Omega-3 Fatty Acids and Mental Health

You have probably heard reports that omega-3 fatty acids may offer cardiovascular benefits, especially for people with high triglyceride levels. But can they affect mental health conditions? Can omega-3s ease psychological symptoms?

What Are Omega-3 Fatty Acids?

Omega-3s are a kind of polyunsaturated (“good”) fat that come in different forms:

  • Docosahexaenoic acid (DHA)—from fish and fish oil
  • Eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA)—from plants and plant oil

Omega-3 supplements are easy to find in supermarkets and pharmacies, but you can also get these fatty acids by changing your diet to include more:

  • Fatty fish (eg, salmon, tuna, mackerel, and herring)
  • Plant foods (eg, wheat germ, oat germ, walnuts, spinach, and tofu)

If you or someone you know has a mental health condition, you may be wondering if omega-3s have been successful as a natural treatment.

What Does the Research Say?

Researchers have studied omega-3s as a potential treatment for a range of mental health conditions. The overall evidence is mixed, though.

Depression

Depression is a mood disorder that is marked by feelings of profound sadness and a lack of interest in activities. Treatment typically involves antidepressant medicines and therapy.

The Findings

Some studies do support the use of omega-3s in people with depression. A review of 35 trials found that these fatty acids may improve symptoms (like feelings of sadness or worthlessness), and people with severe symptoms may experience a greater benefit.

Three small studies found that EPA might help improve symptoms in people not having success with antidepressants.

Also, organizations like the American Psychological Association suggest that omega-3s may be useful as an addition to antidepressant therapy. In one small trial, people who took both antidepressants and omega-3s experienced more of an improvement compared to those who took their medicine and a placebo.

Not all of the findings have been positive, though. A large study involving 432 people found that omega-3s do not appear to reduce symptoms in people who have depression. Researchers also looked at people with both depression and heart disease. Those that took the antidepressant sertraline (Zoloft) and omega-3s did not experience a greater improvement than those that took sertraline and placebo; and a smaller study of 36 people found that DHA did not help improve depressive symptoms.

With these mixed results, it is difficult to say that omega-3s are clearly helpful in relieving depression.

Bipolar Disorder

A person who has bipolar disorder experiences extreme swings in mood (from mania to depression), as well as changes in energy, and the ability to function. Along with counseling, various medications are used to treat this condition.

The Findings

Not as many studies have been done on bipolar disorder and omega-3s. A review of five trials found that there is not enough evidence to determine the effectiveness of these fatty acids for treating bipolar disorder. One trial, though, involving 75 people did find that EPA might reduce the symptoms of bipolar depression.

Schizophrenia

Schizophrenia is a severe brain disorder that includes symptoms like hallucinations, delusions and paranoia. Antipsychotics and supportive therapy are common treatments.

The Findings

In a review of eight trials involving 517 people, researchers did not find enough evidence to support the use of omega-3s to treat schizophrenia. One trial in this review did show some improvement in the mental state of patients.

Researchers have discovered, though, some promising news in the area of prevention. Teens and young adults who are at an extremely high risk of having a psychotic disorder, including schizophrenia, may be able to delay its onset by taking omega-3 supplements. One downside is that since this study focused on a very specific group, it is hard to apply the results to a larger population.

Borderline Personality Disorder

Borderline personality disorder (BPD) is a challenging condition that can involve emotional issues, including impulsivity and severe interpersonal problems. Behavioral therapy and antidepressants are often used to improve symptoms.

The Findings

A review of 28 trials involving 1,742 people with BPD found that medicines and supplements, including omega-3s, might not be helpful in improving symptoms. In one small study, though, 30 women with moderate to severe BPD experienced an improvement in their feelings of depression and aggression while taking EPA.

Attention Deficit Hyperactivity Disorder

People who have attention deficit hyperactivity disorder (ADHD) may be hyperactive, impulsive, and inattentive. These symptoms often interfere with school and work. In addition to behavioral therapy, there are many medicines available to treat ADHD.

The Findings

There is some evidence that omega-3 and omega-6 (another type of fatty acid) might help some children and teens with ADHD. Seventy-five kids were randomized to receive the fatty acids or a placebo for three months. Those who took omega-3 and omega-6 supplements had an improvement in their symptoms.

Other studies have not been as positive. A larger study involving 92 children did not find any association between EPA and an improvement in ADHD symptoms. Along the same line, DHA supplementation may not offer any benefits for children with ADHD.

If You Are Thinking About Taking Omega 3s…

Researchers continue to study the effects of omega-3s for the treatment of mental health conditions. While this area is still being explored, you may be interested in adding more omega-3 rich foods to your diet and possibly taking a daily supplement.

If you do take omega-3s, keep these things in mind:

  • In general, omega-3 supplements are safe. But there is a possibility that they can increase bleeding, especially in people who are taking blood-thinning medications (such as warfarin). So, it is important that you talk to your doctor before taking omega-3s.
  • Make sure that the supplements that you buy do not have toxic contaminants, like mercury.
  • Also, be aware that sometimes omega-3s are paired with vitamins A and D. Since these are fat-soluble vitamins, they can reach toxic levels in your body when taken in excess. You may want to buy omega-3s that do not include these vitamins.
  • Never use omega-3s as a replacement for psychiatric medicines. There are conventional treatments that have shown success, like antidepressants and behavioral therapy. Be sure that you work with your doctor to get the best care possible. Do not try to treat any mental health condition on your own.

REFERENCES:

Amminger GP, Schäfer MR, Papageorgiou K, et al. Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Arch Gen Psychiatry. 2010;67(2):146-154.

Berger GE, Proffitt TM, McConchie M, et al. Ethyl-eicosapentaenoic acid in first-episode psychosis: a randomized, placebo-controlled trial. J Clin Psychiatry. 2007;68(12):1867-1875.

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