Can Fats Make You Happy?: Omega-3 Fatty Acids and Depression

Is all the discussion about Omega-3 fatty acids in health just a bunch of hype? The short answer is “no.”

Our best evidence on the effectiveness of Omega-3s is in the prevention of heart disease. They are particularly good at lowering triglycerides. And as I described in a previous blog, heart disease and depression and not only related, but likely share a similar underlying mechanism.So the fact that Omega-3s are helpful for both makes sense.

The long-chain Omega-3 fatty acids, EPA and DHA, have been used successfully to both prevent and treat depression. Both of these are found in fatty fish. EPA is the Omega-3 that actually treats depression because it specifically lowers inflammation and lowers the stress response. It has been used by itself or has been combined with medications. When it is used with medications, it makes medications work more effectively. The American Psychiatric Association recently recognized EPA as a promising treatment for mood disorders.

DHA helps prevent depression, but does not treat it by itself. It is usually combined with EPA. There is a vegetarian source of DHA, but no vegetarian source of EPA; fish oil is still the best source. Sources and dosages are listed on the side bar. Even in relatively large doses, EPA and DHA are safe for children, pregnant and breastfeeding women, and other populations. In addition, they provide a number of other health benefits for men and women, including lower their risk of heart disease and making them less vulnerable to stress.

For vegetarians, the bad news is that ALA, the Omega-3 in flax seed and other plant sources, such as walnuts and canola oil, does not prevent or treat depression. ALA is not harmful and can be helpful in other ways. But it is metabolically too far removed from EPA to aid in lessening depression.

What I like is that there really is no downside to using Omega-3s. And there is considerable upside. Even if they doesn’t lessen depression by themselves, they increase overall health. And that is a good thing.

Alternative Treatments for Depression in Pregnant Women

There has recently been a lot of discussion in the news about the potential hazards of taking antidepressants while pregnant. Some are concerned that they increase the risk of birth defects. Proponents of antidepressants point out, correctly, that depression during pregnancy is also risky and can lead to premature delivery and other complications.

Health care providers often make treatment decisions by balancing the risks and benefits of a medication. Is the risk of using the medication less than the risk of the mother getting depressed again? In most cases, the risk of using the medication is less than the risk of possible depression, so clinicians will prescribe it. But are antidepressants the only choice?

Curiously, while people debate about antidepressant use in both research studies and the popular media, non-drug treatments for depression are largely absent from the discussion. Fortunately, antidepressants are not the only choice for treating depression and may offer a safe “third choice” for treating depression during pregnancy. Physicians and other health care providers may not consider these non-drug treatments, assuming that they cannot address more severe depression.

But recent research paints a very different picture. There are a number of non-drug treatments that are effective for even major depression. Non-drug treatments include Omega-3s, exercise, bright light therapy, psychotherapy, and St. John’s wort. Many of these can be combined with each other, and are sometimes used in addition to antidepressants (only St. John’s wort cannot be combined with medications). What all these treatments have in common is that they are all specifically anti-inflammatory. In the next few installments, I’ll explain that in more detail. But it’s important to know that there are alternatives, and these are especially important to consider during vulnerable times, like pregnancy.