Mental disease and psychological well-being have a great impact on our daily quality of life. That’s why we should strive to take preventive measures, especially if we know that we are genetically or environmentally susceptible for certain disorders. This article discusses how adding omega-3 fatty acids can possibly help when it comes to mental health.
The omega-3 fatty acid articles are a trilogy that covers all important aspects of adding more of this fatty acid family in your diet. In the first post you will see how eating omega-3 fatty acids can impact your physical health. The second one talks about the mental health aspect, and the last one about our brain and known cognitive outcomes due to omega-3 fatty acids.
When talking about omega-3 fatty acids and mental health, there are two main conceptual ideas for their use.
- Primary or supplemental treatment with omega-3 fatty acids
- Connections between the onset, continuation, or recurrence of a certain disorder or condition and omega-3 fatty acids consumption
In the first one, we use them as the main or supplementary way of treatment. In the second, we pay attention between the connection of adding a source of omega-3 fatty acids into our eating patterns, and the progression, recurrence, or onset of a certain illness.
The connection between omega-3 fatty acid intake and physical health is getting clearer with each year that passes, but there is still a lot of work to do. The same cannot be said for mental health. When it comes to the effects that omega-3 have on mental health, the waters become murkier. We know that they are involved in many physiological processes, as the shift to a lower consumption of omega-3 fatty acids has been associated with an increased number of certain mental illnesses.
However, this increase could be attributed to a number of other changes that have occurred simultaneously with the dietary changes. I’ll give you a short rundown of four mental illnesses and their connection to omega-3 fatty acids.
Epidemiological studies suggest preventive effects of long-term fish intake against depression. And yes, we have to understand that these studies show only connections and never direct links. So saying doing X will result in Y with absolute certainty is not something that can be inferred from it.
Interpreting is a tricky business as the interpretation of such connections could be attributed to a huge number of reasons and only the top-level students of the top Interpretational universities are allowed to do that (that was a joke).
So we move on to more definite research, which possibly provides us with more firm information. In clinical trials and other, more controlled, designs, the results for depression have been mixed.
Very recent results suggest that EPA, and not DHA, may have the main antidepressant effect. Positive results were mostly found when people received an omega-3 fatty acid supplement in which the EPA content was at least 60%. When it was lower, there were mostly no statistically significant effects. If an effect is considered to be statistically insignificant, there is a very high chance of it being a coincidence.
At the same time, more dramatic improvements were found for people suffering from severe cases of major depressive disorder (MDD). This means that an omega-3 fatty acid supplement with a high EPA content could be more useful for people undergoing severe episodes of depression.
It is also important to note that the newer studies show greater variability in results even when people were supplemented with omega-3 fatty acids that had higher EPA contents. However, this could be attributed to a number of reasons:
- Lower amounts of omega-3 fatty acid fish oil supplementation used in certain newer studies
- Different diagnostic criteria that were used in different studies and patients
Another possible reason are methodological differences. A lot of the studies differed in their length, administration, how well they were controlled etc. And these factors could scramble the results. It is possible that we would witness better effects if all of them used similar amounts of omega-3’s and similar diagnostic criteria. Based on these results, omega-3 fatty acids could be used as an augmentation for antidepressants. Moreover, if further studies shows enough promise, they could be even used as a main therapeutic agent, at least for the people who cannot use antidepressants due to various side effects. This would at least ease some symptoms.
Bipolar disorder is classified as a mood disorder with episodes of raised or agitated (manic) mood, which is followed by episodes of depression and then again manic mood possibly never ending.
In the studies done on bipolar disorder so far, omega-3 fatty acid supplementation has been shown to have a significant yet moderate effect. Improvements are mostly related to the depressive symptomatics. This is understandable when we consider what I have written in the previous paragraph. However, there are also some preliminary results that show a possible reduction in anger and irritability, but it is too early to call this a fact, we could carve in stone.
Intriguing, isn’t it?
Some new studies that have assesd the prevention of psychosis with omega-3 fatty acids are promising, but far from conclusive. The results so far suggest that they could be more useful for psychoses, which are not related to emotions or mood. When it comes to the treatment itself, the results become more mixed. Studies show that EPA is more effective than DHA, however, using omega-3 fatty acids as a substitute for antipsychotics is not recommended. While single people may claim drastic improvements and serve as interesting case studies, the bulk of evidence-based medicine and psychiatry doesn’t recommend completely substituting antipsychotics.
But. Due to the low risks, and almost no side effects of omega-3 fatty acid supplementation, using them as a preventive measure is a good rule of thumb. The uses of omega-3 fatty acids span across mental and physical health. Furthermore, by doing this you cut your chances of being deficient in any of the mentioned acids.
In the past there have been no found improvements in large ADHD studies that had a good design, but recently there have been significant improvements in 4 out of 7 clinical trials.
Reasons for those showing no improvements could be discussed.
Possible reasons may be:
- Insufficient omega-3 fatty acid dosing (the same as in some studies with depression)
- Improper EPA:DHA ratio (again – the same as with depression)
- Presence or absence of vitamin E in the study (some included this to avoid lipids from deteriorating) which may have affected the outcome
- The duration of those studies themselves.
While such results show promise for future studies, we should not be too quick to draw conclusions. Studies that would be done in the same way with similar/higher doses should be compared in the future to capitalize on these findings.
As we can see, adding fish to eat healthier, or adding other omega-3 fatty acid sources into our eating patterns, could have some preventive, as well as therapeutic effects on our mental health. While these results may not apply to everyone, it is beneficial to know these things if we are at risk, or if we know anyone who is at risk for any of the mentioned diseases.
I cannot stress enough that the results are very varied due to different methodologies. Seemingly small differences can have large effects on outcomes. This is a reason why we should stay a bit cautious when directly comparing such information by ourselves. It is very well possible that with more controlled and uniform study designs; with larger samples, similar/stricter diagnostic criteria, and a longer time frame, we could notice better results.
And to finish of the trilogy of the omega-3 posts for now, I invite you to read the cognitive benefits of having enough DHA in our eating patterns.