I think this is a very important topic. There is now sufficient evidence to indicate that people with specific variations of genes CYP2D6, SLC6A4, and HTR2A, are unlikely to respond to SSRIs. The evidence indicates that especially Caucasian females are unlikely to respond to SSRIs, if they have the genes SLC6A4 S/S and HTR2A G/G. Evidence also shows that they may not respond to SNRIs as well.
If you are in this population, I wonder if your psychiatrist spoke to you about this. I think it’s a pretty big deal, given the sufficient evidence for Caucasians. I am an Eastern European female, and I had no response at all to any SSRIs or SNRIs, or any medication in general so far. I had trials of mirtazapine, sertraline, abilify, latuda, risperidone, olanzapine, fluoxetine, pristiq, cymbalta, and seroquel. I was then referred to a more specialized psychiatric hospital, and they performed genetic testing for me. The results indicated that I have SLC6A4 S/S and HTR2A G/G genes. The medical records state the following:
SLC6A4 S/S Homozygous for the short promoter polymorphism of the serotonin transporter gene. The short promoter allele is reported to decrease expression of the serotonin transporter compared to the homozygous long promoter allele. The patient may experience a delayed response with selective serotonin reuptake inhibitors, or may benefit from non-selective antidepressants.
HTR2A G/G Homozygous variant for the G allele for the serotonin receptor type 2a. Two copies of the G allele. This genotype has been associated with an increased risk of adverse drug reactions with certain selective serotonin reuptake inhibitors.
CYP2D6 intermediate metabolizer – Higher plasma concentrations may increase the probability of side effects. Consider a lower starting dose and slower titration schedule as compared with normal metabolizers.
I think given that I have not responded to any of the medications (each one was tried for over 8 weeks), and these test results, it’s pretty clear that I am very unlikely to respond to any other SSRIs or SNRIs. I had a very good neuropsychiatrist at the psychiatric hospital, but unfortunately I was transferred to another hospital due to pregnancy. Now I have a psychiatrist who is a resident, so she does not have a lot of experience. I was prescribed lamotrigine and fluoxetine. I think the lamotrigine makes sense, given that I have no tried it, but she only gave me 25mg per day. I don’t think the fluoxetine makes sense, because it’s an SSRI, and I have already tried it. I also stopped sleeping starting the first day I began to take it. I have been sleeping only 3-4 hours a day since I started it 8 days ago.
I wonder if anyone had a good doctor who discussed with them genetic testing and what were their suggestions? What are the options if there is no response to SSRIs and SNRIs? I don’t think my resident psychiatrist has enough experience in this.
I have been diagnosed with clinical depression since 2015, it’s been on and off. Because of this diagnosis, I naturally became interested in medical and talk therapy treatments for depression. In grad school, I had the opportunity to work with a dataset of Facebook posts of users who also had labels as depressed and non-depressed, based on the standard clinical questionnaire.
Using natural language processing (NLP) techniques, one of my findings was that depressed people use more personal pronouns in their text, such as “I”, “he”, “she”, and “we”. For instance, I noticed in my own experiences that when I am more depressed, I tend to ruminate more—thinking about how “I” am unlucky not to have many relatives, or how it’s unfair that he/she (some person that I know) is smarter or has a better job or a better life.
I found a skill that helps manage these thoughts. When I catch myself ruminating, I try to engage in reading something technical or objective that doesn’t involve personal pronouns or comparisons or human relationships in general. For example, I might read an article about Python vs Julia, or why high blood sugar is dangerous, or where turtles go in winter in Ontario. I find that even if the ruminative thoughts continue, forcing myself to read and focus on these kinds of articles can help prevent my ruminative thoughts from escalating.
I am not sure what type of skills this could be called – CBT or DBT, but I think it relates more to the DBT skill of “opposite action”. This skills is based on doing the opposite of what our emotions/mind is telling us to do. So if my mind is telling me to sit and ruminate about my life, myself, myself vs. others, I do the opposite – read something that doesn’t involve any personal life at all.
I was feeling better in the summer, I was swimming a lot, hiking, being out in the sun. Then it started getting colder, I was out less, I also started applying for jobs – so I was sitting a lot in front of my laptop. I became stressed because I have received only a few replies despite multiple applications. I am also trying to have a child and it hasn’t been working, so feeling upset about that as well. I decided to try and feel better – started taking NAC – 600-1200 mg in the evening, started drinking more coffee, consuming yogurt and kefir for probiotics. Well then in the last several weeks I started to feel even worse. Very severe brain fog, as if I am not sure whether I am participating in life or just observing it and it’s happening to someone else. I felt wrapped in gray fog and as is everything was outside the fog, at a distance from me. I also started to feel dizzy.
I’m glad that I remembered that this happened before when I added probiotic supplements and 5-HTP to “feel better”. I actually ended up with a psychotic episode, pretty sure that it was caused by 5-HTP.
So I decided to reset everything – instead of adding more supplements, I stopped all of them. Stopped taking NAC, stopped eating kefir and yogurt. Alsocurrently not consuming anything with lactose or a lot of sugar. Just eating regular healthy food – lentils, vegetables, chicken, salmon, brown rice, etc. Stopped coffee in the morning, only started having one coffee a day in the afternoon (and making it half decaf).
Well, I am actually feeling better now!
I think what happened is that I naturally felt worse as the weather got colder, which is normal, I have added stress from not getting replies to my applications and fertility issues, which normally makes one feel worse! So I then suddenly added all of these supplements + stimulants (more caffeine), and ended up feeling just as bad as I was, plus brain fog!
Now I am feeling better in terms of brain fog and I am trying to just use CBT to deal with my situation, instead of supplements.
Not saying that supplements can’t help, it’s very personal, but just wanted to share my story -that sometimes adding several supplements + more caffeine can actually cause brain fog / depersonalization.
Hello everyone, I just wanted to share my current depression regimen and some situation info, in case anyone has similar health issues. I have experienced many hospitalizations since 2015, including involuntary psychiatric hospitalizations. Finally in 2017 I was diagnosed with autoimmune encephalitis (brain inflammation), as well as autoimmune thyroiditis. I was treated with intravenous corticosteroids and that led to some improvement. I continue to experience health issues, but I have made several life style changes that have helped me and that I wanted to share. Again, I was diagnosed with autoimmune disease, and my neuropsychiatrist believes that the encephalitis greatly contributed to my depression. Clearly it’s not the case for everyone, so I am not stating that this should work for all. I have been doing better since these changes, I was able to complete a graduate degree, get back to painting, and started writing and playing guitar again. These were huge improvements for me as I was not able to enjoy any hobbies when I had severe depression and was not able to pursue graduate courses.
I cut out all refined carbs and processed foods. There is sufficient evidence indicating that these foods contribute to inflammation. I am not doing keto or low carb, I am not trying to be very strict with myself, I enjoy all sorts of complex carbs such as baked plantains, potatoes, oatmeal, fruits, berries, etc.
Switched to low glycemic foods – this related to #1, as cutting out refined simple carbs in general does leave one with complex carbs that have lower glycemic index.
Foods that cause an immune reaction – this clearly does not occur for most people, but some do react to certain foods. I noticed that I feel physically and emotionally worse after eating gluten, dairy, or soy, so I had to drop these from my diet.
I go to sleep earlier and stay away from my laptop/phone screen after 9pm. I used to stay up late, but now I go to bed around 11pm. After 9pm I usually dim the lights in the room a bit and I read on my Kindle. Kindle Paperwhite does not emit a high amount of blue light. I also installed blackout curtains so that I spend the night sleeping in the dark.
Sleep is very important – so when I really can’t fall asleep, I do use a cannabis oil (NightNight CBN + CBD oil). But changing my diet, losing weight, and going to bed earlier, did reduce my insomnia, so I don’t need the oil every day.
Significantly decreasing my caffeine intake – personally for me it did lower my anxiety and the occurrence of panic attacks, I now only have green tea in the afternoon, otherwise I drink rooibos tea, water, kefir, decaf tea.
Intermittent fasting – I do fell less brain fog and more clear headed when I am not eating the whole day. I used to surf the internet at 1am eating Sweet & Salty bars. Then my mind would go into dark places and I would start reading about serial killers. Now I eat two to three meals a day between 9am and 5pm, I fast for 16-18 hours a day.
Seeing a psychologist – going through CBT and DBT did help, and this related to #5. I still experience racing thoughts, anxiety, and other issues, but I can now more easily choose to not follow my thoughts. For example – I did used to read a lot about US serial killers and then I would freak myself out and I would start to think that someone could climb through the window. Now I choose more what I read – should I keep reading about mass murders? What is the point of that for me? Will that change anything for the better?
Sunlight – I try to get some sunlight each morning, if I have no energy to come out, I still stick out of the window and get some sunlight on my face.
Exercise – I experience certain pains due to autoimmune disease, and fatigue, so I don’t do extensive exercise, but I do yoga at home. And by exercise I don’t mean that I do a whole hour after work, I do certain yoga poses occasionally throughout the day. I think that’s still better than no exercise.
Shrooms – I did several shroom trips, at home alone, after I was treated for encephalitis. I haven’t done shrooms for a while due to pregnancy and breastfeeding, but the positive antidepressant effects of the trips still remain for me.
CBT, again – accepting that some days are better than others, some are worse, but also seeing the positive – in general I am doing much much better now than in 2016. I am female, hormones fluctuate, I do feel worse during the luteal phase, but I experience a lot more enjoyable moments than before my steroids treatment and this lifestyle change.
The following summary was created using a google search for specific phrases and then performing natural language processing steps for sentence scoring. Yerba mate is an evergreen tree/shrub that grows in subtropical regions of South America. The leaves of the plant are used to make tea. Yerba mate tea contains caffeine and theobromine, which are known to affect the mood. I was interested in summarizing the existing articles in regards to research on this plant in psychiatry.
The first search phrase used was “yerba mate psychiatry depression research evidence“, and the number of collected articles for this phrase was 18. The text from all articles was combined, and relative word frequencies were calculated (after removing stop-words). These relative frequencies were then used to score each sentence. Sentence length distribution was checked, and the 90th percentile of 30 words was chosen to select sentences below the maximum length. Below are the 10 highest scoring sentences that summarize the text from the 18 articles.
We can infer from the summary that studies have been performed using the yerba mate extract on rats and tasks for chosen as proxies for the rats’ depression and anxiety levels. There are no mentions of human studies in the summary. Also the chosen sentences indicate that based on these studies, yerba mate has potential antidepressant activity, and it may improve memory as well. The results of the anxiety study were not mentioned and it’s not clear whether there were any side effects from yerba mate. These results are in line with descriptions of personal experiences of reddit users that I have reviewed, as many report better mood and improved focus after drinking yerba mate tea. Some users do report increased anxiety correlated with yerba mate consumption.
View abstract. J Agric.Food Chem. Vitamin C Levels Cerebral vitamin C (ascorbic acid (AA)) levels were determined as described by Jacques-Silva et al. Conclusion: In conclusion, the present study showed that Ilex paraguariensis presents an important effect on reducing immobility time on forced swimming test which could suggest an antidepressant-like effect of this extract. Despite previous some studies show the antidepressant-like activity of flavonoids [31, 32] which are present in the extract of I. paraguariensis, any study has evaluated the possible antidepressant-like activity of it. The presence of nine antioxidants compounds was investigated, namely, gallic acid, chlorogenic acid, caffeic acid, catechin, quercetin, rutin, kaempferol, caffeine, and theobromine. Abstract In this study, we investigated the possible antidepressant-like effect of I. paraguariensis in rats. Another study showed that an infusion of I. paraguariensis can improve the memory of rats treated with haloperidol and this effect was related to an indirect modulation of oxidative stress . In addition to flavonoids as quercetin and rutin and phenolic compounds as chlorogenic and caffeic acids, yerba mate is also rich in caffeine and saponins . After four weeks, behavioral analysis of locomotor activity and anxiety was evaluated in animals receiving water (n = 11) or I. paraguariensis (n = 9).In the same way, we evaluated if the presence of stimulants compounds like caffeine and theobromine in the extract of I. paraguariensis could cause anxiety. In the present study, we evaluated the possible antidepressant-like effect of I. paraguariensis by using forced swimming test (FST) in rats. Forced Swimming Test This experiment was performed using the FST according to the method previously published by Porsolt et al. In this context, Yerba mate (Ilex paraguariensis) is a beverage commonly consumed in South America especially in Argentina, Brazil, Uruguay, and Paraguay. I. paraguariensis reduced the immobility time on forced swimming test without significant changes in locomotor activity in the open field test.
I also tried several other search phrases, such as “yerba mate mood anxiety evidence” and “yerba mate side effects evidence“. In total of 17 articles were collected for the first query and 19 articles for the second query. The summaries are presented below. There was nothing in the summary directly discussing mood or anxiety, but there are mentions of neuroprotective effects and antioxidant effects. We can also learn that a cup of yerba mate tea has similar caffeine content as a cup of coffee, and that drinking yerba mate is not recommended while pregnant or breastfeeding. As in the previous summary, no human trials were mentioned, so it seems that all the summarized studies were performed on rats. The side effects query summary mentions the risk of transferring the caffeine from the tea to the fetus when pregnant, as well as a link to cancer for those who drink both alcohol and yerba mate. It also mentions and anxiety is a side effect of the tea.
Query 1: View abstract. J Agric.Food Chem. On the other hand, studies conducted on an animal model showed chemopreventive effects of both pure mate saponin fraction and Yerba Mate tea in chemically induced colitis in rats. Yerba Mate Nutrition Facts The following nutrition information is provided by the USDA for one cup (12g) of a branded yerba mate beverage (Mate Revolution) that lists just organic yerba mate as an ingredient. Researchers found that steeping yerba mate (such as in yerba mate tea) may increase the level of absorption. Yerba mate beverages are not recommended for children and women who are pregnant or breastfeeding. Chlorogenic acid and theobromine tested individually also had neuroprotective effects, but slightly weaker than Yerba Mate extract as a whole, but stronger than known neuroprotective compounds, such as caffeine [ 83 ]. The caffeine content in a cup (about 150 mL) of Yerba Mate tea is comparable to that in a cup of coffee and is about 80 mg [ 1 , 11 , 20 ]. In aqueous and alcoholic extracts from green and roasted Yerba Mate, the presence of chlorogenic acid (caffeoylquinic acid), caffeic acid, quinic acid, dicaffeoylquinic acid, and feruloylquinic acid was confirmed. After consumption of Yerba Mate tea, antioxidant compounds are absorbed and appear in the circulating plasma where they exert antioxidant effects [ 55 ]. According to the cited studies, Yerba Mate tea consumption attenuates oxidative stress in patients with type 2 diabetes, which may prevent its complications.
Query 2: View abstract. J Agric.Food Chem. Because yerba mate has a high concentration of caffeine, drinking mate tea while pregnant can increase the risk of transferring caffeine to the fetus. J Ethnopharmacol. South Med J 1988;81:1092-4.. View abstract. J Am Coll Nutr 2000;19:591-600.. View abstract. Am J Med 2005;118:998-1003.. View abstract. J Psychosom Res 2003;54:191-8.. View abstract. Yerba mate consumed by those who drink alcohol is linked to a higher risk of developing cancer. Anxiety and nervousness are a side effect of excessive yerba mate tea consumption.
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
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’.
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:
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.
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.
“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
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
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…
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
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 millionpeople 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
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…
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 words
Word prob
Topic 2 words
Word prob
Topic 3 words
Word prob
Topic 4 words
Word prob
feel
0.037
day
0.042
depression
0.017
depression
0.019
thing
0.026
work
0.024
effect
0.014
people
0.017
depression
0.022
feel
0.020
antidepressant
0.013
year
0.016
make
0.021
time
0.020
ssris
0.012
give
0.016
life
0.019
sleep
0.018
doctor
0.012
treatment
0.015
time
0.013
good
0.014
anxiety
0.010
month
0.013
bad
0.013
thing
0.012
side_effect
0.010
start
0.013
good
0.012
start
0.010
mg
0.010
find
0.012
lot
0.010
bed
0.009
drug
0.009
hope
0.012
depressed
0.010
exercise
0.009
psychiatrist
0.009
ketamine
0.011
If we choose 10 topics:
Topic 1 words
Word prob
Topic 2 words
Word prob
Topic 3 words
Word prob
Topic 4 words
Word prob
Topic 5 words
Word prob
feel
0.039
people
0.044
day
0.037
ssris
0.027
treatment
0.035
year
0.026
depression
0.037
thing
0.035
antidepressant
0.024
ketamine
0.028
thing
0.022
doctor
0.028
feel
0.033
effect
0.024
year
0.022
symptom
0.020
psychiatrist
0.020
make
0.024
drug
0.022
work
0.021
brain
0.019
make
0.020
find
0.017
side_effect
0.020
drug
0.017
start
0.018
bad
0.016
good
0.016
depression
0.019
hope
0.015
time
0.017
therapy
0.016
exercise
0.016
serotonin
0.016
hear
0.012
make
0.015
therapist
0.015
eat
0.013
prescribe
0.014
lithium
0.011
issue
0.015
find
0.014
walk
0.013
treat
0.013
people
0.010
lot
0.014
problem
0.013
lot
0.013
ssri
0.012
infusion
0.009
Topic 6 words
Word prob
Topic 7 words
Word prob
Topic 8 words
Word prob
Topic 9 words
Word prob
Topic 10 words
Word prob
work
0.053
time
0.033
sleep
0.053
experience
0.039
life
0.062
anxiety
0.030
make
0.028
day
0.037
day
0.030
feel
0.030
mg
0.025
depression
0.015
time
0.030
feel
0.029
depression
0.029
bad
0.020
long
0.015
bed
0.024
depression
0.024
thing
0.020
high
0.020
call
0.014
start
0.024
mind
0.020
find
0.019
vitamin
0.018
depressed
0.014
feel
0.023
give
0.017
good
0.017
diet
0.015
feeling
0.013
morning
0.020
month
0.017
live
0.017
supplement
0.014
people
0.013
wake
0.018
good
0.015
bad
0.014
post
0.012
read
0.013
night
0.014
week
0.013
change
0.014
literally
0.011
focus
0.013
hour
0.013
back
0.012
year
0.013
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:
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… “
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]
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.
Notes of a Neuropsychiatry Amateur 