Periodic
| Paralysis then. Let me tell you what happens with that,
| because it happened to me while taking Seroquel. Familial
| Periodic Paralysis is also called Hyperkalemic periodic
| paralysis and is due to mutations in the gene that
| encodes the alpha-subunit of the skeletal muscle sodium
| channel (SCN4A).
|
| https://www.ncbi.nlm.nih.gov/books/NBK1338/
|
| "The paralytic attacks are characterized by decreased
| muscle tone (flaccidity) more marked proximally than
| distally with normal to decreased deep tendon reflexes.
| The episodes develop over minutes to hours and last
| several minutes to several days with spontaneous
| recovery.
|
| Some individuals have only one episode in a lifetime;
| more commonly, crises occur repeatedly: daily, weekly,
| monthly, or less often. The major triggering factors are
| cessation of effort following strenuous exercise and
| carbohydrate-rich evening meals. "
|
| Look at that! Their muscles stopped and stared working
| again!
|
| And yes, this happened to me while taking seroquel
| because it lowered my potassium so much it affected my
| nervous system.
|
| Any good psychiatrist will tell you that they have no
| idea what is going on. But that does not mean
| neurotransmitters cannot be changed and that they do not
| effect behavior.
|
| > I will lump "genetics" in as another pet-hate
| unsatisfyingly crappy non-explanation that people tag
| onto whatever they want so they can stop thinking about
| it further.
|
| As someone who, as an armature geneticist, helped design
| a genetic study for Stanford, can I say that I put more
| energy into thinking about these things over the last 45
| years than you can even imagine?
|
| >Or "I have this personality because my parents and
| grandparents had it, it's genetic" is an explanation.
|
| I have my hair color, height, skin color, all the
| physical traits from my parents, so why do you think the
| brain is not physical as well? Or or adrenal system? The
| brain is effected by genetics, this is true as has been
| shown clearly as a risk for schizophrenia. I have no idea
| why people think our mood, which is dictated by our
| thoughts which are created and sensed by our brain, which
| is a physical organ, does not have anything to do with
| genetics and neurotransmitters.
|
| and then you go on to talk about epigenetics, like that
| matters by genes don't? Do you know that genes control
| the epigentic response? Genes like DNMT1? So people with
| differences in DNMT1 will have different epigenetic
| responses?
|
| > I agree with this. Society likes assuming everyone is
| the same.
|
| So how are we different? nature AND nurture. Genes AND
| environment. I agree the solution to these problems are
| wrong, but your solution are just as bad as the ones your
| are prescribing.
|
| Listen, there are times when our neurtranmitters are
| supposed to be different, like when we are in pain or
| when some one dies. But some people, like me, have these
| changes regardless of the situation and we can like them
| to other environmental factors like diet, sunlight,
| weather, etc.
|
| I could tell you whey and why I think am so sensitive to
| the world but I doubt you would listen, because no one
| listens, because everyone knows.
| bossyTeacher wrote:
| Arguably specific chemical patterns don't emerge and
| persist on their own. Basic causality will indicate that
| something caused that pattern, whether it is a disorder or
| a traumatic event. Chemical processes are not random.
| Otherwise, carbon based life forms would have never lasted
| this long
| Wojtkie wrote:
| The neurotransmitter model of mental illness is largely
| incorrect. It's much more complex than just "Depressives
| have less serotonin, therefore lets give a reuptake-
| inhibitor to keep serotonin in the brain".
| Projectiboga wrote:
| The creator of the Serotonin hypothesis admitted it was
| wrong, and he shifted to melatonin's precursor later in
| his career. The challange with any research in this area
| is Serotonin and Melatonin both affect biological
| functions by gradient activity not lock and key receptor
| models. This pair is how plants and animals respond to
| seasonal changes which vary year to year. Serotonin is
| the warm and light lide melatonin is for cool and or
| dark.
|
| My personal preference is to always suggest getting
| actual daylight on your retina for 20 min three times a
| week. Not through glasses, including eyeglasses, but can
| be through eyelids. That loads transferatin, as in
| transfer, this loads the enzyme that make serotonin. This
| then allows the body a better chance to make the
| intermediate between Serotionin and Melatonin, and is the
| one believed to help. But the patents have expired so it
| is like an orphan drug now.
|
| https://pmc.ncbi.nlm.nih.gov/articles/PMC3779905/
| naasking wrote:
| > Chemistry trumps psychology. Good enough chemistry
| enables cognitive treatments. But to fix the wrong
| chemistry you need chemistry.
|
| It's not at all clear that chemistry is the root issue. The
| brain is a synaptic graph that does something. Some graphs
| can have weird paths that lead to pathologies (maybe bad
| feedback loops). Chemistry seems like fairly a blunt
| instrument for bludgeoning a "bad" graph into one that's
| "better".
|
| Forced habits, like cognitive exercises from psychology,
| can sometimes rewire the graph by themselves because that's
| how the brain learns/adapts, but we still don't have a good
| grasp on how to do this truly effectively in many cases.
|
| That said, the blunt instrument of chemistry can sometimes
| be useful, particularly if it enhances neuroplasticity, as
| I think psychedelic research is beginning to show.
| lossyalgo wrote:
| Also they are often prescribed as a life-long solution,
| instead of a temporary stop-gap to get through some bad state
| of mind while, as you said, "tackling the root cause". At
| some point they will potentially stop working which requires
| switching meds and often the next one won't work as well,
| plus, leaving the user stuck with withdrawal symptoms for
| unspecified amount of time (potentially years) and anti-
| depressant pushers don't usually warn about this, or even
| acknowledge it when confronted with "since stopping I have
| symptom x, y, z".
|
| Source: multiple friends, family and forums (while
| researching how to help friends & family get off of various
| SSRIs).
| IAmBroom wrote:
| They allow me to function. I've gone through various
| dosages of various types to find the ones that work best
| for me, but they have never stopped working. They also
| allowed me to stick with CBT therapy, and after 20 years my
| therapist told me I didn't need him anymore ("Call if that
| changes").
|
| Your second paragraph reveals a biased motive behind your
| opinion.
|
| I'm really tired of reading anti-medicine testimonials from
| people who had anecdotal bad results. Yes, penicillin won't
| stop antibiotic-resistant strains of some germs, and in
| fact may kill people like me if we take heavy doses. That's
| worse than what you're describing for SSRIs; does that mean
| doctors shouldn't prescribe it?
| braiamp wrote:
| > but rather that they're abused by psychiatrists
|
| Doctors of all countries have been under a lot of pressure by
| patients and health administrators to "fix the issue and
| quick". The last thing that your doctor wants is giving you
| pills so you go away, but that's what the context very
| strongly incentivize. You want doctors to stop abusing pills,
| stop asking them for immediate fix. Give them less patients,
| more time and more resources to deal with the health of the
| population. Also, prevention.
| pixl97 wrote:
| >Also, prevention.
|
| Prevention is one of those things that when we actually
| attempt to fix it would have to completely change the world
| you live in.
|
| Humans are social creatures and a huge part of our mental
| health is dependant on the society around us. If the actual
| problem is "wow capitalism is really broken and showing us
| ads 24/7 that say were not good enough is killing us", then
| taking a pill is a valid solution because changing the
| system will take generations or very violent wars.
| chasil wrote:
| Every time I have a yearly physical, my GP will ask if I have
| feelings of depression.
|
| I know this road leads to SSRIs at the very least, so I
| always reply in the negative.
|
| The parent comment hints to me that this might be a mistake.
| I do not want to become accustomed to an antidepressant, so
| perhaps my course of action was correct.
|
| I was measured low on Vitamin D, which I've hopefully
| corrected, and I haven't always eaten fish regularly. Perhaps
| I should pay more attention to that.
| staticassertion wrote:
| > I know this road leads to SSRIs at the very least, so I
| always reply in the negative.
|
| Seems odd. Your doctor can't force you to take anything. If
| they say "do you want to try X?" just say "No". Not giving
| your doctor full medical context seems like a mistake - for
| example, maybe depression would be indicative of another
| issue, or maybe people who are depressed really shouldn't
| take a specific medication.
|
| To each their own, and perhaps you have other reasons, but
| this seems like a less than ideal solution to a very
| trivial problem if the goal is just to not take an SSRI.
| freedomben wrote:
| Agreed. A friend of mine is a primary care doctor, and
| it's remarkable how often people come in for depression
| and after examination and labs it turns out their
| depression is heavily influenced by other issues,
| especially low testosterone or hypothyroid. A lot more
| people have issues with these than most people realize.
| There have also been people he has seen who were
| reporting depression, often where nearly every anti-
| depressant had been tried, where getting treatment for
| ADHD massively improved their case and was life changing.
| As much as people like to hate on Adderall nowadays, for
| people with ADHD it is miraculous.
|
| Getting treatment for "depression" doesn't always mean
| SSRIs etc. Sometimes it means treating the underlying
| condition(s) that are having downstream affects. I would
| suggest everyone gets their Testosterone levels checked
| among other common things.
| kmos wrote:
| I am in that case, low testosterone and hashimoto
| (hypothyroid), ADHD and big Scolioses. Last weeks I am
| dealing with insomnias, and had to take pills to sleep
| and it seems my parasympathic system is in alert mode for
| years, stress, divorce, ex-kid and older kid, etc.. I
| stopped SSRI after 21 years for 5 months and its probably
| causing my insomnias, the brain was not used for missing
| serotonine and brain don't stop thinking, loop, alert
| mode.
|
| I am doing several blood analysis with a functional
| doctor and lyme may be around or was in the body, and so
| many other things. I was thinking I had lucky gut, but
| seems negative..
|
| I did get my Vit D up to 65 and I seems to be issues with
| ADH hormone since kid and probably that makes
| dehydration. It's a fucking nightmare..
|
| I may only see a testosterone replacement as a solution
| maybe..
| pixl97 wrote:
| >often where nearly every anti-depressant had been tried,
| where getting treatment for ADHD
|
| This is actually a somewhat difficult diagnosis to make,
| especially when diagnosing adult ADHD without the user
| documenting and bringing in a well defined log of their
| behavior (and possibly another person to point out things
| they don't know about themselves).
|
| >ADHD is a highly heterogeneous disorder with a
| significant comorbidity rate.
|
| Is thing that you read about in literature around it. And
| even more common than that is the comorbidity of all the
| above symptoms, that is ADHD and depression + more in
| autism.
| grep_name wrote:
| N=1, but last yearly physical my primary care doctor
| asked me if I ever had anxiety. I said yes, but that I
| wasn't really interested in treating it outside of
| lifestyle change. They asked if I wanted a prescription
| for prozac, without explaining anything about how to does
| it or titrate up or down or a time frame. I said I wasn't
| interested again, and that I particularly didn't want to
| take any medications that you can't just stop taking one
| day on a whim (a statement she didn't respond to).
|
| She then proceeded to say "well I'll just write you the
| prescription anyway and you can do your research later
| and decide to fill it or not".
|
| I was actually shocked by this interaction, and think
| about it often. She's a regular family doctor with the
| local hospital system, and this was just a regular
| checkup. I answered one question with a "yes, but it's
| manageable and I think I can handle it with lifestyle
| change" and then said no twice to medication and ended up
| with a prescription, which I ignored but don't appreciate
| having on my record, since it's a false indicator for
| future prescribing physicians.
| staticassertion wrote:
| Crazy. I hear such wild horror stories with doctors. I'd
| never return to a doctor like that, sorry you had that
| experience. Still, this feels like a case where the
| lesson is "get a new doctor" not "lie to one" but I
| understand that circumstances can make that a pain.
| vikingerik wrote:
| Likely the office was getting a kickback from the
| supplier for writing that prescription. This is
| shockingly common in the US. A straight cash payment is
| prohibited, but it's easy to work around that legally and
| provide equipment or "compensate" some other expense.
| drumdance wrote:
| There are also SNRIs, which don't have the sexual side
| effects. I've done mostly SSRIs but in the last few years
| I've been on an SNRI called Pristiq and it's the best by
| far.
| somehnguy wrote:
| YMMV for sure - I was on an SNRI (Cymbalta) for a few
| months as an attempt to eliminate nerve pain. It all but
| destroyed my ability to climax both during and for maybe
| 6 months after getting off of it.
|
| The brain zaps were also hell if I was even like an hour
| later than usual to take it
| mrguyorama wrote:
| Why do you think SNRIs wouldn't have sexual side effects?
| They still inhibit the reuptake of serotonin just like
| SSRIs. That's the part that causes (certain) sexual side
| effects.
| Fischgericht wrote:
| You really should give some modern SSRI like Escitalopram a
| chance. It has made my life so much better, and that of a
| lot of friends, too. The two most common complaints I have
| heard are:
|
| 1.) It's killing my libido 2.) It's too strong
|
| For 1.) - yes, this is a very very common side effect. And
| it's logical - you simply get "triggered" less. Applies for
| me, too.
|
| And 2.) is the same that a lot of people fail to
| understand: Then try a lower dosage!
|
| Unlike most anti-depressants, where you have to constantly
| increase the dose because your brain just generates more
| receptors to fight back, SSRIs hardly wear off.
|
| Also, relax about the "become accustomed" part. Should your
| Serotonin levels be too low, then they are too low. Just
| think about it like you think about table salt. It would be
| just as unhealthy to try to "get off" salt.
|
| All of this being said: There are tons of different kinds
| of root causes for depression. A good rule of thumb is: Are
| you depressed because bad things happened to you? Then seek
| psychological therapy, and potentially combine this with
| medication in case it would be too painful to uncover the
| dark things. Are you depressed on a regular basis, but can
| not name any valid logical reason? Then your brain has a
| chemical problem, so stop treating it like this is an
| illness, but do what you would do if your car would turn on
| the "oil warning" lamp. You can not replace oil with
| therapy or willpower.
| PurpleRamen wrote:
| Most forms of depressions have no "root cause" you can fix.
| Sometimes they have amplifiers or triggers, you might be able
| to work around, but that also demands first to reach a point
| where the patient is able to work on something.
| Forgeties79 wrote:
| > The hate on antidepressants is not because they're not
| effective, but rather that they're abused by psychiatrists.
|
| I don't know how rampant that problem actually is, but I
| don't think you should discount the impact of social stigma
| when it comes to mental health. It is only in the past 10 to
| 15 years, at least in the US, that mental health has entered
| the public dialogue in any meaningful sense. Historically it
| has been a source of massive shame with people expressing
| embarrassment at their loved ones suffering from mental
| health crises. And now we have a whole generation of
| influencers and politicians who are trying to tell people to
| pour out all their medications, reject doctors wholesale,
| take their specific brand of colloidal silver, and be free.
|
| I just think this is a lot more complicated than
| "psychiatrists abuse the diagnosis."
| fc417fc802 wrote:
| > but rather that they're abused by psychiatrists
|
| Well that but also they have poorly understood long term
| effects even after being discontinued (in some people, not
| others) and they don't work for everyone. The latter is
| probably most of the reason they get hated on. I don't recall
| the source but a given antidepressant only works for
| something like 1/3 or less of the population. So take a
| person not in a great place emotionally, who is also
| statistically not in a great place in life overall, subject
| them to an insufferable bureaucratic process, give them a
| drug that doesn't end up working for them, add in some pretty
| wild side effects, sprinkle on a few long term effects _that
| persist after they discontinue the thing that didn 't work to
| begin with_, and of course you end up with a bad reputation.
|
| The tl;dr is that our understanding of the brain and mood
| disorders kind of sucks.
| pluralmonad wrote:
| The US is heavily over-medicated, for sure. The pharma reps
| are very intimate with our doctors and it expresses as one
| might expect. If you go to the doc with nearly any
| significant complaint, you will very likely come away with
| some drugs. But it is not all doctors; people want easy fixes
| that do not require any change in habits. Not an easy problem
| to solve, systemically.
| pixl97 wrote:
| >people want easy fixes that do not require any change in
| habits
|
| Because it's easy to say change your habits when the
| problems are systematic as you say. Cutting yourself off
| social media, or stopping watching the news isn't easy.
| Being bullied/stressed about work and not having other work
| options isn't easily dealt with. Being bombarded with
| advertising telling you that you suck is not something you
| can personally deal with.
|
| The US especially has this idea that we're all rugged
| individualists and any problem we have is our own and not
| one created by the larger society around us and therefor
| communal solutions are bad, and you should toughen up.
| Murfalo wrote:
| The truth about antidepressants is that the majority of
| people with depression that respond to an antidepressant
| would also have responded to a placebo. This doesn't mean
| that their depression isn't real or that antidepressants
| "don't work". It just means that placebo has a relatively
| high response rate in trials for depression. The hate is
| (among other points) because they are only arguably,
| marginally, better than placebo, and antidepressants also
| have real side effects (activation syndrome, increased
| suicidality, sexual side effects, withdrawals, etc.) over
| placebo.
| andruby wrote:
| > The truth about antidepressants is that the majority of
| people with depression that respond to an antidepressant
| would also have responded to a placebo.
|
| ^ citation needed
|
| What does "would have responded" mean? Are you saying that
| >50% of people with depression that are "helped" by
| antidepressant, would have been helped _to a similar
| extend_ with a placebo?
| arghwhat wrote:
| I believe that is indeed what they meant. The perception
| of being given a remedy is very powerful indeed,
| especially for issues ultimately linked to the mind.
|
| That placebos can work should not be seen as undermining
| the severity or pain of the depression, but rather
| underline the power of tricking the mind into
| improvement.
| IAmBroom wrote:
| > The hate is (among other points) because they are only
| arguably, marginally, better than placebo
|
| Only true for some. Inarguably, well-proven false for
| others.
|
| Likewise, placebos and aspirin are comparable at relieving
| those headaches where aspirin doesn't really solve the
| source, but that doesn't mean aspirin's well-documented
| effects are meaningless in general.
| raincole wrote:
| > it's more of a "here, take these indefinitely"
|
| And when you question this approach, the famous lecture
| comes: "but diabetes patients take insulin for life. You
| realize depression is a real condition and need to be treated
| right?"
| DauntingPear7 wrote:
| Yeah some people pop a melatonin every night before bed
| chickensong wrote:
| > I have the impression that's exactly what people do in the
| USA?
|
| It's not a great idea to make general assumptions about such
| a large and diverse country. Some drugs may be over
| prescribed, I have no idea if Ambien is one of them, but
| trying to fit 340 million people across 50 states into the
| same box isn't going to be very accurate.
| cameronh90 wrote:
| I suffer from severe crippling OCD and anxiety. Years of
| therapy and psychoanalysis have failed to find any cause,
| and, if anything, made it worse. The best explanation has
| been it's probably because I'm autistic, and these things
| tend to happen to autistics.
|
| Luckily, sertraline was an almost instant cure.
|
| I can come off it for periods, but it tends to reoccur after
| a while. So, it does mean I have to take a drug indefinitely,
| but is that really a problem? It turns my life into one worth
| living.
|
| The reason we can't take sleeping pills daily is because they
| stop working in fairly short order. But if, like
| antidepressants (typically), they didn't lose their
| effectiveness over time, would there even be a problem with
| using sleeping pills if you had trouble sleeping?
| Aerbil313 wrote:
| Bit off-topic, but melatonin taken at right doses appears
| to work very well. (commonly prescribed doses are 10-30x
| too much and likely cause tolerance). See the post
| https://slatestarcodex.com/2018/07/10/melatonin-much-more-
| th...
| corv wrote:
| I've heard this before that common doses are
| unnecessarily high but why is that? Patents?
| zemvpferreira wrote:
| Rather, lack of. Melatonin is over-the-counter, generic,
| badly understood by the people taking it and dosed
| according to personal preference which means marketing it
| is all abouy big numbers. Bigger number on package = more
| sales.
| quietsegfault wrote:
| > why is that
|
| Why buy 1mg pill when you can buy 100mg pill?
| temp0826 wrote:
| Even funnier is that often 0.25mg or 0.5mg is closer to
| the correct dose, and those sizes tend to be hard to
| find.
|
| There actually is a condition that calls for extremely
| high (100mg+ doses), but it is a _very_ rare thing, no
| one should ever consider that much without instruction
| from a doctor. But you 'll find it right next to the
| normal <=5mg doses without any explanation.
| calfuris wrote:
| The Natrol liquid isn't usually too hard to track down.
| They advertise it as 1 mg or 2.5 mg, but it's the same
| stuff, the bottle just direct you to take 4 or 10 mL
| respectively.
| Projectiboga wrote:
| So 1ml (20 drops) would yeild an average dose of .25mg in
| that form.
| kstrauser wrote:
| They're considered dietary supplements and not medicine,
| so they're not meaningfully regulated in the way meds
| are.
| Projectiboga wrote:
| The help aiding sleep is only one function for melatonin.
| The reason for higher suggested doses is due to its anti-
| oxident function. From personal experience melatonin
| needs to be paired with vitamin e to really clear out
| over night. I take vitamin e as I get into bed right
| before I take a melatonin sublingual. Another benefit of
| melatonin is that it upregulates our insulin receptors.
| andai wrote:
| I'm not an expert so maybe someone else can clarify
| further, but in relation to sleep medications I've heard
| that they should not be used for more than two weeks, or
| they can permanently fuck up your sleep cycle.
|
| They also give you low quality sleep, because they just
| knock you out. It's not a natural kind of sleep.
|
| At least that's how it was a while ago. Maybe the situation
| has improved.
| FuriouslyAdrift wrote:
| I used ambien for sleep and provigil for mindfullness
| (the go/no go packets) during long deployments in the
| military and it took me years to get back to anything
| normal after leaving the Army. These are very powerful
| medications.
| lII1lIlI11ll wrote:
| > At least that's how it was a while ago. Maybe the
| situation has improved.
|
| Fortunately it has. Orexin antagonists don't cause
| dependency and provide high-quality ("natural") sleep.
| andrewl wrote:
| "It's like if we took sleeping pills every time we had
| trouble sleeping. Having said that, I just realised I have
| the impression that's exactly what people do in the USA?"
|
| Not that my personal experience is actually a statistically
| significant sample, but I don't know anybody who takes
| sleeping pills. Or maybe I do, but they haven't told me. I've
| also never heard heavy sleeping pill use is one of the
| stereotypes about Americans. There are an estimated 342
| million people in the United States, so impressions aren't
| always meaningful.
| Aurornis wrote:
| > The hate on antidepressants is not because they're not
| effective,
|
| But that's exactly what many claim. Even this article is
| trying to claim that Vitamin D has 4.5X higher effect size
| than antidepressants (e.g. that they don't work)
|
| > It's like if we took sleeping pills every time we had
| trouble sleeping. Having said that, I just realised I have
| the impression that's exactly what people do in the USA?
|
| USA is actually not the world leader in over medication in
| this domain, even though it's popular and safe to hate on
| Americans. The rates of benzodiazepine and Z-drug
| prescription in some countries like France are substantially
| higher than the USA.
| mrguyorama wrote:
| The "hate" on antidepressants is mostly from a place of
| "The kids are taking pills for things that aren't diseases
| and just need to get out more" and other stupid takes about
| how "back in my day we didn't have this much mental
| illness", which is why the hate is maintained even for
| things like ADHD medications which are so thoroughly proven
| scientifically that they are one of the best proven
| treatments humans have access to for _any_ disease.
|
| Similarly, SSRIs have much better evidence in treatments
| for many other situations, like anxiety, and yet the
| medicine itself is attacked, not using it to poorly treat a
| disorder we barely even begin to understand.
|
| The "hate" is not based in science, despite the fact that
| SSRIs are objectively a mediocre treatment for depression.
|
| We just don't really have much in terms of better
| treatments because we know so damn little about depression.
|
| The medical community _knows_ SSRIs are mediocre and have a
| low success rate at treating depression. They don 't have
| better tools. _Everything_ is a bad treatment for
| depression because "depression" is a loose collection of
| symptoms and statistics that we have really poor
| understanding of, and will certainly be broken up into the
| actual _diseases_ that make it up when we figure them out,
| and we will be able to medicate those diseases more
| effectively.
|
| Every single doctor that would prescribe you an SSRI for
| your depression will _also_ prescribe vitamin D
| supplementation if your blood shows low levels.
|
| Someday we will also have a situation where we are going to
| have to admit that for some subset of the population, their
| depression has no cause other than "Your life is utterly
| terrible, for reasons entirely outside of your control, and
| nothing I can do as a medical professional can fix that".
| pixl97 wrote:
| >The "hate" is not based in science
|
| The lingering roots of Calvinism in the US cause us all
| kinds of problems.
|
| "You were born broken because god made you that way,
| don't make yourself better, and hurry up and die"
| permeates huge parts of our culture. It's why lots of
| other cultures look at us and what we do with relative
| confusion.
| wolvoleo wrote:
| Yeah in Holland too. I deeply despise our Calvinist
| roots. It's so depressing.
| FatherOfCurses wrote:
| "Imagine if we took insulin every time our pancreas failed to
| properly process sugar."
| elil17 wrote:
| Wellbutrin can/should(?) be taken indefinitely and there's
| nothing wrong with that, it doesn't pose big long term health
| risks. As I understand it the issue is with SSRIs (they do
| pose health risks, obviously there's nothing wrong with
| taking them if it is a net positive for you).
| jlebar wrote:
| > Ideally, a professional will prescribe them as a necessary
| helper to becoming (more) mentally healthy whilst tackling
| the root cause.
|
| I wish people would stop saying this.
|
| Our understanding of the brain is not sufficiently
| sophisticated to allow us to identify the "root cause"
| (whatever that means) of depression in most people. Indeed we
| have no reason to believe that there even _is_ a root cause
| to most people 's depression.
|
| If you take antidepressants, go to therapy (or meditate or
| exercise or whatever), then go off them and still feel good,
| that's great.
|
| And if you take antidepressants indefinitely because doing so
| improves your life, that's also great! Your life is improved!
| This isn't an "abuse" of the drugs.
|
| No psychiatrist is making you do anything. They're advising
| you based on their clinical judgement and experience, but
| ultimately it's your decision to take the pills or not. If
| your goal is to go on antidepressants temporarily, any decent
| psychiatrist will support you in that (because, again, they
| understand that they can't make you take the pills one day
| longer than you want to).
|
| I've been on Lexapro and done evidence-based therapy for
| years. They both have been helpful, but if I had to pick one,
| I'd immediately pick Lexapro. For me it is a miracle drug.
| And the miracle is, I can choose how I feel.
|
| (I also added a small dose of Buspar to help with the sexual
| side-effects.)
|
| If you're on the fence about trying an antidepressant, I
| really encourage you to talk to a psychiatrist. If you try it
| and hate it, then you can stop. But a lot of people try it
| and love it. And I think a lot more people would be willing
| to try it if the notion that this is somehow "wrong" were
| gone.
|
| For further reading I recommend
| https://lorienpsych.com/2021/06/05/depression/. I don't agree
| with everything Scott Alexander says, but his writing about
| mental health specifically has been useful to me.
| tootie wrote:
| I was diagnosed a while back with a chronic neurological
| disorder. One that has a heavy effect on my mood and can
| conversely be triggered by my mood. The underlying cause is
| scientifically proven to be physiological. I lack a
| specific neurotransmitter due to inactive cells in my
| hypothalamus.
|
| For a long time I wrote off my symptoms as being all in my
| head. And after a formal diagnosis, I am 100% certain they
| are all in my head because that's where my brain is.
| Symptoms are also unequivocally psychosomatic. What I'm
| feeling can influence my physical symptoms and rather
| abruptly at that. It's right in the definition of the
| illness. None of this means that disease is imaginary or
| not real or I can talk myself out of it. It's as physically
| irreversible as losing an arm. There are some very good
| treatments, but I will never ever be cured (barring a
| miraculous breakthrough).
|
| While the causes of mood or personality disorders are less
| well understood, it seems entirely plausible that they can
| be just a physically inevitable. Every thought, feeling,
| sensory input and motor output is a physical process
| originating in your brain and your brain can malfunction if
| it's ill. And we can treat illness with medicine.
| andai wrote:
| > It's like if we took sleeping pills every time we had
| trouble sleeping. Having said that, I just realised I have
| the impression that's exactly what people do in the USA?
|
| I can't speak for USA but in parts of Europe a lot of people
| have PTSD that prevents normal sleep, so they end up on these
| pills, and then they end up with PTSD and _worse_ insomnia
| caused by long term use of sleep meds.
|
| I think it's just incentives. Easier to take a pill than to
| deal with horrible trauma. And that probably stays true
| forever.
| pixl97 wrote:
| The easiest way to deal with horrible trauma is to prevent
| said trauma in the next generation.
|
| What is either revealing or terrifying is seeing how many
| people attempt to prevent that. Sexual abuse for example is
| pretty rampant in the US. Sexual education at a young age
| so people know they are being abused under no uncertain
| terms is a good solution for this.
|
| And yet you will run into far too many people that under no
| uncertain terms want their children to be excused from sex
| abuse education. What deeply concerns me is when you see
| people with this position that you know where sexually
| abused themselves.
|
| I don't know, people really suck.
| shermantanktop wrote:
| > I just realised I have the impression that's exactly what
| people do in the USA?
|
| How would you have formed that impression? Whatever media and
| culture you're consuming, or how you are interpreting it, is
| leading you to incorrect conclusions. You should examine
| that.
|
| We all live in a cultural bubble but any time you find
| yourself thinking that millions of people somewhere else do
| something crazy, you should probably talk to someone from
| there.
|
| Sleeping meds might be prescribed at a higher rate in the US,
| that wouldn't surprise me due to the specific incentives in
| our health care system. But that's a far cry from your
| impression.
| LordDragonfang wrote:
| It's not like sleeping pills at all actually. Sleeping pills
| have a huge dependence and tolerance factor. Antidepressants,
| generally, do not. Once you find one that works, they keep
| working effectively forever.
|
| It's _actually_ like statins. Ideally, a doctor will
| recommend diet changes in addition to the pills. However,
| relying on lifestyle interventions almost never is effective,
| And the more we learn about it, the more we realize that
| cholesterol is mostly genetic based rather than diet based
| anyway. So the most effective thing they can do is say
| "here, take these indefinitely". And thank God they do
| because it saves thousands of lives annually.
|
| For many people with depression, a neurochemical imbalance
| _is_ the root cause. Just like with statins, addressing it
| means taking some pills.
| kstrauser wrote:
| Sometimes the root problem is that your neurochemistry is
| FUBAR and no amount of counseling with overcome a biological
| cause.
|
| Frankly, I see this as similar to telling diabetics that they
| should use just enough insulin to get them to learn to stop
| being diabetic. That's possible for a few type 2 diabetics
| who could make lifestyle changes that got them back into good
| ranges. It's completely useless for type 1 diabetics, or type
| 2 who can no longer go back.
|
| I'm neither diabetic nor depressed. I don't have a dog in
| this hunt. I'm just always astonished at "have you tried not
| being depressed?" Some people can "snap out of it". Many
| times that number of people cannot.
| thewebguyd wrote:
| > I'm just always astonished at "have you tried not being
| depressed?"
|
| There's a lot of this attitude, at least in the USA, when
| it comes to mental illness in general. I have ADHD, it's a
| common trope/meme at this point of "Have you just tried
| focusing?" "Gee thanks, I'm cured!"
|
| It's a form of institutional ableism, particularly
| prevalent in the US I think because of our hyper
| individualist culture. A lot of people tend to assume that
| you are just lazy, or not trying hard enough, as if it was
| just a matter of willpower.
|
| Kind of frustrating, because those same people would never
| walk up to someone in a wheelchair and say "have you just
| tried walking?" but for some reason mental illnesses get a
| free pass to be ableist.
| kstrauser wrote:
| That was my experience with ADHD. In retrospect, I
| clearly struggled with it my entire life, with it
| starting to cause problems around middle school age. I
| started getting treatment a couple years ago and it was
| like someone flipped a light switch. Wait, this is what
| it's like for everyone else? They can just decide to
| start doing a necessary thing _before_ it becomes a
| crisis?!
|
| In before "of course things are easier when you're taking
| stimulants!", which is another dumb thing I hear too
| often. I feel basically nothing from taking Adderall, and
| not in the least stimulated or more alert or more awake
| or anything. I can just concentrate on boring things
| afterward.
| pixl97 wrote:
| What is that they say, if you have ADHD then ADHD
| medication doesn't act like a stimulant in the same way
| it affects non ADHD people.
| pixl97 wrote:
| >in the US I think because of our hyper individualist
| culture.
|
| Calvinism.
|
| There's been a number of papers written about how
| pervasive Calvinistic ideas are in the medical community.
| This tracks with the New England area of the US pumped
| out the most doctors while medicine was 'growing up', and
| protestant christianity was the most common form there.
| When you view the creation of the US medical system with
| that view many of our screwed up systems make sense. A
| lack of willpower is a failure of man to be in touch with
| god, and not a problem a doctor should solve.
| htek wrote:
| It's a symptom of the "health care" insurance industry. Many
| people end up paying a specialist doctor's co-pay when they
| see a psychiatrist. Some plans limit you to a maximum number
| of sessions you can have (6, in my case) per year. Talk
| therapy eats up sessions and co-pays like Pac-Man eats dots.
| One doctor expected me to come in twice a week. Americans
| don't get all the PTO and/or excused sick time they want to
| accommodate such a schedule.
| pixl97 wrote:
| With that said, does anywhere have enough specialists to
| cover as many sessions as would be needed for as many
| people would seem to need it?
| biofox wrote:
| SSRIs saved my life. No exaggeration. They might be
| overprescribed, only effective is some individuals, and they
| certainly have their share of side effects, but they're still
| the gold standard treatment for clinical depression and
| anxiety.
| graemep wrote:
| If it is SAD have you tried bright daylight balanced lighting?
| isoprophlex wrote:
| Yeah, I have an extremely bright lamp designed to tread SAD
| that I sit, or well used to sit, in front of every morning.
| Daylight responsive led strip in my home office. And a pair
| of glasses with blue LEDs for on the go. It did... 10%? of
| what citalopram eventually did for me.
| graemep wrote:
| Thanks for the reply. Does the citalopram completely
| obviate the need for the extra lighting or do you find
| there is still a benefit to having the daylight lighting
| too?
| isoprophlex wrote:
| I've stopped caring for my various lamps. I turn on the
| bright panel out of habit while working at my desk... but
| I don't feel "drawn" to it as before. I'd, for example,
| set my phone to the highest brightness in a dark room to
| motivate myself to get out of bed, or at least get to the
| light switch. Now I don't care, I just get up.
|
| And I can look at the dark world outside the kitchen
| windows in the morning and not feel oppressed. It's just
| a lack of light, no menacing presence.
| wincy wrote:
| Have you tried more light? Like, a lot more light? Like,
| getting a light meter and aiming for 10-20,000 lux in your
| room? This blog was a good start for me.
|
| https://www.benkuhn.net/lux/
| dizhn wrote:
| I still think you should have tried eating a banana first.
| luxuryballs wrote:
| I experienced this but ended up getting off of them after
| developing some back/hip issues but I didn't think it was
| related, it wasn't until I quit the citalopram that my
| shoulders were suddenly relaxed and the hip "looseness" or
| constant need to be adjusted back into place went away, like
| everything tightened back up, it is really strange, then I
| looked up how SSRIs can impact this and even bone healing,
| decided I couldn't risk my body falling apart.
| kyleblarson wrote:
| I had disk issues in my lumbar spine that caused nearly
| unbearable pain and terrible quality of life. Tried everything:
| PT, OTC painkillers, epidurals, massage, nothing worked. Was
| prescribed pragabalin and duloxotine. Duloxotine is an SNRI
| that also treats nerve pain. That combination helped some but I
| was sleeping 11+ hours per day and generally felt like my head
| was in a complete fog, was pretty much useless with work. I had
| been trying to avoid surgery but finally had 2 procedures in
| 2024 that helped immensely. Weaning off those 2 drugs was no
| fun: sweating constantly, anxious, headaches for about 2 weeks.
| Extremely happy I went the surgery route and stopped those
| meds. I can't imagine living day to day feeling like that.
| freedomben wrote:
| Duloxetine was indeed a beast to get off of. It got so bad
| that I would open the capsules and count the number of beads
| to taper as slowly as possible. It was hell
| Esophagus4 wrote:
| Tangent... but for sweaty feet, try a ski boot dryer!
|
| You can get them for $50... they dry out my shoes which makes
| them last a lot longer before they get so smelly I have to
| throw them away. Plus, who doesn't like warm shoes in the
| morning?
|
| That, and there are some creams called Sweat Block or whatever
| you can rub on your feet which reduce sweating. Those work as
| well.
| aweiland wrote:
| You can also 3D print them:
| https://www.printables.com/model/194340-60mm-radial-fan-
| boot...
| larrywright wrote:
| Also try wearing merino wool socks. It seems counterintuitive
| to put wool on your sweaty feet, but they're quite
| comfortable and they help you avoid that "clammy feet"
| feeling when you are sweating in cotton socks. They also
| don't develop odor the way that cotton does.
| maximedupre wrote:
| Imaging the number of people that this comment could inspire to
| get on SSRIs lol
|
| I'm not saying it's a bad.
|
| But I'm also saying there are no magic pills...!
| lr4444lr wrote:
| They've been losing ground to placebo in more recent research.
|
| Plus, most of the more serious side effects take a lot more
| time to manifest than the typical length any given patient
| remained in the older clinical trials that secured FDA approval
| and grounded the official manufacturer literature.
|
| I am glad we have these tools, but I suspect they are vastly
| overused, and patients not well informed.
| setgree wrote:
| I'm glad to hear that. Another frame is that your depression
| turned out to be "math hard" rather than bodybuilding hard [0].
| Your disciplined, methodical approaches were steady
| applications of effort, whereas what you actually needed was
| easy to implement but hard to envision.
|
| [0] https://www.alexcrompton.com/blog/2017/05/26/hard-is-not-
| def...
| welshwelsh wrote:
| How do you know it was the SSRI?
|
| To cherry-pick a quote from a review of SSRI studies:
|
| >the magnitude of symptom reduction was about 40% with
| antidepressants and about 30% with placebo.
|
| That tells me that antidepressants have some effectiveness, but
| placebos work shockingly well. You can give someone a sugar
| pill with no medical properties whatsoever, and a good portion
| of people will recover, likely crediting the pill for their
| recovery.
| ncasenmare wrote:
| Hi, author of the blog post here! Thank you for sharing your
| experience with antidepressants, I'm really glad it worked for
| you & made your life better.
|
| I _did_ mention the following at the end of the
| "antidepressants" section, but reading your comment convinced
| me to move it further up. The intro now reads:
|
| > The "standardised effect size" of antidepressants on
| depression, vs placebo, is around 0.4. (On average; some people
| respond much better or much worse.)
|
| Also, I wasn't expecting my article to do well on Hacker News;
| thank you everyone for the comments & critiques! I'll edit the
| blog post as I go along, to refine it in response to your
| comments.
| marcd35 wrote:
| Thank you for the blog post! I live in New England and always
| had the winter blues, always just assumed it was because of
| the weather but never acted on it.
|
| About a week ago, there was a reddit post claiming it's
| actually geographically impossible for anyone where I live to
| produce enough Vitamin D naturally from the sun alone, due to
| the shorter days and lower angles throughout the day. I had
| no idea.
| ncasenmare wrote:
| Thank you! I relate; I live in Montreal, close to New
| England, with similar climate. The current UV Index for
| Montreal is... 0. And the current UV Index for Boston is...
| 0.6. (1.6 later today)
|
| I can't find a rigorous academic source right now, but the
| top web results all say we need at _least_ UV Index 3 for
| our skin to be able to make enough Vitamin D. I guess
| summer may work for us, in the Montreal /New England area,
| but other than that, yeah, you and I will _need_ to get
| Vitamin D from diet and /or supplements. And fish is
| expensive, so supplements it is.
| isoprophlex wrote:
| My personerino let me be ridiculous and fawn a bit, and tell
| you that you're one of my internet heroes.
|
| Don't take it as criticism, more of a personal take on
| figuring out what antidepressants do for me. Furthermore,
| since posting that parent comment I've converted my vit. D
| dose to IUs and I realised i'm only taking 800 IUs daily. So
| a thank you for clueing me in on that, and who knows what
| happens if I up that. Maybe you were right all along and all
| i DID need was a _heroic_ dose of vitamin D. (... thats what
| she said)
| ncasenmare wrote:
| Aw, thank you for your kind words! I hope the extra D
| helps! ^_^
| Aurornis wrote:
| > I won the SSRI lottery I guess,
|
| From reading internet comments you'd think so, but your
| experience is more typical than anything.
|
| Depression is deceptively common. As a consequence, SSRI use
| over a lifetime is also more common than most would assume. Any
| drug will come with negative side effects for some portion of
| its users. Multiply that by the high number of people who have
| ever taken an SSRI and it starts to become obvious why there
| are so many Internet anecdotes about SSRIs not working.
|
| Meanwhile, most people who take SSRIs successfully aren't going
| around and advertising the fact that they're on psychiatric
| medications. There is less stigma now than there was in the
| past, but it's still not something most people like to
| broadcast to the world. For patients on long term SSRIs in
| stable states, the SSRI is just a routine thing they take in
| the background and don't really think about. There's no reason
| for it to come up in conversation.
| zigman1 wrote:
| To add to this discussion as someone who had above experience
| this winter, after (literally) years of mood fluctuations,
| fatigue and brain fog.
|
| I have started taking SSRI after a harder-than-usual body
| collapse, and after no matter what I did my mood hasn't
| improved for a month. Regular running, meditating, writing,
| crafting, coding etc were my antidote to my mood swings but
| this time it didn't work. Started taking SSRI and continue
| doing all this things, and I was reborn.
|
| My therapist said that a big chunk of why i am feeling better
| is also because I kept doing things that are good for me.
| That she sees with a lot of her patients that they think a
| pill will magically change the situation. It doesn't work on
| itself, you need to show up and do things that release
| serotonin in your body.
|
| But seriously, unbelievable, years of frustration and
| friction in my life disappeared and I have never felt better.
| butlike wrote:
| Why were you getting body collapses?
| steve_adams_86 wrote:
| > Depression is deceptively common
|
| I didn't even know I had it, but when I was diagnosed, my
| psychiatrist was very concerned and made a point of
| encouraging me to keep in touch, making sure I worked through
| things and engaged with the problem. I initially thought
| something like "I'm fine, just a little down here and there,
| I wonder if this person is inventing work for themselves?"
|
| Same with anxiety. I would have told you something like "I'm
| not an anxious person at all. I don't even know what that's
| like, though I can sympathize with people who suffer with
| it". As it turned out, I was suffering pretty severe anxiety.
| In retrospect it's as clear as day, but at the time it was
| just... The way life was.
|
| The thing is, all of my assessments remarked that I
| demonstrated relatively high self awareness and openness. My
| experience being diagnosed with ADHD and depression made me
| seriously concerned for people who 1) can't afford this
| process and support, and 2) will just continue to grind like
| I was, living half-dead without knowing it can be any other
| way.
|
| I suspect there are a ton of these people--I think I notice
| them quite often--and I was arguably accidentally pulled from
| that stupor and would likely still be there, unaware, if it
| weren't for a chance encounter that caused me to think
| slightly differently about the possibility of having ADHD.
| roody15 wrote:
| Same I am in outstanding physical health and my diet / exercise
| is excellent. Taking Lexipro has made a massive improvement on
| my emotional bandwidth. I take vitamin D / fish oil and bits of
| other supplements. At least for me no question this medication
| even at a 10mg dose has made a major positive impact.
| raffael_de wrote:
| Bessel van der Kolk also mentions in his excellent book "The
| Body keeps the Score" that the effect of antidepressants is
| correlated with the source of the depression. If the depression
| is a comorbidity from early childhood trauma then
| antidepressants are limited due to trauma-related reshaping of
| how the brain is organized. Cases like yours or those that a
| related to traumatic experiences as an adult are more the
| result of a shallow neurochemical imbalance which
| antidepressants are able to impact beneficially.
| anthonyrstevens wrote:
| >> "The Body Keeps The Score"
|
| Such a great book. Highly recommended.
| wafflemaker wrote:
| I'm guessing you can afford spending $300 on light therapy
| glasses.
|
| Disclaimer: I'm not a doctor, but saw 4 seasons of dr. House.
| Moreover, few hours of Huberman Lab on sleep and light and most
| importantly, this episode of Additude Mag Podcast on curing SAD
| and ADHD day-rhytm shifting with light glasses:
| https://www.youtube.com/watch?v=fu4mLgkNc6I
|
| What happens in the seasonal affective disorder season is the
| sunlight pattern diverges from 6-18 that we evolved with.
| Without daily reminder of getting enough sun (or sun-like)
| light at the 6 o'clock0, your body clock will drift.
|
| It can start by feeling groggy instead of refreshed in the
| morning, even if you've slept enough. And can escalate into
| loosing the will to do anything or even live.
|
| No wonder. You're still an animal. You need to be fed, put to
| bed, etc. at a specific time. If you try to make your body
| sleep during the day, and eat and work during what body expects
| to be night, you won't really sleep and won't really live/work.
| Enough of not really sleeping and not really living - you mess
| up your body, your gut biome, your hormonal balance and your
| brain chemistry. You kind of should get depressed when you do
| it.
|
| You can steer your body clock with light. Most of us do it, by
| exposing ourselves to strong (strong enough it won't matter if
| it includes blue wavelength or not).
|
| But you can do it consciously (and in a way good for you) by
| putting on light therapy glasses (I'm using Lumiere 31, and
| they are not the only ones, find your own) at 60 everyday, or
| right after you wake up if you're trying to readjust your
| rhythm. Or if you have time and want to save $200, use a
| stationary lamp and just sit in front of it doing nothing. I
| don't have the time. When readjusting, small doses of melatonin
| (0.5mg) 1h before sleep will accelerate body clock shift.
|
| But don't listen to me, if you have SAD, you should really
| listen to that ADHD experts episode.
|
| I feel for you, struggling with that stuff for a long time. Vit
| D, fish oil (lot of). All lights at home set to reduce
| intensity after 18. Strict going to bed routine. Still sleep
| poorly once in a while, but can do things in winter again. Hope
| it will help :)
|
| 0: choose whatever suits you. With small doses of melatonin and
| discipline in using light glasses you can even flip day and
| night. Just stay consistent, good farmer always feeds his cows
| at the same time.
|
| 1: at the time of buying ( fall '25 ) they were cheapest and
| best overall in norway. Solid build, ok battery, can have them
| on during yoga using attached rubbers and kind of can have them
| over glasses. Mine are very large and have blue light filter,
| but I manage 20min without eyeglasses. Medical certificate. Few
| leds, holo strip, battery and some plastic - my inner Scrooge
| says it's not worth $285, but everything else was worse and
| more expensive.
| wincy wrote:
| I just spent $300 on LED light bulbs. Especially if you have
| an older house the sockets are all wired up for incandescents
| so you can just split the socket and run 7 bulbs per socket,
| I have 30 light bulbs, including two 200W corn bulbs and the
| rest are "100-200W equivalent"
| Noaidi wrote:
| Re "citalopram" and "SSRI lottery I guess"...in fact,
| citalopram is not a true SSRI and in fact no SSRI is only an
| SSRI as they also on, at increasing doses, many other
| neurotransmitters like norepinephprine and Muscarinic
| acetylcholine receptors.
|
| However, citalopram specifically has a big effect on the
| histaminegma the sigma-1 receptor. I will focus on the sigma-1
| receptor:
|
| https://www.sciencedirect.com/science/article/pii/S134786131...
|
| Never heard of it? Yeah, don't be ashamed, it is the biggest
| secret in depression. In fact they are finding that many
| "SSRIs" are sigma-1 agonists, even prozac.
|
| https://www.frontiersin.org/files/Articles/1691987/fnins-19-...
|
| It tunrs out that Sigma receptors modulate glutamatergic
| dysfunction in depression, and glutamate, being excitatory,
| well, you can. make your assumptions from there.
|
| https://www.frontiersin.org/journals/neuroscience/articles/1...
|
| It seems the main function of the Sigma-1 receptor is Calcium
| release. And calcium ion channels are one of the most studies
| ion channels in mood disorders. By increasing calcium release
| you increase neuronal activity, hence, the uplifted mood.
|
| It is too bad that the sigma-1 receptor is just starting to be
| studied and there is limited evidence of how omega-3 and
| Vitamin D effect it. But I do know that Vitamin D has a huge
| effect on SLC6A4 (SERT).
|
| https://www.nature.com/articles/s41598-020-79388-7
|
| I have Schizoaffective Disorder Bipolar Type (disabled) and
| have been on no less than 14 types of meds. I knwo how they
| work better than my psychiatrists, which I why I no longer take
| them. I also know my genetics which gave me clues to what is
| happening in my body. Now I eat a mostly seafood diet and my
| needs for meds has mostly vanished. I am still an odd old
| fellow, but at least I am not ranting in the streets or trying
| to kill myself anymore.
|
| Meds saved my life, but a diet high in Omega 3, D, and a bunch
| of other things has removed so much suffering from my life,
| more than any medication has.
|
| (Also, if you want to get into the weeds of depression, you
| might wat to look at ATP and depression
| https://onlinelibrary.wiley.com/doi/full/10.1111/cns.14536)
| anonymous344 wrote:
| have u ever tried niacin?
| Noaidi wrote:
| Yes. Made me manic. You know we make niacin in our own
| bodies, from tryptophan, down the kynurenine pathway. Sine
| many of the enzymes that are in this pathway need B6 and
| B2, being low in these may lower endogenous niacin in the
| body.
|
| https://www.researchgate.net/publication/353319033/figure/f
| i...
|
| Many people I know, when tested, were low in B6. That is
| more important to me than niacin.
| ulnarkressty wrote:
| For others who want to try this, taking too much B6 is
| associated with nerve damage -
| https://en.wikipedia.org/wiki/Megavitamin-B6_syndrome
| lII1lIlI11ll wrote:
| From your link: "The common supplemental form of vitamin
| B6, pyridoxine, is similar to pyridine, which can be
| neurotoxic."
|
| Vitamin B6 in p5p form is cheap and widely available
| alternative.
| throwforthings wrote:
| The things that keep me away from SSRIs are the potential for
| addiction and not being able to take psychedelics.
|
| I had a friend on SSRIs not tell us they were on them when they
| hit a DMT vape pen at a party years ago and they got serotonin
| syndrome. Had I known I would have warned them not to.
| nerdsniper wrote:
| It's more "dependency" than "addiction". No one's waking up
| jones-ing for another hit of their SSRI. Dependency works
| well because some people are dependent on it like I am
| dependent on glasses/contacts.
| wincy wrote:
| Whatever the word, getting off of them is not fun. It took
| 6 months after getting of Paxil to stop feeling like I was
| being dropped down an elevator shaft at random times day
| and night.
| throwforthings wrote:
| Yeah, that's fair, there's not really a loss of control so
| dependency is probably the better term. Still, if you go
| off of them I've seen people get rocked with physical
| symptoms. I really try to avoid anything that would have
| such an affect on me physically.
| shevy-java wrote:
| > This just goes to show that for me, they're extremely
| effective.
|
| I am not so convinced. Perhaps your case was simpler, but
| people can feel chronic depression. They may take some drugs to
| modify that, but what if the external factors won't change? You
| can see this issue for some people who have a disease that only
| gets progressively worse. I think we can not unify all this as
| "dislike on antidepressants" as a one-size-fits-all formula.
| YeahThisIsMe wrote:
| I had pretty much the same reaction after two days of taking
| it.
|
| Took a while longer to get the dose right so that my anxiety
| also mostly disappeared, but the difference in quality of life
| it made for me is hard to put into words.
| quotz wrote:
| Have you tried SAD lamp light therapy? But not those lamps you
| get on amazon or other marketed SAD lamps, those are a scam.
| Just buy a 2 floodlights that are pretty powerful, say 100 watt
| each. Works like a charm. 15-30 mins a day its all it takes
| dghlsakjg wrote:
| As someone that falls on the side of "depression is real and
| antidepressants can help" it is very clear that there are
| people in this thread that need to hold their tongues because
| they know not of what they speak. (Not you OP)
|
| There are some forms of depression that you cannot think or act
| your way out of. If you haven't experienced that, I promise
| that you do not understand what it is like. You cannot really
| understand unless you have experienced it. Your opinion on it
| is irrelevant, and frequently offensive.
|
| The same is true for people that say that antidepressants are
| mostly placebo. They are not. When people say that
| antidepressants saved their life, they aren't joking or
| exaggerating in the least.
|
| Yes, I understand that other therapies are also effective, and
| that some people are non-responsive to some drugs.
|
| Keep your pet theories to yourself if you are not a subject
| matter expert or someone who has experienced it first hand.
|
| Edit: I understand that the placebo effect is still an effect.
| My point is that there are a lot of people being incredibly
| dismissive of real lived experiences and outcomes on a VERY
| serious issue.
| monero-xmr wrote:
| Lexapro saved my life
| wincy wrote:
| Lexapro made me feel like I was randomly being dropped down
| an elevator shaft for 6 months after I stopped taking it.
| I'm glad it worked for you, and am not minimizing that, but
| these medications have a side effects profile a mile long
| and should be a therapy of last resort in my opinion.
| htek wrote:
| The problem with antidepressants are that while we know,
| more or less, what they do, we don't know why they work
| for some and not for others. Escitalopram (Lexapro) was a
| vast improvement for me over Citalopram. Then it
| plateaued and a year later, left me anhedonic. Tried an
| SNRI that would give me brain zaps every day a few hours
| before my next dose and it was horrendous to quit using.
| It also messed with my ability to meditate for a long
| while. Basically, I could put myself in a mental state
| that would trigger the same kind of painful brain zaps
| that withdrawal from the SNRI caused.
| avipars wrote:
| They have a half life and you cannot stop taking them
| cold turkey without these symptoms, your psychiatrist
| should help you ween off of it slowly.
| aaronbrethorst wrote:
| I can't go so far as to say it saved my life, but I'm part
| of that cohort of 10% of men who develop postpartum
| depression. Taking a small dosage of Lexapro had zero side
| effects for me and helped me deal with not just the anxiety
| and depression I was experiencing but also a lot of pre-
| existing anxious behavior that I didn't even realize was
| abnormal.
|
| Huge quality of life improvement. 10/10 would medicate
| again.
| bawolff wrote:
| > The same is true for people that say that antidepressants
| are mostly placebo. They are not.
|
| In fairness, anti-depressants are a lot of drugs. The article
| gives a list. 23 of them seemed to be better than placebo, 19
| of them were much less clear.
|
| > When people say that antidepressants saved their life, they
| aren't joking or exaggerating in the least.
|
| Placebos can also save people's lives.
| marcuschong wrote:
| I was incapable of the compassion you're talking about until
| I had a bad shroom trip and felt some horrible, hard-to-
| describe anxiety the next morning. It was some of the worst
| hours of my life until my serotonin system rebalanced itself.
|
| I'm not saying it's the same thing as depression or regular
| anxiety, but it gave me tremendous perspective on how bad
| these conditions can be and you just don't have the ability
| to "shake it off" when things are unbalanced.
|
| Maybe that's how my wife feels when she's off the meds. Shit.
| Now imagine having a douchebag by your side second-guessing
| your pain. Never again.
| kayodelycaon wrote:
| > Maybe that's how my wife feels
|
| The good thing is it isn't necessary to know how someone
| else feels to have compassion.:)
|
| It's enough to accept you don't understand the other
| person's thought process and stop trying to tell them what
| they are thinking. You don't need to fix things, you just
| need to listen and not make them justify or explain
| themselves to you.
|
| Doing nothing is better than doing the wrong thing.
|
| This comes from my own personal experience. I can't relate
| to people on an emotional level. Every relationship is
| processed with deliberate, logical action. If I love a
| friend, I need to figure out what would change their
| internal state so they can experience that love.
|
| From the outside, this looks like I can relate on an
| emotional level.
| marcuschong wrote:
| Precisely. That's what I took from the experience as
| well. If that's so hard and I had no idea about it until
| now, maybe there are other things that I don't know, and
| some that I will never learn, and I should tread lightly.
| ifyoubuildit wrote:
| A: The same is true for people that say that antidepressants
| are mostly placebo. They are not.
|
| B: When people say that antidepressants saved their life,
| they aren't joking or exaggerating in the least.
|
| Are placebos unable to save lives?
|
| Not claiming antidepressants are or are not mostly placebo,
| and don't mean to minimize the pain of depression in anyway.
| I just don't think whether or not they saved a person's life
| is an indication either way. The placebo effect is real,
| right? As in the subject actually gets better after taking
| it.
|
| > Keep your pet theories to yourself if you are not a subject
| matter expert or someone who has experienced it first hand.
|
| This is the internet, friend. I wish you the best, but maybe
| don't put too much hope into that one. I think you'll have
| better luck cultivating the ability to be comfortable having
| your own beliefs while others have different (possibly
| wrong!) ones.
| hombre_fatal wrote:
| When you do this, you're just accusing people of having no
| real evaluative power about their own experience. It's
| pointless, and it's not really an opinion.
|
| Placebo-controlled RCTs show that some people react well to
| antidepressants with major variation from person to person.
| ifyoubuildit wrote:
| Maybe I wasn't being clear, since I didn't mean to accuse
| anyone of anything.
|
| I'm not disputing that someone had the genuine experience
| of antidepressants saving their life. I'm asking if that
| precludes antidepressants acting as a placebo.
|
| In other words both things can be true: antidepressants
| saved someone's life and antidepressants can act as
| placebo (even in the case where they saved someone's
| life). And notice I'm saying "can be true". I'm not
| saying they are true, cause I have no idea.
|
| This is a logic question, not some kind of moral attack.
| thisislife2 wrote:
| There are indeed some form of serious depression that are
| non-responsive to psychotherapy alone. Those are however not
| the norm. Dr. David D Burns, practising psychiatrist and
| author of the book _Feeling Good: The New Mood Therapy_ has
| written a whole chapter in it on the appropriate use case and
| effectiveness of anti-depressants today. (If you are
| considering using anti-depressants, I urge everyone to get
| the latest revision of his book and read that chapter). He
| believes anti-depressant has its use _during treatment_ but
| also shares studies that suggest modern psychotherapy, like
| Cognitive Therapy which he advocates, has now begun to
| _surpass_ the effectiveness of anti-depressants in "curing"
| depression in the _long-term_.
|
| A particular point he makes about depression in it is
| insightful: _Although depression is conventionally viewed as
| a medical illness, research studies indicate that genetic
| influences appear to account for only about 16% of
| depression. For many individuals, life influences appear to
| be the most important causes._
| zeroonetwothree wrote:
| As a counterpoint, I experienced such severe negative
| symptoms after taking SSRIs that I had to be hospitalized for
| months. Medical treatment is not without its risks. I would
| always advise trying NPIs before drugs.
| detourdog wrote:
| If only I knew what an NPI was.
| dghlsakjg wrote:
| Non pharmaceutical intevention
| dghlsakjg wrote:
| I don't in any way mean to discount adverse affects, or
| negative experiences. Those are just as valuable points.
| People should be aware of the risks when they take any
| pharmaceutical, and there are doctors who will happily
| prescribe these drugs without educating the patient or
| themselves about downsides and alternatives.
|
| My point is that a lot of the commenters here are saying
| some variation of "have you tried being happier?" and
| "these drugs do nothing". Both of which are absurd to the
| point of offensiveness to people who have gone through it,
| in the same way that it would be absurd (and offensive) to
| claim that these drugs have no possible downsides and a
| negative reaction is placebo.
| tracerbulletx wrote:
| The placebo effect is a statistical reporting effect. Not a
| physical effect.
| kevin_thibedeau wrote:
| Somaticizers absolutely will change their behavior in
| response to a placebo.
| throwaway314314 wrote:
| Thank you for saying this, I wholeheartedly agree.
| Antidepressants have an excessively bad reputation.
|
| I'm sure they have their problems too on occasion, but for me
| the decision to start taking Escitalopram was one of the best
| things I've ever done.
|
| The side effects were totally negligible compared to the
| benefits.
|
| I've stopped taking it a year ago or so and... it's basically
| cured me.
|
| I'm not saying antidepressant are a literal pharmaceutical cure
| for depression, but in my case it simply put me in a position
| mentally to change habits and patterns of thinking in a
| sustainable way.
|
| My only regret is not doing this 10 years earlier; the poor
| reputation contributed to that.
| wojciii wrote:
| It takes a 10 min talk with a doctor to get antidepressants
| around here. Perhaps a test which looks like multiple choice
| score of symptoms with some weights.
|
| I had an old gf receive two different drugs each with terrible
| side effects. To me it looked as poison.
|
| I decided that I would rather hurt myself myself than fuck with
| my brain chemistry this way.
|
| During the dark northern Winters I lack vitamin D (your doctor
| can measure this using a blood test). The symptoms are some
| physical issues and probably something that can be described as
| light depression which goes away if I remember to take the
| vitamins.
|
| We are all different. Some people might need anti-depressants.
| I just need some vitamins.
| chasd00 wrote:
| I had a similar experience except instead of antidepressants it
| was when i started taking Adderall as an adult. A sense of
| peace and serenity in my mind that I had never felt before, it
| was almost overwhelming.
| QuantumGood wrote:
| What dosage of Citalopram? 40 mg/day?
|
| (Roughly equivalent to Lexapro 15mg/day; Saffron 30 mg/day if
| Crocin+Safranal properly standardized)
| isoprophlex wrote:
| 10 mg a day, down from 20 but that made me feel wired, like I
| ate a bunch of 9V batteries for breakfast. Big pupils,
| trouble sleeping, manic thoughts, the works.
|
| I'm a small, generally sensitive guy so ymmv...
| QuantumGood wrote:
| Thanks. Ever try Saffron extract standardized to crocin
| content (typically 2-3% crocin, dosed at 20-30 mg/day)?
|
| One meta-analysis showed an antidepressant effect size
| around 1.2-1.6 , and unlike pharmaceutical antidepressants,
| saffron with standardized crocin has no well-documented or
| commonly reported withdrawal syndrome in clinical studies
| or reviews.
| wincy wrote:
| I had severe SAD to the point of having a mental break where I
| told my wife I was flying that very day to Miami to get away
| from the cold. I didn't end up flying to Miami, which is likely
| why I'm still married...
|
| So I ended up spending $300 on LED bulbs, both corn bulbs and
| 200W equivalent, bought some 7-Way splitters for my ceiling fan
| so it's holding 28 light bulbs (people have joked I have a
| "biblically accurate ceiling fan" because it's so bizarre
| looking, like a weird glowing biblical angel), and get about
| 10,000 lux in my home office now. As a bonus, I don't have to
| run a space heater in my home office (since I only need it in
| winter, I'd have been using that electricity anyway via a space
| heater). Solved the issue completely for me.
| bossyTeacher wrote:
| sweet feet seems so random, maybe some serotonin receptors down
| there? are they noticeably sweety?
| isoprophlex wrote:
| something's fucking my hydro balance. i've done my fair share
| of psychedelics, and i have to keep drinking water on shrooms
| too. i dont know, something highly idiomatic haha. i also
| sweat more in other places, but my feet are the moistest.
| right now i just change socks often, it's hardly a
| debilitating side effect...
| randusername wrote:
| Same story here, but different drugs. Every year Nov to Mar
| means no lapses whatsoever in diet, exercise, sleep,
| supplements, clutter, lighting otherwise the SAD will seep in
| and erode me. I tried udosing ADHD meds this year and suddenly
| subsistence is easy and I have gas left in the tank for
| worthwhile things.
|
| I feel like I speedrun Maslow's hierarchy of needs.
|
| No anhedonia so far this year and my creative output is at all-
| time high. Hope that helps someone get over their own biases
| about prescriptions.
| kranner wrote:
| Similar story here but for ADHD and Atomoxetine.
|
| I finally went and got diagnosed at age 46 for what had been an
| childhood-onset issue in retrospect. All the signs were there:
| inability to start work until enough challenge or novelty or a
| state of crisis had come about, etc. When I spoke to friends
| about considering treatment, they said they thought of me as a
| hyperfocus kind of person. But they didn't see how many support
| systems I had put in place to function normally, how I saw
| others around me just doing things while I had to work myself
| up to start and then keep checking and double-checking for the
| silly inattentive mistakes I knew from experience I would keep
| making.
|
| I've had a meditation practice for a long time and it has
| helped with anxiety but it hasn't really helped with getting
| started on tasks, especially those perceived as boring. I even
| had to psych myself up to sit down and start meditating, even
| though I knew I would enjoy it.
|
| I didn't know until a year or two ago that non-stimulant
| medication existed to treat ADHD. I always thought it was only
| Adderall and the like, and I couldn't risk anything that would
| ramp my anxiety up, or take additional treatment for the
| anxiety with SSRIs because I have severe hemophilia and any
| additional risk of bleeding from SSRIs was an untenable
| proposition.
|
| After sitting on the idea for some time and just hoping that I
| could fix it with more meditation, I finally decided to see a
| psychiatrist. The doctor suggested Atomoxetine, but said it
| doesn't work for most people and even then takes 3-4 weeks to
| take full effect. I started on the absurdly low dose of
| 10mg/day for the first month to be sure it wouldn't cause
| additional bleeds. By day 3 I could see a huge improvement in
| my working memory and ability to perform tasks. It gave me
| insomnia for a bit but I would wake up at 3 AM, sit down
| happily to work and write the best code I've written in years.
| I could not believe the difference it made. There were quite a
| few side effects initially but I was willing to put up with
| them because of how smoothly my brain was functioning. I became
| a nicer person to deal with. I felt this sense of possibility
| and freedom that I haven't felt since my 20s. My only regret is
| not having done this sooner.
|
| So yeah, please don't avoid medication based on internet
| reading.
| MisterTea wrote:
| Similar. I was on stimulants as a kid and hated them as they
| did nothing but make me feel high then taper off leaving me
| exhausted. Nevermind the total loss of appetite. Later on as
| an adult I obtained adderall from a friend and experimented
| with it and it seemingly worked for a few days but it never
| stopped the intrusive thoughts or help with the anxiety. In
| fact all I did was chase a high with cup after cup of coffee
| when coming down. That put me off to meds for a long time.
|
| More recently I was on a vacation where I took mushrooms and
| had a nice trip. Two days later at work I felt very relaxed
| driving in and sat at my desk BUT something was wrong, my
| head was dead quiet (the GP explained this exactly like I
| would.) So quiet that for a second I had a bit of panic as I
| thought something was wrong. Then something wonderful
| happened: I realized I was able to just do my work. There was
| no stress, no worry, no nothing. Just a calm quiet confidence
| to get the job done. Best day of my life.
|
| After that I called a mental health center and connected with
| an ADHD specialist who has been working with me. I am also on
| Atomoxetine myself and while it has not brought me back to
| that zen head space it brings me close enough. My only gripe
| is at a higher dose it gives me sensations in my head.
| However, I learned that eating a proper breakfast helps a lot
| as I was taking it on a near empty stomach. Overall my life
| has been slowly improving and I feel more confident at work.
|
| > So yeah, please don't avoid medication based on internet
| reading.
|
| This - 100%
| bjourne wrote:
| > I won the SSRI lottery I guess, the side effect are sweaty
| feet, vivid dreams and a dry mouth. That's all.
|
| Yes, you did. Had the same medication and got tremors and
| stiffness so bad I thought I had early-onset Parkinson. Could
| hardly unlock the door without dropping the keys five or six
| times. Fortunately, it ceased when I stopped the SSRI.
| ericmcer wrote:
| Same for me with Adderall.
|
| I do wonder if being highly functional and feeling capable is
| normal though, like as a species it seems almost dysfunctional
| to happily plow through 8 hour workdays and bills and
| appointments and all the little bureaucracies we have to
| navigate. Sometimes a little voice screams "Run to the woods!"
| when I sit down and look at a long todo list for the day, but
| with Adderall I can generate some semblance of enjoyment from
| ticking off the boxes.
|
| Granted our world is what it is, and we are mostly helpless to
| enact large changes. Finding some kind of peace with reality is
| probably better than bashing your head against why you don't
| fit into it well.
| qxxx wrote:
| and then the effects wear of. You just feel "normal" or the
| same as before. I used to take ssri meds too. It was nice in
| the beginning. Stopping was a nightmare, I needed to taper down
| foe like half a year..
| jollyllama wrote:
| Do you take the citalopram year round, then?
| isoprophlex wrote:
| This is my first year, doc told me to wait until at least
| march, April to start talking about tapering. I have zero
| symptoms in summer, so I'm inclined to get off them outside
| the darkest months... we'll see how bad the discontinuation
| syndrome hits.
| jollyllama wrote:
| Here's hoping it goes well, whichever path you take.
| drukenemo wrote:
| Thank you for your comment. I think that can help many people.
| thewebguyd wrote:
| Similar story for me, but with Bupropion (Wellbutrin). None of
| the SSRIs/SNRIs worked for me, spent years trying different
| medications, Wellburtin was finally the one that worked, and oh
| man what a difference.
| pavel_lishin wrote:
| > _Cold showers, ... no alcohol, strict sleeping rituals._
|
| I feel like doing those three things would make me feel like
| reheated cat shit, regardless of the weather outside.
| wolvoleo wrote:
| They do for me too. Alcohol gives me a huge downer the next
| day but the party itself is amazing so I just waste the day
| after with a pillow over my head.
|
| And I hate strict rules and rituals, I love chaos. So that
| also gets me down. I often stay up till 6am (the parties I
| mentioned above only start at midnight)
|
| So yah it might make some people better but for me the times
| I break it are the ones that are exceptionally good.
| fleebee wrote:
| Please talk to a doctor if you're curious about this instead of
| following this advice. Megadosing vitamins and supplements comes
| with risks not addressed by the author.
| lqstuart wrote:
| The only problem here is that "going from an F to a C in mental
| health" is vastly different than "going from a C to an A." It's
| very well known and well documented that antidepressants have
| very little effect on mild depression compared to say, exercise,
| but that F grade of depression tends to be a different beast with
| different causes.
|
| That's not to suggest that exercise etc isn't great, just that
| society has come a long way in destigmatizing mental health and
| just being like "oh just take fish oil" to someone dealing with
| that kind of depression, either through shitty genes or childhood
| trauma or whatever, can be really harmful.
| defraudbah wrote:
| wait till they discover sex, drugs and alcohol :)
| amai wrote:
| Coincidence? "Vitamin D is currently the only Essential Vitamin
| or Mineral which appears to have deficiency rates at a similar
| level to Magnesium"
|
| https://examine.com/supplements/magnesium/research/#nutrient
|
| Dai (2018): Magnesium status and supplementation influence
| vitamin D status and metabolism: results from a randomized trial
| https://pubmed.ncbi.nlm.nih.gov/30541089/ "Our findings suggest
| that optimal magnesium status may be important for optimizing
| 25(OH)D status. "
|
| So it might well be that general deficiency in Vitamin D is
| caused by the deficiency in magnesium status. This would also be
| an explanation why we see Vitamin D deficiency in sunny Africa:
| https://theconversation.com/think-vitamin-d-deficiency-is-no...
| elAhmo wrote:
| To many people without relevant expertise give medical advice
| online.
|
| I remember a similar case with levelsio who was advocating people
| to take melatonin and discussing how much grams is good vs bad.
| When I said that people shouldn't take medical device from
| someone who was successful in building web apps, he blocked me.
| torcete wrote:
| I would add that the issue with Omega-3, is the imbalance between
| Omega-3 and Omega-6. It turns out that many of the food products
| have been manufactured with Omega-6 rich oils and that is causing
| some issues. One can ingest Omega-3 supplements, try to eat foods
| rich on that fatty acid or reduce foods with lots of Omega-6 in
| order to restore that balance.
| dingdingdang wrote:
| Confusing mg and IU units up front really do NOT inspire
| confidence on the topic and conclusion as a whole.
| comrade1234 wrote:
| Before you start taking crazy amounts (or any amount) of vitamin
| D just get a blood test. It's simple. As part of my insurance I
| can get a bunch of different blood tests, but I did have to pay
| about $50 extra to add the vitamin D test.
|
| Based on the test I was just a tad under where I should be and so
| now I am taking 800 IU per day. I may stop in the summer when I
| get more sun.
|
| I read somewhere that too much vitamin D has similar effects as
| too little (permanent hair loss, anemia, etc) but that may have
| just been on a blog similar to the linked blog on this
| submission.
| CafeRacer wrote:
| I eat so much vitamin d and omega 3 i should be shitting fish
| shitting sunshine... and yet, cold baltic winters with only a few
| hours of sun still make me depressed.
| shellkr wrote:
| This made me think of Pauling
| (https://en.wikipedia.org/wiki/Linus_Pauling) who was a famous
| scientist and big proponent of high-dosage C-vitamin. He claimed
| it could cure everything from a cold to heart disease and cancer.
| Later studies did though not find any benefit of high-dosage
| C-vitamin and that potentially had a higher risk of prostate
| cancer. Pauling died of prostate cancer.
|
| Edit: This may also be of interest:
| https://en.wikipedia.org/wiki/Orthomolecular_psychiatry
| vijaybritto wrote:
| My dad if he was alive would have shouted "I told you so"
| elif wrote:
| Here you go HN commenters. Last month when I made the observation
| that "from what I've read recently, I've started to get the
| impression that the explosion in mental health problems
| (depression, autism rates etc) has more to do with the western
| diet than genetics"[0]
|
| Y'all called me MAHA and down voted me into the negatives.
| Please, insult your own analytical ability by doing the same
| here. This time I'll just revel in your ideologically confined
| science denial this time.
|
| [0] https://scitechdaily.com/simple-three-nutrient-blend-
| rapidly...
| Cipater wrote:
| A study proposing that diet can affect the expression or
| severity of some autism-related behaviours is not the same
| thing as claiming "80% of what people consider autism is
| actually just the western diet's effect on normal brain
| chemistry."
| dartharva wrote:
| Except depression rates are rising at similar or worse levels
| in other places too, including sunnier/tropical regions and the
| ones with "better" diets.
|
| The main instigator of depression is still societal as the
| postmodern era is pushing everyone into seclusion and addicting
| them to constant individualized dopamine hits, increasing the
| miserable effect on one's chronic mood and exacerbating one's
| self-consciousness about it.
| alastairr wrote:
| While I agree with the general point
|
| Vitamin D is toxic (and ultimately fatal) at high doses, which is
| why the 'suggested' dosages of between 400IU and 1000IU are so
| conservative. You _may_ need more, but you should get a blood
| test.
| bell-cot wrote:
| _THIS_. And not just for Vitamin D. Not everyone absorbs /
| metabolizes / excretes vitamins or minerals in the same way.
| Learning whether or not you're an outlier can be done either
| the safe way, or the dangerous way.
| zvqcMMV6Zcr wrote:
| > So why are all the official sources still so paranoid about
| Vitamin D
|
| It is fat soluble vitamin, together with A, E and K. That in
| itself makes in more risky in terms of overdose. I didn't hear of
| any cases outside kids eating jars of vitamin gummies but it does
| happen.
| anonymous344 wrote:
| can only say, if you have depression or mental problems: NIACIN.
| not the niconinamid or whatever which is a scam. do not drink
| alco or smoke! kidneys will suffer.
| mda wrote:
| I would take these articles about vitamin D with a grain of salt,
| there is a big vitamin D supplement and testing market and most
| of the studies about the miracles of it are dubious at best
| buddhistdude wrote:
| including the mentioned meta-analysis? if yes, can you explain
| why you think that it's dubious?
| lynguist wrote:
| For a single time fix ("rewire brain to be healthy again") you
| need psychedelics (psilocybin has seen multiple studies where its
| effect is way better than psychopharmacological drugs). A single
| dose can make you healthy for a year to come, potentially also
| for life as you're no longer a potential victim to it ever again.
| tiffanyh wrote:
| Before anyone goes out and overdoses on Vitamn D (since lots of
| multiple vitamin include too much), see this article on toxicity
| from too much Vitamin D
|
| https://www.ncbi.nlm.nih.gov/books/NBK557876/
| cwillu wrote:
| Juxtaposing with the quoted passage from the post: "Because
| vitamin D is potentially toxic, intake of [1000 IU/day] has
| been avoided even though the weight of evidence shows that the
| currently accepted [limit] of [2000 IU/day] is too low by at
| least 5-fold." --https://www.sciencedirect.com/science/article/
| pii/S000291652...
| seba_dos1 wrote:
| It cites a study about vitamin D toxicity where the range of
| cumulative intake causing it was identified to be 2.2 million -
| 6.3 million IU. When you take 6000 IU daily for a whole year
| you only reach the lower end of that range, and you definitely
| shouldn't do that without checking your levels somewhere in
| between. Taking it for a few months may get you above the
| recommended blood levels, but is very unlikely to cause issues
| unless you started with very high levels already (which you
| most likely did not).
|
| Toxic levels of vitamin D can be life threatening, so do keep
| your levels in check, but you won't get there unless you really
| try, so if you can't get out of the bed to have your blood
| tested just start taking it and check it after 3 months when
| things get hopefully easier for you. Just make sure to get the
| number of zeros in the dose right.
| samsartor wrote:
| Several people in my family have a MTHFR gene mutation that
| screws stuff up, including causing problems with
| anxiety+depression. But a simple B12 shot every couple of weeks
| does wonders.
| RobotToaster wrote:
| One flaw in this analysis is that the source he cites for
| antidepressant effectiveness didn't include tranylcypromine (or
| any MAOI class drugs), which the STAR-D trial found was one of
| the most effective antidepressants.
|
| (The STAR-D had a cumulative remission rate of 67%, I don't know
| how to convert that to the format he used)
|
| Otherwise I agree that vit D and omega 3 are underrated for
| depression, it would be interesting to see if they have a
| cumulative effect with antidepressants.
| HisNameIsTor wrote:
| Wrong unit in text, right? Graphs shows UI. 5000 UI would mean
| 125ug of D-vitamin. Which is a bit smaller than 5000 000 ug from
| the next
| rollulus wrote:
| Anecdotal, and even meta-anecdotal, but hey: four months ago I
| started to supplement omega 3 thanks to this hyperbolic HN
| comment: https://news.ycombinator.com/item?id=45169875
|
| Unlike the commenter, I didn't suddenly turn into a chess
| grandmaster, but I did notice that my winter blues didn't show up
| this year, the first time in a decade!
| dassarin wrote:
| The article even states that nothing here is written in
| certainty. It's just pure speculation. No, fish oil and vitamin D
| do not have a larger effect than SSRIs for depression.
|
| Not to say they don't help, but it's asinine to state that
| nutrients are a replacement for selective serotonin reuptake
| inhibitors, whose sole purpose is to help with depression, and
| has been designed by an army of scientists, researchers,
| psychologists, psychiatrists.
| Forgeties79 wrote:
| The amount of people in this thread rejecting behavioral health
| as a legitimate science/field and calling for bootstraps to solve
| depression et al. is wild to see. So many anecdotes and grand
| statements saying that it's all nonsense. Very sad to see.
| snickerer wrote:
| If you look at the studies on which this post is based, you find
| out that the (very) positive effect oft Vitamin D is only short-
| term.
|
| The effect after taking the Vitamin longer than 24 is not
| significant anymore.
| seba_dos1 wrote:
| As one would expect when you get your blood level out of the
| deficient range? It takes a while to get back down.
| snickerer wrote:
| If you look at the studies on which this post is based, you find
| out that the (very) positive effect of a Vitamin D supplement is
| only short-term.
|
| The effect after taking the Vitamin longer than 24 weeks is not
| significant anymore.
| janpeuker wrote:
| Super interesting, just sad that Omega-3 supplements are one of
| the main drivers of unsustainable Krill overfishing
| https://seashepherd.org/2025/02/25/protecting-the-oceans-vit...
| mixmastamyk wrote:
| Look for algae oil instead.
| Aeroi wrote:
| Most commonly from lanolin, a grease extracted from sheep's wool.
|
| It's processed into (7-DHC), the same compound in human skin.
|
| 7-DHC is bombarded with UV light, triggering a chemical reaction
| that creates Vitamin D3.
| humanfromearth9 wrote:
| The first thing I would do in case of depression is to make sure
| that the patient's energy levels are good and that mitochondria
| and other energy-related biochem phenomena work as expected.
|
| I know first-hand that low energy-levels and lacking energy
| production mechanically lead to depression.
|
| Also, look at how people (children also) experience the world and
| their relationships and their stresses when they are tired (or
| even just hungry) compared to when they are fit...
|
| Fix those, and the depression might be gone.
|
| This is not bashing against anti-depressants, they play their
| role to. But in some cases, energy-management is key.
| nikolatt wrote:
| Thank you for the comment. This is not in my area of expertise,
| so I hope you can clarify - how does one test that
| "mitochondria and other energy-related biochem phenomena work
| as expected"?
| StiviGee wrote:
| Second the question
| ibeckermayer wrote:
| There are tests out there like https://www.chrismasterjohn-
| phd.com/mitome
|
| (No affiliation, just have been subscribed to the founder's
| substack for a while)
| Aurornis wrote:
| Chris Masterjohn is a noted quack. He takes bits of actual
| science and research and weaves them together into
| narratives that make it sound like he has everything
| figured out with his unique protocols, but it doesn't hold
| up to actual scrutiny. People spend years following his
| ever changing protocols without getting anywhere (beyond
| placebo effect and a large bill for supplements)
|
| I know I won't convince the parent commenter but hopefully
| I can convince other readers not to go down this road or
| invest any money in anything related to him.
| ibeckermayer wrote:
| Pure ad hominem FUD. "This guy sometimes disagrees with
| scientists employed by the government, don't listen to
| him!".
|
| The technical details are beyond my understanding but
| I've heard from a PhD in the field that Masterjohn's
| understanding of metabolism is second to none. Whether
| his protocols work or not is certainly a case by case
| matter (like any health protocol), but he always appears
| to substantiate it with well-cited lines of argument, and
| is willing to engage with interlocutors.
|
| As for spending years with changing protocols without
| getting anywhere besides spending lots of money, well
| that can be said for people with complex issues who go
| the institutionally approved route as well. It isn't
| discrediting in its own right that a protocol didn't work
| for some.
| Aerbil313 wrote:
| Just as an example, here is a small part of it: MTFHR
| mutation causes megaloblastic anemia:
| https://news.ycombinator.com/item?id=45085439
| francisofascii wrote:
| It's interesting that one way to improve mitochondrial
| dysfunction is getting sunlight, the same way you get Vitamin
| D.
| dennis_jeeves2 wrote:
| How many of you feel worse when taking vitamin D supplements?
| Alternatively how many of you feel only temporarily better?
| Aurornis wrote:
| Vitamin D and Omega-3 are the two supplements that consistently
| appear to be super powerful in small studies and then fail to do
| anything significant at all in larger studies.
|
| Pause for a moment and consider the mere plausibility of the
| claims in the first few paragraphs: The effect size for
| antidepressants is 0.4, but the effect size for Vitamin D is 1.8?
| Are we to believe that Vitamin D supplements have an effect size
| 4.5X larger than antidepressant drugs, and nobody noticed this
| massive discrepancy until now?
|
| Effect size is also a favorite metric in this vein of supplement-
| over-pharma writing because it's so commonly misunderstood and
| it's so easy to find small supplement studies that have outlier
| effect sizes.
|
| To put it in context, even common OTC pain meds can have effect
| sizes lower than 0.4 depending on the study. Have you ever taken
| Tylenol or Ibuprofen and had a headache or other pain reduced?
| Well you've experience what a drug with a small effect size on
| paper can do for you.
|
| Please be very careful when someone tries to tell you that
| supplements are miraculous and pharmaceutical drugs don't work at
| all. I know too many people who delayed trialing SSRIs for years
| due to internet driven fears and lost many years of their lives
| to depression based on content like this. People with cabinets
| full of dozens of supplement bottles that were chosen based on
| studies, too. Then they finally decided to try real
| antidepressant medications and wished they'd done it sooner.
|
| As much as I wish we could all just cure depression by taking a
| simple Vitamin D supplement that has 4.5X higher effect size than
| antidepressant drugs, this claim just isn't passable.
| dec0dedab0de wrote:
| Anecdotally, Vitamin D and B12 had more of a positive effect on
| my mental health than therapy or any of the half dozen
| prescription meds I tried.
|
| Hiking has the biggest effect though.
|
| I think maybe the problem is that therapists are diagnosing
| people, and psychiatrists are prescribing pills based on those
| diagnoses, but neither are ordering bloodwork to check for
| deficiencies. Which leads to a lot of people suffering from
| lack of basic health, and treating the symptoms with SSRIs that
| have withdrawl symptoms a million times worse than most of the
| problems they treat.
|
| Now to your point, I seriously doubt that vitamin D will hold
| up against anti-depressants and therapy if we control for other
| health and quality of life issues. I just think there is a ton
| of misdiagnosis, and lack of root cause analysis in the mental
| health field, and health care in general.
| NoiseBert69 wrote:
| > Hiking has the biggest effect though.
|
| Keeping the mind busy with beautiful things and being
| physically exhausted can heal a lot of things.
|
| Its like surfing on a big day - you are just too tired to be
| depressive afterwards. It feels like a weight blanket.
| wolvoleo wrote:
| It's also endorphins. Natural drugs.
|
| I don't have the energy to do all that when I'm down
| though. I hate all sports though I do like hiking (there's
| no team or competitive bullshit) but I'm too clumsy for it.
| wincy wrote:
| I bought an E-Bike two years ago and it's changed my life. I
| want to ride my bike all the time, and am counting down the
| days to spring. During the warmer months I run all the
| errands I possibly can with my bike instead of driving, and
| ride for pleasure often, going on multi hour bike rides. It's
| just such a blissful feeling, and as I've gotten more fit
| I've been able to turn down the bike assist and built a lot
| of leg muscles.
| klondike_klive wrote:
| Are you riding on roads or trails? How are you treated by
| other road users? I'm tempted by ebikes but live in semi-
| rural UK with very poor (and getting worse) road surface
| and lots of blind bends.
| wincy wrote:
| I largely ride on paved bike trails that are wholly
| separate from the roads, or suburban residential roads
| that have a Swiss cheese of bike trails interconnecting
| via parks. It's never the fastest way, but there's almost
| always a "safe way" to bike somewhere, due to a lot of
| effort by our city council. I'm more avoidant of the
| major roads, an elderly man was extremely close to me and
| my kid in her bike trailer when he made a right turn, I
| think I'd be more cautious if I didn't have so many
| accessible ways to bike separate from the roads.
|
| Oddly a lot of the "guys with road bikes wearing full
| gear" seem to just ride on the road anyway. I have no
| idea why, I've double checked the laws and I'm allowed to
| ride there.
| LazyMans wrote:
| Getting an e-bike has got me out getting exercise way more
| than a regular bike ever did. Being able to dial my effort
| up and down pushes me further, quite literally in distance
| and fitness goals. I'm by no means fit and almost did a 5
| hour 40 mile ride one day. I completely used up the battery
| in that time, my legs were cooked from the effort. I would
| have never attempted something like that on a regular bike
| unless I was fit.
| matsemann wrote:
| I do understand there are many things that can make it
| infeasable to bike during winter, but if you miss your bike
| absolutely give it a try! I bike year around in Norway.
| Studded tires help tons, and that the city maintains the
| bike infrastructure during winter.
| alexpotato wrote:
| > Hiking has the biggest effect though.
|
| I remember reading that pine trees give off a chemical that
| is a natural human bronchodilator.
|
| One thought of why people love hiking, especially in piney
| woods, is that the chemical allows humans to process more
| oxygen which in turn helps them feel more "energized".
|
| I point this out for two reasons:
|
| 1. It's a fascinating bit of trivie
|
| 2. It highlights that there are MANY confounding variables so
| it will always be tough to figure out the isolated impact.
| Nevermark wrote:
| I go on regular long walks and it is a huge help.
|
| A few months ago I tried walking with a weighted vest, and my
| body and brain got completely shocked in a really good way.
| Wakes up everything. So that is in my mix now.
|
| Walking with 20 then 40 lbs was a lot easier than I expected,
| and the results were much greater.
| directevolve wrote:
| I will say that my LMHNP ordered a blood test for me during
| my ADHD evaluation. I live in the Pacific Northwest and had a
| serious vitamin D deficiency, apparently like everyone else
| who doesn't supplement. also got me started monitoring my
| blood pressure.
|
| I can definitely tell that the Adderall I was prescribed had
| an immediate, huge benefit. Not sure about the vitamin D.
|
| But I really appreciated that he took a wide angle look at my
| health.
| ncasenmare wrote:
| Hi, author of the blog post here! Thank you for writing in with
| your concerns. First:
|
| > Please be very careful when someone tries to tell you that
| supplements are miraculous and pharmaceutical drugs don't work
| at all.
|
| I'll concede I unintentionally gave the tone that one should
| _replace_ antidepressants with supplements, even though the
| conclusion specifically writes: "(Don't quit your existing
| antidepressants if they're net-positive for you!) you may also
| want to ask your doctor about Amitriptyline, or those other
| best-effect-size antidepressants."
|
| I have now edited the intro to more explicitly say "you can
| take these supplements alongside traditional antidepressants!
| You can stack interventions!"
|
| ===
|
| > and nobody noticed this massive discrepancy until now?
|
| Researchers have noticed it for 13 years! From the linked
| Ghaemi et al 2024 meta-analysis (
| https://pmc.ncbi.nlm.nih.gov/articles/PMC11650176/ ):
|
| > Several meta-analyses of epidemiological studies have
| suggested a positive relationship between vitamin D deficiency
| and risk of developing depression (Anglin et al., 2013; Ju,
| Lee, & Jeong, 2013).
|
| > Although some review studies have presented suggestions of a
| beneficial effect of vitamin D supplementation on depressive
| symptoms (Anglin et al., 2013; Cheng, Huang, & Huang, 2020;
| Mikola et al., 2023; Shaffer et al., 2014; Xie et al., 2022),
| none of these reviews have examined the potential dose-
| dependent effects of vitamin D supplementation on depressive
| symptoms to determine the optimum dose of intervention. Some of
| the available reviews, owing to the limited number of trials
| and methodological biases, were of low quality (Anglin et al.,
| 2013; Cheng et al., 2020; Li et al., 2014; Shaffer et al.,
| 2014). Considering these uncertainties, we aimed to fill this
| gap by conducting a systematic review and dose-response meta-
| analysis of randomized control trials (RCTs) to determine the
| optimum dose and shape of the effects of vitamin D
| supplementation on depression and anxiety symptoms in adults
| regardless of their health status.
|
| ===
|
| > even common OTC pain meds can have effect sizes lower than
| 0.4 depending on the study. Have you ever taken Tylenol or
| Ibuprofen and had a headache or other pain reduced? Well you've
| experience what a drug with a small effect size on paper can do
| for you.
|
| I must push back: that's an effect of 0.4 _plus placebo effect
| and time_.
|
| There's now RCTs of open-label placebos (where subjects are
| _told_ it 's placebo), which show even open-label placebos are
| still powerful for pain management. So, I stand by 0.4 being a
| small effect; even if you took a placebo _you know to be
| placebo_ , you'd feel a noticeable reduction in pain/headache.
|
| EDIT: Here's a systematic review of Open-Label Placebos,
| published in Nature in 2021:
| https://www.nature.com/articles/s41598-021-83148-6.pdf
|
| > We found a significant overall effect (standardized mean
| difference = 0.72, 95% Cl 0.39-1.05, p < 0.0001, I2 = 76%) of
| OLP.
|
| In other words, if the effect on antidepressants _vs placebo_
| is ~0.4, and the effect of a placebo _vs no placebo_ (just
| time) is ~0.7, that means the _majority_ of the effect of
| antidepressants & OTC pain meds is due to placebo.
|
| (I don't mean this in an insulting way; the fact that placebo
| alone has a "large" effect is a big deal, still under-valued,
| and means something important for how mood/cognition can
| directly impact physical health!)
| Aurornis wrote:
| > Researchers have noticed it for 13 years! From the linked
| Ghaemi et al 2024 meta-analysis
|
| You're cherry picking papers. Others have already shared
| other studies showing no significant effects of Vitamin D
| intervention.
|
| For any popular supplement you can find someone publishing
| papers with miraculous results, showing huge effect sizes and
| significant outcomes. This has been going on for decades.
|
| With Omega-3s the larger the trial size, the smaller the
| outcome. The largest trials have shown very little to no
| detectable effect.
|
| I think a lot of people are skeptical about pharmaceuticals
| because they see the profit motive, but they let their guard
| down when researchers and supplement pushers who have their
| own motives start pushing flawed studies and cherry picked
| results.
|
| > In other words, if the effect on antidepressants vs placebo
| is ~0.4, and the effect of a placebo vs no placebo (just
| time) is ~0.7, that means the majority of the effect of
| antidepressants & OTC pain meds is due to placebo.
|
| You keep getting closer to understanding why these effect
| size studies are so popular with alternative medicine and
| supplement sellers: They're so easy to misinterpret or to
| take out of context.
|
| According your numbers, taking Tylenol would be _worse_ than
| placebo alone! 0.4 vs 0.7
|
| Does this make any sense to you? It should make you pause and
| think that maybe this is more complicated than picking
| singular numbers and comparing them.
|
| In this domain of cherry picking studies and comparing effect
| sizes, you've reached a conclusion where Vitamin D is far and
| away more effective than anything, placebo is better than OTC
| pain medicines, and OTC pain meds are _worse than placebo_.
|
| It's time for a reality check that maybe this methodology
| isn't actually representative of reality. You're writing at
| length as if these studies you picked are definitive and your
| numeric comparisons tell the whole story, but I don't think
| you've stopped to consider if this is even realistic.
| ncasenmare wrote:
| > You're cherry picking papers.
|
| I just picked the most recent meta-analysis I could find,
| which also _specifically_ estimates the dose-response
| curve. (Since averaging the effect at 400 IU and 4000 IU
| doesn 't make sense.)
|
| > Others have already shared other studies showing no
| significant effects of Vitamin D intervention.
|
| Yes, and the Ghaemi et al 2024 meta-analysis addresses the
| methodological problems in those earlier meta-analyses.
| (For example, they average the effects at vastly varying
| doses from 400 IU and 4000 IU)
|
| > According your numbers, taking Tylenol would be worse
| than placebo alone! 0.4 vs 0.7
|
| No, I understand this fine. Taking Tylenol would give you
| active medication + placebo + time, which is 0.4 + 0.7 + X
| > *1.1.* Taking open-label placebo is just placebo + time =
| *0.7* + X.
|
| (Edit: Also, these aren't "my" numbers. They're from a
| major peer-reviewed study published in Nature, the highest-
| impact journal. I don't like "hey look at the credentials
| here", but I bring it up to note I'm not anti-science, see
| below paragraph)
|
| ===
|
| Stepping back, I suspect the broader concern you have is
| you (correctly!) see that supplement/nutrition research is
| sketchy & full of grifters. And at the current moment, it
| seems to play into the hands of anti-establishment anti-
| science types. I agree, and I'll try to edit the tone of
| the article to avoid that.
|
| That said, there still _is_ some good science (among the
| crap), and I think the better evidence is accumulating (at
| least for Vitamin D) that it 's on par with traditional
| antidepressants, possibly more. I agree that much larger
| trials are required.
| svara wrote:
| > They're from a major peer-reviewed study published in
| Nature, the highest-impact journal.
|
| No, the domain name is nature.com because it's in a
| Nature Publishing Group journal, _Scientific Reports_ ,
| which is their least prestigious journal.
|
| It's a common mistake, and they do that on purpose, of
| course, to leverage the Nature brand.
|
| It's also a mistake that implies a complete lack of
| familiarity with scientific publishing, unfortunately,
| which makes it a bit difficult to take your judgements
| regarding plausibility very seriously.
| directevolve wrote:
| It's less prestigious because it doesn't judge papers on
| novelty, only on technical accuracy. For incremental
| research like this, it is an appropriate choice. The
| lower prestige has no bearing on the accuracy of their
| findings.
| keybrd-intrrpt wrote:
| Hello, there is another study that might be relevant to
| you
|
| https://pubmed.ncbi.nlm.nih.gov/28768407/
|
| > A statistical error in the estimation of the
| recommended dietary allowance (RDA) for vitamin D was
| recently discovered
|
| > ... This could lead to a recommendation of 1000 IU for
| children <1 year on enriched formula and 1500 IU for
| breastfed children older than 6 months, 3000 IU for
| children >1 year of age, and around 8000 IU for young
| adults and thereafter.
| ncasenmare wrote:
| Thank you! I'll give this a read.
| kadushka wrote:
| _the larger the trial size, the smaller the outcome_
|
| I find this a bit surprising. Could there be something else
| affecting the accuracy of larger trials? Perhaps they are
| not as careful, or cutting corners somewhere?
| hirvi74 wrote:
| Just my hypothesis, but I wonder if larger sample sizes
| provide a more diverse population.
|
| A study with 1000 individuals is likely a poor
| representation of a species of 8.2 billion. I understand
| that studies try to their best to use a diverse
| population, but I often question how successful many
| studies are at this endeavor.
| kadushka wrote:
| _use a diverse population_
|
| If that's the case, we should question whether different
| homogeneous population groups respond differently to the
| substance under test. After all, we don't want to know
| the "average temperature of patients in a hospital", do
| we?
| lamename wrote:
| Maybe. Those could be the case. But ignoring all
| confounding factors, this phenomenon is possible with
| numerical experiments alone. One of the meanings of "the
| Law of Small Numbers".
|
| Basically, the possibility that the small study was
| underpowered, and just lucky...then the large studies
| with more power are closer to the truth.
| https://en.wikipedia.org/wiki/Faulty_generalization
| kadushka wrote:
| Sure, could be just lucky. But if there are several
| successful small studies, and several unsuccessful large
| ones (no idea if this is the case here), we should
| probably look for a better explanation.
| svara wrote:
| It does not require more explanation: publication bias
| means null results aren't in the literature; do enough
| small low quality trials and you'll find a big effect
| sooner or later.
|
| Then the supposed big effect attracts attention and
| ultimately properly designed studies which show no
| effect.
| directevolve wrote:
| A point I think is crucial to mention is that "effect size"
| is just standardized mean difference.
|
| If a minority of patients benefit hugely and most get no
| benefit, then you get a modest effect size.
|
| This is probably why this discussion always has a lot of
| people saying "yeah, it didn't help me at all" and a few
| saying "it changed my life."
|
| I believe we should be focusing on more relevant statistical
| methods for assessing this hypothesis formally. Basically,
| using mean differences is GIGO if you assume you're comparing
| a bimodal or highly skewed distribution to a bell curve.
| CGMthrowaway wrote:
| _> Vitamin D and Omega-3 are the two supplements that
| consistently appear to be super powerful in small studies and
| then fail to do anything significant at all in larger studies._
|
| That statement is broadly true for most outcomes studied, but
| specifically for depression the larger study results are pretty
| mixed.
|
| VITAL (the heavily cited metastudy) shows no effect.
| https://pubmed.ncbi.nlm.nih.gov/32749491/
|
| But there are other large metastudies like this one for Vit D
| (https://pubmed.ncbi.nlm.nih.gov/39552387/) and this one for
| Omega 3 (https://pubmed.ncbi.nlm.nih.gov/31383846/) that do
| show robust moderate effects.
| Nevermark wrote:
| > The effect size for antidepressants is 0.4
|
| What the article states, then fails to take into account, is
| that is the mean effect size, and there is huge variation.
|
| Anti-depressants are notorious for producing different effects
| for different people.
|
| What that high variance means in practice, is for any anti-
| depressant, the people who get good results are getting a much
| higher effect than 0.4. And the other people move on to try
| something else.
|
| So to keep comparing 0.4 directly to the effect of Vitamin D
| and Omega-3 directly is very misleading.
| seba_dos1 wrote:
| I believe presenting vitamin D supplements as effective in
| treating depression is kinda misleading. It's rather vitamin D
| deficiency that is super effective at making you miserable, but
| it's not the only thing that can do it to you. And since a lot
| of us are in fact deficient (and the threshold of being
| categorized as deficient may be placed too low too), it will
| appear as being quite effective overall, especially compared to
| other drugs that act on less common and poorly understood
| causes.
| perrygeo wrote:
| Thank you. Fixing a vitamin deficiency is an obvious benefit
| to physical health. But does it "cure depression"? To the
| extent that your depression was caused by vitamin deficiency,
| sure. But then didn't you just cure a vitamin deficiency? I'm
| sure a lot of things starting improving once your body starts
| getting proper nutrients after years of neglect! That doesn't
| indicate causality.
| _aleph2c_ wrote:
| A very important article for the hacker news community. Maybe we
| should pin this on the top for a couple of days.
| jlebar wrote:
| Scott Alexander observes in this piece
| https://www.astralcodexten.com/p/all-medications-are-insigni...
| that the effect size for even EXTREMELY EFFECTIVE medications are
| remarkably low.
|
| > Zolpidem ("Ambien") has effect size around 0.39 for getting you
| to sleep faster. Ibuprofen ("Advil", "Motrin") has effect sizes
| between from about 0.20 (for surgical pain) to 0.42 (for
| arthritis). All of these are around the 0.30 effect size of
| antidepressants.
|
| ...
|
| > Some of our favorite medications, including statins,
| anticholinergics, and bisphosphonates, don't reach the 0.50
| level. And many more, including triptans, benzodiazepines (!),
| and Ritalin (!!) don't reach 0.875.
|
| As for why, read his essay I guess. But I wouldn't take at face
| value the interpretation of effect sizes in the original article.
|
| (I also couldn't say why the effect size of vit D and Omega-3's
| is so large, although per Scott Alexander's article if fewer
| people drop out of the treatment group, that should increase the
| effect size, so maybe the relative tolerability of the treatments
| is part of the story?)
| joshhart wrote:
| Vitamin D toxicity is absolutely real, causes hypercalcemia, and
| can occur even at the 4,000 IU dose. I would really recommend you
| be getting regular bloodwork done if you go beyond that. Here's a
| fun podcast on a case study.
| https://www.barbellmedicine.com/podcast/episodes/episode-381...
| benterix wrote:
| > "mild hypercalcemia" increased from 3% to 9%. IMHO, that's a
| small cost for reducing the risk of major depression & suicide."
|
| - I believe this crucial bit is missing from TLDR
| NathanielBaking wrote:
| Why does this keep popping up?
|
| "Evidence does not support the use of vitamin D supplementation
| for the prevention of cancer, respiratory infections or
| rheumatoid arthritis. Similarly, evidence does not support
| vitamin D supplementation for the treatment of multiple sclerosis
| and rheumatoid arthritis or for improving depression/mental well-
| being."
|
| https://pmc.ncbi.nlm.nih.gov/articles/PMC4907952/#:~:text=Bo...
| shevy-java wrote:
| I am taking so much Vitamin D and I can confirm!
|
| It is depressing ... :(
|
| (Note: my own real therapy is to do what is fun. That is, humour.
| This can occur via social interaction; it can also happen to some
| extent by studying human behaviour via ... youtube videos! There
| are some surstromming videos that are just epic display of human
| behaviour. If aliens ever arrive here, I'll show them the Top 3
| videos there. Either they will laugh too - or flee from this
| strange planet.)
| Roark66 wrote:
| I used to take a supplement with 10k vit D units. Made by a
| reputable company here in Europe.
|
| I did a blood test for vit D metabolites (oh 25 or something). It
| turned out I was deficient.
|
| The doc gave me 8k units as a prescription drug. In theory
| weaker. After 2 months I was no longer defiecient (kinda
| borderline). After 4 months the doc decided to go down to 4k iu.
|
| Now I wonder why some experts are telling people to take 10k iu?
| Is it because the supplements are crap and contain 10% of what
| they claim? (I've been taking vit K as well)
| Aurornis wrote:
| > Now I wonder why some experts are telling people to take 10k
| iu?
|
| Taking 10K per day is a bad idea. I went into the excess
| Vitamin D range with half that dose even in winter with an
| indoor job.
|
| More is not always better.
| dec0dedab0de wrote:
| I think the general idea is that the stats labs use to decide
| what is normal is not necessarily ideal, and like everything
| else will vary per person.
|
| Too much Vitamin D3 can be toxic, so doctors are reluctant to
| tell you to go over published guidelines. but if you don't have
| other issues, and stick to what you can get OTC from a normal
| vitamin brand and follow the instructions, you're probably
| safe. There was a story a while ago about a woman who died from
| too much D3, but it turned out she was taking a whole bottle's
| worth every day for years.
| SubiculumCode wrote:
| Precision Medicine is the way, and maybe we will get there one
| day Too many effective agents are averaged away because the
| population for whom it is effective is just a subset of the
| population with the targeted symptom.
| bevan wrote:
| A useful way to look at the effects of vitamin d and omega-3s:
| supplementation isn't really a hack, it's more that their removal
| is a handicapping of our "normal" state. Our evolutionary
| conditions would have been more rich in both of those things.
| Also see light exposure during the day, proximity to green space,
| etc.
| Geee wrote:
| You might want to take magnesium with Vitamin D, because taking
| vitamin D depletes magnesium. Not sure if it's strictly
| necessary, but if you're already low on magnesium it might be an
| issue. I once got tinnitus (which lasted a few months) when
| supplementing Vitamin D, the only explanation I've figured is
| that my magnesium was very low, which can cause tinnitus. Might
| be something else too, who knows.
| sreekanth850 wrote:
| I had sleeplessness that eventually led to depression and
| gastritis. I took medication for two years to recover. The root
| cause was a vitamin D deficiency my level was 8 ng/mL, which was
| far below the required range. There was a period when i was only
| able to sleep with medicines. Now coming back to normal life.
| empressplay wrote:
| Also magnesium! Magnesium bisglycinate, in particular. Great
| stuff.
| JohnMakin wrote:
| I have seasonal affective disorder and was taking a medication
| that sort of helped, but was causing mood swings if taken even
| slightly out of rhythm, increased my blood pressure, and was just
| generally not that effective, but it was better than nothing.
| Last winter I switched to vitamin D (it was already uncovered in
| blood tests I had a deficiency, which is what turned me onto it -
| when I started taking it, I felt a lot better) and omega 3 and I
| won't go back. I wish someone had told me a decade ago, probably
| would have saved a lot of damage to my organs (another reason I
| got off of it)
| dimitrov wrote:
| To add another data point: 4,000 IU (two Kirkland capsules) daily
| keeps my Vitamin D levels at the high end of the reference range.
| I also take six Kirkland fish oil capsules which happens to hit
| the 1,500 mg DHA+EPA target suggested in the article.
|
| Honestly, Costco supplements are hard to beat since they're both
| USP certified and are usually the cheapest.
| maerF0x0 wrote:
| I saw a thing from HealthyGamerGG youtube[1] that he said one of
| the things about depression is that it causes/influences one to
| avoid the things that would make their life less depressing.
|
| eg just to paint the picture: you're depressed so you don't get
| out of bed, therefore you don't go do your workout, therefore you
| lack endorphins and look in the mirror and see squishy, you're
| sad about how squishy you are and so you get more depressed.
| You're more depressed so you also don't do your dishes, when you
| do get out of bed you are depressed you feel like a slob and
| you're squishy, so you get more depressed...
|
| Whereas adding anti-depressants, and other virtuous cycle things
| like vitD/O3, exercise et al. Give the boost necessary to _make
| your life less depressing_ ...
|
| So if you know someone who's depressed, it might be helpful to
| help them make their life less depressing too. (in addition to
| all the best medical advice!)
|
| [1]- he's a real Dr... Dr. Alok Kanojia (Dr. K), a Harvard-
| trained psychiatrist (MD, MPH) specializing in modern mental
| health
| witherk wrote:
| >he's a real Dr.
|
| Careful, he is also a believer in Ayurveda[1]. Which basically
| basically categorizes people into different elements like fire
| and water and then tries to change their diet and habits to
| match their elemental style or something. You can hear him
| talking about it here [2]. Kinda reminds me of Humorism [3].
| Dr. K seems like a nice enough guy but don't get too lured in
| by the "Harvard-trained" credentialism.
|
| [1] https://en.wikipedia.org/wiki/Ayurveda [2]
| https://www.youtube.com/watch?v=rQ2xnThRGPg [3]
| https://en.wikipedia.org/wiki/Humorism
| maerF0x0 wrote:
| I agree there's nuance, but he's way above the "has a webcam
| and yeti blue" bar that most of youtube falls under, that was
| my point in putting his credential up. Not to rise him to a
| perfect status, but to not allow him being on youtube to fall
| to the minimum bar of youtube.
| tracker1 wrote:
| At this point, I mostly avoid prescribed medications and don't
| take very many things at all regularly. Mostly because I've had
| some of the worst interpretations of the side effects of most
| medications I've ever been on. These include hospitalizations and
| side effects I'm still dealing with years after (looking at you
| Trulicity/Ozempic)...
|
| I'm usually able to reason or force my way through depression and
| the like, but have had a few deep bouts in my life. The
| medications have ranged from ineffective to building a tolerance
| quickly, to just plain worse than the symptoms being treated.
| Nothing like missing your highway exit multiple times back and
| forth because you get lost "in" the drive on medication, or
| having 140 browser tabs open and losing 5 hours of work time.
|
| Everyone is different. I am amazed at how much western society
| has so many hormonal issues that come down to the lack of quality
| or appropriate fatty acid intake and a lack of something as
| simple as more outdoor/sun time. I think the "low
| fat/cholesterol" advice for most of the past half century
| combined with the increase in snacking and junk foods have been
| massive disservices to humanity as a whole. I wouldn't be
| surprised if some of the effects are multi-generational in the
| making either.
| bawolff wrote:
| > The twisted kink is caused by the hydrogens being on opposite
| sides, hence "trans". (And yes, if they're on the same side it's
| "cis". Latin was a mistake.)
|
| Why you being mean to latin? ;)
| meroes wrote:
| I used to have very rough winters. Despite the fact that I ate
| well and was outside 2+ hours every day. I got my blood tested
| and I had very low vitamin D, two tiers below normal. This was
| the first winter being on Vitamin D, and my energy and hunger
| levels stayed normal. I never crashed or had extreme hunger or
| trouble sleeping.
|
| Getting Vitamin D from food is a fools errand, and since
| sunscreen and protective clothing slow vitamin D from the sun
| drastically, it's in most people's best interest to get it
| tested.
| strontian wrote:
| You may consider that you have a dust mite allergy. If you have
| any of: chronic coughing, frequent sickness, eczema, or IBS
| then that is even more evidence this is your problem.
| meroes wrote:
| Not a bad suggestion, I live in the country so it's very
| dusty here and my digestion has always been wonky. Thank you.
| hmhrex wrote:
| This is all in a book called The Depression Cure by Stephen S.
| Ilardi (https://bookshop.org/p/books/the-depression-cure-
| the-6-step-...)
|
| I read this years ago and it's fascinating. Looks like it's been
| updated for a second edition last year.
| lazarus01 wrote:
| I've personally found meditation, exercise and healthy food
| intake are more effective for self regulation and coping with
| tough emotions over medication and supplements.
|
| Each human being is unique, as is the recipe for sustained
| positive metal health.
|
| I think it's helpful to consider and experiment with different
| ideas and strategies.
|
| I strongly disagree there is one single solution that can provide
| significant lift for a large population.
| fairytalemtg wrote:
| Homemade Avocado toast is easy and inexpensive
| buildsjets wrote:
| Anecdotally, I've been taking a 5,000 IU vitamin E supplement
| this winter. Seattle area, indoor desk job, I am a vampire. It
| does seem to help, I would rate it as going from a C to a B
| grade. I'd prefer not to use antidepressant medications to fix a
| problem that for me is mostly caused by living at a different
| latitude than I grew up in.
|
| Do be aware that not all vitamin E supplements actually contain
| the dosage that they are labeled at, and that inclues both no-
| name brands and some big name brands. I'm having trouble finding
| a good reference on google due to AI and SEO pollution. But I
| recall Nature Made was labelled accurately and that is what I
| buy.
|
| My wife on the other hand has struggled with life-long
| anxiety/depression even when living in Atlanta. For her a fairly
| low dose of lexapro enables her to live her life like a normal
| person. We wish we could get her mother to give it a shot for a
| few weeks, as she now can see a lot of similarities in both their
| personality traits that were affected by a life of untreated
| anxiety.
|
| We also have cat that would probably have been put down for fear-
| biting of people and attacking our mild and mellow dog until we
| got his aggression under control with kitty prozac. I kid you
| not, it's a transdermal fluoxetine cream we put in his ear each
| day. Without the constant anxiety stimulus in the way, his real
| personality came through and he is actually very sweet. To me at
| least. Still bites my wife, but not hard anymore, just enough to
| keep her alert.
| basch wrote:
| >caused by living at a different latitude than I grew up in.
|
| or society in its current incarnation. its an underexpressed
| opinion that maybe depression is a justified reaction to ...
| life, as humans across a lot of earth in 2026.
| y1n0 wrote:
| Do you mean vitamin D? Humans don't produce vitamin E at any
| latitude.
| ece wrote:
| Staying awake is an antidepressant, up to a limit.
| devops000 wrote:
| On mobile a padding would make reading better. Add px-4 if you
| use tailwind in the article body.
| jsolomon wrote:
| I was an RA at the RAND Corp who put together literature reviews
| for mental health interventions like this. The Vitamin D result
| is implausible. If true it would be the biggest breakthrough in
| the history of psychiatry.
|
| This is the referenced meta-analysis:
| https://www.cambridge.org/core/journals/psychological-medici...
|
| The largest N study (N=18,353; more than half of the entire 31
| study sample) included is
| https://jamanetwork.com/journals/jama/fullarticle/2768978, which
| found: "Risk of depression or clinically relevant depressive
| symptoms was not significantly different between the vitamin D3
| group...and the placebo group."
|
| The highest dose study (100,000 IU/week) included is
| https://pubmed.ncbi.nlm.nih.gov/30532541/, which found: "...the
| treatment response or BDI scores did not differ significantly
| between groups."
|
| The paper/supplementary materials doesn't include a simple table
| of the depression outcomes for the 31 included studies, which is
| a glaring omission.
|
| I think someone just messed up here. Maybe missed a decimal
| place?
|
| For a more realistic perspective, here's another careful meta-
| analysis of RCTs of Vitamin D for depression that found null
| result:
| https://www.sciencedirect.com/science/article/abs/pii/S08999...
| (granted, 2015). And another from 2025 that found a .36 effect
| size, which is plausible and still fantastic:
| https://www.frontiersin.org/journals/psychiatry/articles/10....
|
| I don't mean to dissuade people from trying these given the low
| risk profile, just don't expect to go from a C to an A.
| hirvi74 wrote:
| I started back on Vitamin-D and Omega-3 (with extra EPA & DHA)
| about 2 months ago or so. Sadly, I don't feel much of a
| difference, but I believe the potential harms are quite minimal,
| so I am going to maintain supplementation for the purposes of
| self-experimentation.
| seba_dos1 wrote:
| It took me more than 3 months to get to the lower edge of the
| desired range with my blood level on about 8000 UI daily. There
| was no instant improvement, it takes time.
|
| Do keep your levels in check though.
| RankingMember wrote:
| Hey OP, kudos for being so engaged in the discussion + making
| edits and not just firing the link off and then going AFK. Makes
| the comments more interesting and ( _I_ think) the actual work
| better.
| Fischgericht wrote:
| I can only provide anecdotical evidence, which is ... not
| evidence, really.
|
| Within my peer group of people on the spectrum (which very often
| comes with a depression, which is logical) we've discussed
| Vitamin D studies for years. And multiple of us decided to give
| it a try for a couple of months. And neither those who tried it
| INSTEAD of an SSRI, nor those that took both (SSRI + D) could
| report any measurable difference.
|
| I have a theory on why is that: It is known that low levels of
| Vitamin D is one likely cause for depression - in Northern
| Europe, where during winter time people do not get enough
| sunlight, that correlates very clearly with the suffering of
| depression.
|
| But potentially it simply does not work the other way round: I
| moved to near the equator, and I therefore basically have
| sunlight shining out of my butt, but still am depressed. It makes
| sense that in this case Vitamin D makes no difference at all.
|
| In summary my theory would be: Vitamin D only has an effect on a
| depression that was _caused by a lack of Vitamin D._
| tsoukase wrote:
| As a neurologist I cannot be persuaded. Their is a huge placebo
| and confounding component in the spectrum stress-depression.
| There are syndromes where AD drugs make wonders, literally saving
| lives, and others where they are useless. But taking 150000 IU of
| vitD per month definitely doesn't have the effects it promises.
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