It is known that both aggressive and depressive people have high levels of omega-6 arachidonic acid (AA) and low levels of EPA and DHA (omega-3) in their blood and brain cell membranes. In order to ensure that information can be transmitted rapidly and correctly between its billions of cells, the brain contains a lot of cholesterol and omega-3 and omega-6 polyunsaturated fatty acids (DHA, EPA and AA). Over time these polyunsaturated acids oxidize and lose their functionality, resulting in a loss of memory. In order to slow this natural aging process down or to prevent this from happening our body has the ability to replace “old” polyunsaturated fatty acids with new ones provided through our diet. The cholesterol and polyunsaturated fatty acids in our brain are actually constantly (every few hours) being replaced throughout our lives. The cholesterol which is needed is synthesized directly in the brain; it does not come from our diet. The omega-3 and omega-6 fatty acids, however, do need to come from our diet. Due to the fact that many physiological and biochemical processes in our body slow down as we get older, we need to make sure to increase our daily omega-3 intake as we age. This may help to prevent depression and slow down memory loss, dementia and other mental disorders in senior citizens.
If our diet is too rich in omega-6 fatty acids, especially in AA, and lacking EPA and DHA, we start accumulating pro-inflammatory AA which likely will lead to chronic inflammation in the brain tissue. Additionally, the lack of EPA and DHA in our brain inhibits the release of important neurotransmitters called dopamine and serotonin. Both directly connected to our emotional wellbeing.
While dopamine regulates our perception for positive sensations, serotonin is more responsible for our emotional equilibrium. In its function as “anti stress hormone”, it actively stops the adrenalin cascade. Serotonin is also responsible or co-responsible for a good night sleep because part of it can be transformed into melatonin – our bodies natural sleeping drug, it is anti-depressive, enhances motivation, reduces the sensation of pain and is an importan appetite regulator for our body. If the level of serotonin in our brains drops, depression, lack of motivation, sleep disturbances, hyperactivity and many other symptoms set in.
Numerous clinical studies have been published in recent years which clearly demonstrate the positive effects of a diet supplemented with EPAand DHA for the treatment of depression in adults (119, 120 and 121) and in children (124). An interesting epidemiological study was published in 1998 by Hibbeln et al. (122) which showed that in countries in which a large amount of fish (rich in omega-3 fatty acids) is consumed, such as Japan and Taiwan, fewer people suffer from depression than in countries where fish is not as prevalent in the diet (such as Germany, New Zealand and the U.K.). The Japanese, for example, who eat about 67 kilos of fish per person per year, have 40 times fewer incidences of depression compared to Germans who consume an average of only 13 kilos of fish per person per year.
The pharmacological therapy approach often applies 5-hydroxytryptophane containing drugs which increase the cerebral serotonin level. Combining this pharmacological approach with a dietary supplement rich in EPA and DHA would be a very efficient way of treating different forms of depression. Certain subgroups of depression known as manic depression and melancholic depression can often even be treated with EPA alone. In most of these cases there is no need for chemically synthesized anti-depressive drugs. In general, symptoms of depression show the first signs of abating starting at a dosage of 1g EPA per day – without any serious side-effects. Male non-smokers who suffer from recurrent depression have shown to benefit clearly from a daily supplementation of 1 to 2 g of EPA (125). It is interesting to note that smokers do not seem to benefit as much as non-smokers from EPA supplementation.
Figure. 26: Incidence of depression in % of population versus annual fish intake per person
AA clinical study with 48 depressed patients receiving a daily supplement of 2g of concentrated EPA over a period of eight weeks compared to a standard antidepressant found virtually no difference between the EPA group and the pharmaceutical group, and came to the conclusion that “...as EPA is a dietary supplement it may prove more acceptable to patients than antidepressants.” (126)
Because a fetus requires high levels of DHA in order for its brain to develop and because its only source of DHA is its mother, the mother’s natural DHA deposits run low during pregnancy and during the first 6 to 12 months of lactation. By far the mother’s largest DHA-deposit is in her brain. In the last trimester of pregnancy the brain of the fetus enters into a phase of rapid growth which quickly drives up its need for the mother’s DHA. If the mother is not able to provide the DHA required, the consequences to the cerebral and visual function of the baby can be disastrous.
The demand for DHA from the mother does not end when the baby is born. For the entire first year of lactation the newborn needs a nutritious diet rich in DHA in order to grow and for its nerve cells and sight to develop. Breast milk, containing a ratio od DHA:EPA of 4:1, is the best way to ensure that the baby gets the nutrients it needs.
It is very important that the mother replenish her supply of DHA and EPA during this period. Mothers with low DHA reserves also have low EPA and DHA levels in their blood and as a consequence they lack serotonin. This lack of serotonin leads to an elevated risk of postpartum depression. Therefore, an omega-3 dietary supplement during pregnancy and lactation ideally, contains DHA plus EPA in a ratio 4:1. The reasoning for this particular ratio is that, as mentioned above, natural mothers milk contains DHA:EPA 4:1. Therefore an adequate omega-3 supplement should return such a ratio of approximately 4:1 back to the mother. During the entire period of pregnancy and lactation the mother should try to ensure that she takes in at least 250 to 500 mg DHA+EPA every day.
Manic depression (“bipolar disorder”)
Manic depression, also known as bipolar disorder is a mental disease which affects up to 4% of the adult population. In recent years, developed countries have noticed an increase in this mental illness in children and adolescents. The disease manifests in constant oscillation between a phase of extreme euphoria and a phase of pronounced depression. In the euphoric phase the person feels very excited and full of energy. But then there is a sudden switch to the depressed phase which is characterized by a sensation of powerlessness, a complete lack of interest, sadness and frustration. During this phase there is a high risk of suicide or self-harm. After a number of hours, days or weeks, manic depressives return again to the emotional phase (emotional yo-yo). These people often show a lack of essential fatty acids (omega-3 and omega-6) and very low levels of cholesterol in their plasma.
Many people who suffer from bipolar disorder often also show very unbalanced ratio of EPA (Omega-3) to arachidonic acid (AA“Omega-6”). Their blood frequently contains far too much omega-6 and very little omega-3. This group of patients would especially benefit from a daily omega-3 supplement - rich in EPA. Best results were obtained in studies supplementing over 2g EPA per day.
Depression and alcoholism
Approximately every second alcoholic suffers from depression. One of the explanations for these depressive symptoms is the fact that alcohol can eliminate a portion of the DHA in the neuronal system of the brain. This makes the neural membranes more rigid and reduces or completely stops the level of serotonin release. As a consequence, symptoms of depression can appear, often accompanied by aggression due to an increased release of adrenaline. With low DHA levels in the brain, information passes between the neurons at a much slower rate, leading to new frustrations and aggression. As a result, alcohol abuse may lead to reduced intellectual capacity and a reduced ability to successfully interact in society.
The harmful effect of alcohol on our brains described above also explains why pregnant mothers should avoid consuming alcohol. Ninety percent of our cerebral mass is formed while we are still in the womb. Mothers who consume excessive amounts of alcohol during this period run the risk of giving birth to children with significant brain damage and/or physical deformations. People who consume elevated amounts of alcohol every day should stop doing so and significantly increase their daily intake of EPA and DHA to 1,200 to 1,700 mg EPA + DHA per day.
Finally, Anxiety Disorders or simply exaggerated fear response is a wide-spread disorder that effects up to 18% of the US population (16 million). The probability of suffering from anxiety disorder increases with the age and therefore is mostly seen in elderly people. In combination with depression it often increases the risk of suicide.
People suffering from anxiety disorder, social phobia, post-traumatic disorder and other panic disorders also are characterized by very low concentrations of omega-3 fatty acids in their red blood cells compared to healthy people. These people are often treated with pharmaceutical anti-depressants but indeed could also be helped in many cases by a regular EPA+DHA supplementation. Studies have shown that EPA and DHA decrease the amount of corticotropin-releasing hormone in our central nervous system. This hormone is utmost importance for the control of violent behavior, fear and anxiety. If the concentration of EPA and DHA in our body is low then this leads to an increased formation of hormones which trigger violence and/or anxiety sensations.
Even in the field of Exam/Test Anxiety supplements rich in EPA and DHA may have excellent results among students: lowering their cortisol level, rendering better overall performance, showing better overall organization, having better quality of sleep and strongly reducing or even eliminating test anxiety.