Vitamin D and Omega-3 have a larger effect on depression than antidepressants

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.

That statement is broadly true for most outcomes studied, but specifically for depression the larger study results are pretty mixed.

VITAL (the heavily cited metastudy) shows no effect. https://pubmed.ncbi.nlm.nih.gov/32749491/

But there are other large metastudies like this one for Vit D (https://pubmed.ncbi.nlm.nih.gov/39552387/) and this one for Omega 3 (https://pubmed.ncbi.nlm.nih.gov/31383846/) that do show robust moderate effects.

What the article states, then fails to take into account, is that is the mean effect size, and there is huge variation.

Anti-depressants are notorious for producing different effects for different people.

What that high variance means in practice, is for any anti-depressant, the people who get good results are getting a much higher effect than 0.4. And the other people move on to try something else.

So to keep comparing 0.4 directly to the effect of Vitamin D and Omega-3 directly is very misleading.

> 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!)

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?

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 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.

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 an old gf receive two different drugs each with terrible side effects. To me it looked as poison.

I decided that I would rather hurt myself myself than fuck with my brain chemistry this way.

During the dark northern Winters I lack vitamin D (your doctor can measure this using a blood test). The symptoms are some physical issues and probably something that can be described as light depression which goes away if I remember to take the vitamins.

We are all different. Some people might need anti-depressants. I just need some vitamins.

I finally went and got diagnosed at age 46 for what had been an childhood-onset issue in retrospect. All the signs were there: inability to start work until enough challenge or novelty or a state of crisis had come about, etc. When I spoke to friends about considering treatment, they said they thought of me as a hyperfocus kind of person. But they didn't see how many support systems I had put in place to function normally, how I saw others around me just doing things while I had to work myself up to start and then keep checking and double-checking for the silly inattentive mistakes I knew from experience I would keep making.

I've had a meditation practice for a long time and it has helped with anxiety but it hasn't really helped with getting started on tasks, especially those perceived as boring. I even had to psych myself up to sit down and start meditating, even though I knew I would enjoy it.

I didn't know until a year or two ago that non-stimulant medication existed to treat ADHD. I always thought it was only Adderall and the like, and I couldn't risk anything that would ramp my anxiety up, or take additional treatment for the anxiety with SSRIs because I have severe hemophilia and any additional risk of bleeding from SSRIs was an untenable proposition.

After sitting on the idea for some time and just hoping that I could fix it with more meditation, I finally decided to see a psychiatrist. The doctor suggested Atomoxetine, but said it doesn't work for most people and even then takes 3-4 weeks to take full effect. I started on the absurdly low dose of 10mg/day for the first month to be sure it wouldn't cause additional bleeds. By day 3 I could see a huge improvement in my working memory and ability to perform tasks. It gave me insomnia for a bit but I would wake up at 3 AM, sit down happily to work and write the best code I've written in years. I could not believe the difference it made. There were quite a few side effects initially but I was willing to put up with them because of how smoothly my brain was functioning. I became a nicer person to deal with. I felt this sense of possibility and freedom that I haven't felt since my 20s. My only regret is not having done this sooner.

So yeah, please don't avoid medication based on internet reading.

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.

I do wonder if being highly functional and feeling capable is normal though, like as a species it seems almost dysfunctional to happily plow through 8 hour workdays and bills and appointments and all the little bureaucracies we have to navigate. Sometimes a little voice screams "Run to the woods!" when I sit down and look at a long todo list for the day, but with Adderall I can generate some semblance of enjoyment from ticking off the boxes.

Granted our world is what it is, and we are mostly helpless to enact large changes. Finding some kind of peace with reality is probably better than bashing your head against why you don't fit into it well.

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.

I feel like doing those three things would make me feel like reheated cat shit, regardless of the weather outside.

So I ended up spending $300 on LED bulbs, both corn bulbs and 200W equivalent, bought some 7-Way splitters for my ceiling fan so it’s holding 28 light bulbs (people have joked I have a “biblically accurate ceiling fan” because it’s so bizarre looking, like a weird glowing biblical angel), and get about 10,000 lux in my home office now. As a bonus, I don’t have to run a space heater in my home office (since I only need it in winter, I’d have been using that electricity anyway via a space heater). Solved the issue completely for me.

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.

I feel like I speedrun Maslow's hierarchy of needs.

No anhedonia so far this year and my creative output is at all-time high. Hope that helps someone get over their own biases about prescriptions.

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.

[0] https://www.alexcrompton.com/blog/2017/05/26/hard-is-not-def...

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 sure they have their problems too on occasion, but for me the decision to start taking Escitalopram was one of the best things I've ever done.

The side effects were totally negligible compared to the benefits.

I've stopped taking it a year ago or so and... it's basically cured me.

I'm not saying antidepressant are a literal pharmaceutical cure for depression, but in my case it simply put me in a position mentally to change habits and patterns of thinking in a sustainable way.

My only regret is not doing this 10 years earlier; the poor reputation contributed to that.

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.

(Roughly equivalent to Lexapro 15mg/day; Saffron 30 mg/day if Crocin+Safranal properly standardized)

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.

I'm not saying it's a bad.

But I'm also saying there are no magic pills...!

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.

There are some forms of depression that you cannot think or act your way out of. If you haven’t experienced that, I promise that you do not understand what it is like. You cannot really understand unless you have experienced it. Your opinion on it is irrelevant, and frequently offensive.

The same is true for people that say that antidepressants are mostly placebo. They are not. When people say that antidepressants saved their life, they aren’t joking or exaggerating in the least.

Yes, I understand that other therapies are also effective, and that some people are non-responsive to some drugs.

Keep your pet theories to yourself if you are not a subject matter expert or someone who has experienced it first hand.

Edit: I understand that the placebo effect is still an effect. My point is that there are a lot of people being incredibly dismissive of real lived experiences and outcomes on a VERY serious issue.

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)

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.

Yes, you did. Had the same medication and got tremors and stiffness so bad I thought I had early-onset Parkinson. Could hardly unlock the door without dropping the keys five or six times. Fortunately, it ceased when I stopped the SSRI.

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.

> 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.

I'm not stating the dosage is wrong. Looks like it is anyway.

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.

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!

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.

> 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).

Careful, he is also a believer in Ayurveda[1]. Which basically basically categorizes people into different elements like fire and water and then tries to change their diet and habits to match their elemental style or something. You can hear him talking about it here [2]. Kinda reminds me of Humorism [3]. Dr. K seems like a nice enough guy but don't get too lured in by the "Harvard-trained" credentialism.

[1] https://en.wikipedia.org/wiki/Ayurveda [2] https://www.youtube.com/watch?v=rQ2xnThRGPg [3] https://en.wikipedia.org/wiki/Humorism

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).

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.

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.

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.

Pinpointing problems in your life as the cause of your depression is a trap.

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..?)

> 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/

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.

Im on week 3 of no coffee now, I will maybe give it a month or two more to make a judgement call if I want to continue with coffee or not.

It is unfortunate as I really enjoy coffee, but it causes some issues for me with anxiety and stomach problems.

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'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.

Those are two different things. Cutting out caffeine can help with anxiety but not ADHD. It's the opposite for ADHD, stimulates help significantly.

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.

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?

I gave it maybe 2-3 months and decided it's not worth it.

Tempted to give it another shot!

or society in its current incarnation. its an underexpressed opinion that maybe depression is a justified reaction to ... life, as humans across a lot of earth in 2026.

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...

Too much Vitamin D3 can be toxic, so doctors are reluctant to tell you to go over published guidelines. but if you don't have other issues, and stick to what you can get OTC from a normal vitamin brand and follow the instructions, you're probably safe. There was a story a while ago about a woman who died from too much D3, but it turned out she was taking a whole bottle's worth every day for years.

Taking 10K per day is a bad idea. I went into the excess Vitamin D range with half that dose even in winter with an indoor job.

More is not always better.

Toxic levels of vitamin D can be life threatening, so do keep your levels in check, but you won't get there unless you really try, so if you can't get out of the bed to have your blood tested just start taking it and check it after 3 months when things get hopefully easier for you. Just make sure to get the number of zeros in the dose right.

Do keep your levels in check though.

The main instigator of depression is still societal as the postmodern era is pushing everyone into seclusion and addicting them to constant individualized dopamine hits, increasing the miserable effect on one's chronic mood and exacerbating one's self-consciousness about it.

Comment is neither helpful nor is it funny.

So sunbathing is one of many way of integrating Vitamin D in our body not THE way.