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.
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?
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?
Source: multiple friends, family and forums (while researching how to help friends & family get off of various SSRIs).
Chemistry trumps psychology. Good enough chemistry enables cognitive treatments. But to fix the wrong chemistry you need chemistry.
To nitpick: The mind is applied biochemistry. Psychology intervenes in the chemistry, like many other activities do. The goal of that is to solve the root cause so that your future levels will be maintained at the right level, instead of just forcing the level by sourcing the respective chemicals externally.
A good rule of thumb in biology and particular any kind of hormone production and balance is "use it or lose it" - if you start regularly receiving something externally, internal production will scale back and atrophy in response, in many cases permanently.
When looking at the same reality one persons sees the situation as OK and another as a an endless and hopeless disaster it is hard to tell who is right. A depressed person would tell that most people around him are wrong and are optimistic only because they don't understand how bad all is.
I'm incredibly optimistic and am content with my position in life. My default state is being mindful of the present and I don't think about things too far into the future. I very rarely ever feel stressed out over things in life.
However, none of that changes the fact that I feel completely empty and find no joy in things. Interests are nearly non-existent, emotions dialed to 1, and the only thing I'm motivated to do is lay in bed staring at the ceiling... unless I'm on sertraline.
Admittedly that's just anecdotal, but I worked in a clinical neuroscience lab researching treatments for severe treatment-resistant depression (read: people who tried so many options including CBT that they even tried electroshock therapy). The only thing that helped those subjects was a regimen of personalized neuroimaging-guided transcranial magnetic stimulation for 10 minutes every hour for 10 hours every day for a week. Even then, it wasn't permanent. Some saw improvement for months, others only weeks.
For some people, it's not just a matter of "perspective".
Or because of a legitimate chemical imbalance or some other cognitive issue they can’t control alone. Right?
"Analysis: Depression is probably not caused by a chemical imbalance in the brain – new study" - https://www.ucl.ac.uk/news/2022/jul/analysis-depression-prob...
"There is no convincing evidence that depression is caused by serotonin abnormalities" - https://www.psychologytoday.com/us/blog/insight-therapy/2022...
"Although the etiology of depression is incredibly complex, the narrative that it is caused by a simple “chemical imbalance” persists in lay settings. We sought to understand where people are exposed to this explanation (i.e., the “source”), and the relative influence of each source." -https://pmc.ncbi.nlm.nih.gov/articles/PMC11752450/
No, anxiety and depression aren't simply a matter of perspective.
A few HN submissions recently are in the style "thinking about doing the thing is not doing the thing. Planning the thing is not doing the thing. <etc etc>. Only doing the thing is doing the thing". Comparing a brain to a large software project with bugs hiding in it, in that vein giving the computer 11 hours of 'sleep' each night is not debugging the code; overclocking or undervolting the CPU is not debugging the code; installing the latest updates and patches is not debugging the code. 'knowing there is nothing to worry about' is not debugging the code. Only debugging the code is debugging the code. Reading a badly explained idea on an internet comment and dismissing it with a mocking "thanks I'm cured" isn't debugging the code. Saying "I've tried everything" isn't debugging the code.
A more specific example, if you are going on a rollercoaster and you are experiencing physical and mental symptoms of worry - nervous, anxious, angry at the person pushing you to ride, twitching and trying to back away, eyes looking around searching for an exit, coming up with excuses to do something else instead, nervous shaking, dread tightness in the chest, affected breathing, perspiring, gritted teeth, etc. etc. then washing over all that with "I know there is nothing to worry about so this must be a problem of brain chemistry" seems a clearly incorrect conclusion.
Such a person clearly has a worry. Quite likely one that's out of proportion (e.g. "rollercoasters kill thousands of people every day!"). Possibly one that's completely incorrect (e.g. "going more than 10mph makes people's insides fall out!"). Quite likely a less clear and less obvious one - which could be anything, e.g. they saw a documentary about a rollercoaster which behaded a child and that's their only thought about rollercoasters; they saw a show about fighter pilots pulling high-G maneouvres and passing out and think that will happen to them on a big rollercoaster; they see the rollercoaster track and support flexing and don't understand that a some flexibility doesn't mean weakness; they went to a theme park as a child and older children bullied them into riding a scary ride and they wet themselves and figuratively died of shame and buried the memory; they were pushed into learning to drive at 15 by their wicked stepfather and this is pattern matching to the same kind of experience; etc. etc.
Saying "there is nothing to worry about, rollercoasters are safe enough and you know it, so your brain chemistry must be broken" isn't debugging the problem. It isn't even explaining the problem. Why would broken brain chemistry particularly affect them at a theme park, or in Winter, and not the rest of the time? How was this broken chemistry identified and measured and quantified and that hypothesis proven?
Likewise, just because the parent poster has tried sleeping and exercising and taking Vitamin D, doesn't address that humans evolved in Africa, connected to oceans and trees and tribal living, and not commuting to a fluourescent lit beige box filled with strangers writing JavaScript while being bombarded with news items about wars and genocides and stories of how everyone else is having a wonderful Christmas, earning more money than you, with a cost of living crises always on their mind, etc.
> "Good enough chemistry enables cognitive treatments."
Drugs can force people to carry on with a life that's making them miserable when they have no other available options to find out why and fix it. That isn't evidence that "there is no root cause"(!). Any more than turning it off and on again can let you get on with your job, but that doesn't show there's no root cause for a program locking up.
> "then you deduce that the black cloud is produced within."
And you have a lifetime of your prior experiences affecting your mood. When you remember that your aunt hit you when you swore at the dinner table, or you saw someone slip on ice and fall over and break their wrist, or watever, every life learning experience is "the mood is produced within".
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.
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.
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.
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.
Yes, that's normal in the US. I have multiple family members who take Ambien (zolpidem) before bed every night.
^ citation needed
What does "would have responded" mean? Are you saying that >50% of people with depression that are "helped" by antidepressant, would have been helped _to a similar extend_ with a placebo?
That placebos can work should not be seen as undermining the severity or pain of the depression, but rather underline the power of tricking the mind into improvement.
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.
Seems odd. Your doctor can't force you to take anything. If they say "do you want to try X?" just say "No". Not giving your doctor full medical context seems like a mistake - for example, maybe depression would be indicative of another issue, or maybe people who are depressed really shouldn't take a specific medication.
To each their own, and perhaps you have other reasons, but this seems like a less than ideal solution to a very trivial problem if the goal is just to not take an SSRI.
She then proceeded to say "well I'll just write you the prescription anyway and you can do your research later and decide to fill it or not".
I was actually shocked by this interaction, and think about it often. She's a regular family doctor with the local hospital system, and this was just a regular checkup. I answered one question with a "yes, but it's manageable and I think I can handle it with lifestyle change" and then said no twice to medication and ended up with a prescription, which I ignored but don't appreciate having on my record, since it's a false indicator for future prescribing physicians.
Getting treatment for "depression" doesn't always mean SSRIs etc. Sometimes it means treating the underlying condition(s) that are having downstream affects. I would suggest everyone gets their Testosterone levels checked among other common things.
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?"
I'm not sure if it is common but I've definitely taken my fair share of my dog's trazodone.
meanwhile people are like "just take magnesium or melatonin lol"
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.
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 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.
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.
Wouldn't a "NOOP" be the opposite of a "Nope"?
Sorry for the pedantry, but this forum seems an appropriate place for this.
Similar experience. Apparently pretty much ubiquitous with SSRIs
please people, take my post for what it is: anecdotal evidence. SSRIs can basically give you any possible side effect, including destroying your libido.
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.
Is this your trauma speaking, or do you automatically associate any sexual needs with a pathology?
You've done it twice in this thread alone.
But I understand that it would have been better to ask and not associate because it's a fraction of the cases.
Either OP is confused about what libido means, or has some kind of heavy shame around sexuality.
Sex is awesome and liberating! Should be anything but shamed.
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.
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.
I can't find a rigorous academic source right now, but the top web results all say we need at least UV Index 3 for our skin to be able to make enough Vitamin D. I guess summer may work for us, in the Montreal/New England area, but other than that, yeah, you and I will need to get Vitamin D from diet and/or supplements. And fish is expensive, so supplements it is.
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.
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.
Thats why they are eventually tapered and discontinued once you are able to be on your own.
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.
I'm not saying it's a bad.
But I'm also saying there are no magic pills...!
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.
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.
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.
"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...
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.
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.
(Do not take 5000 mg, that's 200,000,000 IU. You'd have to chug dozens of bottles per day)
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 is that pathway to death you are worried about?
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.
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.
No, that’s literally what I was doing when I reached the excessive range: 5000 IU/day in winter with an indoor job.
This commonly repeated idea that everyone is deficient and you can’t overdose on 5000 IU/day is wrong.
> Just test your blood levels before you start and then after 3 months or so. It's quick and cheap, and the only way to know whether the dose is right.
Literally what I did.
Every time I explain this online it seems like the supplement people ignore what I wrote and just parrot the same “5000 IU/day and everyone is so deficient you can’t overdose” myth.
That doesn't make it easy for most people. In my case it was barely enough to move the needle, but that's not how it will be for most people either.
> you can’t overdose on 5000 IU/day is wrong
Of course you can (though it would usually have to be really prolonged to actually cause you troubles). Most people won't, but you don't know whether you're in that group or not until you test yourself.
> Literally what I did.
That's good, but my post obviously used plural "you" as a general advice.
(BTW. There's no evidence of toxicity below blood level of 150 ng/ml, but there are many guidelines that consider levels way below that, such as 50 ng/ml, as "too high" already)
> 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."
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).
We have a saying here to take cod liver oil all months ending with R (in Norwegian that's September to Februar) to get both omega 3 and the vitamin D.
spoken like someone who has never lived in the UK
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.
During the spring, summer, fall months I barely need it since I'm outside so much with my dog.
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.
I'm not stating the dosage is wrong. Looks like it is anyway.
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".
Edit: for clarity I am not saying it is impossible to overdose on oral tablets, but rather that with most tablets 400 IU to 1000 IU and the safe limit so much higher than these, it seems like it would be extremely unlikely for someone to be taking 30+ tablets daily. Not impossible, but not easy either.
First: the RDA and the safety limit are not the same, and an RDA in a country being too low does not mean that the maximum safe dose is wrong.
And it certainly does not mean that there is a higher risk in under-dosing than overdosing when taking the RDA (which already includes recommendations for supplementing if you spend most of your time indoors).
I'm not a scientist, so I only know what physicians told me and what's explained in news publications or by consumer advocacy non-profits.
Here are a study (which I didn't read) and the NHS's advise on Vitamin D toxicity:
https://www.ncbi.nlm.nih.gov/books/NBK557876/
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
The study says:
> Most cases of vitamin D toxicity resolve without serious complications or sequelae. However, in some instances, severe hypercalcemia can lead to acute renal failure requiring hemodialysis. Cases of permanent renal damage due to vitamin D toxicity are rare.
Which sounds good, but I don't think it supports that there is no risk of oral Vitamin D overdose.
* Toxicity resulting from lack of monitoring is frequently seen in patients requiring high doses to treat ailments like osteoporosis, renal osteodystrophy, psoriasis, gastric bypass surgery, celiac, or inflammatory bowel disease.
* Patients who are on high doses of Vitamin D and taking inadvertently increased amounts of highly fortified milk are also at increased risk for vitamin D toxicity.
* According to the latest report from America's Poison Centers (APC), there were 11,718 cases of vitamin D exposure recorded in the National Poison Data System. More than half of these cases were in children younger than 5 years.
* The clinical signs and symptoms of vitamin D toxicity manifest from hypercalcemia's effects.
* Clinical management of vitamin D toxicity is mainly supportive and focuses on lowering calcium levels.
* Isotonic saline should be used to correct dehydration and increase renal calcium clearance.
A lot of those point to people drinking too much milk! (enriched milk)
* People with osteoporosis thinking "I better drink more milk for strong bones" when they are already on supplements/medicine.
* Kids drinking lots of milk and presumably not drinking any water - hence the dehydration.
PS: There are a lot of people out there that don't drink any water, and stick to juice or milk or soda, etc. They are not always fat, but that doesn't mean they don't have issues.
And my takeaway is not that everyone should be taking 10k IE, but it's a great reminder to be more consistent in taking my Vitamin capsules in winter.
I'm still standing by my point that it's "easy" to overdose on Vitamin D. Like the article already mentions, one should remember possible kidney issues and not take insane doses of it.
What the recommended daily intake should be, I don't know.
The whole reason I'm commenting on this is I used to take one of the "top" antidepressants on this list.
And I am a skeptic of antidepressants, that doesn't mean I deny all positive effects in people who are prescribed them, of course.
For what it's worth, it's also easy to overdose on Venlafaxine. It's still considered safe.
Just an example to make clear that my comment was not a critique of taking Vitamin D in general.
I don't find the article's main point surprising though. That's the reason I'm taking Vitamin D, too. Doesn't mean that it's impossible to overdose, and this point is also important, because many people still think that it would be impossible to take too much of an vitamin or mineral. Thankfully, high-dose Vitamin A / retinol supplements are not as widespread.
Seems to be a thing in conspiracy theories "they try to hide those simple tricks from you (drinking bleach, ivamectin, 100k D3, ...)
> 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.
https://hn.algolia.com/?q=vitamin+d+mistake
Vitamin D is a favorite topic around here:
Edit because the comment might be to shallow for HN: I sympathize with the struggle against depression and, after first-hand experience, share the skepticism against the widespread prescription of antidepressants and the methods of evidence presented for it.
Very serious and important topic.
Regarding Vitamin D, I am also supplementing in the Winter, but I have not read the article, which says it has an estimated reading time > 10min. I use one 1000IE (0.025mg according to the package) tablet a day max.
I'll bookmark this discussion page to read TFA later maybe.
Also important to take it with Vitamin K.
Seems like it would be best to increase time spent outdoors though.
It's my understanding that northern Europeans evolved fair skin in order to cope with the lack of vitamin D in their diet.
i understand it as: absorbing is in the intestine, generating D happens in the skin when exposed to the sun
My starting levels were unknown but I assumed they were low given my usual sun exposure and some low-energy symptoms (which resolved a couple of weeks after I started taking it). I discontinued VitD then and now I only take 1000 IU/day in the winter.
I wonder if even the simplest LLM would make this particular mistake.
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!
See: Vitamin D and health: evolution, biologic functions, and recommended dietary intakes for vitamin D (293 citations)
> An adult in a bathing suit exposed to 1 minimal erythemal dose of ultraviolet radiation (a slight pinkness to the skin 24 h after exposure) was found to be equivalent to ingesting between 10,000 and 25,000 IU of vitamin D (Fig. 6).
Doesn't say 30 minutes, but it may be 30 minutes depending on your skin colour and the local strength of the sun.
So the paper may be well researched or whatever, but the interpretation of it is questionable.
From the abstract:
> The safe upper limit for children can easily be increased to 2,000 IU of vitamin D/day, and for adults, up to 10,000 IU of vitamin D/day has been shown to be safe. The goal of this chapter is to give a broad perspective about vitamin D and to introduce the reader to the vitamin D deficiency pandemic and its insidious consequences on health that will be reviewed in more detail in the ensuing chapters
The full article is available on researchgate[1]. Direct link to PDF [2].
[1] https://www.researchgate.net/publication/226676251_Vitamin_D...
[2] https://www.researchgate.net/profile/Michael-Holick/publicat...
EDIT: I just looked up the author, Michael F. Holick. Apparently he is one the people who identified calcitriol in 1971. I know appeal to authority doesn't prove anything, but it might be prudent to at least consider his findings.
I think the downvotes are harsh btw and in general HNers have gotten too reflexively downvoting IMHO.
Can you give the replyee some pointers, for example? Link to articles or studies that show a different view?
But also here is something to think about: your body will produce more D3 than that by being in the sun for just several minutes. So if you consider such a low dose of D3 an overdose then you better steer clear of the sun!
This is another superficial statement, that displays shallow-at-best understanding. Staying in the sun and producing via the skin, and intake via food are 2 separate pathways. You cannot just make wild assumptions about one of those pathways from stuff you know about the other pathway.
And actually: Yes, you shouldn't stay in the sun for too long without proper protection. Having the sun shine on your skin is not some inherently healthy thing. It too comes with acceptable dosage and overdose. Symptoms of overdose are commonly known as getting a sunburn.
The problem with that is, that you still need to know how to interpret any results and statements within the supposedly scientific papers. If you are not a statistician, you might overlook methodology mistakes. If you are not an expert in the matter of the paper, you might not realize some side condition, that makes some statement or result of the paper irrelevant for your individual situation.
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.
> 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!
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.
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.
(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.
> 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!
You are however correct about population being important (which is a big reason meta analyses can be very useful).
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.
(No affiliation, just have been subscribed to the founder’s substack for a while)
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.
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).
every vegan should supplement b12, so they probably do too
There's your answer
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.
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.
from https://www.bhf.org.uk/informationsupport/heart-matters-maga... :
Eating ground flax seeds gives you more benefits than whole seeds, as whole seeds remain undigested and pass through the system.
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.Just get an algae oil based DHA+EPA supplement.
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.
> 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).
HN and dubious self-medication advice go hand-in-hand. Please consult a medical professional instead of a bunch of ad-tech devs.
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
Doing this has had a massive positive effect for me, and combined with decent nutrition and daily exercise, has been wonderful.
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.
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.
Those are two different things. Cutting out caffeine can help with anxiety but not ADHD. It's the opposite for ADHD, stimulates help significantly.
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.
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.
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.
There's definitely something special, just poorly studied: typical "how much caffeine is in X?" tables show tea having caffeine levels similar to coffee, but I never feel the same effects.
> Caffeine pills generally have really high dosages, FYI.
I use 200 mg tablets split into quarters for doses of 50–100 mg. Yet, they produce a much milder curve than coffee (which I no longer drink) and, as a side effect, cause no gastrointestinal side effects!
I have never seen a caffeine comparison table that shows tea and coffee at the same level.
It’s common knowledge that typical coffee brews are in the range of 2-5X higher in caffeine content than typical tea brews.
Tea is widely used as a lower caffeine alternative to coffee.
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'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'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.
I gave it maybe 2-3 months and decided it's not worth it.
Tempted to give it another shot!
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?
Things like journaling / breathing / etc calm the nervous system while caffeine stimulates it. I would say caffeine is counterproductive to those practices.
I briefly quit caffeine once but it as well before any realization of anxiety. So, hard to extrapolate forward from that experience.
What feels different to me (compared to you) is this: sometimes I'll drink 2 cups of coffee in the morning and be awake but useless. Sometimes totally productive. Caffeine in some form is there - recently sometimes substituting coffee for a Celsius.
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.
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.
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.
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.
Pinpointing problems in your life as the cause of your depression is a trap.
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.
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..?)
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.
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.
The effect after taking the Vitamin longer than 24 weeks is not significant anymore.
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.
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.
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!
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...
(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 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.
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...
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.
This is not to say that they're unhealthy of course.
EDIT: see the sibling comment by code_biologist, it's much more comprehensive than what I've written.
> 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?)
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.
- I believe this crucial bit is missing from TLDR
The effect after taking the Vitamin longer than 24 is not significant anymore.
Edit: This may also be of interest: https://en.wikipedia.org/wiki/Orthomolecular_psychiatry
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.
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.
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.
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?
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.
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...
So sunbathing is one of many way of integrating Vitamin D in our body not THE way.
Comment is neither helpful nor is it funny.