Vitamin D & Omega-3 have a larger effect on depression than antidepressants
- Effect Size Comparison: The author presents research suggesting that Vitamin D and Omega-3 (specifically EPA) have larger effect sizes on depression than many standard antidepressants and psychotherapies.
- Recommended Dosages:
- Vitamin D: ~4000 IU daily (the official safe limit), with a note that 10,000 IU has been used in trials without lasting adverse effects.
- Omega-3: ~1500 mg daily of high-EPA Omega-3 (where EPA is at least 60% of the total).
- Stacking Interventions: The author emphasizes that supplements are not necessarily a "replacement" for medication but can be used alongside them ("stacked") to improve outcomes.
- Other High-Impact Factors: Beyond supplements, the post highlights other lifestyle interventions with significant effect sizes, including good sleep (1.10), aerobic exercise (0.79), and bright light therapy (0.48).
- The "Vicious Cycle": Depression is described as a negative feedback loop where low energy leads to low-effort choices, which further drains energy; intervention is needed to break this cycle.
- Personal Philosophy: The author views depression as a combination of biology and "mind-debugging," advocating for evidence-based tools like Cognitive Behavioral Therapy (CBT) and tracking progress with metrics like the Burns Depression Checklist.
Hacker News Discussion
- Skepticism of Effect Sizes: Many commenters warn that the "massive" effect sizes for supplements often come from small, low-quality studies and typically shrink or disappear in larger, more rigorous clinical trials.
- Causality Concerns: Users pointed out that low Vitamin D levels might be a symptom of depression (staying indoors, poor diet) rather than the primary cause, making supplementation less of a "magic bullet" than the data might suggest.
- Pharma vs. Supplements: Some criticized the "supplement-over-pharma" narrative, noting that while antidepressants have a smaller effect size on paper, they are life-saving for many, whereas supplements often fail to show significance in meta-analyses.
- Bioavailability and Specificity: Discussion touched on the importance of specific forms of supplements, such as D3 vs. D2 and the critical EPA/DHA ratio in fish oil, echoing the author's point about EPA-dominant Omega-3.
- The "Small Study Effect": Several comments highlighted the "file drawer problem," where only small studies with positive, outlier results get published, leading to an exaggerated perception of efficacy for natural remedies.