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Fish Oil (Omega-3 Fatty Acids) for Bipolar Disorder |  | | By Newsweek |
Brain food: Omega-3 fatty acids
are found in salmon, spinach,
multigrain cereal, eggs, walnuts
and fish oil capsules
Nourishing Your Brain:
It’s no secret that the fats in fish
and walnuts are good for your
heart. New research suggests
they may also ward off
depression and mental
maladies
By Anne Underwood
NEWSWEEK
April 23 issue — Psychiatrist
Andrew Stoll has seen plenty of
patients with bipolar disorder,
but few more serious than a
middle-aged man he calls “X.”
Patient X suffered his first
episode of mania in Rome,
where he became so delusional
that he landed first in jail and
then in a psychiatric ward.
PATIENT X ESCAPED AND
was re-arrested, but by then the
Italian authorities had had
enough. They bundled him onto
a plane back to Boston, where
he was taken to Stoll’s office at
Brigham and Women’s
Hospital. Stoll tried all the usual
medications. But lithium alone
didn’t work, and Patient X was
unable to tolerate the side
effects of strong antipsychotic
drugs. That’s when Stoll, an
assistant professor of psychiatry
at Harvard, turned to a more
unconventional remedy—he
instructed Patient X to eat a
quarter pound of salmon every
day, while continuing to take his
lithium. The treatment proved a
success.
The brain is an astonishing 60
percent fat, and it needs
omega-3s to function properly.
Salmon? As psychiatric
regimens go, it may sound fishy.
But in a new book called “The
Omega-3 Connection,” Stoll
argues that fish oils—with their
high content of polyunsaturated,
omega-3 fatty acids—may help
a range of psychiatric disorders.
The brain is an astonishing 60
percent fat, and it needs
omega-3s to function properly.
In the last century, however,
Americans have drastically
reduced their intake of these
oils, as we moved to diets
based on processed foods. This
deficit, scientists agree, has
contributed to an epidemic of
heart disease. Now a spate of
cross-national studies has also
linked low fish consumption to
high rates of major depression,
bipolar disorder, postpartum
depression and suicidal
tendencies. “Heart disease and
depression often go hand in
hand,” says Dr. Joseph Hibbeln,
the National Institutes of Health
psychiatrist who conducted a
number of these surveys. “Now
we may know why.”
It is impossible to reduce
the cause to a single
explanation—especially since
omega-3s may function
differently in each of these
conditions. For major
depression, omega-3s appear
to work in part by making it
easier for the receptors on brain
cells to process mood-related
signals from neighboring
neurons. “Think of the receptor
as a doorbell on a house,” says
Dr. Lauren Marengell of Baylor
College of Medicine. Omega-3s
provide the lubrication that frees
up a stuck doorbell and allows it
to respond to a messenger’s
touch. The same fats may
combat bipolar disorder (which
involves mania as well as
depression) by inhibiting a
process called signal
transduction, which occurs
inside a brain cell after a
messenger has “rung the bell.”
In a normal brain, the process is
orderly. But in a bipolar patient,
it’s as if everyone in a house
started running in different
directions at the sound of the
buzzer—and not necessarily
answering the door.
Omega-3s—like all the major
medications used to treat
bipolar disorder—help quiet this
confusion.
If a woman is low on omega-3s
to begin with, this depletion may
set the stage for postpartum
depression.
While omega-3s are
important for everyone, an
adequate supply is especially
critical for infants and mothers.
Gestating and newborn babies
often deplete their moms of
these fats in order to nourish
their own brains. If a woman is
low on omega-3s to begin with,
this depletion may set the stage
for postpartum depression. A
child takes in large amounts of
these fats during the third
trimester of gestation, and
breast milk maintains a steady
supply following birth. Infant
formulas, by contrast, deliver
very little. (The World Health
Organization recommends
supplementing formulas with
omega-3s, but the U.S. Food
and Drug Administration has not
yet approved supplementation.
The matter is under review.)
No one doubts that
omega-3 fatty acids help build
and maintain brain tissue. But
can the same fats help treat
psychiatric disorders?
Researchers have not
conducted the large clinical
trials needed to answer that
question, but the early evidence
is encouraging. When Stoll
supplemented the medications
of 30 bipolar patients with either
10 grams of omega-3s or a
placebo, those getting the fish
oil did so much better that he
switched the controls over to fish
oil just four months into a
nine-month trial. British doctors
have also gotten impressive
results in trials for depression
and schizophrenia. Other
researchers, however, have
found negative or neutral results
in pilot studies, so it’s not yet
possible to deem fish oil an
effective therapy. “The field is
still in its infancy,” cautions
Hibbeln. “What we have now are
provocative hypotheses, not a lot
of hard-nosed data.” Fortunately,
because omega-3s are a
normal part of the diet, they have
caused virtually no side effects
in the trials. “Omega-3s just give
back to the body what it requires
for proper functioning,” says
Stoll.
Focus on Health: Prescription
Drugs At Bargain Prices
So how can we boost our
omega-3 levels? The American
Heart Association has recently
changed its dietary guidelines to
recommend that adults eat at
least two servings of fish each
week. Oily fish such as
anchovies, mackerel and
salmon have the most
omega-3s. (The FDA, however,
recently warned pregnant
women against eating four types
of fish with high mercury
levels—shark, swordfish, tilefish
and king mackerel.) Flaxseed,
flaxseed oil, wheat germ and
walnuts are good sources, too,
as are dark greens such as
spinach and kale. You can also
boost your omega-3 levels by
switching from corn and
soybean oil to canola oil. Some
hens are even fed flax and
fishmeal to boost the levels of
omega-3s in their egg yolks.
Look for cartons that mention
omega-3 levels. Beyond that,
says Stoll, your best bet is
supplements. For general
health, one to two grams of
omega-3s a day should be
sufficient. To correct mood
problems, two to five grams or
more may be required.
For all their promise,
omega-3 fatty acids won’t
replace Prozac. Except in mild
cases, omega-3s will likely be
an adjunct to standard therapy.
Stoll calls them “an ‘and’ rather
than an ‘or’.” “Many factors play a
role in modifying depression,”
says Hibbeln. “People are too
complex to be governed by one
or two molecules.” But look on
the bright side. Even if
omega-3s don’t leave you
depression-proof, they’ll boost
your heart health. It’s hard to be
downbeat about that.
© 2001 Newsweek, Inc.
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