The Joy of Omega-3 Fats

There is real hope for those looking to heal depression naturally.

If you’re only going to do one thing to promote improved mood and well-being, it should be to create a cellular “oil change” by increasing your intake of omega-3 fatty acids. This won’t yield the same caliber of benefit as a comprehensive program (discussed in my article “Depression, Drugs, and DHA), but evidence is strong that this specific change is foundational – that the others (including even drugs meant to “treat” depression) won’t work nearly as well without it.

Unless you’ve been ignoring the health headlines for quite some time, you know that fish and fish oil supplements are highly recommended for prevention of heart disease, stroke, and autoimmune disease, and their role in infant and child health is becoming increasingly appreciated. The health benefits of fish and fish oil are attributable to their high content of the omega-3 long-chain polyunsaturated fatty acids (LCPUFAs), DHA and eicosapentaenoic acid (EPA).

Diets have dramatically changed over the past 100 years, and have changed even more dramatically from the diets of hunter-gatherers who have inhabited the planet for millions of years. One of the most important shifts in modern diets has been a near-obliteration of DHA, EPA, and the short-chain omega-3, alpha-linolenic acid (ALA) from which DHA and EPA can be formed under the right circumstances. These healthful fats were unwittingly replaced by saturated fats and omega-6 (often, hydrogenated versions, which are now known to be deadly to the heart and to cause cancer) fats from fatty meats, dairy, and highly processed vegetable oils. Hunter-gatherer diets were made up of omega-6 to omega-3 fats in about a 1:1 ratio; modern Western diets are usually closer to a ratio of 25:1. The concurrent, astronomical increase in chronic disease states such as heart disease, cancer, and depression is very likely not a coincidence.

What evidence do we have to support this conclusion?

  • There is a compelling relationship between the consumption of DHA and its rate of depressive symptoms (more DHA = less depression). This relationship between DHA intake and depression risk has also been found in both clinical and postpartum depression: higher fish intake is correlated with a significantly lower risk of depression.
  • Women with higher DHA concentrations in their breast milk, suggesting higher intake or stores of the nutrient, have lower risk of postpartum depression.
  • Omega-3 fats are an important raw material for the building of the nervous system – particularly, the membranes of nerve and brain cells. Just as certain building materials make a better house than others, the building material of omega-3 fats make a better brain cell membrane. A membrane built from the more inferior material – omega-6 fatty acids – is, in the words of depression and bipolar disorder expert John McManamy – “less able to deal with neurotransmitter traffic.”
  • In fact, DHA is super-concentrated right at the business ends of nerve cells: the membranes on either side of the synapse, where nerve impulses pass from one cell to the next via neurotransmitter release and uptake. It comes as no surprise that DHA and EPA have been found to positively (and powerfully) affect the actions of dopamine and serotonin – the very neurotransmitters that are the targets of most antidepressant drugs.
  • Research suggests that adequate DHA is needed to restore optimal serotonin activity. Without adequate DHA, even SSRI drugs may not do the job.
  • Lowered DHA levels in blood and tissues have been found in depressed individuals with coronary heart disease (CHD) – and this could be the common ground that makes depression a known CHD risk factor.
  • Tests show that people with major depression are likely to have lower blood, cell membrane, and tissue levels of DHA than people who are not depressed. <
  • Blood flow within the brain has been found to be altered in depressed people; omega-3 deficiency has been found to reduce blood flow in the brain.
  • Phosphatidylserine (PS) is a major component of nerve cell membranes; PS supplementation has been found to improve cognition and memory, and can help to stave off age-related memory loss. A deficiency of DHA has been found to reduce levels of PS in the brain.
  • And, the clincher: many studies have demonstrated a significant therapeutic effect of fish oil supplements for depression and bipolar disorder. Moreover, the addition of omega-3 fats to antidepressant treatment has been found to significantly improve the therapeutic effects of the medicine.

By now, I’m sure you agree that the evidence is compelling in favor of omega-3s as natural antidepressants. The risk of trying an omega-3 supplement is virtually zero. Even with very high doses, gastrointestinal complaints are the worst side effects, and these can be avoided by taking the recommended daily intake in several “installments” over the course of the day.
Two caveats:

  • If you are currently being treated for depression or bipolar disorder, do not stop your medication “cold turkey.” It’s safe to use omega-3s along with your medicines, and you can suffer some very unpleasant withdrawal effects if you stop neurotransmitter-altering drugs without medical guidance!
  • Omega-3s are mild blood thinners. This is a beneficial side effect unless you are scheduled to have surgery. Ask your physician if you should taper off your DHA/EPA supplement in the week or so before having surgery and resume it after the operation.

How Much Supplemental DHA and EPA Should You Take?

Joseph Hibbeln, MD of the NIH and Andrew Stoll, MD of Harvard are hot on the research trail that will hopefully lead to the widespread use of fish oil for the treatment and prevention of depression. The intakes these physicians have found to be successful are quite high, ranging from four (4) to ten (10) grams or more of DHA and EPA per day. Dr. Stoll used 6.5 grams of EPA and 3.5 grams of DHA in his studies of bipolar disorder. Intakes up to 4.4 g EPA and 2.2 g DHA have been used successfully to alleviate depressive symptoms.

Start with an Intake of fish oil, krill oil, or algae-derived DHA/EPA that contains 1,000 to 2,000 mg of DHA or combined EPA and DHA each day. If this Intake is ineffective after a month or so, you can gradually increase the Intake, spending a month or so at each successive Daily Intake. Do not go beyond 10 grams per day of EPA/DHA.

If using high Intakes (above 2,000 mg DHA/EPA per day), take a pharmaceutical grade omega-3 supplement that contains 90 percent omega-3s (most commercially available supplements are only 30-60 percent omega-3s). You can expect DHA/EPA therapy to take one to three months to have substantial effect on depressive symptoms. Always let your doctor know what you’re up to if you take any prescription medications. You can also eat fish two to three times weekly; stick with wild-caught deep-water fish like wild Alaskan salmon and sardines.

To avoid toxins commonly found in fish, use an oil that has been molecularly distilled. You’re safest using a supplement containing oil from cold-water sea creatures that are low on the food chain (salmon, sardine, anchovy, krill, algae).

Some beneficial side effects you might experience: a positive change in high blood cholesterol levels; more supple, less irritable skin; and reduced allergies. If you aren’t depressed, but want to maintain levels of DHA and EPA in your body that are high enough to prevent depression, you can take 400 mg of omega-3s per day.

Keep in mind that there’s much more to healing depression naturally than DHA and EPA supplementation: other dietary changes, amino acid supplementation, and exercise are important, too. For now, as you increase your intake of omega-3s, back off of the omega-6s (fatty meats, full-fat dairy, and processed foods fried in or made with any nut, seed, or vegetable oil aside from canola or olive). Reduce your intake of sugars and other refined starches; this optimizes the effects of DHA and EPA in your system.

For a truly comprehensive look at the relationship between omega-3 fatty acids, depression, ADHD, senile dementia, and Alzheimer’s disease, please refer to Chapter Eight of my book, Brighter Mind.

References

de Wilde MC, Farkas E, Gerritis M, Kiliaan AJ, Luiten PGM. The effect of n-3 polyunsaturated fatty acid- ich diets on cognitive and cerebrovascular parameters in chronic cerebral hypoperfusion. Brain Res 2002; 947: 166-73.

Ellis EF, Police RJ, Dodson LY, McKinney JS, Holt SA. Effect of dietary n-3 fatty acids on cerebra m icrocirculation. Am J Physiol 1992; 262: H1379-H1386.

Glenmullen, Joseph, M.D., Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil, and Other Antidepressants With Safe, Effective Alternatives, Simon & Schuster, New York, NY: 2000.

Ito H, Kawashima R, Awata S, Ono S, et al. Hypoperfusion in the limbic system and prefrontal cortex in depression: SPECT with anatomic standardization technique. J Nucl Med 1996; 37: 410-4.

Kamphuis MH, Geerlings MI, Tijhuis MA, et al. Depression and cardiovascular mortality: a role for n-3 fatty acids? The American Journal of Clinical Nutrition 2006 Dec; 84(6):1513-7.

Kimbrell TA, Ketter TA, George MS, Little JT, et al. Regional cerebral glucose utilization in patients with a range of severities in unipolar depression. Biol Psychiatry 2002; 51: 237-52.

Parker GB, Heruc GA, Hilton TM, et al. Low levels of docosahexaenoic acid identified in acute coronary syndrome patients with depression. Psychiatry Res 2006 Mar 30; 141(3):279-86.

Zito JM, Safer DJ, dosReis S, et al, “Trends in the Prescribing of Psychotropic Medications to Preschoolers,” JAMA 2000; 283:1025-1030.

Riylan ZY, Bernard GC, LeFamconnier JM, Durand GA, Bourre JM. Effect of dietary n-3 fatty acid deficiency on blood-to-brain transfer of sucrose, alpha-aminoisobutyrie acid and phenylalamine in the rat. Neurosci Lett 1992; 137: 9-13.

Stoll, Andrew L, MD, The Omega-3 Connection: The Groundbreaking Antidepression Diet and Brain Program, Free Press, 2002.

Zimmer L, Vancassel S, Cantagrel S, Breton, et al. The dopamine mesocorticolimbic pathway is affected by deficiency in n-3 polyunsaturated fatty acids. The American Journal of Clinical Nutrition 2002; 75: 662-7.

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