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I found this to be the case. Tried Sertraline for a while, gave me headaches and made me feel sick. Then as part of a new gym plan, started taking Omega 3+VitD daily, and I just felt a sense of calm and peace after a few weeks. The massive uptick in exercise probably also helped. I also felt quite an extreme uptick because I was a vegan for 10 years, and found out I had basically zero Omega 3 in my blood. I suspect one of the main reasons my mental health declined was due to the lack of Omega 3.

Disclaimer, not saying vegans should stop being vegans, just make sure you find a good supplement, and make sure you understand the difference between EPA/DHA Omega 3.

And better than taking pills for the former, add hemp hearts or flax seeds to your cereal. One serving of hemp hearts has 10 grams of protein and 12 grams of Omegas 3 and 6. Flax seeds are lower in protein but an even better source of Omega 3 in particular.
Please do not take 5000mg/day of Vitamin D. The author confuses IU and mg which is very dangerous.
Even 5000IU a day is huge and will likely result in calcium buildup.
> A 2014 systematic review concluded that vitamin D supplementation does not reduce depressive symptoms overall but may have a moderate benefit for patients with clinically significant depression, though more high-quality studies were determined to be needed.

https://en.wikipedia.org/wiki/Vitamin_D#Depression

Chia seed and flaxseed high in omega3
Can I just add: In addition to this, if you struggle with anxiety or have some sort of ADHD, then try cutting out caffeine entirely. Not just switching to "decaf" (which isn't), but cutting out tea and coffee, and switching to an alternative like Barleycup.

Doing this has had a massive positive effect for me, and combined with decent nutrition and daily exercise, has been wonderful.

Counterpoint, purposely adding caffeine in the form of different mushroom coffees has greatly improved my ADHD symptoms.
I am in the middle of trying this out. When I first stopped caffeine I had better sleep and very vivid dreams every night. I also feel better as I think coffee was making my stomach too acidic which was causing me other indigestion problems, not to mention that coffee was nuking my teeth as well with acid.

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

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

I cut coffee for over 6 months, and one of the most significant thing it did for me is that, when I resumed, I noticed that caffeine actually helped me feel more awake and alert (while I didn't notice any effect when taking a lot of it before stopping cold-turkey)
My physician prescribed Vitamins D and B12, so a quality Omega 3 is the only supplement I currently purchase.

After an absurd amount of trial and error with every over-the-counter, trendy supplement over the last couple of decades (and lord only knows how much money), these are the only ones that seem to make a subjective difference on my quality of life and an objective difference in my bloodwork.

Your body makes Vitamin D when in sunlight. Could it be that sunlight - and the whole being outdoors situation - is the thing that helps rather than vitamin d levels?
If this is true, then what would explain just oral vitamin D supplementation working?

that said, yeah let's all get outside more for sure

can vouch for a diet high in fatty fish along with supplementation of D3 + cofactors (K2, A, magnesium, zinc, copper, boron). sample size of one but noticeably improves mood and energy levels.

recent evidence [0] suggests there's not much of a link between serotonin and depression, and therefore the effects of SSRIs are either placebo or an as of yet unexplained mechanism of action. IMHO it seems much more likely that modern lifestyles (excessive screen time, poor diet, lack of socialization, no connection to nature, no spirituality, etc) have more of an effect than serotonin levels.

[0] https://pubmed.ncbi.nlm.nih.gov/35854107/

Over the last few months, I’ve increasingly come to believe that depression is not caused by a chemical imbalance. After trying ten different antidepressants with no success, I found far greater improvement by changing my patterns of thinking.
Yeah, I call bullshit. Tried both, and SSRIs are a godsend.
Can confirm. Since I take 20000 IU vitamin D every sunday, my winter depression is gone.
These are always tricky, vitamin D deficiency and low fat diets clearly cause depressive symptoms.

Does that mean vitamin D treats depression in general?

When most people talk of depression they aren't even using talking about major depression.

We live in a world that in many ways is comfortable but crushing. Is that depression? Or just harmful levels of understandable unhappiness? Are they different?

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Be careful - many studies in the Vitamin D meta-analysis *enrolled patients already taking antidepressants.* [1] Reporting effect sizes without specifying "on which population?" is misleading.

(As an aside, Cohen would be the person not to tell you to assign qualitative values to effect sizes. They are as arbitrary as any other threshold used by working statisticians.)

[1] https://www.cambridge.org/core/journals/psychological-medici...

EDIT – that is, please don't draw the conclusion that you can substitute supplements for antidepressants. The meta-analyses don't seem designed to examine that hypothesis, and I doubt anyone would ever participate in a such a trial. In general (and as a working biostatistician), I would be very, very, very cautious applying estimates of average effect to myself, you, or any other individual person in a field as murky as psychiatry. That's why even the stingiest American health insurance plans still have an incredibly large range of antidepressants in their formularies.

then it would suggest why depression gets worse in colder and less sunny part of the year. That even has its own name - Seasonal Affective Disorder (SAD).
With depression it is important to find the cause of it.

You might be depressed because you life objectively sucks. Then you symptoms are good and healthy and a signal to make changes in your circumstances.

You might actually have a good life but still feel depressed because there is a chemical imbalance in your brain. (Very simplified). That is when drugs come in.

It might be just a seasonal thing and you need to go outside more and take some supplements.

You might have some other undiagnosed issue. You might have ADHD, autism and other things that cause you to struggle and develop depression as a side effect.

So find out what works and what doesn't work for you.

Because it's common to hate on antidepressants, I've always personally had a bias against them.

For the past 15-20 years, november thru february are basically a writeoff due for me due to seasonal affective disorder. Cold showers, exercise, no alcohol, strict sleeping rituals. Vitamin d. I can still sleep 11 hours and feel like reheated cat shit.

Enter citalopram. "It will take up to six weeks to dial in" they said. Within four days I felt like the inside of my head was designed by Apple in their glory days. My mind became an orderly, well lit, tastefully designed space... instead of a dimly lit crack den. I'm more emotionally available, no longer tired, less cranky. I felt cozy. I could cry with joy because I could finally understand emotionally why people like the Christmas season.

I won the SSRI lottery I guess, the side effect are sweaty feet, vivid dreams and a dry mouth. That's all.

This just goes to show that for me, they're extremely effective.

Bessel van der Kolk also mentions in his excellent book "The Body keeps the Score" that the effect of antidepressants is correlated with the source of the depression. If the depression is a comorbidity from early childhood trauma then antidepressants are limited due to trauma-related reshaping of how the brain is organized. Cases like yours or those that a related to traumatic experiences as an adult are more the result of a shallow neurochemical imbalance which antidepressants are able to impact beneficially.
I'm guessing you can afford spending $300 on light therapy glasses.

Disclaimer: I'm not a doctor, but saw 4 seasons of dr. House. Moreover, few hours of Huberman Lab on sleep and light and most importantly, this episode of Additude Mag Podcast on curing SAD and ADHD day-rhytm shifting with light glasses: https://www.youtube.com/watch?v=fu4mLgkNc6I

What happens in the seasonal affective disorder season is the sunlight pattern diverges from 6-18 that we evolved with. Without daily reminder of getting enough sun (or sun-like) light at the 6 o'clock⁰, your body clock will drift.

It can start by feeling groggy instead of refreshed in the morning, even if you've slept enough. And can escalate into loosing the will to do anything or even live.

No wonder. You're still an animal. You need to be fed, put to bed, etc. at a specific time. If you try to make your body sleep during the day, and eat and work during what body expects to be night, you won't really sleep and won't really live/work. Enough of not really sleeping and not really living - you mess up your body, your gut biome, your hormonal balance and your brain chemistry. You kind of should get depressed when you do it.

You can steer your body clock with light. Most of us do it, by exposing ourselves to strong (strong enough it won't matter if it includes blue wavelength or not).

But you can do it consciously (and in a way good for you) by putting on light therapy glasses (I'm using Lumiere 3¹, and they are not the only ones, find your own) at 6⁰ everyday, or right after you wake up if you're trying to readjust your rhythm. Or if you have time and want to save $200, use a stationary lamp and just sit in front of it doing nothing. I don't have the time. When readjusting, small doses of melatonin (0.5mg) 1h before sleep will accelerate body clock shift.

But don't listen to me, if you have SAD, you should really listen to that ADHD experts episode.

I feel for you, struggling with that stuff for a long time. Vit D, fish oil (lot of). All lights at home set to reduce intensity after 18. Strict going to bed routine. Still sleep poorly once in a while, but can do things in winter again. Hope it will help :)

0: choose whatever suits you. With small doses of melatonin and discipline in using light glasses you can even flip day and night. Just stay consistent, good farmer always feeds his cows at the same time.

1: at the time of buying ( fall '25 ) they were cheapest and best overall in norway. Solid build, ok battery, can have them on during yoga using attached rubbers and kind of can have them over glasses. Mine are very large and have blue light filter, but I manage 20min without eyeglasses. Medical certificate. Few leds, holo strip, battery and some plastic - my inner Scrooge says it's not worth $285, but everything else was worse and more expensive.

Re "citalopram" and "SSRI lottery I guess"...in fact, citalopram is not a true SSRI and in fact no SSRI is only an SSRI as they also on, at increasing doses, many other neurotransmitters like norepinephprine and Muscarinic acetylcholine receptors.

However, citalopram specifically has a big effect on the histaminegma the sigma-1 receptor. I will focus on the sigma-1 receptor:

https://www.sciencedirect.com/science/article/pii/S134786131...

Never heard of it? Yeah, don't be ashamed, it is the biggest secret in depression. In fact they are finding that many "SSRIs" are sigma-1 agonists, even prozac.

https://www.frontiersin.org/files/Articles/1691987/fnins-19-...

It tunrs out that Sigma receptors modulate glutamatergic dysfunction in depression, and glutamate, being excitatory, well, you can. make your assumptions from there.

https://www.frontiersin.org/journals/neuroscience/articles/1...

It seems the main function of the Sigma-1 receptor is Calcium release. And calcium ion channels are one of the most studies ion channels in mood disorders. By increasing calcium release you increase neuronal activity, hence, the uplifted mood.

It is too bad that the sigma-1 receptor is just starting to be studied and there is limited evidence of how omega-3 and Vitamin D effect it. But I do know that Vitamin D has a huge effect on SLC6A4 (SERT).

https://www.nature.com/articles/s41598-020-79388-7

I have Schizoaffective Disorder Bipolar Type (disabled) and have been on no less than 14 types of meds. I knwo how they work better than my psychiatrists, which I why I no longer take them. I also know my genetics which gave me clues to what is happening in my body. Now I eat a mostly seafood diet and my needs for meds has mostly vanished. I am still an odd old fellow, but at least I am not ranting in the streets or trying to kill myself anymore.

Meds saved my life, but a diet high in Omega 3, D, and a bunch of other things has removed so much suffering from my life, more than any medication has.

(Also, if you want to get into the weeds of depression, you might wat to look at ATP and depression https://onlinelibrary.wiley.com/doi/full/10.1111/cns.14536)

The things that keep me away from SSRIs are the potential for addiction and not being able to take psychedelics.

I had a friend on SSRIs not tell us they were on them when they hit a DMT vape pen at a party years ago and they got serotonin syndrome. Had I known I would have warned them not to.

> This just goes to show that for me, they're extremely effective.

I am not so convinced. Perhaps your case was simpler, but people can feel chronic depression. They may take some drugs to modify that, but what if the external factors won't change? You can see this issue for some people who have a disease that only gets progressively worse. I think we can not unify all this as "dislike on antidepressants" as a one-size-fits-all formula.

I had pretty much the same reaction after two days of taking it.

Took a while longer to get the dose right so that my anxiety also mostly disappeared, but the difference in quality of life it made for me is hard to put into words.

Have you tried SAD lamp light therapy? But not those lamps you get on amazon or other marketed SAD lamps, those are a scam. Just buy a 2 floodlights that are pretty powerful, say 100 watt each. Works like a charm. 15-30 mins a day its all it takes
As someone that falls on the side of “depression is real and antidepressants can help” it is very clear that there are people in this thread that need to hold their tongues because they know not of what they speak. (Not you OP)

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

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

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

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

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

Thank you for saying this, I wholeheartedly agree. Antidepressants have an excessively bad reputation.

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

The side effects were totally negligible compared to the benefits.

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

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

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

It takes a 10 min talk with a doctor to get antidepressants around here. Perhaps a test which looks like multiple choice score of symptoms with some weights.

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

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

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

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

I had a similar experience except instead of antidepressants it was when i started taking Adderall as an adult. A sense of peace and serenity in my mind that I had never felt before, it was almost overwhelming.
What dosage of Citalopram? 40 mg/day?

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

I had severe SAD to the point of having a mental break where I told my wife I was flying that very day to Miami to get away from the cold. I didn’t end up flying to Miami, which is likely why I’m still married…

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

sweet feet seems so random, maybe some serotonin receptors down there? are they noticeably sweety?
Same story here, but different drugs. Every year Nov to Mar means no lapses whatsoever in diet, exercise, sleep, supplements, clutter, lighting otherwise the SAD will seep in and erode me. I tried udosing ADHD meds this year and suddenly subsistence is easy and I have gas left in the tank for worthwhile things.

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

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

Similar story here but for ADHD and Atomoxetine.

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

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

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

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

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

> I won the SSRI lottery I guess, the side effect are sweaty feet, vivid dreams and a dry mouth. That's all.

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

Same for me with Adderall.

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

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

and then the effects wear of. You just feel "normal" or the same as before. I used to take ssri meds too. It was nice in the beginning. Stopping was a nightmare, I needed to taper down foe like half a year..
Do you take the citalopram year round, then?
Thank you for your comment. I think that can help many people.
Similar story for me, but with Bupropion (Wellbutrin). None of the SSRIs/SNRIs worked for me, spent years trying different medications, Wellburtin was finally the one that worked, and oh man what a difference.
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> Cold showers, ... no alcohol, strict sleeping rituals.

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

> I could cry with joy because I could finally understand emotionally why people like the Christmas season.

SSRIs are known to induce a

https://en.wikipedia.org/wiki/Mixed_affective_state

I seriously messed up my life early on by not being able to recognize the difference between being happy and manic.

One of those manic symptoms was often feeling like crying out of joy, and another was feeling way more cognitively capable that I was.

I described SSRIs like this:

When you're depressed, you're in a hole that's too deep to get out of.

The SSRI basically shovels stuff from the top of the hole to the bottom of the hole so your head is above ground level. You are still in the hole though and you need to climb out of it.

The side effects are suicidal ideation and brain zaps
Please talk to a doctor if you're curious about this instead of following this advice. Megadosing vitamins and supplements comes with risks not addressed by the author.
The only problem here is that "going from an F to a C in mental health" is vastly different than "going from a C to an A." It's very well known and well documented that antidepressants have very little effect on mild depression compared to say, exercise, but that F grade of depression tends to be a different beast with different causes.

That's not to suggest that exercise etc isn't great, just that society has come a long way in destigmatizing mental health and just being like "oh just take fish oil" to someone dealing with that kind of depression, either through shitty genes or childhood trauma or whatever, can be really harmful.

wait till they discover sex, drugs and alcohol :)
Coincidence? "Vitamin D is currently the only Essential Vitamin or Mineral which appears to have deficiency rates at a similar level to Magnesium"

https://examine.com/supplements/magnesium/research/#nutrient

Dai (2018): Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial https://pubmed.ncbi.nlm.nih.gov/30541089/ "Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. "

So it might well be that general deficiency in Vitamin D is caused by the deficiency in magnesium status. This would also be an explanation why we see Vitamin D deficiency in sunny Africa: https://theconversation.com/think-vitamin-d-deficiency-is-no...

To many people without relevant expertise give medical advice online.

I remember a similar case with levelsio who was advocating people to take melatonin and discussing how much grams is good vs bad. When I said that people shouldn't take medical device from someone who was successful in building web apps, he blocked me.

I would add that the issue with Omega-3, is the imbalance between Omega-3 and Omega-6. It turns out that many of the food products have been manufactured with Omega-6 rich oils and that is causing some issues. One can ingest Omega-3 supplements, try to eat foods rich on that fatty acid or reduce foods with lots of Omega-6 in order to restore that balance.
Confusing mg and IU units up front really do NOT inspire confidence on the topic and conclusion as a whole.