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.
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?
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?
> 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.
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).
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.
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.
> 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.
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).
"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.
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.
> 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.
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.
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.
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.
> 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.
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.
> 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.”
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?"
> 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.
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.
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.
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.
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.
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.
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
“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.
> 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.
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.)
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%80%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.
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.
> 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.
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.
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)
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.
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.
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.
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.
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.
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.
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.
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.
I’m glad to hear that. Another frame is that your depression turned out to be “math hard” rather than bodybuilding hard. Your disciplined, methodical approaches were steady applications of effort, whereas what you actually needed was easy to implement but hard to envision.
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.
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.
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:
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.
It tunrs out that Sigma receptors modulate glutamatergic dysfunction in depression, and glutamate, being excitatory, well, you can. make your assumptions from there.
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).
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.
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.
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.
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.
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.
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.
If you spend a lot of time among some folks or talk a lot to LLMs, you are guaranteed to pick up manners, manners of speech, ways of thinking, behaviors (where applicable) ...
Me and my brother just can't stop mixing English and German when we talk to each other. But we don't or barely do it when we talk to others.
When I learned about code, logic, math, I started talking and thinking in different ways and from different and towards different perspectives.
The more I read, which I haven't done in a long long while, the more massive and vast the info I pack into a few sentences becomes.
The more I draw or play the guitar or work on game mechanics and story design or dialogues, the more annoying my speech and manners become but to my environment, that also means that I become "more" social and actually somewhat likeable and bearable.
You smell like Non-evidence based arrogance. I was always surrounded by people who smelled like that. But they are good little copypasta soldiers who follow trends and mutually assure that they don't go completely off the rails. But if one does, they leave him on his real or imaginary battlefield. Nobody wants to evolve anymore. It hurts some people just a little too much, I guess. They'd rather poison others and have their code deleted before getting to live a second life. I hope I could get you on edge a little. I'm just fucking around. But you will probably think something the likes of ... "there's always some truth to it when ..."
It does not, at all. Forming that judgment because of “Enter X” is ridiculous. I recognize my friend Claude in disguise all the time on HN and this is not one of those cases.
See, I'm all for calling out LLM spam, but because of people like you who have a terrible calibration and make false accusations against obviously human generated messages, I get all manners of people criticising me for pointing out things I know for sure are actually LLM-generated. You really think "Enter citalopram" as a singular instance you point out weights this more towards LLM-generated than "thru" and "reheated cat shit", among the entire tone of the message, weights it towards human-generated? Your heuristics are wildly miscalibrated.
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.
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.
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?
> 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.
> 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!)
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)
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
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.
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.
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.
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".
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.
"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."
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.
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.
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.
> 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.
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.
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.
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!
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.
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!
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.
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.
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.)
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.
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!
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).
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.
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"?
(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.)
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.
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).
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!
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.
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
> 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.
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
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
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.
> 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.
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.
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.
"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."
> 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.
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).
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?
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
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.
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.
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.
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.
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.
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.
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.
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.
> 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.
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.
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.
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.
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.
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?
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.
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)
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.
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.
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.
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.
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.
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
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.
> 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.
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..?)
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...
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.
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.
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.
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...
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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
> 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?)
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.
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.
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.
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.
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
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...
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.
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.
> 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.
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?
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
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.
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.
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.
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.
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.
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."
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.
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).
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.
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?
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.
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.
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.
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?
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?
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> 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.
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).
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.
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> 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.
> 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.
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).
"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.
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.
> 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.
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> 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.
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.
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.
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.
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> 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.
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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.
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Yeah some people pop a melatonin every night before bed
> 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.”
"Imagine if we took insulin every time our pancreas failed to properly process sugar."
> 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?"
> 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.
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> 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.
> 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.
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.
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.
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.
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
“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.
> 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.
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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.)
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Villazodone was created partly to address that. Once I switched to that, I had no libido-related issues again.
> except it killed my libido
Similar experience. Apparently pretty much ubiquitous with SSRIs
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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%80%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.
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Libido can be supplemented with Wellbutrin. Works great, even better than before.
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.
> 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.
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.
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)
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.
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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.
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.
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.
look my other comment for niacin
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.
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.
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.
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.
I’m glad to hear that. Another frame is that your depression turned out to be “math hard” rather than bodybuilding hard. Your disciplined, methodical approaches were steady applications of effort, whereas what you actually needed was easy to implement but hard to envision.
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.
You can also 3D print them: https://www.printables.com/model/194340-60mm-radial-fan-boot...
I still think you should have tried eating a banana first.
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.
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...!
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)
have u ever tried niacin?
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.
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.
If it is SAD have you tried bright daylight balanced lighting?
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.
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.
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.
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If you spend a lot of time among some folks or talk a lot to LLMs, you are guaranteed to pick up manners, manners of speech, ways of thinking, behaviors (where applicable) ...
Me and my brother just can't stop mixing English and German when we talk to each other. But we don't or barely do it when we talk to others.
When I learned about code, logic, math, I started talking and thinking in different ways and from different and towards different perspectives.
The more I read, which I haven't done in a long long while, the more massive and vast the info I pack into a few sentences becomes.
The more I draw or play the guitar or work on game mechanics and story design or dialogues, the more annoying my speech and manners become but to my environment, that also means that I become "more" social and actually somewhat likeable and bearable.
You smell like Non-evidence based arrogance. I was always surrounded by people who smelled like that. But they are good little copypasta soldiers who follow trends and mutually assure that they don't go completely off the rails. But if one does, they leave him on his real or imaginary battlefield. Nobody wants to evolve anymore. It hurts some people just a little too much, I guess. They'd rather poison others and have their code deleted before getting to live a second life. I hope I could get you on edge a little. I'm just fucking around. But you will probably think something the likes of ... "there's always some truth to it when ..."
The OP just writes well. Also an llm is unlikely to write "thru"
It does not, at all. Forming that judgment because of “Enter X” is ridiculous. I recognize my friend Claude in disguise all the time on HN and this is not one of those cases.
See, I'm all for calling out LLM spam, but because of people like you who have a terrible calibration and make false accusations against obviously human generated messages, I get all manners of people criticising me for pointing out things I know for sure are actually LLM-generated. You really think "Enter citalopram" as a singular instance you point out weights this more towards LLM-generated than "thru" and "reheated cat shit", among the entire tone of the message, weights it towards human-generated? Your heuristics are wildly miscalibrated.
Your sense of smell is not something to write home about.
Yes only I wrote it while taking a shit. Sorry man.
A kinda strained endeavor, I must say. It's not bad but the SSRI side effects make continuous hydration obviously important. A small price to pay.
How would you prove that?
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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.
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.
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!)
Please do not take 5000mg/day of Vitamin D. The author confuses IU and mg which is very dangerous.
I also noticed that. Opened issue: https://github.com/ncase/blog/issues/4
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)
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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)
People don't always realize: https://www.chemistryworld.com/news/university-fined-in-caff...
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
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Why didn't the author notice? AI slop?
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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.
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.
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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.
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".
It is easily possible to overdose on oral Vitamin D tablets and damage your body.
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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.
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).
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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.
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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.
> 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
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.
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.
Next time I get sunburn I'm calling it a vitamin D overdose
.. 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.
This is nonsense advice for pretty much anybody that is shovelling snow right now.
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So 5000 IU is the recommended amount?
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.
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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.
According to what I read in a newspaper article, the recommended dose is much lower, at 800.
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With K3! Otherwise you're fucking yourself up.
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
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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.
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I used an LLM to summarize and it told me 5000 IU.
Wow, so what value is there in LLM slop exctracted from already dubious self-medication advice?
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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.
Is "IU" another case of xkcd 927?
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
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!
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)
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Before I take medical advice from a newspaper, I might as well ask my local esoteric nut.
Can you provide a link to the newspaper article at least while whining about the downvotes?
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Misinformation. Do more research.
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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:
https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...
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
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!
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.
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.
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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.
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!
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).
I said "many", not "all". (Many don't indicate, either.)
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.
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"?
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)
Second the question
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.)
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.
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).
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!
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.
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> as part of a new gym plan
There's your answer
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
> 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.
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
Omega 3 comes from algae, which might be okay for some vegans.
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
Unlikely any vegan would have any moral qualms about algae, given that they’re not animals. Maybe you were thinking of oysters/clams/bivalves?
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.
What vegans would not be ok with algae?
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Or fish oil
> 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.
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... :
from https://www.peoplespharmacy.com/articles/must-you-grind-flax...
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.
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.
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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...
> 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
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/
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?
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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
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...
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.
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.
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.
> 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.
Agree, althouh quiting it altogether might simply help with establishing the new habit.
> 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.
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.
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.
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.
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.
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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.
> 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.
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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.
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.
Yes, I'm sensitive to it, and a slow metaboliser. A lot of people will be in the same boat and not realise it.
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!
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.
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?
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.
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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)
Exercise is another good thing to do on a daily basis. It prevents me from self-medicating with alcohol.
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I love coffee so much, I'd prefer to deal with the anxiety, and I do suffer from it.
Or the addiction just makes you think that this is good for you when actually you'd feel better without it?
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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
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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.
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.
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.
You mean relatively sucks. Else every single human ancestor would have to be super depressed too given the standard of life in the past.
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.
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.
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
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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.
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.
> 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.
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..?)
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...
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.
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/
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.
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.
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.
Confusing mg and IU units up front really do NOT inspire confidence on the topic and conclusion as a whole.
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...
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!
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.
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.
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...
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.
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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.
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.
A very important article for the hacker news community. Maybe we should pin this on the top for a couple of days.
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.
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.
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
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?)
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.
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.
How many of you feel worse when taking vitamin D supplements? Alternatively how many of you feel only temporarily better?
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.
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.
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/
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...
Chia seed and flaxseed high in omega3
+ great for fiber. I load up chia as much as I can throughout the day.
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.
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.
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.
> 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.
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?
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
including the mentioned meta-analysis? if yes, can you explain why you think that it's dubious?
Wrong unit in text, right? Graphs shows UI. 5000 UI would mean 125µg of D-vitamin. Which is a bit smaller than 5000 000 µg from the next
> "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
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.
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.
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.
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.
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...
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."
Can confirm. Since I take 20000 IU vitamin D every sunday, my winter depression is gone.
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.
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).
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.
Yeah, I call bullshit. Tried both, and SSRIs are a godsend.
My dad if he was alive would have shouted "I told you so"
wait till they discover sex, drugs and alcohol :)
[flagged]
was this written by an LLM?
I couldn't express this clearly in English with my current level, so the LLM interpreted my idea and expanded on it for me.
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?
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.
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.
And I guess you need uncovered skin which can be tricky in a cold winter.
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.
In most northern countries like the UK, there is simply not enough UVB in the winter to make any Vitamin D through sunlight.
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.
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.
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
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.