<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>wouldbecouldbe</author><text>Jeez, chill out.&lt;p&gt;You have zero proof &amp;amp; did zero research on this person, yet trying to put someone who down sees profound benefit with the good old: &amp;quot;it&amp;#x27;s just placebo&amp;quot;.&lt;p&gt;Just because there is no direct studies backing it up yet doesn&amp;#x27;t mean there isn&amp;#x27;t real effect. Could be keto, could be lack of certain starches or other foods, could be the focus &amp;amp; rhytm, whatever it is let&amp;#x27;s not discourage someone who is having a great practical benefit.&lt;p&gt;In this case there is literature &amp;amp; studies on epilepsy and keto, and OP was on put on epileptic medicine &amp;amp; describes a link: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.ncbi.nlm.nih.gov&amp;#x2F;pmc&amp;#x2F;articles&amp;#x2F;PMC6361831&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.ncbi.nlm.nih.gov&amp;#x2F;pmc&amp;#x2F;articles&amp;#x2F;PMC6361831&amp;#x2F;&lt;/a&gt;</text><parent_chain><item><author>jdietrich</author><text>&lt;i&gt;&amp;gt;I can&amp;#x27;t help but think &amp;quot;finally&amp;quot; and &amp;quot;told ya so&amp;quot; regarding this news.&lt;/i&gt;&lt;p&gt;I don&amp;#x27;t want to dismiss your personal experiences, but I think that&amp;#x27;s the wrong conclusion to draw.&lt;p&gt;Common mental illnesses - particularly depression and anxiety - have incredibly high placebo response rates. &lt;i&gt;Everything&lt;/i&gt; looks like a promising treatment for depression in an uncontrolled trial. You can pick practically any intervention - including literal sugar pills - and get ~40% remission rates in an open-label pilot study. Many thousands of potential treatments supported by plausible theories, anecdotal accounts, case reports and small uncontrolled trials have fallen flat as soon as they were tested rigorously. The base rate suggests that the chance of a keto diet (or any other intervention with this level of evidence) being an effective treatment for depression is on the order of 0.1%.&lt;p&gt;If keto works for you then you should stick with it. The problem is that it&amp;#x27;s overwhelmingly likely to be no more effective for other people than a low-fat diet or a low-GI diet or sugar pills or faith healing. Articles like this one do a huge disservice to patients, because they completely neglect the base rate and perpetuate a cycle of hype and disappointment that can ultimately lead to distrust and despair.&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;pubmed.ncbi.nlm.nih.gov&amp;#x2F;7945737&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;pubmed.ncbi.nlm.nih.gov&amp;#x2F;7945737&amp;#x2F;&lt;/a&gt;</text></item><item><author>elliotec</author><text>I can&amp;#x27;t help but think &amp;quot;finally&amp;quot; and &amp;quot;told ya so&amp;quot; regarding this news.&lt;p&gt;It&amp;#x27;s difficult to describe how massively my life changed when I started keto.&lt;p&gt;Like the subject of the article, I&amp;#x27;ve had Bipolar (1 in my case, they didn&amp;#x27;t specify their version) for most of my life, since way before it&amp;#x27;s supposed to manifest in late adolescence. I was misdiagnosed here and there since I was a very young child, but I finally got on the right treatment plan at 20 years old.&lt;p&gt;The maintenance of that treatment plan has been taking a medium dose of Lamictal, an epilepsy drug, daily. It worked damn well compared to the regular mania, often culminating in psychosis and occasional full-on can&amp;#x27;t-even-hold-a-job levels of suicidal depression, but within a week of full-blown ketosis, I was a new person.&lt;p&gt;I found out about it through some documentary disguised as &amp;quot;In Defense of Fat&amp;quot; or something similar, and I was fascinated by the epilepsy cure thing. I had always known there was a connection between my condition and epilepsy, given that I was on seizure drugs and often experienced what I figured were mini-seizures (often described as brain zaps, I think).&lt;p&gt;I couldn&amp;#x27;t find any information on links except a few random, very weak studies, and sorta just told everyone who naysayed me to fuck off cuz it works for me. I lost 20 lbs of excess covid weight as a very nice side-effect, but I can safely say this is the most effective treatment I&amp;#x27;ve ever experienced for my condition (of the many, many I&amp;#x27;ve tried) and I feel like I have superpowers in comparison.&lt;p&gt;It is very obvious if I get kicked out of ketosis now after a few days or so. I&amp;#x27;ve done it purposefully on vacations or just random cheat times. After a while I feel worse in the head, body, and soul. I make dumb or impulsive decisions (like my old self), or am grumpy in a way I haven&amp;#x27;t been since starting. I start to have awful dreams again and wake up my wife sleep-talking in distress, and am tired all the time like the old days.&lt;p&gt;It&amp;#x27;s certainly not the easiest diet to adhere to, it&amp;#x27;s also surely not the best for the environment unless you&amp;#x27;re really strict in specific ways like some, and it&amp;#x27;s potentially disruptive socially, but it&amp;#x27;s a lifestyle choice that has given me personally a truly new and improved life that I don&amp;#x27;t ever want to or plan to return from.</text></item></parent_chain></comment><story><title>Patients say keto helps with mental illness. Science is racing to understand why</title><url>https://www.npr.org/sections/health-shots/2024/01/27/1227062470/keto-ketogenic-diet-mental-illness-bipolar-depression</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>elliotec</author><text>I’m not drawing any conclusions or promoting it for anyone else. I’m expressing excitement that there is clearly _something there_ that other people see too and are willing to put through research rigor. It’s validating to see that others might have found treatment this way in their own vacuum and is worth looking into.&lt;p&gt;Regarding placebo - they do touch on this in the article. I have pretty high confidence it’s not placebo for me. But that’s the point, we just don’t know yet and all I’m saying is I’m glad we will soon know more based on my experience.</text><parent_chain><item><author>jdietrich</author><text>&lt;i&gt;&amp;gt;I can&amp;#x27;t help but think &amp;quot;finally&amp;quot; and &amp;quot;told ya so&amp;quot; regarding this news.&lt;/i&gt;&lt;p&gt;I don&amp;#x27;t want to dismiss your personal experiences, but I think that&amp;#x27;s the wrong conclusion to draw.&lt;p&gt;Common mental illnesses - particularly depression and anxiety - have incredibly high placebo response rates. &lt;i&gt;Everything&lt;/i&gt; looks like a promising treatment for depression in an uncontrolled trial. You can pick practically any intervention - including literal sugar pills - and get ~40% remission rates in an open-label pilot study. Many thousands of potential treatments supported by plausible theories, anecdotal accounts, case reports and small uncontrolled trials have fallen flat as soon as they were tested rigorously. The base rate suggests that the chance of a keto diet (or any other intervention with this level of evidence) being an effective treatment for depression is on the order of 0.1%.&lt;p&gt;If keto works for you then you should stick with it. The problem is that it&amp;#x27;s overwhelmingly likely to be no more effective for other people than a low-fat diet or a low-GI diet or sugar pills or faith healing. Articles like this one do a huge disservice to patients, because they completely neglect the base rate and perpetuate a cycle of hype and disappointment that can ultimately lead to distrust and despair.&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;pubmed.ncbi.nlm.nih.gov&amp;#x2F;7945737&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;pubmed.ncbi.nlm.nih.gov&amp;#x2F;7945737&amp;#x2F;&lt;/a&gt;</text></item><item><author>elliotec</author><text>I can&amp;#x27;t help but think &amp;quot;finally&amp;quot; and &amp;quot;told ya so&amp;quot; regarding this news.&lt;p&gt;It&amp;#x27;s difficult to describe how massively my life changed when I started keto.&lt;p&gt;Like the subject of the article, I&amp;#x27;ve had Bipolar (1 in my case, they didn&amp;#x27;t specify their version) for most of my life, since way before it&amp;#x27;s supposed to manifest in late adolescence. I was misdiagnosed here and there since I was a very young child, but I finally got on the right treatment plan at 20 years old.&lt;p&gt;The maintenance of that treatment plan has been taking a medium dose of Lamictal, an epilepsy drug, daily. It worked damn well compared to the regular mania, often culminating in psychosis and occasional full-on can&amp;#x27;t-even-hold-a-job levels of suicidal depression, but within a week of full-blown ketosis, I was a new person.&lt;p&gt;I found out about it through some documentary disguised as &amp;quot;In Defense of Fat&amp;quot; or something similar, and I was fascinated by the epilepsy cure thing. I had always known there was a connection between my condition and epilepsy, given that I was on seizure drugs and often experienced what I figured were mini-seizures (often described as brain zaps, I think).&lt;p&gt;I couldn&amp;#x27;t find any information on links except a few random, very weak studies, and sorta just told everyone who naysayed me to fuck off cuz it works for me. I lost 20 lbs of excess covid weight as a very nice side-effect, but I can safely say this is the most effective treatment I&amp;#x27;ve ever experienced for my condition (of the many, many I&amp;#x27;ve tried) and I feel like I have superpowers in comparison.&lt;p&gt;It is very obvious if I get kicked out of ketosis now after a few days or so. I&amp;#x27;ve done it purposefully on vacations or just random cheat times. After a while I feel worse in the head, body, and soul. I make dumb or impulsive decisions (like my old self), or am grumpy in a way I haven&amp;#x27;t been since starting. I start to have awful dreams again and wake up my wife sleep-talking in distress, and am tired all the time like the old days.&lt;p&gt;It&amp;#x27;s certainly not the easiest diet to adhere to, it&amp;#x27;s also surely not the best for the environment unless you&amp;#x27;re really strict in specific ways like some, and it&amp;#x27;s potentially disruptive socially, but it&amp;#x27;s a lifestyle choice that has given me personally a truly new and improved life that I don&amp;#x27;t ever want to or plan to return from.</text></item></parent_chain></comment><story><title>Patients say keto helps with mental illness. Science is racing to understand why</title><url>https://www.npr.org/sections/health-shots/2024/01/27/1227062470/keto-ketogenic-diet-mental-illness-bipolar-depression</url></story>