A rare type of encephalitis

Encephalitis (inflammation of the brain) is rare in general, luckily, but in this post I will write about an even more rare cause of encephalitis. Primary Amebic Meningoencephalitis, or amebic encephalitis, is infection of the brain caused by microscopic ameba, a single-celled organism. Specifically, it is caused by naegleria fowleri. This ameba is found in warm freshwater, therefore it can be in lakes, rivers, and hot springs, it can be found in the soil as well. The ameba can enter the brain through the nose, and the infection is usually fatal. There have been cases in the US of this type of encephalitis – from lake water and tap water.

I know this happens quite rarely, and hopefully we will keep it that way, but some researchers predict an increase in the number of cases due to the rising average temperatures. Therefore it’s important to rinse your nose only with previously boiled water, and check any warnings by the municipality in regards to the body of water where you want to swim.

Rare brain-eating amoebas killed Seattle woman who rinsed her sinuses with tap water. Doctor warns this could happen again.

“I think we are going to see a lot more infections that we see south (move) north, as we have a warming of our environment,” said Dr. Cynthia Maree, a Swedish infectious-disease doctor who co-authored the case study about the woman’s condition.”

Breastfeeding and dopamine volatility

It’s really fascinating, did you know that breastfeeding can cause dopamine crashes?

Not everyone who drinks coffee gets a coffee crash, but if you do, you know what I’m talking about. A cup of strong coffee makes more dopamine suddenly more available. Then for the next few hours you are rewarded more by your brain for anything that you do, so you feel more confident and successful at your tasks, you feel better about doing them. Then dopamine reabsorption blocking decreases, and less dopamine becomes available. A coffee crash is exactly that – for those who are sensitive to this decrease in available dopamine, you suddenly feel a “realization” that in fact what you are doing is pointless, and all we are is dust in the wind.

Well, turns out that breastfeeding triggers a similar mechanism – when prolactin increases, less dopamine becomes available.

Breastfeeding and dopamine article

Health habits – some interesting myths

There are some advice that we hear many times from multiple people, but some common beliefs about health habits are not actually true. Fat was thought to be a cause of obesity, but that is contradictory to the more recent findings that low carb high fat diets can promote weight loss. Low fat products turned out to be high in carbs, and actually less healthy. Unsaturated fats such as olive oil and avocado are now promoted as health foods, and salmon, which contains high levels of fat, is considered to be very nutritious and beneficial for brain health. What are then some of the other myths about health habits?

Hot cocoa before bed can help you sleep – actually the National Sleep Foundation recommends avoiding dark chocolate/cocoa/cacao in the evening. Dark chocolate contains caffeine, therefore a cup of hot cocoa would not be caffeine free. The USDA National Nutrient Database indicates that a cup would contain 7.44 mg caffeine. That’s not a lot, but chocolate also contains theobromine, which increases hearth rate and can cause sleeplessness. Theobromine is an alkaloid, it is found in the cacao plant, the tea plant, and the kola nut. All of these plants are known stimulants. Therefore the combination of caffeine and theobromine for a lot of people would create a state of alertness, and therefore it will not help you sleep. Interesting fact – caffeine is partly metabolized into theobromine in humans. Theobromine is also an antagonist of adenosine receptors, just as caffeine, but weaker. Wakefulness is promoted when adenosine receptors are blocked in the brain.

Coffee increases anxiety – I don’t think there is a yes or no answer to this question, that’s why this statement is not correct. It seems that it varies for people. For some it seems that it does increase cortisol and therefore can contribute to feelings of anxiety and fear. For others it may actually be helpful. Some studies indicate that coffee is beneficial for people with OCD and helped to reduce intrusive thoughts and compulsive behaviours.
The roles of arousal and inhibition in the resistance of compulsive cleansing in individuals with high contamination fears

We are better off taking a multivitamin every day – no, we don’t actually know that. Maybe, maybe it makes no difference, maybe worse off. Obtaining vitamins and minerals from food, plus from a multivitamin, may lead to overconsumption. And more, as we know, is definitely not always better. Over consumption of folate may increase the risk of some cancers, overconsumption of iodine may lead to thyroid disorders, too much vitamin A can be harmful, and iron build up in the brain may be associated with declines in thinking and memory.
Folate consumption
Iron and the brain

Mood supplements that are sold over the counter are safer than antidepressants – they are really not. For example, 5-HTP supplement is sold in most pharmacies in Canada and in health stores, that doesn’t make it safer than Prozac. From Wiki: 5-Hydroxytryptophan is a naturally occurring amino acid and chemical precursor as well as a metabolic intermediate in the biosynthesis of the neurotransmitter serotonin. So if you consume it, will it just raise your serotonin and make you happier? Not necessarily. If someone is unaware that they are bipolar, taking supplements such as SAMe, 5-HTP, or St. John’s Word could make them manic. These supplements are not mood stabilizers. And since it can affect serotonin levels, it is not without side effects, just as antidepressants are not. Some people experience increased suicidal thoughts when taking medications or supplements that increase serotonin. You can also read user reviews of 5-HTP to see for yourself that it is not completely safe. Some users state experiencing elevated heart rate, vivid nightmares, suicidal thoughts, and insomnia. Be careful with any supplement that you try, observe any changes that happen, read about possible side-effects and contraindications.
https://www.drugs.com/comments/5-hydroxytryptophan/

Red meat and dairy are bad for you – I heard this often, but it’s not what actually recent studies show. I’m sure in some high amounts, daily consumption of red meat and dairy would lead to too much saturated fat, but that does not mean that the optimal amount is zero. A recent article in Nature states that the longest life expectancy in Japan may be related to the balanced diet consisting of a typical Japanese diet food products, as well as Western diet items such as meat and dairy. “The decreasing mortality rates from cerebrovascular disease are thought to reflect the increases in animal foods, milk, and dairy products and consequently in saturated fatty acids and calcium, together with a decrease in salt intake which may have led to a decrease in blood pressure… The typical Japanese diet as characterized by plant food and fish as well as modest Westernized diet such as meat, milk and dairy products might be associated with longevity in Japan.
https://www.nature.com/articles/s41430-020-0677-5

There are also inconclusive results in regards to red meat consumption and mental health. A systematic review of meat abstention and depression, 2020, indicated that “the most rigorous studies demonstrated that the prevalence or risk of depression and/or anxiety were significantly greater in participants who avoided meat consumption.” On the other hand, a cross-sectional study published in 2021 concluded that “after controlling for potential confounders, women in the highest quartile of red meat had a highest prevalence of depressive symptoms.”
https://www.tandfonline.com/doi/full/10.1080/10408398.2020.1741505
https://www.sciencedirect.com/science/article/pii/S0965229920318550

Inflammation and Schizophrenia – a short lecture

Came across this short lecture on schizophrenia and the inflammation hypothesis. The author mentions three hypothesis for the causes of schizophrenia – elevated dopamine, glutamate receptor abnormalities, and inflammation. He also mentions the fact that autoimmune diseases can present with psychosis – lupus, Hashimoto’s encephalopathy, celiac disease, etc. It’s great to hear a professional acknowledging this fact, as not all doctors look into the link between psychiatric symptoms and autoimmune diseases.

Important notes from the lecture – some inflammation can be determined in a straightforward way by checking the C-reactive protein levels. Elevated levels of this substance increase the risk of schizophrenia onset. C-reactive protein levels are used to check for infection or chronic inflammatory disease, they also lead to increased risk of heart disease. It can be elevated due to a variety of diseases, such as obstructive sleep apnea, some viral infections, lupus, and rheumatoid arthritis.
In one study lumbar puncture was performed on a sample of patients with schizophrenia. 54% of the patients had self-directed antibodies in the cerebrospinal fluid (another piece of evidence to support the immune system disturbance hypothesis). What could the antibodies be targeting? Possibly neuronal proteins or neuronal receptor proteins.

Inflammation and Schizophrenia video lecture

Reddit Depression Regimens cont’d

Previous posts on the topic of scraping reddit data from the depressionregiments subreddit:

Reddit Depression Regimens – Topic Modeling

Reddit Depression Regimens – Topic Modeling cont’d

Next we will create some plots with javascript. For example, it would be interesting to see how often specific psychotropic medications and supplements are mentioned in the text data.
Below is a chart with frequencies of the most common antidepressant medications. The counts were performed by combining the frequencies of the brand name and the chemical name (for example Wellbutrin count is wellbutrin (54) + bupropion (27) = 81).

The data was generated using python and exported as a .csv file, with columns ‘term’ and ‘freq’.

HTML part:

<html>
<head>
  <script src="https://cdn.plot.ly/plotly-2.0.0.min.js"></script>
  <script src="https://d3js.org/d3.v5.min.js"></script>
  <script src="https://cdn.jsdelivr.net/npm/chart.js@2.9.3"></script>
  <script type="text/javascript" src="script1.js"></script>
</head>
<body onload="draw()">
chart 1
<div id="jsdiv" style="border:solid 1px red"></div>
chart 2
<canvas id="chart"></canvas>
</body>

JS part:

function makeChart(meds) {
  // meds is an array of objects where each object is something like

  var hist_labels = meds.map(function(d) {
    return d.term;
  });
  var hist_counts = meds.map(function(d) {
    return +d.freq;
  });

  arrayOfObj = hist_labels.map(function(d, i) {
      return {
        label: d,
        data: hist_counts[i] || 0
      };
    });
  sortedArrayOfObj = arrayOfObj.sort(function(a, b) {
      return b.data - a.data;
    });

   newArrayLabel = [];
   newArrayData = [];
   sortedArrayOfObj.forEach(function(d){
      newArrayLabel.push(d.label);
      newArrayData.push(d.data);
    });


  var chart = new Chart('chart', {
    type: "horizontalBar",
    options: {
      maintainAspectRatio: false,
      legend: {
        display: false
      }
    },
    data: {
      labels: newArrayLabel,
      datasets: [
        {
          data: newArrayData,
          backgroundColor: "#33AEEF"
        }]
    },
    options: {
      scales: {
        yAxes: [{
          scaleLabel: {
            display: true,
            labelString: 'med name'
          }
        }],
        xAxes: [{
            scaleLabel: {
                display: true,
                labelString: 'freq'
            }
        }],
      },
      legend: {
          display: false
      },
      title: {
          display: true,
          text: 'Frequencies of common antidepressants'
        }
    }    
  });
}

// Request data using D3
d3
  .csv("med_list_counts_df.csv")
  .then(makeChart);

We can generate charts with other medication/supplement lists using the same code. Below is a plot with frequencies of common antipsychotics. As you can see, antipsychotics are not mentioned that frequently as antidepressants, and a lot of names in the input list were not mentioned at all (such as haldol or thorazine), and therefore they do not show up in the chart.

Other medications and common supplements mentioned:

Reddit Depression Regimens – Topic Modeling cont’d

In the previous posts we applied LDA topic modeling to text documents from data collected from the subreddit depressionregimens. Here I will continue with the results from the derived topics model – obtaining the most representative text for each topic. As was stated, the chosen model has ten topics, and LDA assumes that each document is composed of multiple topics, with each topic being assigned a probability. Each topic is composed of multiple words, with each word assigned a probability.

Previous post: Reddit Depression Regiments – Topic Modeling

Since each document is composed of multiple topics, for each topic we can find a document with the highest probability for that topic, therefore that will be our most representative document.

Topic 1

(‘feel’, 0.040), (‘year’, 0.026), (‘thing’, 0.022), (‘symptom’, 0.020), (‘brain’, 0.019), (‘start’, 0.018), (‘time’, 0.017), (‘make’, 0.015), (‘issue’, 0.015), (‘lot’, 0.014)

Most representative post id with topic 1 probability of 0.45:
Full text here: https://www.reddit.com/r/depressionregimens/comments/gib17h

“Blank Mind Syndrome” – Sub group of specific symptoms including: – Loss of Internal Monologue, lack of coherent automatic thoughts, no track of time passage, lack of self insight – Depersonalisation/Derealization Feeling detached, having no “sense of self”, missing mental features, having no emotional autobiography, feeling as if every day is the same, loss of relationship or emotional attachments, feeling detached from external reality – Cognitive Decline, Loss of Visual imagination, inability to think in a deep or complex way, inability to hold information, loss of past learned skills and knowledge. – Complete Lack of goal-directed motivation, having no automatic self direction, no long term goals – Anhedonia – inability to enjoy or derive pleasure, nothing to look forward to, no bodily joy, satasfaction and so on – Lack of atmosphere/deepness of the outside reality, inability to appreciate beauty, things look flat and insignificant. All symptoms in various severity of course, It’s time to talk, what is this condition exactly, Did you suffer from depression your entire life? Is this episodic? how are you planning to solve it? how did you acquire it? had any professional been aware of it? Is it medication induced? Is there any outside outlet acknowledging this specific phenomena? How much time do you suffer from it? What were you diagnosed with? Was it sudden or progressively? Had anything helped at all? Would you join a group for people suffering the same condition? Is anyone interested in doing so? Please do respond!

Topic 2

people 0.044, depression 0.037, doctor 0.028, psychiatrist 0.020, make 0.020, bad 0.016, therapy 0.016, therapist 0.015, find 0.014, problem 0.013

Most representative post for this topic, with probability for topic 2 of 0.53: https://www.reddit.com/r/depressionregimens/comments/iij4tr

I talked to him today, he says all my problems are my choice and I choose to be lazy, suicidal, depressed etc. Is he right?,Dude… if he believes this then he must also believe that his career is total quackery. Get a new psychiatrist immediately. What a piece of shit.,absolutely not, please get a new psychiatrist!! you don’t choose to be suicidal or depressed, and in my experience, depression causes laziness more often than not. it’s worrisome that a professional outright said this to you and honestly I would report him if you can. that’s such a harmful thing to say to anyone suffering from such issues and to say it to the wrong person could be really catastrophic. i’m sorry he’s a dick to you, don’t listen to his bullshit. if it was so easy as to choose not to be depressed then nobody would fucking be depressed. it’s like he thinks people enjoy feeling this way ugh,OMG please please PLEASE never go back there. I once had a psychiatrist tell me I was gonna end up on a street corner with a sign (spoiler alert: I have a career and own a house). I got up and left and never looked back. Remember that YOU are a huge part of your mental health journey. It’s a collaborative effort between you, your psychiatrist, therapist (if you have one), and any other professional you choose to involve. You always have a say, and if something doesn’t seem right, you don’t have to go along with it. Your feelings are ALWAYS valid—don’t ever let anyone tell you differently. You are not alone in this. So many of us are depressed, anxious, suicidal, attention deficit, bipolar, lazy…these are NOT choices. Who would choose to be this way? There are plenty of helpful professionals out there, just make sure you screen them carefully. I believe in you and wish you well!!! …

Topic 3

day 0.037, thing 0.035, feel 0.033, make 0.024, find 0.017, good 0.016, exercise 0.016, eat 0.013, walk 0.013, lot 0.013

https://www.reddit.com/r/depressionregimens/comments/dztdw9

Topic probability: 0.53

Wanted to share something that I’ve recently found to help when I’m struggling to find motivation to complete basic chores. This one specifically deals with laundry, but it can apply to other tasks as well. If you’re like me, you can have laundry sitting there for weeks not being put away. The mountain of clothing is so overwhelming that I just ignore it all together. I’m also an all-or-nothing person; I just wait and wait until a good day when I’ll have enough energy to get it done. Those days are exceedingly rare, so that mountain of clothes will sit there for a loooong time, stressing me out and depressing me even more. I’m trying to switch my mindset to not feeling like I need to take on such giant tasks all at once. I decided to break up the tasks into smaller ones. For the mixed load of laundry that needed to be put away, I told myself I only need to put away the socks and underwear today. Then tomorrow I put away the shirts. The next day, fold pants, and the next everything else that goes on hangers. These smaller tasks only take like 5-10 minutes each, and it’s satisfying to see the pile of clothes dwindle every day versus sit there ominously for several weeks. If you’re feeling overwhelmed, break up your tasks into very small, easily attainable goals. Go easy on yourself and do what you can for the day. Even just the tiniest amount of progress is a good thing.,great advice. ​ Anytime you get anxiety over a task or a situation seems to complex or overwhelming. Just break in down into manageable pieces. Doing SOMETHING is always better than nothing even if it seems like too little or not enough or w/e.,I saw a meme about ‘anything worth doing is worth doing badly’ that addresses this. I try and remember that some days. Us perfectionists want to always do 100%. But in a lot of things (not everything, obviously, just as a general rule) doing 50% of the job, or 90% of the job, is way better then the 0% of the job we do because of that crippling dedication to doing 100%. Not an excuse for doing bad jobs on the stuff that really matters, but can be a much healthier way to approach doing general day-to-day stuff…

Topic 4

ssris 0.027, antidepressant 0.024, effect 0.024, drug 0.022, side_effect 0.020, depression 0.019, serotonin 0.016, prescribe 0.014, treat 0.013, ssri 0.012

Reddit post: https://www.reddit.com/r/depressionregimens/comments/bheg7d

Topic probability: 0.64

Hey y’all, this is a repost of the stickied post made by /u/jugglerofworlds, who appears to have deleted their account and their post along with it. I’ve edited it a little and will continue to keep it updated as needed. Suggestions are welcome. As the former post was, I’m trying to keep this confined to prescription medications, and not natural/herbal remedies (though I recognize that they definitely can be helpful means of treatment). I’m also typically avoiding medications that have been withdrawn from the market and thus aren’t really prescribed. In a future revision of this post I hope to add an additional column featuring which medications are available where, as some of these are approved in European countries but not in the U.S., and vice versa. # Icon key * ✔️ = approved to treat condition by a regulatory agency (FDA, EMA, ANSM, etc) * ➕ = approved as an adjunct treatment by a regulatory agency, to be used in combination with other medications to treat a condition (may or may not be used off-label as a monotherapy) * 🏷️ = Off label use; widely prescribed for condition but not necessarily rigorously studied for it * ⚠️ = experimental medication; in FDA Phase III trials or pending approval # Selective Serotonin Reuptake Inhibitors (SSRIs) |Generic name|Brand name(s)|Treats depression|Treats anxiety| |:-|:-|:-|:-| |citalopram|Celexa|✔️|🏷️| |escitalopram|Lexapro|✔️|✔️| |fluoxetine|Prozac|✔️|✔️| |fluvoxamine|Luvox/Luvox CR|✔️|✔️| |paroxetine|Paxil/Paxil CR|✔️|✔️| |sertraline|Zoloft|✔️|✔️| # Serotonin Modulator and Stimulators (SMS) |Generic name|Brand name(s)|Treats depression|Treats anxiety| |:-|:-|:-|:-| |vortioxetine|Trintellix|✔️|🏷️| |vilazodone|Viibryd|✔️|🏷️| # Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) |Generic name|Brand name(s)|Treats depression|Treats anxiety| |:-|:-|:-|:-| |venlafaxine|Effexor/Effexor XR|✔️|✔️| |desvenlafaxine|Pristiq|✔️|🏷️| |duloxetine|Cymbalta|✔️|✔️| |milnacipran|Savella|✔️|✔️| |levomilnacipran|Fetzima|✔️|🏷️| |atomoxetine|Strattera|⚠️|⚠️| # Tricyclics (TCAs) ## TCAs with a preference for serotonin |Generic name|Brand name(s)|Treats depression|Treats anxiety|…

Topic 5

treatment 0.035, ketamine 0.028, year 0.022, work 0.021, drug 0.017, hope 0.015, hear 0.012, lithium 0.011, people 0.010, infusion 0.009

Reddit post: https://www.reddit.com/r/depressionregimens/comments/axtnj8

Topic probability: 0.58

https://www.washingtonpost.com/health/2019/03/06/biggest-advance-depression-years-fda-approves-novel-treatment-hardest-cases ​ The Food and Drug Administration approved a novel antidepressant late Tuesday for people with depression that does not respond to other treatments — the first in decades to work in a completely new way in the brain. The drug, a nasal spray called esketamine, has been eagerly anticipated by psychiatrists and patient groups as a powerful new tool to fight intractable depression. The spray acts within hours, rather than weeks or months as is typical for current antidepressants, and could offer a lifeline to about 5 million people in the United States with major depressive disorder who haven’t been helped by current treatments. That accounts for about one in three people with depression. “This is undeniably a major advance,” said Jeffrey Lieberman, a Columbia University psychiatrist. But he cautioned much is still unknown about the drug, particularly regarding its long-term use. “Doctors will have to be very judicious and feel their way along,” he said. The label for the drug will carry a black box warning – the most serious safety warning issued by the FDA. It will caution users they could experience sedation and problems with attention, judgment and thinking, and that there’s potential for abuse and suicidal thoughts. People who take esketamine will have to be monitored for at least two hours after receiving a dose to guard against some of these side effects…

Topic 6

work 0.053, anxiety 0.030, mg 0.025, bad 0.020, high 0.020, vitamin 0.018, diet 0.015, supplement 0.014, post 0.012, literally 0.011

Reddit post: https://www.reddit.com/r/depressionregimens/comments/alh4r3

Topic probability: 0.52

About 3 or 4 years ago, I developed a severe form of anxiety disorder where it manifested in panic attacks characterized by intense bouts of nausea, gagging, and retching. It didn’t usually get bad enough to get to vomiting, though it did in a few instances (in which I went to the hospital afterwards). My body responds to stress naturally by gagging and nausea. So imagine being anxious all the time but also NAUSEOUS 24/7, and I mean literally 24/7 without any respite. At times I was seriously considering suicide because of how bad I felt all the time every day. The whole thing started I think because I had to present at a large conference with thousands of people in attendance, and I had a very bad experience being insulted by some people at a previous iteration of this conference years ago. I was commuting to work one day (before the conference) and suddenly got this massive bout of nausea where I felt like I was dying. I realized however that this was my body telling me I have stagefright. I expected my nausea to evaporate once I finished speaking, as it usually would have in the past. Except that it didn’t. It stayed, and remained with me for years. I tried everything but avoided antidepressants for the longest time due to the bad rep they get. I tried the following medications: * Ginger – in various forms – for nausea (didn’t work) * Peppermint – in various forms – for nausea (didn’t work) * Ondansetron (zofran) – 4 mg; as needed – for nausea (didn’t work) * Chlordiazepoxide/clidinium bromide (librax) – 5 mg; once daily – for nausea and anxiety (didn’t work) * Pyridoxine/doxylamine (diclectin) – 10 mg pyridoxine, 10 mg doxylamine; 2 tablets at bedtime – for nausea (didn’t work) * Metoclopramide – 1 tablet daily – for nausea (didn’t work) * Domperidone – 10 mg; once daily – for nausea (didn’t work) * Propranolol – 10 mg; twice daily – for anxiety (didn’t work) * Prochlorazapine – 10 mg; twice daily – for nausea (didn’t work) * Lorazepam (Ativan) – 1 mg; 1 tablet at bedtime – for anxiety (didn’t work; just made me really sleepy) * Pantoprazole (Tecta) – 1 tablet daily – for nausea (didn’t work) * Dimenhydrinate (Gravol) – 1 tablet as needed – for nausea (didn’t work) * Nabilone (cesamet) – 0.5 mg as needed – for nausea (worked for nausea but not anxiety, and gave me a really uncomfortable high) * Clomipramine (Anafranil) – 10 mg. once daily – for anxiety (didn’t try properly due to side-effects) I was afraid even of getting out of my own house. I was afraid of meeting people. I was afraid of leaving my own room – the only place where I felt somewhat at ease and the nausea wasn’t THAT bad. The only thing that worked somewhat to relieve the nausea was chewing on things, whether that meant food at mealtimes, or fennel seeds, or sucking on mints/cough drops. So I carried mints and fennel seeds with me at all times no matter where I was – including in the washroom in my own house and even when I wanted to take a shower I had to have them nearby otherwise I would literally throw up in the shower. But these were not long-term cures to my problem and only a short alleviation of the symptoms (and not that effective if I was more anxious than usual). I somehow graduated from university with a degree in neuroscience and fought through this nausea-anxiety for 2 years doing so. My graduation ceremony – which was supposed to be a happy occasion – was marred by constant nausea and me going through at least 3 entire tins of mints because my body handles excitedness the same way as it does for anxiety. Literally nothing was working and I was at my wit’s end. So I went downtown Toronto and bought CBD oil from a dispensary. I only did this because I was literally desperate, even though I had never done any recreational drugs in my life upto that point (except caffeine), and even though I had a horrible experience with nabilone (synthetic THC for cancer patients to reduce their nausea) so I was really kind of anxious about even using that. But it worked…

Reddit Depression Regimens – Topic Modeling

Text data (top posts and top comments for those posts) was downloaded from the subreddit depression regimens (https://www.reddit.com/r/depressionregimens/). Data was grouped by post id, in total there were 101 such ids, therefore 101 text documents. After collecting the data, the following data cleaning steps were performed:

  • any emails were removed from text
  • urls were removed (http and www)
  • common contractions were expanded (‘ain’t >> ‘is not’; ‘bday’ >> ‘birthday’; ‘don’t’ >> ‘do not’; etc.)
  • new line characters were removed
  • single quotes were removed

After the data cleaning steps were complete, sentences were tokenized into words, and punctuation was removed. English stop words were removed from documents. Python’s gensim.models.phrases.Phraser() was used in order to detect common phrases (bigrams). Lemmatization was then performed and part of speech tagging (POS). Only lemmatized words with certain POS tags were kept, including nouns, adjectives, verbs, adverbs, and proper nouns. Proper nouns were kept in case medication or supplement names get tagged as such. We are interested in how reddit users describe their experiences with certain psychotropic medications and supplements, and therefore the chosen POS tags are the ones that are relevant for descriptions.

An example of an original post is presented below. As a human, we can decipher that the post below is about ketamine and that the user had a positive experience with this treatment. We would be interested in the verbs, adverbs, adjectives, and nouns, that the author used to describe their experience.


I wanted to post this to give hope to those who need a little extra. I know how excruciating both having and battling treatment options for depression and anxiety can be. I’ve seen what I thought was rock bottom. I’ve been to my actual rock bottom, but I am free now.

One year ago, I was sitting in the recliner at my local ketamine clinic receiving my first infusion. The day before I had outlined my plan for suicide and had all my affairs in order, but a friend I had confided in about my depression had a “feeling” I was in a very dangerous place inside my head. I don’t know how she knew what I was planning, but thank goodness she had the foresight and the strength to push me to try one. more. thing. I had heard (and shared) quite a few podcasts from people who had been through treatment, administered the treatments, and even those who had been doing the research behind it all. had been chatting about ketamine as a potential treatment since nothing else had ever worked. She researched clinics, called them all to pick the best one, and made the appointment on an urgent basis getting me in that day.

She took me to the doctor, and after a while, I told him about my plan. I told him that I would give this a try, but this was my last try. After 25 years of my brain being a lab rat for every pill imaginable, years and years of therapy and everything else you can imagine, I was just so tired. He was sympathetic, caring and sat with me for quite a while. Then he started that first IV.

I won’t bore you with all the details of treatment (feel free to ask), but I can say that after the first treatment – one year ago today – I didn’t want to die anymore. I haven’t wanted to since. From time to time, the depression will creep in a little too much for comfort, but I have a lot of self-care tricks to help me get through it. And if It comes down to it, I go in for a booster treatment.
In the past year, I have had 11 infusions. The last 3 were to help me get off the last, and most difficult antidepressant that I ever took. Now, I’m on a very low dose of Lexapro, which I honestly doubt I even need. But I’m stable. I actually know what happiness feels like. And most importantly, I’m alive.
Thanks for reading.

After we perform the steps described above – data cleaning, removing stop words, lemmatization, and keeping only terms with specific POS tags, extract common bigrams, the post above results in the following:

want post give hope need little extra know excruciating battle treatment option depression anxiety see think rock bottom actual rock bottom free year ago sit recliner local ketamine clinic receive first infusion day outline plan suicide affair order friend confide depression feel dangerous place head know know plan thank goodness foresight strength push try thing hear share quite podcast people treatment administered treatment even research chat ketamine potential treatment else ever work research clinic call pick good make appointment urgent basis get day take doctor tell plan tell would give try last try year brain lab rat pill imaginable year year therapy else imagine tired sympathetic caring sit quite start first bear detail treatment feel free ask say first treatment year ago today want die anymore want time time depression creep little much comfort lot self_care trick help come go booster treatment year infusion last help last difficult antidepressant ever take low_dose lexapro honestly doubt even need stable actually know happiness feel importantly alive thank read

In regards to topic modeling, we are interested in the general topics that are discussed in this particular subreddit, Latent Dirichlet Allocation (LDA) can be used specifically for this sort of task. LDA is an unsupervised method for finding topics in text data. Our text is composed of documents, in this case each document is a combination of a post and top comments for a specific post id. LDA assumes that each document is composed of different topics and each topic is composed of different words. Therefore documents can contain overlapping topics and topics can contain overlapping words, but the probabilities for those topics and words will be different.

Since the problem is unsupervised, there are no labels, just text, and we don’t know how many topics there are in our subreddit. There is no exact formula to determine the optimal number of topics for the LDA model. One common way, that we will implement here, is to loop through different number of topics and calculate coherence scores. Then we should choose the model with the highest coherence score. In this specific case, I implemented models for 2, 4, 8, …, 14 topics, and plotted the corresponding coherence scores. As we can see from the chart, the highest value occurs when the number of topics is four, also we see peaks at 10 and 12 topics.

Now let’s see what the topics are.

Number of topics = 4

Topic 1 wordsWord probTopic 2 wordsWord probTopic 3 wordsWord probTopic 4 wordsWord prob
feel0.037day0.042depression0.017depression0.019
thing0.026work0.024effect0.014people0.017
depression0.022feel0.020antidepressant0.013year0.016
make0.021time0.020ssris0.012give0.016
life0.019sleep0.018doctor0.012treatment0.015
time0.013good0.014anxiety0.010month0.013
bad0.013thing0.012side_effect0.010start0.013
good0.012start0.010mg0.010find0.012
lot0.010bed0.009drug0.009hope0.012
depressed0.010exercise0.009psychiatrist0.009ketamine0.011

If we choose 10 topics:

Topic 1 wordsWord probTopic 2 wordsWord probTopic 3 wordsWord probTopic 4 wordsWord probTopic 5 wordsWord prob
feel0.039people0.044day0.037ssris0.027treatment0.035
year0.026depression0.037thing0.035antidepressant0.024ketamine0.028
thing0.022doctor0.028feel0.033effect0.024year0.022
symptom0.020psychiatrist0.020make0.024drug0.022work0.021
brain0.019make0.020find0.017side_effect0.020drug0.017
start0.018bad0.016good0.016depression0.019hope0.015
time0.017therapy0.016exercise0.016serotonin0.016hear0.012
make0.015therapist0.015eat0.013prescribe0.014lithium0.011
issue0.015find0.014walk0.013treat0.013people0.010
lot0.014problem0.013lot0.013ssri0.012infusion0.009
Topic 6 wordsWord probTopic 7 wordsWord probTopic 8 wordsWord probTopic 9 wordsWord probTopic 10 wordsWord prob
work0.053time0.033sleep0.053experience0.039life0.062
anxiety0.030make0.028day0.037day0.030feel0.030
mg0.025depression0.015time0.030feel0.029depression0.029
bad0.020long0.015bed0.024depression0.024thing0.020
high0.020call0.014start0.024mind0.020find0.019
vitamin0.018depressed0.014feel0.023give0.017good0.017
diet0.015feeling0.013morning0.020month0.017live0.017
supplement0.014people0.013wake0.018good0.015bad0.014
post0.012read0.013night0.014week0.013change0.014
literally0.011focus0.013hour0.013back0.012year0.013

I think that even with this small sample size – 101 top posts and corresponding top comments, LDA results provide us with a good understanding of what users discuss in the depressionregimens subreddit. There are discussions about life, feeling depressed, for how long the depression has been going on (mentions of week/month/year), mentions of how the day goes (Topic 7), mentions of specific treatments (Topic 4), supplements (Topic 5), SSRIs and side effects (Topic 3), exercise (Topic 2).

It’s possible to then apply the chosen model to each document in order to obtain the topics distribution by document. For example, we can choose the model with 10 topics, obtain topics distribution by document, and determine the topic with the maximum probability for each document. Then we can select sample documents that have the highest probability for a given topic. If we choose topic 2, which contains the following word distribution:

(‘people’, 0.04), (‘depression’, 0.038), (‘doctor’, 0.028), (‘psychiatrist’, 0.020),
(‘make’, 0.020), (‘bad’, 0.016), (‘therapy’, 0.016), (‘therapist’, 0.015), (‘find’, 0.014),
(‘problem’, 0.013)

We can find documents that have the maximum probability for topic 2:


“This might be an unconventional treatment considering that many of us post about their experience with various drugs.
I myself struggled with mental health in the past. I can say my mental health issues in the past were to 90% biological (hormonal problems). Once I treated the causes, over time the upwards spiral in my personal wellbeing (and life in general) started again.
In early twenties, my life was starting to go down the gutter. My life started to fall apart in every domain. I was severely depressed. I found out that some of my hormones were very low. I started hormone replacement. Whereas before my life was a nightmare, it has been great ever since. I could even get off the SSRIs I was on.
I wrote an article about my journey. How Hormones Destroyed and Saved My Life.
My dream is to live in a world where no one is held back from living an at least decent life the way I was. Even though not my fault, it is my life. And thus my responsibility. Without accepting and acting on that I just don´t know where I would be today. For sure I wouldn´t be writing this. Hope you find value in it… “

(Can read full text at https://www.reddit.com/r/depressionregimens/comments/lef32x )

The topics distribution for this document is as follows:
[1: 0.074, 2: 0.338, 3: 0.032, 4: 0.069, 5: 0.083, 6: 0.084, 7: 0.052, 8: 0.054, 9: 0.073, 10: 0.153]

Lemmatized text:

[‘may’, ‘unconventional’, ‘treatment’, ‘consider’, ‘many’, ‘us’, ‘post’, ‘experience’, ‘various’, ‘drug’, ‘struggle’, [‘may’, ‘unconventional’, ‘treatment’, ‘consider’, ‘many’, ‘us’, ‘post’, ‘experience’, ‘various’, ‘drug’, ‘struggle’, ‘mental_health’, ‘say’, ‘mental_health’, ‘issue’, ‘biological’, ‘hormonal’, ‘problem‘, ‘treat’, ’cause’, ‘time’, ‘upwards’, ‘spiral’, ‘personal’, ‘wellbeing’, ‘life’, ‘general’, ‘start’, ‘early’, ‘twenty’, ‘life’, ‘start’, ‘go’, ‘gutter’, ‘life’, ‘start’, ‘fall’, ‘apart’, ‘domain’, ‘severely_depresse’, ‘find‘, ‘hormone’, ‘low’, ‘start’, ‘hormone’, ‘replacement’, ‘life’, ‘nightmare’, ‘great’, ‘ever’, ‘since’, ‘could’, ‘even’, ‘ssris’, ‘write’, ‘article’, ‘journey’, ‘hormone’, ‘destroy’, ‘save’, ‘life’, ‘dream’, ‘live’, ‘world’, ‘hold’, ‘back’, ‘live’, ‘least’, ‘decent’, ‘life’, ‘way’, ‘even’, ‘fault’, ‘life’, ‘thus’, ‘responsibility’, ‘accept’, ‘act’, ‘know’, ‘would’, ‘today’, ‘sure’, ‘write’, ‘hope’, ‘find‘, ‘value’, ‘opinion’, ‘replace’, ‘hormone’, ‘deficient’, ‘far’, ‘natural’, ‘also’, ‘effective’, ‘artificial’, ‘med’, ‘however’, ‘believe’, ‘hormone’, ‘deficiency’, ‘may’, ‘much’, ‘common’, ‘assume’, ‘people‘, ‘never’, ‘get’, ‘hormone’, ‘check’, ‘often’, ‘even’, ‘life’, ‘want’, ‘give’, ‘head’, ‘other’, ‘pull’, ‘trigger’, ‘medication’, ‘claim’, ‘medication’, ‘work’, ‘hormone’, ‘check’, ‘opportunity’, ‘cost’, ‘high’, ‘similar’, ‘experience’, ‘hormone’, ‘hormone’, ‘dangerous’, ‘play’, ‘make‘, ‘sure’, ‘talk’, ‘doctor‘, ‘monitor’, ‘doctor‘, ‘lock’, ‘post’, ‘people‘, ‘would’, ‘see’, ‘unlocked’, ‘pm’, ‘otherwise’, ‘leave’, ‘lock’, ‘play’, ‘hormone’, ‘medical’, ‘supervision’, ‘highly’, ‘detrimental’, ‘health’, ‘thyroid’, ‘hormone’, ‘deficient’, ‘know’, ‘other’, ‘start’, ‘take’, ‘mcg’, ‘thyroxine’, ‘treat’, ‘hypothyroidism’, ‘run’, ‘family’, ‘fog’, ‘seem’, ‘lift’, ‘agree’, ‘hormone’, ‘underrated’, ‘come’, ‘depression‘, ‘thank’, ‘share’, ‘hormone’, ‘specifically’, ‘testosterone’, ‘direct’, ‘correlation’, ‘dopamine’, ‘high’, ‘test’, ‘high’, ‘dopamine’, ‘vice’, ‘versa’, ‘generally’, ‘testerone’, ‘wellbutrin’, ‘increase’, ‘libido’, ‘endocrine’, ‘system’, ‘research’, ‘seem’, ‘lag’, ‘research’, ‘treatment’, ‘know’, ‘million’, ‘could’, ‘suffer’, ‘needlessly’, ‘ignore’, ‘op’, ‘entire’, ‘post’, ‘structure’, ‘sway’, ‘people‘, ‘way’, ‘link’, ‘closing’, ‘paragraph’, ‘also’, ‘spamme’, ‘numerous’, ‘time’, ‘different’, ‘thing’, ’cause’, ‘depression‘, ‘know’, ‘enough’, ‘dark’, ‘age’, ‘exclusive’, ‘seratonin’, ‘hormone’, ‘receptor’, ‘regulation’, ‘drug’, ‘abuse’, ‘dopamine’, ‘ach’, ‘brain’, ‘damage’, ‘gaba’, ‘glutamate’, ‘imbalance’, ‘relate’, ‘several’, ‘brain’, ‘region’, ‘receptor’, ‘site’, ‘together’, ‘hormone’, ‘conversion’, ‘chain’, ‘adhd’, ‘bp’, ‘level’, ‘bdnf’, ‘several’, ‘type’, ‘disease’, ‘additionally’, ‘low’, ‘end’, ‘hormone’, ‘scale’, ‘total’, ‘free’, ‘may’, ‘feel’, ‘symptom’, ‘other’, ‘would’, ‘conversely’, ‘man’, ‘may’, ‘almost’, ‘nil’, ‘estrogen’, ‘high’, ‘estrogen’, ‘side_effect’, ‘decent’, ‘doctor‘, ‘full’, ‘blood’, ‘panel’, ‘hormone’, ‘panel’, ‘include’, ‘ask’, ‘depend’, ‘free’, ‘go’, ‘private’, ‘cost’, ‘uk’, ‘take’, ‘important’, ‘relative’, ‘commit’, ‘find‘, ‘thyroid’, ‘level’, ‘way’, ‘back’, ‘thyroid’, ‘problem‘, ‘handle’, ‘psych’, ‘med’, ‘need’, ‘depression‘, ‘probably’, ‘lifelong’, ‘become’, ‘unmanageable’, ‘thyroid’, ‘cancer’, ‘luckily’, ‘old’, ‘easy’, ‘catch’, ‘get’, ‘point’, ‘hormone’, ‘low’, ‘find‘, ‘hormone’, ‘check’, ‘yearly’, ‘perfectly’, ‘normal’, ‘even’, ‘high’, ‘yet’, ‘still’, ‘depressed’, ‘hormone’, ‘may’, ‘help’, ‘people‘, ‘many’, ‘still’, ‘depress’, ‘physiological’, ‘duck’, ‘row’, ‘infuriate’, ‘many’, ‘doctor‘, ‘refuse’, ‘prescribe’, ‘hrt’, ‘guess’, ‘taboo’, ‘medical’, ‘school’, ‘pull’, ‘tooth’, ‘find‘, ‘decent’, ‘doctor‘, ‘even’, ‘consider’, ‘apparently’, ‘fear’, ‘cancer’, ‘induce’, ‘hormone’, ‘frankly’, ‘rather’, ‘live’, ‘good’, ‘life’, ‘even’, ‘mean’, ‘get’, ‘cancer’, ‘live’, ‘cancer’, ‘free’, ‘life’, ‘mentally’, ‘miserable’, ‘post’, ‘multiple’, ‘account’, ‘whole’, ‘time’, ‘person’, ‘post’, ‘often’, ‘article’, ‘different’, ‘account’, ‘sometimes’, ‘claim’, ‘last’, ‘year’, ‘biology’, ‘student’, ‘other’, ‘last’, ‘year’, ‘medicine’, ‘student’, ‘post’, ‘lame’, ‘excuse’, ‘lure’, ‘costumer’, ‘hormetheu’, ‘thank’, ‘share’, ‘disregard’, ‘irrational’, ‘post’, ‘intelligent’, ‘enough’, ‘determine’, ‘right’, ‘see’, ‘sort’, ‘ground’, ‘swell’, ‘business’, ‘activity’, ‘even’, ‘touch’, ‘consultation’, ‘hormone’, ‘way’, ‘business’, ‘s’, ‘even’, ‘well’, ‘talk’, ‘get’, ‘free’, ‘professsional’, ‘guidance’, ‘think’, ‘people‘, ‘stick’, ‘depression‘, ’cause’, ‘people‘, ‘pursue’, ‘treatment’, ‘may’, ‘save’, ‘life’, ‘know’, ‘firsthand’, ‘appropriate’, ‘way’, ‘respond’, ‘tell’, ‘support’, ‘other’, ‘say’, ‘mother’, ‘first’, ‘tell’, ‘hit’, ‘would’, ‘sit’, ‘kitchen’, ‘table’, ‘cry’, ‘uncontrollably’, ‘start’, ‘hrt’, ‘right’, ‘take’, ‘nurse’, ‘year’, ‘tortuous’, ‘severe’, ‘depression‘, ‘ask’, ‘do’, ‘hormone’, ‘panel’, ‘flabbergast’, ‘go’, ‘lowt’, ‘men’, ‘health’, ‘center’, ‘addition’, ‘find‘, ‘severely’, ‘low’, ‘receive’, ‘great’, ‘man’, ‘health’, ‘care’, ‘know’, ‘funny’, ‘deduce’, ‘man’, ‘mid’, ‘life’, ‘crisis’, ‘hormone’, ‘imbalance’, ‘likely’, ‘low’, ‘get’, ‘ball’, ‘bust’, ‘buy’, ‘corvette’, ‘woman’, ‘get’, ‘sympathy’, ‘go’, ‘change’, ‘enough’, ‘question’, ‘come’, ‘first’, ‘opinion’, ‘testosterone’, ‘brain’, ‘get’, ‘testosterone’, ‘shot’, ‘help’, ‘put’, ‘dent’, ‘depression‘, ‘make‘, ‘feel’, ‘well’, ‘still’, ‘leave’, ‘pretty’, ‘severe’, ‘depression‘, ‘admittedly’, ‘hormone’, ‘vitamin’, ‘could’, ‘do’, ‘aggressively’, ‘recently’, ‘do’, ‘put’, ‘brain’, ‘glide’, ‘path’, ‘depression‘, ‘amazing’, ‘think’, ‘fix’, ‘fix’, ‘brain’, ‘still’, ‘aggressively’, ‘pursue’, ‘low’, ‘hear’, ‘cortisol’, ‘kill’, ‘testosterone’]



Reddit Scraper for Depression Regimens – Ngrams

Reddit is a great source of information containing posts about depression treatments, supplements, diets, and nootropics. Since only specific psychotropic medications are prescribed for depression and anxiety and go through clinical trials with large enough sample sizes, for others we only have anecdotal stories from online users. I can’t perform a randomized controlled trial for green tea matcha’s possible antidepressant qualities without a lab and a grant, but we can use natural language processing to at least summarize some information based on user’s reviews of various supplements.

Below are top ngrams (unigrams, bigrams, and trigrams), based on the text from posts and comments from the depressionregimens subreddit. For this data sample only the top posts and top comments were selected. Posts or comments of word length less than three were removed. The data sample consisted of 1,458 documents (each document being a post of a comment). Data cleaning included removing html tags, expanding common contractions, removing newlines and tabs, removing urls, spelling correction (python’s SymSpell), lemmatization, lowercasing, and removing special characters and extra whitespaces. A list of names that included supplements, neurotransmitters, antidepressants, and other psychotropic medications, was created and excluded from spell check, in order to avoid changing these words (for example we don’t want to change ‘ssris’ to ‘saris’, which is what the SymSpell library was doing).

The ngrams were selected such that each ngram appears in less than 70% of the documents. Absolute and relative frequencies were calculated for each ngram. The top unigrams were as follows: get, depression, feel, go, try, thing, day, work, take, make, help, time, good, one, also.

Examples of posts/comments (original text, before data cleaning) with these top unigrams:

I am going to write this down somewhere.. and then take steps to figure out how to work them all away…I do all of these.. The social media/phone time one is the hardest for me. Maybe I’ll invest in one of those timer boxes I can throw it into. Then I’ll have no choice but to be productive and hopefully more creative. My depression always gets so bad around shark week. So hard to sleep and stay asleep. So for a few days out of the month I really don’t have a choice on that one. But it can easily spiral out of control if I’m not putting in constant effort. I am very tired but also wired feeling right now.

Being diagnosed with terminal cancer you will probably die. There are a lot alternatives to treat depression, regular cardio, different therapy methods, drugs and non-drugs treatments (rTMS, ECT etc.), and if you try everything and nothing work, you can survive until a new treatment arrives. Anyway, I read a lot people refusing antidepressant because “side effects”, so I think depression isn’t so bad for them, Because think about this: a guy/girl with terminal cancer will take any treatment on market if he/she can pay, ignoring side effects because she/he want live.

Thanks for sharing – having a particular difficult day today, it’s nice to hear a success story. I’ve researched this in my area, seems quite expensive, hence I’ve not been able to try it, though I’ve wanted to. Has it been that way for you?
Also, I’ve been told several times that those dependent on benzodiazepine medications do not respond as well (or at all) to IV ketamine, so those must be discontinued before infusions. During the 25 years of so many medicines, did you take benzodiazepines at all?
> But I’m stable. I actually know what happiness
feels like. And most importantly, I’m alive.
Amazing to read! Thanks again for a real success story. I wish you the very best of continued health and happiness!

The top bigrams were as follows: side effect, every day, make feel, feel well, mental health, long term, year ago, depression anxiety, treatment resistant, treat depression. Below are some post/comment examples with the top bigrams:

Ketamine crushed rumination that I had been trapped in my whole life. Repeating intrusive negative thoughts of the past. Wiping out the massive, crippling fog of depression was wonderful but that side effect of stopping those negative thoughts was life altering. Glad we found it, even if I am approaching 50 years old.

I broke the sleep/ work depression routine by walking at first. Hour long walks at a quick pace, fast enough that it was challenging. Did that for a month or so. I actually managed to lose 5 pounds that first month so there was a nice bonus. It got me thinking my diet needed improving so I cut out fast food as much as I could and starting making lean meals for myself as much as I could. After another month, that “swollen” feeling you describe started to lessen. So two months in, down 12 pounds, I joined a gym but never touched free weight. Just cardio. It was more intense than walking and took a bit to adjust to the new pace. I left a sweaty mess every day. Did that for about 6 months. I was in decent shape. Down about 30 pounds overall. My brain felt clearer and I had more energy. It’s important to isolate the depression, give it less ammunition to use against you. **One way to do that is to not let it use your body against you.**

After trying over 15 different medications and several rounds of Ketamine IV infusions for my severe treatment-resistant depression, I was about to give up. On everything. I saw a couple posts on this group about how some people have had success with Trintellix, so in a last ditch effort in desperation, I talked to my doctor and started it about a month ago. Within a week my life had changed. The existential dread had lifted. I became interested in things again. For the first time since I can remember I wasn’t exhausted in the middle of the day. I had energy. I smiled. I felt some joy. And it has continued and it’s only been getting better. I think what really happened was that it gave me the jumpstart I needed to start a small exercise regimen and care about eating right, which made me feel even better. It did make me extremely nauseous for the first week but it helped to take it with food and then the side effect went away. Thank you to those who shared their experience and I hope maybe this helps someone as well. There is hope, just keep swimming.

The top trigrams were as follows: treatment resistant depression, major depressive disorder, sexual side effect, make feel good, make feel well, mental health issue, get new psychiatrist, severe treatment resistant, stay bed day, time every day. Below are some post/comment examples with the top trigrams:

Speaking from personal experience, the only type of medication that improved my symptoms were the MAOIs.
These are more old school, and more dangerous. But many have said they are a life saver for
treatment resistant depression.
Contrary to conventional antidepressants, they don’t just boost serotonin/dopamine/norepinephrine – they also boost a range of neurochemicals such as trace amines like b-phenylethylamine, which themselves promote the release of neurotransmitters.
MAOIs are so powerful that you have to watch your diet and abstain from a whole range of other drugs.

The sexual side effects, tiredness, agitation and added anxiety all pushed me away from SSRIs. I did like being numb though. Except in the genital area… that created a huge depression in itself. Been off for months now.

Wait, you’ve told your psychiatrist about this, and they didn’t do anything? If so, you need to get a new psychiatrist.
I don’t want to make a diagnosis but have you considered the possibility that you might have bipolar depression? SSRIs can cause hypomania and are considered dangerous for patients with BP. That’s why I said a new doctor is in order. Thankfully, there are antidepressants that don’t cause this reaction, as well as mood stabilizers to prevent the crash you talked about.
Lastly, it sounds like you’re also dealing with a lot of stuff from your past. Are you seeing a therapist right now? They can help you work through those memories and deal with the intense emotions you get in a way that makes your life better and not worse.

We can even obtain some four grams: severe treatment resistant depression, job really well respected, amazing job really well, previous alcoholism push man, girl ever meet amazing.
Post/comment examples below. I really enjoyed reading the first story as I have not heard previously about diphenidine and it was interesting to find out about this substance and the user’s experience.

I meant to post about this sooner and regret not doing so, but hopefully it’s helpful to some and doesn’t break any rules I’m not aware of. I know this subreddit has a focus on safe and researched substances and realise that this is an entirely anecdotal report concerning a not very well-researched substance, but I hope it’s not a problem and think it’s valuable information for someone suffering from severe treatment-resistant depression.
Back in 2015, my husband (23 years old, weight 62 kg) had been feeling severely depressed with suicidal ideation for several weeks. It got to the point where I felt I had to either call in the mental-health people (whom I knew from previous experience to be quite inept) or take a drastic pharmacological measure.
I had read about the rapid and long-lasting antidepressant responses to NMDA-receptor antagonists like ketamine before, and acquired samples of two of ones that are orally active (diphenidine, as well as methoxphenidine, also known as MXP).
NMDA-receptor antagonists appear to produce their antidepressant effects by causing an increase in levels of brain-derived neurotrophic factor (BDNF) that can last for days or weeks following a single dose, whereas the most commonly used antidepressants produce a similar increase in BDNF only after weeks of continuous administration, while also causing many side effects.
Neither of us had ever used any kind of dissociative before, just classical psychedelics, stimulants and marijuana (while visiting a country where that’s legal), so, given his fragile psychological state, I wanted to start with a very careful small dose.
Looking at people’s comments on diphenidine and methoxphenidine online, I couldn’t find anything related to attempts at therapeutic use, nor a clear consensus on a preference for either one. I ended up looking up dosage information for diphenidine, and read that 50 mg was considered a threshold dose.
I first gave him 10 mg of diphenidine in a capsule the first time to be safe; as expected, that had no noticeable effects.
2 hours later I gave him another 20 mg, which still led to no noticeable effects, except possibly a very mild numbing of the senses.
Another 2 hours later I gave him another 30 mg. About 15-20 minutes after this, he reported that he was maybe starting to feel slight derealisation effects.
Until this point he had been playing Skyrim to try to take his mind off his bad feelings; he really wasn’t expecting this to work at all, but he trusted my knowledge of drugs and figured it couldn’t hurt to at least try it.
When the effects started to set in, I told him I’d read that some people like to lie in bed while on drugs like this, and he did so.
His mood didn’t seem much changed, but after lying in bed for a bit, he started talking to me about some of the things that had been bothering him. He sounded sad while talking about these things, but I tried to steer the conversation toward solutions that we could decide on that would make life more satisfying for him.
After chatting for a bit, he seemed to be getting somewhat amused by the effects of the drug; he said things he touched felt very different, and everything felt strange, but not in a bad way.
As we talked some more about his issues, his mood slowly lifted (I think this was around the peak of the experience, which lasted a good portion of the day), and suddenly he got a little smile on his face and said that he was starting to feel… happy. Of course this made me really happy.
He started saying how things felt “solid”, “thick”, “real” and “tangible”, in contrast not only to the way things normally felt but also to the way things had been feeling to him particularly during his weeks of feeling depressed. He related this more solid experience of physical objects to an improved outlook on life.
Interestingly, despite diphenidine being a dissociative drug, it appears to have triggered a reversal of symptoms of dissociation/derealisation that accompanied his depression prior to the treatment.
He said he kind of felt similar to being very drunk, I assume in relation to physical coordination.
He also reported feeling significant time dilation, “in a good way”. (He contrasted this with the time dilation he feels on classical psychedelics, which he tends to find uncomfortable or scary, as though a moment will last forever.)
He then seemed to get a big urge to get up and do lots of tidying and cleaning around our apartment, and he started doing so; I helped. We folded clothes, organised the living room, cleaned the kitchen, stuff like that.
He said that he felt like everything was being put in its place again, both physically and mentally; that his mind was tidy again.
Around this point, he seemed to have this constant feeling of awe at how content he was feeling with life. This wasn’t some kind of unnatural euphoria, just a very strong feeling of contentness, which had obviously been missing from his life for a long time.
Several times, he seemed to have tears in his eyes in awe of how at peace he felt with the world.
Seeing someone emerge from such a deep depression in a matter of hours was really beautiful.

Several times, he hugged me and told me how grateful he was to me for finding this drug for him.
I imagine the talking was therapeutic (which could also have happened without the drug, but was, I imagine, stimulated by it), but mainly I’m certain the drug caused a biochemical change in his brain that has reversed, at least for a time, the natural process that makes him prone to feeling depressed all the time.
The dissociative effects did not fully diminish until he slept; he had no trouble sleeping.

Two days later I asked him how he was feeling, and he smiled and said he was feeling just fine.
More than two weeks later, his depression still had not returned.
This was a massive change. It seems diphenidine can be a powerful medicine. 🙂


He later took it again, this time at 60 mg in one go (about 1 mg/kg), and he felt that this reinforced the antidepressant effects, and that repeating this every few weeks would probably keep him happy in the long term, and the interval we settled on was one dose every 12 days (taken right after waking up to avoid impacting sleep the next night).
In the 5 years that followed, he continued to benefit enormously from diphenidine, and he continues to take it every 12 days. Although after a while there was some tolerance and it no longer led to complete resolution of symptoms, he continues to find it well worth it. The dosage has slowly had to be raised from 60 mg 5 years ago to around 125 mg currently (by about 16% per year) to maintain a similar level of acute effects. We’ve also discovered that adding 200-250 mg of black pepper (which contains piperine, a bioavailability enhancer) in the same capsule makes it a lot more potent.


I wonder how many people commit suicide every year who could have been saved by something like this… granted not a lot of research has been done on using NMDA-receptor antagonists for this indication and there may be unknown risks, but when someone has severe depression that cannot be managed effectively with approved medication or is even ready to commit suicide, I think there’s a very strong case to be made that something like diphenidine should be tried, at least as a last resort.

Of course it’s important to be careful not to use substances like this too frequently, since they have been known to lead to addiction with very frequent use (although, having tried it myself, I personally don’t see how the effects of this particular one could be considered enjoyable by most people). But for my husband, there has been no addiction or any other ill effect over 5 years of regular use.
He is now also taking the MAOI tranylcypromine (Parnate); based on the limited research that has been done, and our experience, there is no interaction between it and diphenidine, although there probably would be with various other dissociatives.

Another example with four gram:

We’ve all been there brother. I lost the best girl I’ve ever met, an amazing job at a really well respected business and a lot of good friends through my previous alcoholism. You just have to push through it man. Even making the tiniest changes in your life will snowball into a world of difference, life always finds a way of working itself out.

1985 Article – Food and Psychiatry

Interesting article all the way back from 1985 on correlation between specific foods and psychiatric symptoms. For some reason though diet is still not really discussed with patients by psychiatrists. I assume general diet concerns do get mentioned – such as is the patient eating too much sugar, not enough protein, is malnourished, etc., but in my experience no psychiatrist had discussed with me specific ingredients that could potentially increase anxiety.

I would say that diet was not discussed much with me except some questions such as whether I ate full meals. I did eat full meals, I never had trouble eating, but no one asked whether I experienced any abdominal pain after meals and what my meals contained. I was asked whether I drank alcohol, I did not, but no one asked how many Starbucks drinks I had, and how much sugar each drink contained. I never thought that I was overconsuming sugar, I was not checking how many grams of sugar per day I was eating, which was probably over 100 grams. I have also never heard at that point, during my initial psychiatric visits, that there could be any possible link between a food component and mood. No psychiatrist so far has ever mentioned this to me, nor agreed with me that it was possible. I, on the other hand, am quite certain that cow dairy protein causes intrusive thoughts and anxiety for me and that a high lactose consumption decreases my energy and increases depressive symptoms.

Even though for some reason psychiatrists right away focus on prescribing medication, without any discussion of changes in diet potentially improving symptoms, there has been numerous papers pointing to a link between specific foods and psychiatric issues, also links between diet causing changes in gut bacteria, and in turn affecting mood and anxiety. It was interesting to find this short article from 1985 describing research on certain foods and possible link to mood disorders. The study was performed by the University of Chicago.

https://www.chicagotribune.com/news/ct-xpm-1985-09-08-8502280775-story.html

“Some of the first solid evidence indicating that certain foods can cause mood disorders in some people has been found in a University of Chicago study that implicates a faulty immune system as the culprit.

”A lot of people said it was impossible to know if food related mood changes were real or if they were all in a person`s mind,” said Dr. John Crayton, associate professor of psychiatry. ”We have found that it may not be all in their minds.”

The findings tend to support the contention of other doctors, such as Dr. Theron Randolph, that depression, anxiety, irritability, inability to concentrate and other mood disorders may be caused by such foods as sugar, milk, wheat, corn, and chocolate, he said.

While other studies have suggested mood changes from food, the U. of C. study is the first to show major changes in the function of the immune system that occur with behavioral changes after certain foods are consumed, said Crayton.

Wheat and milk produced the most marked reactions, while chocolate was less reactive, he added. The immune reactions should not be confused with traditional food allergies that produce rashes or hives, he explained.

Neural Network Predicting Subreddit Karma and Comments for Mental Health Topics

Introduction:

Problem Description:

This project analyses whether the attributes of the subreddit posts’ content are predictive of social support (karma points and number of comments) posts receive.

Context of the Problem:

Mental health problems tend to go under-reported and under-addressed, which places a high social-economic cost on the society. Research shows that social support is valuable for improving quality of life for people with mental health illnesses.

This project examines what content attributes of anonymous social media posts on reddit platform elicit higher levels of social support in the form of karma points and comments.

Limitation About other Approaches:

We have examined two most relevant papers on the topic, [1] and [2]. Neither Schrading, N. et al. [1], nor De Choudhury, M. & De, S. [2] use subreddit indicator variables (i.e., indicators for schizophrenia, depression, anxiety, etc.) in their analysis. It is likely that posts are treated differently, depending on a mental illness indicated (as per Mann, C. E. & Himelein, M. J. [3], “stigmatization of schizophrenia was significantly higher than stigmatization of depression”). Also, De Choudhury, M. & De, S. [2] used a resource intensive manual labelling approach to arrive at keywords.

Solution:

In this project, the analysis includes subreddit indicators in the neural network model predicting social supports for reddit posts. The figure below shows statistics for subreddit indicators for a sample dataset. It can be seen that the mean for the target variables is very different between subreddits.

Additional inputs include counts of frequent bigrams and emotion labelling of keywords. Emotion labelling was done through an NLP approach, using an already existing emotions lexicon.

Background:

ReferenceExplanationDataset/InputWeakness
Schrading, N. et al. [1]They trained and compared multiple classifiers on content of reddit posts to determine the top semantic and linguistic features in detecting abusive relationships. Subreddit posts with comments that focus on domestic abuse, plus subreddit posts with comments unrelated to domestic abuse as a control set.Future studies could be implemented on datasets from multiple websites to compare online abuse patterns across forums.
De Choudhury, M. & De, S. [2]They trained a negative binomial regression model on content of reddit posts (i.e., length, use of 1st pronoun, relationship words, emoticons, positive and negative words, etc.) to predict social support variables (karma points and number of responses).Posts, comments and associated metadatafrom several mental health subreddits, including alcoholism, anxiety, bipolarreddit, depression,mentalhealth, MMFB (Make Me Feel Better), socialanxiety, SuicideWatch.– Out of the top 15 discussed predicting variables used in the regression model, the highest coefficient have the intercept and the use of the 1st pronoun. – There is no discussion about correlations between predicting variables (for example, the study uses such variables as negative emotion, positive emotion and number of emoticons, which could be correlated).

Methodology

Schrading, N. et al. [1] reported that out of the post features they analyzed, ngrams were the most predicting ones when detecting abusive relationships in reddit posts. De Choudhury M. & De, S. [2] tried to predict social support variables for mental health related reddit posts using post length, emoticons, unigrams, variables built based on presence of emotionally charged unigrams, etc.

In this project, to predict social support variables (scores and number of comments) for mental health related reddit posts, the model was built using the neural networks approach and with emotionally charged unigrams as indicators of 10 different emotions, emotions count, post length, part of speech frequencies (counts of verbs, pronouns, adverbs and adjectives), count of first pronouns, number of question marks, post length, count of frequent bigrams, and subreddit indicators as predictive variables.

Below is the list of the input used in the models for predicting the score and number of comments:

‘anger’, ‘anticipation’, ‘disgust’, ‘fear’, ‘joy’, ‘negative’, ‘positive’, ‘sadness’, ‘surprise’, ‘trust’,’len_post’, ‘len_post_orig’, ‘first_pronoun_count’, ‘freq_bigram_count’, ‘q_count’, ‘verb_count’, ‘pronoun_count’,’adverb_count’, ‘adjective_count’, Subreddit(display_name=’BipolarReddit’), Subreddit(display_name=’Anxiety’), Subreddit(display_name=’depression’), Subreddit(display_name=’schizophrenia’), Subreddit(display_name=’bipolar’), Subreddit(display_name=’mentalhealth’), Subreddit(display_name=’depression_help’), Subreddit(display_name=’BPD’), Subreddit(display_name=’socialanxiety’), Subreddit(display_name=’mentalillness’)

Emotion lexicon

A public lexicon dataset was used to determine counts of specific emotion words. The NRC Emotion Lexicon is a list of English words and their associations with eight basic emotions (anger, fear, anticipation, trust, surprise, sadness, joy, and disgust) and two sentiments (negative and positive).

https://nrc.canada.ca/en/research-development/products-services/technical-advisory-services/sentiment-emotion-lexicons

Below are examples of posts with most frequent bigrams highlighted. Frequent bigrams ‘feel like’, ‘feels like’ are consistent with the finding by De Choudhury M. & De, S. [2] of frequent unigrams related to emotional expression.

N-grams

For this project we identified most popular bigrams and trigrams. The counts of most frequent bigrams and trigrams were used while testing various models, and the most useful data turned out to be counts of most frequent 16 bigrams, which were used as one of the inputs to the model.

Below is the list of the most popular bigrams used and a few examples of their usage in raw texts.


Implementation

Data Collection

Obtained data via a public API from 10 mental health subreddits: “depression”, “anxiety”, “bipolarreddit”, “mentalhealth”, “socialanxiety”, “depression_help”, “bipolar”, “BPD”, “schizophrenia”, and “mentalillness”.

  • First, checking 10 hot posts for each subreddit indicator
  • Collecting data

top_posts dimensions: (9949, 9)

hot_posts dimensions: (9890, 9)

new_posts dimensions: (9896, 9)


Preparing the Data

reddit data scraping is limited to a maximum of 1000 records per subreddit per each of 3 post categories (“hot”, “top” and “new” posts). To maximize the dataset size, we collected posts of all 3 categories and removed duplicate records that have categories overlapping. As mentioned by De Choudhury M. & De, S. [2], reddit posts reach most of their commentary within the first 3 days from being posted. Thus, we removed posts that were “younger” than 3 days old at the data collection time.

  • Removing stop words and punctuation
  • Created ngrams (bigrams, trigrams and fourgrams)
  • Applying smoothing for trigrams and removing extra words referring to posts, unrelated to this analysis (i.e., moderator’s posts)
  • Creating emotions dataframe, count POS (part of speech) tags, and topic/subreddit dummies

Reddit score prediction model – results based on first layer weights:
In a multi-layer neural network it is hard to interpret raw internal weights, but it looks like mental health-specific variables (such as indicators for fear or surprise, or subreddit indicators) are more important than generic (such as verb count or the length of the post, which looks to be least useful). In particular most subreddit indicators (“depression_help”, “depression”, “schizophrenia”, etc.), which were not used in other papers, are in top 10 for total weights.


Conclusion and Future Direction

In conclusion, neural network results showed that the model inputs do have some predictive power for social response variables ‘number of comments’ and ‘score’, as the sums of weights for input variables were found to be greater than zero. Also during model testing, starting with fewer input variables, adding the rest of the input variables reduced the absolute mean errors.

One of the future improvements for this analysis could be incorporating a variable that indicates whether the post is from a throwaway account or an existing long-term reddit account, as De Choudhury, M. & De, S. [2] mention that reddit’s throwaway accounts allow individuals to express themselves more honestly and to ‘discuss uninhibited feelings’.

Also, while content and length of post titles and how users action on posts (click, read, and reply) might have an impact on post’s score, neither of the research papers cited, nor this analysis used title analysis as a part of the model. As such adding title attributes and post actioning statistics variables to the model could be a potential area for improvement.


References:

[1]: Schrading, N., Alm, C. O., Ptucha, R., & Homan, C. M. An Analysis of Domestic Abuse Discourse on Reddit, The 2015 Conference of Empirical Methods in Natural Language Processing, Lisbon, Portugal, September 2015, pages 2577-2583.

[2]: De Choudhury, M. & De, S. Mental Health Discourse on reddit: Self-Disclosure, Social Support, and Anonymity. Eights International AAAI Conference on Weblogs and Social Media, North America, May 2014, pages 71-80. Available at: https://www.aaai.org/ocs/index.php/ICWSM/ICWSM14/paper/view/8075/8107.

[3] Mann, C. E. & Himelein, M. J. Factors Associated with Stigmatization of Persons with Mental Illness. Psychiatric Services, Vol. 55, No. 2., February 2004, pages 185-197. Available at: https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.55.2.185.