Show HN: Things that help with depression and anxiety

48 points by baccheion ↗ HN
As there seem to be many here that suffer with depressive symptoms and/or anxiety, maybe you'll get some benefit from looking into the following stacks:

https://trackmystack.com/users/baccheion

You can also join the following subreddit, as the users there regularly talk about and consume many of these supplements/nootropics: https://www.reddit.com/r/nootropics .

Other sites that may be helpful:

- https://examine.com

- http://www.longecity.org/forum/

These supplements come into play after you've ensured you don't have any vitamin or mineral deficiencies (it's common to not be getting enough vitamin D & K, magnesium, and calcium).

If supplementing with vitamin D, then it's important to supplement with vitamin K as well (to direct calcium away from soft tissues to where it needs to go), and to avoid extra/unnecessary calcium supplementation (as vitamin D increases the amount of calcium absorbed through the intestines). Life Extension has a vitamin D & K product which shows a good ratio of vitamin D to vitamin K MK-4 to vitamin K MK-7.

If you have a magnesium deficiency (or want to ensure you don't), the best approach to resolving it is to get one of the magnesium oil sprays (Life-Flo brand if you're not sure), then to apply it all over like lotion (avoiding the "sensitive" areas, as it can sting/burn) while orally supplementing (the glycinate/lysine chelated form is a good one) the RDA. That is, oral supplementation of the amounts required to clear a deficiency tend to be distressing to the digestive system, and it's highly likely enough won't be absorbed. Going the topical route avoids the digestive system, while also creating a signal that you have enough magnesium (the body won't really absorb magnesium through the skin if it doesn't need more, which will result in a white film (dried salt) forming).

As each 8oz magnesium oil spray bottle contains 26g elemental Mg (the body has about 28g all throughout), once a bottle is finished (or a white film begins forming on the skin, implying the body isn't absorbing any more), you can be fairly certain you no longer have a magnesium deficiency.

You can also get a blood test done (RBC magnesium levels or the ExaTest, however, not serum levels, as serum levels can be misleading (the body takes magnesium from the red blood cells to keep serum levels high, so OK serum levels may lead one to believe there isn't a problem, when in fact the body desperately needs more magnesium)).

Many of the recommendations (on the Track My Stack page) work well, but you can also become addicted to them (or develop a tolerance, or have nasty side effects) if not taken properly (frequency and dosage). Therefore, it's strongly recommended that one first properly research each thing (and also discuss with whoever's relevant (Doctor?)).

In any event, safety issues aside, when these supplements/nootropics work, they work well, and can often significantly alleviate or completely eliminate symptoms/issues.

You can also search PubMed ("site:www.ncbi.nlm.nih.gov/pubmed INSERT_SUPP_NAME_HERE") to read through the abstracts of whatever clinical studies exist.

Tianeptine Sulfate is effective for many people with symptoms of depression (not sure about clinical depression), especially when they've failed to respond to SSRIs (while having less potential side effects/issues).

Phenibut is effective for many with anxiety, but one can become addicted and/or tolerance can form, so it's recommended you only take 1-2g (split across 2 servings) 1-2x/week (and that you also take fasoracetam each day).

Memantine is effective for OCD, but it can cause debilitating brain fog (or dissociation), so it's recommended that you start at 2.5mg (or 5mg), then taper up in 2.5mg increments every 3-4 days until it begins working (which usually happens at around 10mg ...

49 comments

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Something that has worked for me is 5000 IU of Vitamin D. I do not seem to suffer from any Vitamin D absorption issues, nor am I (any longer) overweight, and I try to get sufficient sunlight (although I live in the north).

On top of that, walking about 5 miles a day also has its own benefits that stack well with Vitamin D usage.

5000 IU of Vit D everyday? Is there a particular brand you take?
Yes, every day.

Source Naturals, NOW, or Jarrow, whichever is cheapest.

Do you supplement with proper amounts of vitamin K as well? Life Extension has a good vitamin D and K product which shows proper ratios and the forms of vitamin K required. If you only supplement with vitamin D, then you run the risk of (excess) calcium being directed toward soft tissue and other places, rather than where it should actually go.

Another sign you may have a magnesium deficiency is supplementation with vitamin D and K resulting in anxiety or difficulty sleeping. That is, you should be able to take D & K before bed without any issues.

To be fair, I eat a rather natural diet that includes Vitamin K1 and K2 in it. Anything discussed in this thread should be prefixed with "don't eat junk" as the first step of things to do.

http://www.lifeextension.com/vitamins-supplements/item01840/...

I think you meant this product. 1100 mcg of K2 seems a bit high.

Yes, that's the vitamin D & K supplement I use. Natural sources may not always include enough of the MK-7 form of vitamin K2. As for dosage, I think those are good. Some could cut the K2 amount by 50%.
> https://www.reddit.com/r/nootropics

Yikes. Please no.

Don't get me wrong. I like /r/nootropics, and I'm glad it exists. I think it's neat that people are willing to risk frying their brain looking for cognitive enhancers, and sometimes I wish I was as cool as gwern and willing to do blind LSD experiments on myself. Very cyberpunk. But telling people with serious conditions to go there for medical advice is dangerous and irresponsible. If you have depression or anxiety, please see a professional.

I'm not telling them to go there for medical advice (and I'm not sure how well these things work when it's clinical depression that's the problem), I'm saying that's another potential resource for information and anecdotes.

Also, I'm not suggesting one ignore a doctor's advice or take them out of the loop altogether. Rather, I'm presenting other options (that will likely help many) such that everyone can become more aware of other alternatives.

I applaud the idea of helping people with depression, anxiety, mood disorders, and that cluster of symptoms and illnesses. We talk a lot about how it's prevalent, but we don't talk a lot about what to do about it.

That said, I don't agree with the advice of the original poster. Self-medicating, /especially/ when you're in the thick of depression, is dangerous; there really isn't a whole lot of data around with regards to either safety /or/ efficacy in patients with depression. It's important that you have a support system around you.

So the paragraph that's buried in the middle -- "discuss with whoever's relevant" -- I think is the crux of it. And beyond that, the most important thing is to begin. Talk to your primary care physician; if you don't trust them, talk to a close friend; find a referral to either a psychiatrist or a psychologist. There are forms of therapy these days that are grounded in evidence, and once you have a support system in place, you might well find that experimenting with pharmacological therapies that are outside the gamut of institutional medicine is something that you want to try.

But if you have pain every day, the most significant bit is that it doesn't have to be that way, and there are ways to treat it; and beyond that, there are tested ways, and it's probably worth going with those first, so that you have the highest probability of feeling better faster, with the lowest risk of feeling even worse or compounding your problems with other side effects.

Yes, as I said in the other comment, I'm not suggesting all out self medication (or not involving a doctor), I'm trying to present a set of supplements and nootropics that many with these issues may have not heard about before. Maybe they can research each thing and/or talk about them with their doctor to see if they will help.

Also, I'm especially making these recommendations, as standard medications and advice from doctors didn't really help me, but when I tried these alternatives I had better success. That is, these are good things to keep in mind should traditional routes not work out well, or if the side effects from antidepressants or anti-anxiety meds grow unbearable.

I can understand your viewpoint having gone through similar and fixed it on my own. If people want to cure their depression and anxiety through self help, my advice is to try adjusting your mindset before thinking about nutrients.

My theory is that having the wrong mindset for long enough sets in motion a process that ends up in physical illness, inflammation and nutrient problems - which make the mental illness worse. So people should try learning mindfulness, stoicism, CBT and giving them at least a few months (with a good diet/exercise) before trying this route.

Nutrient deficiencies can cause all sorts of problems - I read about it extensively when I was ill. At one point I was convinced I might have a magnesium deficiency but when I got a proper test done (not the standard one) it showed high levels of magnesium. So, it's not always the miracle that it appears.

Yes, there are also other things like meditation and brainwave entrainment (Neuro-Programmer 3). Blood tests, urine tests, hair sample analysis, and assessing gene data are readily accessible (unless too expensive or not covered by insurance), so there shouldn't be anything standing in the way of at least getting those tests done to see if there are any immediately identifiable/addressable issues, deficiencies, or excesses.
Good ideas, but debilitating depression and anxiety have left me poor and broke. I don't have the luxury of shopping for a psychiatrist. I did go once when I had some money and she gave me her Abilify samples. It worked wonders, but she told me the samples she gave me would normally cost $800 US bucks a month. I'm on govt health insurance for the poor that doesn't cover that, so herbs are it.
It appears that there's been a generic abilify for about a year now and also that it's definitely covered under Medicaid in at least some states.
Hey thanks, I'll look into it
This seems like a lazy attempt to market your affiliate links.
Where are my affiliate links? I don't own the site I linked to and I haven't provided any links that include an affiliate code.

If Track My Stack is adding affiliate links, then you can avoid them by directly entering each supplement or nootropic into a search engine. You'll probably be able to get better vendors, prices, and quality that way. I'm mainly using that site to hold the actual stacks, not to suggest where to buy each supplement/nootropic.

If you are looking for ideas to protect yourself from depression http://examine.com is amazing. They back their articles with actual scientific studies on whether or not supplements work. Their articles on omega 3(e.g. fish oil), zinc, rhodiola rosea, and creatine are a great place to start for ideas to help deal with depression. I use all of these on a daily basis, and I found out why and how thanks to their suggestions. These are supplements that are safe and your doctor will likely support their usage as well when you ask them.
Yes, Examine has a lot of good information. I've added a mention of it to the OP.
Thanks for being open to feedback, I know some people here are quite critical when it comes to supplementation suggestions and really anything medical. You clearly take the time to think and test this stuff out and improve your post, so I think this is something we could use more of!
Yea, I was already familiar with that site, I just didn't think to include the link. I used it a lot as I researched various supplements. The FAQ section of the /r/Nootropics subreddit has links to other useful resources. Also, the owner of Examine.com is an active member of /r/Nootropics.

I'm annoyed by the critical reaction to supplement suggestions (mainly because no one is being forced to get anything), but on the other hand, I understand the reason for skepticism or lack of confidence. What would be great, however, is a bias toward first looking into what's recommended, rather than just settling into blind blanket dismissal/rejection.

People expect the sources to have some sort of marketing scheme behind them. Examine.com is the exception by having well researched suggestions backed with actual studies and a status of being a reliable third party. I understand their skepticism, because of how much learning it takes to actually do supplementation safely and effectively. Most supplements just help based on placebo effect anyway, I aggregated the supplement effects studied on examine.com and 50% of studied effects were neutral. Only 8% of the supplement effects they investigated were more than minor, the numbers can only get worse when you consider publication and selection bias! So there is good reason to be critical, because the odds are against supplements helping enough to be noticeable beyond what a sugar pill can do.
I spent years on the self-medication supplement train. I still take Vitamin D and a few other modest supplements, but I finally got REAL relief after just biting the bullet and trying nearly every anti-depressant under the sun. After a few, my doctor did a DNA test to determine gene-drug interaction because of the wild results I was having. Thankfully, this was covered under my insurance. It shed a lot of light on why many of the pills I had taken failed -- the test showed they're likely to have bad reactions based on my genes.

We used the information to choose Viibyrd, a fairly new anti-depressant (2011). I've kind of become an evangelist for it since.

It works like a traditional SSRI but also affects the 5-HT1A receptors. Another great feature of the medication is that it usually takes less than a week to notice results -- and results I noticed.

I've been plagued with anxiety since age 18 and depression since I was a kid. For the first time in 11 years, I'm anxiety free. For the first time in a long time, I'm nearly depression free.

The best part? I'm myself. I'm not dull. I'm not a zombie. Some of my other impulsivity and ADHD symptoms vanished. I'm way more productive, social, and less afraid to take on life.

It was fun and interesting to do the whole supplement stack, but ultimately a huge time and money waster. I spent far less time going to my Psychiatrist and trying different options to get REAL results.

I feel like in many ways Nootropic supplements are the Homeopathy for Nerds -- we're using cutting edge research to anecdotally try to fix our issues, and ignoring that even we're just as susceptible to the placebo effect as the rest of the population.

Here's a good read that's sort of on topic about the stigma of medication and mental illness:

https://themighty.com/2016/02/myths-about-mental-illness-med...

What you should become an evangelist for is doing the gene testing (to get further insight/clarity into potential interactions and issues) you mention.

In my case, I was forced to seek traditional help, but that didn't work for me, which lead me to looking into alternatives. I researched for a long time, then came across (and had better luck with) many of the supplements and nootropics in the stacks I link to.

That is, I'm not saying to use this as an excuse to avoid traditional routes; it's more that many either have tried such routes only to see no real improvement, or want to quickly give off-the-shelf options a try before becoming "a part of the system." Not everyone is a fan of prescription anti-anxiety, antidepressant, or antipsychotic medication (or their side effects, especially).

> Not everyone is a fan of prescription anti-anxiety, antidepressant, or antipsychotic medication (or their side effects, especially).

Lots of people go along with the "professional's" prescription, not knowing that these drugs are known to not work very well. They're only used because the professionals think that "they're the best we have at present time," (paraphrasing Harriet Hall MD's quote from skeptic magazine). The thinking is that if the first drugs don't work, they can always "try, try again".

Benzodiazepines are great for anxiety, until they stop working after about 4 weeks. Then you're just addicted to them to keep from spiraling down into an anxious hell.

SSRI's are the epitome of corporate science. Someone came up with the serotonin-deficiency theory of depression, Wall Street came up with a drug to sell, poof everyone got switched from anti-serotonin antidepressants to the new pro-serotonin patent drugs. There are some negative articles about Prozac in the Boston Globe's archives circa-2000, but their exposé wasn't enough to stop the juggernaut. There is now a page somewhere on Wikipedia that talks about why the SSRI's actually work for a small percentage of the people who take it... More often than not, SSRI's have a tendency to ruin people. Lexapro helped my girlfriend relapse, years ago.

"Anti-psychotics" were originally sold as tranquilizers. These drugs are given to difficult patients so that the system can pretend it's helping people, but really these bad drugs make the patient more psychotic over time. Most psychotic patients recover with time and/or sobriety.

See my comment history for references.

Many studies have shown 5-HTP is about as effective as SSRIs for depression and OCD. Memantine has also been shown in studies to work well for OCD (and sometimes even depression or anxiety), and that's mainly because it's an uncompetitive NMDA antagonist first, then an Alzheimer's treatment option (as it has been pigeonholed into being).
This doesn't seem like an appropriate place for this type of... 'content'.
Why is that? It's not directly tech, programming, or startup related, but I decided to post it as programmers (a large percentage of users on this site) frequently mention struggling with depression or anxiety.
Maybe you're new, but anxiety and depression is a topic that has gotten a lot of discussion on hacker news in the past.
My issue isn't with the topic. It's with the psuedo-science masquerading as medical advice, and with the poster who is wantonly throwing out unsubstantiated advice for taking compounds that he almost certainly knows nothing about-- except where to buy them... his fantastic affiliate site!
I don't own Track My Stack, or any other site. As for science vs. pseudoscience, if you look into the supplements and nootropics mentioned, then maybe you'll find anecdotes and clinical studies that clarify what they do, how they work, how well they work, and how likely they are to work.

What exactly (of what I mentioned above) do you consider pseudoscience? It seems you just like throwing out (as is common with many on this site) "cliche" terms and using them to feel almighty and important. Perhaps you can do as you imply wasn't done (to arrive at what was said above), and provide some evidence or data to back up the accusations you are pointing in my direction.

This is my main problem with sites dominated primarily by Te users (INTJs, ISTJs, ENTJs, and ESTJs): stupid, ignorant, judgmental, and dismissive is often put into play with the belief it's actually astute insight or perceptiveness.

In the future, it would be better if you know (and provide support for) what you're talking about, rather than just throwing out blind blanket BS accusations.

You know what, you are right. My comment was a drive-by.

I'm glad these things worked for you. For me I'll see my doctor and dentist yearly, eat 'right', exercise regularly and rigorously, and enjoy and cultivate fulfilling relationships with friends and family.

Drugs can be a great tool for healing and recovery. I remain unconvinced that what you claim is helpful for even a small number of the population.

@1121redblackgo: well, I'd imagine the etceteras you mention are already generally "known of", and that many (especially on this site) with these issues are (or were) already doing these things without much success.
Ive been working on this exact problem, and have been for about a year and a half now.

The idea is to mail a user an EEG, which they rent, then provide real-time feedback to the user. This is called neurofeedback[1] helps the user learn how it feels prior and during various moods and mental states. Overall, this has been around for 30 years, our improvement is that it is doable in the home at 1/10 the price.

We are launching a beta in the bay area soon if anyone is interested.

[1] http://synaptitude.me/blog/neurofeedback-in-200-words/

Vitamin D can be obtained naturally, how it was intended.

1 hour in the mid-day sun (shorts + t-shirt) will yield you 10,000 IU in most cases, depending on location. Ideally, go shirtless. Bright sunlight hitting the retina has clinical studies backing its effectiveness in regulating hormones and potentially improving mental illness.

PS: Northern Hemisphere - Need to supplement during winter.

Sure, however, if you do this, then maybe you can also supplement with Astaxanthin (2mg-4mg?) to help protect the body against sunburn (and other sun exposure related issues). Also, if you go this route, you should definitely get blood tests to verify that sun exposure has in fact increased vitamin D levels to the desired range (40-60 ng/ml, with 50 often being mentioned as an "ideal").
Astaxanthin can be obtained naturally as well. Wild salmon. Emphasis on wild, not farmed. One of the reasons wild salmon have a bright red pigment is because of the astaxanthin.

While we're on subject, wild salmon has one of the highest VitaminD counts of all food. One 3oz serving = 500IU. Probably in the top-three healthiest foods on Planet Earth (if you can even make such a criteria)

(comment deleted)
Yes, but it's not likely one will be able to get sufficient amounts from natural sources each day. That is, the typical approach is to supplement with 8mg, 12mg, or even 16mg/day for 12 weeks (to saturate the body), then with 2mg or 4mg/day thereafter.
Kratom worked like a charm for me and relieved my depression and anxiety. I was happy, cheerful and working (programming) effectively for the 5 months I took it. But I didn't know it was an analog of opiates (works on same receptors) and addictive. I quit cold-turkey to save some money and was amazed to find myself in the midst of a terrible opiate withdrawal (I had experienced it before on pain meds) Yech. I was doing 30 gm a day. Check out reddit.com/r/quittingkratom if you find yourself in a similar situation and need support. *edit (sp)
N-Acetyl Selank (or regular Selank to be using the older more tested version) and Tianeptine Sulfate may be good alternatives (one can become addicted to Tianeptine Sulfate, but it's not as likely).
I was diagnosed with borderline personality disorder, and major depressive disorder about 5 years ago.

Today I only have an anxiety thing. The thing that helped? DBT: dialectical behavioural therapy.

So, I am extremely disappointed that it only got (barely) mentioned in passing at the end:

> There are also things like meditation, brainwave entrainment (Neuro-Programmer 3), CBT, etc.

From a purely subjective sample set of one (me) - lightboxes help with the winter blues and the worst thing possible is to reach for an evening cocktail which just makes things worse the next day.
Lightboxes helping strongly suggest you have serotonin or vitamin D issues. You can try an adjustment in diet or can look into some of the supplements mentioned above to help with those issues.

It's great if it's working out for you, but you should consider blood work (or genetic testing) to see if you have any vitamin, mineral, etc deficiencies.

Exercise. Seems like a lame answer but helps me. Doesn't have to be obsessive to work wonders - a bit done regularly goes a long way.
I'd echo this, despite recent studies suggesting exercise does nothing for depression. Personally, I suspect there responders and non-responders when it comes to long term relief. However, short-term I suspect it's extremely effective, i.e. in the hours range. It's hard to feel too miserable while lifting heavy weights or smashing a boxing bag.
Yes, it has good effects (at least short-term). High-intensity interval training (avoids burning muscle) or weight lifting are especially good. It also enhances the effects of things like Piracetam and Acetyl L-Carnitine, which in turn enhance capability/capacity during exercise (piracetam helps with oxygen usage, in addition to being a nootropic, and Acetyl L-Carnitine helps with endurance-- so much so that many bodybuilders use the PLCAR form before workouts and the LCLT form after workouts (to speed recovery and minimize the odds of DOMS)).
Also, https://labdoor.com/ is a potentially good place to check for product/brand recommendations, as they've tested the major brands to check label accuracy, product purity, estimated efficacy, etc.

They've mainly tested more common supplements (vitamins, minerals, probiotics, fish oil, etc), but it's still a good site to keep in mind.