mental health – Notes of a Neuropsychiatry Amateur

What worked for me for reducing caffeine consumption

I have recently been working on reducing caffeine intake. My intake increased in the summer, as I started going into the office more frequently. I really enjoy the taste and smell of coffee. I don’t have a coffee machine at home, but in the office I would drink at first one coffee a day, then two per day. I also usually have at least one cup of black tea per day, or more.

This is not a new issue for me. I realized that high caffeine consumption causes anxiety for me already during undergrad, more than 15 years ago. It was then when I started buying coffee regularly on campus and I noticed that if I had more than a small cup of coffee, such as a medium Starbucks coffee, I would get shaky hands, increased heart rate, and paranoid thoughts. Sort of like from THC.

Also as I got older, I noticed that if I consume a lot of caffeine for several days in a row, then I will get brain fog and a sense of derealization. Recently this happened to me again, in the fall, and I was able to realize that it was due to the two cups of coffee per day. The brain fog was quite bad. I had a feeling that I was an observer in the world, that I could not really participate, and that maybe all of the events have already happened in the past. It’s difficult to describe this strange sensation. But because I felt such depersonalization / derealization, I had a lot of motivation to reduce caffeine intake, as I was feeling quite out of it.

So here are my suggestions, based on what worked for me, and what didn’t in the past.

Caffeine intake is a continuous variable.

Just because high caffeine consumption causes negative symptoms, it doesn’t mean that the optimal intake would be 0 mg per day. Personally I find that some caffeine daily is better for me than no caffeine at all, as coffee actually reduces my OCD symptoms (intrusive thoughts), but I can’t have more than a total of one cup of coffee per day. Otherwise I get a mood / motivation crash, brain fog.

What didn’t work at all

Going to 0 caffeine consumption and ending up with very exacerbated intrusive thoughts. This never improved for me even after weeks of being caffeine free, and I did not find benefits of zero caffeine consumption.

Trying to replace my drinks with stuff suggested on the internet also did not work. This includes things like chamomile tea, dandelion root “coffee” drinks, mint tea, or water. I do not like the taste of any of those. I don’t like plain water, and if you are going to completely get rid of the drinks that you do enjoy, it will feel miserable. I don’t like water or pop, and I don’t drink juices. I have been drinking black tea since about 5 years old, and coffee since a bit later on. Tea and coffee are the only tastes that I like, especially with something creamy such as soy milk or oat milk. Neither chamomile tea nor mint tea nor dandelion root drinks taste anything similar at all and they do not combine well with soy milk, so I just felt miserable drinking them and an important enjoyable part of my day was gone.

What worked for me

When I actually figured out what I am willing to drink and what I enjoy, I was able to cut down on caffeine. Now I usually drink one cup of coffee after breakfast, which I make using a pour-over filter with 1.5 teaspoons of regular ground coffee and 1.5 teaspoons of decaf coffee. Later on in the day I make some tea where I combine loose leaf rooibos tea and loose leaf black tea, so the amount of caffeine is reduced, as rooibos is caffeine free. Sometimes I have an additional cup of coffee later on in the day, but I use mostly decaf, and maybe one teaspoon of regular coffee. After 5pm I don’t consume any caffeine, I usually drink rooibos tea with some soy milk.

I suggest first stocking up on the ingredients and having a plan of what you will drink instead of regular tea/coffee, only then proceeding with caffeine intake reduction. I purchased a lot of loose leaf rooibos, so now when I want a hot cup of tea, I add about one teaspoon of rooibos, and around 0.5 teaspoons of black / puerh tea, to add the bitterness that I enjoy. I also keep a bag of ground decaf coffee.

If you had iron deficiency anemia in the past, or other deficiencies, I suggest regular blood work

If you had iron deficiency anemia in the past, or other deficiencies, I suggest regular blood work.

I have been feeling worse in the past months than in the summer / fall. I attributed this to the Canadian winter – cold, dark after 4pm, almost no sunlight even during daylight time. And I’m sure the weather and the darkness plays a big role. I have been taking vitamin D regularly and also I use fortified soy milk in my cooking and lattes. I also take Optifer, since my ferritin was low about a year ago.

About a year ago, my ferritin was 21 µg/L, which is below the 30 µg/L threshold. My family doctor also mentioned that more recent evidence suggests that to actually feel well, ferritin should be at least around 50 µg/L, not just barely within range. She told me to start taking Optifer every other day. I have been doing that consistently for the past year, so I assumed the issue would be resolved and didn’t bother to repeat any blood work.

I was certain that the weather was the only factor contributing to worsening mood at this point, especially since I already take Optifer, vitamin D, and soy milk is fortified with B vitamins.

My psychiatrist recently suggested that I do blood work, just in case. It came back showing low ferritin again, as well as low vitamin D and B12 right at the lowest threshold value. My ferritin was 29 µg/L, and the lab note stated that <30 µg/L is consistent with iron deficiency, so after a full year of taking iron supplements, it barely increased and is still well below the level associated with actually feeling well. My vitamin D was 73 nmol/L, while the normal range is 75–250 nmol/L, so it is below range. My B12 was 241 pmol/L; the reference ranges are >220 pmol/L as normal (deficiency unlikely), 150–220 pmol/L as borderline (deficiency possible), and <150 pmol/L as low (consistent with deficiency), so even though mine is technically in the normal range, it is very close to borderline. My psychiatrist mentioned that ideally B12 should be in the 400s to actually feel well, not just barely above the cutoff. I wish I would have done the blood work sooner instead of assuming everything was fine.

I have an ongoing issue with ferritin, vitamin D, and B12 being low, these deficiencies has happened in the past. I assumed though that the supplements I was taking were enough.

I ended up getting an iron infusion. I am also now making sure to take Optifer early morning on an empty stomach, so that it would be at least an hour before food, for better absorption. I was also told that taking it every other day instead of daily is more efficient for absorption. I increased my vitamin D and B12 dosage and will do blood work again in a month.

So my suggestion is that if you have experienced deficiencies in the past, do regular blood work. Don’t assume that the deficiencies have resolved. My psychiatrist said she believes that I may have poor absorption due to Celiac disease. I don’t eat gluten, but celiac disease can still cause poor absorption even on a gluten-free diet.

The symptoms of these deficiencies often overlap and are easily mistaken for general seasonal changes or stress. Iron deficiency, or low ferritin, typically causes a deep, persistent fatigue, cognitive fog, and an inability to stay warm. It is also a primary cause of restless leg syndrome, an uncontrollable urge to move your legs, usually in the evening. Vitamin D deficiency is closely linked to significant shifts in mood, muscle aches, and a general feeling of physical heaviness. Meanwhile, low B12 can lead to neurological symptoms like tingling or “pins and needles” in your hands and feet, increased irritability, and even subtle memory lapses.

If you have had deficiencies several times in the past, it’s possible that you also have poor absorption and that deficiencies may persist despite supplementation, which means you actually need to monitor them regularly instead of assuming they’re fixed.

Rumination and the life I “should” have had

I have been thinking lately about how the brain creates continuous narratives about our past and future, stories about what should have happened and what is supposed to happen next. These narratives set expectations, but in depression, this tendency often turns into rumination. The APA Monitor describes rumination as part of a self-reinforcing cycle where negative thinking deepens a low mood, which in turn fuels more negative thinking (https://www.apa.org/monitor/nov05/cycle).

A depressed brain can easily fixate on how life “should” have gone, how it did not, and why the current outcomes now seem bad. Instead of moving toward problem-solving, the mind circles the same themes over and over. What interests me even more, though, is not just the repetition of these thoughts, but the underlying assumption behind them.

The content of those thoughts does not always make logical sense. Since I do not believe in higher powers or destinies, I don’t believe any human is born to be anything specific; people just happen to be born. The idea that my life “should” have followed a particular path isn’t grounded in any law of physics or biology. It is simply the brain constructing a narrative and then treating that narrative as if it were objective truth.

Psychologists also point out that rumination is less about the negative content and more about a repetitive style of thinking. It is the act of recycling thoughts without moving toward action. It feels like analysis, but it isn’t actually solving anything.

https://www.psychologytoday.com/ca/blog/triggered/201912/when-depression-meets-ocd-understanding-rumination

I have definitely been prone to forming these rigid narratives about how things “should” be for me. Until my early twenties, I carried a constant narrative that I was an “upcoming writer,” even though I only really wrote in a diary, some LiveJournal posts, and a few short stories. While I wasn’t depressed at the time, my brain was already getting stuck in specific stories. During much of my undergrad, for instance, I told myself that finance courses were boring and “not for me.” I convinced myself I wasn’t like the students destined for corporate jobs; my passion was writing, and I just needed to get my degree over with so I could finally focus on it.

After undergrad, when I had to get a job to pay rent and still hadn’t started a book, my narrative simply shifted. I decided I would be a professor because 9-to-5 jobs weren’t for me. I told myself I was smarter than that and was going to do something more impactful, like research, even though I had always been an average student. Consequently, when I couldn’t complete my PhD because I didn’t actually have any thesis ideas, I started to feel like I was disappearing.

I have written before about having autoimmune encephalitis in my mid-twenties, which definitely contributed to my depression. However, I also think a lack of cognitive behavioral therapy skills and the persistence of these rigid narratives played a role in that feeling of disappearing.

The CBT advice for dealing with this is often quite simple: interrupt the loop. The American Psychiatric Association suggests deliberately breaking the cycle through physical activity or by breaking problems into small, actionable steps. The goal is to turn abstract thinking into concrete movement (https://www.psychiatry.org/news-room/apa-blogs/rumination-a-cycle-of-negative-thinking).

I’ve noticed that these narratives create a direct conflict in my brain. One part of me insists that I failed because I didn’t become a professor, writer, economist, or doctor. I just have a regular 9-to-5 job. But at the same time, I realize I don’t actually want to work long hours or deal with high-level work stress. I enjoy hiking or cross-country skiing during my lunch breaks. I like swimming in an outdoor pool at noon on a weekday. I actually prefer lower responsibility and more free time.

There is a clear tension here: one part of my brain insists I should have been something extraordinary, while another part actually prefers a calm and ordinary life. Perhaps the skill isn’t to eliminate these narratives entirely, but to simply notice that they are stories, not laws of nature.

Did your psychiatrist talk to you about CYP2D6, SLC6A4, and HTR2A genes and SSRI response?

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.

Using Objective/Technical Reading as a Tool Against Depressive Rumination

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.

Reset my supplements and caffeine, started to feel better!

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.

Postpartum psychosis stories

I think it’s very important to talk about this condition that not everyone is aware of – postpartum psychosis. Postpartum psychosis is when psychosis occurs sometime after a woman gives birth, it’s a separate condition from postpartum depression. Below I have posted links to several stories of postpartum psychosis. One important message stated was that a woman would likely not be aware that she is suffering from psychosis. The delusions/hallucinations that occur during psychosis feel very real to the patient. If a woman had never experienced psychosis before and maybe even was not aware of existence of postpartum psychosis, it would be quite difficult for her to understand in that state that what she is experiencing is not real and is a serious medical condition.

I think it’s very useful for everyone to hear these stories below and to be aware what are the symptoms. During psychosis the person can have auditory hallucinations, hear voices, they can also feel that objects/people are sending them messages. In one of the stories a woman described how during her psychotic episode she heard voices coming from the radiator and thought that different colours were sending her messages. Insomnia can also be a symptom of psychosis and can exacerbate the lack of sleep caused by having a new born, and lack of sleep in turn can exacerbate psychotic symptoms. Another woman tells her story of how she started to see her mom, who actually passed away. She also hallucinated a man in her house who she thought was planning to kill her. Manic symptoms can also occur such as believing that there is a divine intervention and you are now being able to know things that others can’t, believing that you can achieve anything such as learning a language overnight, as well as rapid speech and sleeping only a few hours a day.

Postpartum psychosis – Katy’s story

Postpartum psychosis – story #2

Postpartum psychosis – story #3

NLP: Summarizing l-theanine articles

In this post I will describe my use of NLP (Natural language processing, not neuro-linguistic programming. Natural language processing is cool, while neuro-linguistic programming is some pseudoscience stuff) in the application of summarizing articles from the internet. Specifically, I chose the topic of l-theanine and psychiatry, as previously I have already summarized the Nootropics subreddit discussions on l-theanine. The next step, therefore, is to summarize existing articles on this topic.

Summarizing experience with green tea from the Nootropics subreddit

The first step was to perform an automated Google search for a specific term. I chose the term “l-theanine psychiatry” and set the number of unique urls to be 15. Some of the resulting urls are listed below:

Can L-Theanine Help Treat Symptoms of Bipolar Disorder?

Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial

L-theanine

How does the tea L-theanine buffer stress and anxiety

It can be seen that the article titles are quite relevant to our topic. The next step is formatting the text and summarizing the information.

The idea behind the summarization technique is calculating word frequencies for each word in the combined text of all articles (after stop words removal), and then selecting words in the top 10% of frequencies. These words will be the ones used in scoring each sentence. More frequent words will be given more importance, as they are deemed more relevant to the chosen topic, therefore sentences containing those words will receive higher scores. This is not a machine learning approach, but a basic frequency count method. In total, 148 words were used for sentence scoring. Some of the most frequent words (from all articles combined) are listed below:

Theanine, administration, effects, placebo, weeks, study, four, sleep, scores, cognitive, may, stress, function, fluency, studies, related, symptoms, participants, bacs, anxiety

BACS was one of the top frequent words, it stands for the Brief Assessment of Cognition in Schizophrenia. Once each sentence was scores, 15 highest scoring sentences were selected in order to create a summary. The summary of the articles is presented below. From the summary we can infer that l-theanine was studied for its effects on cognition, anxiety, and stress. Some studies had positive results, indicating that l-theanine performed significantly better than placebo in regards to positive cognitive effects such as improved verbal fluency and executive function. Studies also noted significant improvements in stress reduction with the use of l-theanine. Other studies did not find any significant differences between l-theanine and placebo.

Second, only about 20% of symptoms (the PSQI subscales) and cognitive functions (the BACS verbal fluency, especially letter fluency and executive function) scores showed significant changes after L- theanine administration compared to the placebo administration, suggesting that the effects are not large on daily function of the participants.

Although psychotropic effects were observed in the current study, four weeks L-theanine administration had no significant effect on cortisol or immunoglobulin A levels in the saliva or serum, which was inconsistent with previous studies reporting that salivary cortisol [34] and immunoglobulin A [33] levels were reduced after acute L-theanine administration.

Considering the comparison to the placebo administration, the current study suggests that the score for the BACS verbal fluency, especially letter fluency, but not the Trail Making Test, Stroop test, or other BACS parameters, significantly changes in response to the 4 weeks effects of L-theanine.

The BACS verbal fluency, especially letter fluency (p = 0.001), and executive function scores were significantly increased after L-theanine administration (p = 0.001 and 0.031, respectively; ), while the Trail Making Test A and B scores were significantly improved after placebo administration (p = 0.042 and 0.038, respectively).

When score reductions in the stress-related symptoms were compared between L-theanine and placebo administrations, changes in the PSQI sleep latency, sleep disturbance, and use of sleep medication subscales were significantly greater (p = 0.0499, 0.046, and 0.047, respectively), while those in the SDS and PSQI scores showed a non-statistically significant trend towards greater improvement (p = 0.084 and 0.073, respectively), during the L-theanine period compared to placebo.

Stratified analyses revealed that scores for verbal fluency (p = 0.002), especially letter fluency (p = 0.002), increased after L-theanine administration, compared to the placebo administration, in individuals who were sub-grouped into the lower half by the median split based on the mean pretreatment scores.

Discussion In this placebo-controlled study, stress-related symptoms assessed with SDS, STAI-T, and PSQI scores decreased, while BACS verbal fluency and executive function scores improved following four weeks L-theanine administration.

The present study aimed to examine the effects of four weeks L-theanine administration (200 mg/day, four weeks) in a healthy population, i.e., individuals without any major psychiatric disorder.

The PSQI subscale scores for sleep latency, sleep disturbance, and use of sleep medication reduced after L-theanine administration, compared to the placebo administration (all p < 0.05).

The effects on stress-related symptoms were broad among the symptom indices presented in the study, although a comparison to the placebo administration somewhat limits the efficacy of L-theanine administration for some sleep disturbance measurements.

For cognitive functions, BACS verbal fluency and executive function scores improved after four weeks L-theanine administration.

PMID: 31623400 This randomized, placebo-controlled, crossover, and double-blind trial aimed to examine the possible effects of four weeks L-theanine administration on stress-related symptoms and cognitive functions in healthy adults.

The anti-stress effects of L-theanine (200 mg/day) have been observed following once- [ 33 , 34 ] and twice daily [ 35 ] administration, while its attention-improving effects have been observed in response to treatment of 100 mg/day on four separate days [ 36 ] and 200 mg/day single administration [ 37 ], which was further supported by decreased responses in functional magnetic resonance imaging [ 38 ].

These results suggest that four weeks L-theanine administration has positive effects on stress-related symptoms and cognitive function in a healthy population.

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

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>
  https://cdn.plot.ly/plotly-2.0.0.min.js
  https://d3js.org/d3.v5.min.js
  https://cdn.jsdelivr.net/npm/chart.js@2.9.3
  http://script1.js
</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: