Just under 10% of people in America suffer from some form of depression. There are many reasons for this, including both genetic and environmental. Concerning the environmental factors, nutrition is highly important. Adequate intake and absorption of amino acids from protein sources is necessary for the production of key neurotransmitters, such as serotonin (often called the “happy chemical”). Sufficient healthy fats, especially EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are also necessary for neuron (brain cell) membranes themselves. Without a strong infrastructure of neural membranes, many functions in the brain cannot work efficiently—leading to depression and other mental illness.
Where to Find Healthy Fats
The primary source for EPA and DHA fats in the human diet is from cold-water fish. These Omega-3 fatty acids have been found to show benefit for many mood disorders by decreasing inflammation levels and increasing levels of serotonin, dopamine, and norepinephrine (1-3). Epidemiological surveys in many countries have observed a significant inverse correlation between per capita fish or seafood consumption and lifetime prevalence rates of major depression (4,5). Other studies have shown a similar correlation for postpartum depression (6) and bipolar spectrum disorders (7). Regarding supplementation of fish oil, a cross-section survey of 21,835 adults who took cod liver oil on a daily basis were 30% less likely to have depressive symptoms than non-users (8). For children, studies also have shown a correlation between a lack of these important fatty acids and depressive symptoms (9-14).
Historically, Americans used to eat a higher quantity of Omega-3 fatty acids (15). Now most of our fat intake comes from high Omega-6 fatty acids from processed foods. We have seen how this shift in the American diet away from fish-based diets in Arctic communities has led to a skyrocket of seasonal affective disorder, depression, suicide, and cardiovascular disease (16).
When Neurotransmitter Modification Can Help
Of course, the causes of these disorders and conditions are multi-faceted. Regular consumption of fish, or a fish oil supplement may not be enough to counteract pathology once it has begun. Controlled and open-label trials have found that fatty acid supplementation, when combined with neurotransmitter modification (e.g. SSRI medications), leads to an even greater reduction in depressive symptoms (17-20).
In all cases, accurate testing and protocol adjustment based on follow-up testing is advised. The best biomarker, or indicator, of fatty acid levels is a blood test of oleic acid. If oleic acid levels are low, nutrient absorption for many co-factors of neurotransmitter production will be compromised. The best biomarker, or indicator, of appropriate neurotransmitter levels, in the case of depression, is a urine test of serotonin and GABA. The best approach to fighting depression is a method which combines follow-up testing of these important fatty acid levels and neurotransmitters.
They say that “An ounce of prevention is worth a pound of cure.” At Sanesco, we believe in wellness, not in treating disease. Emerging clinical evidence suggests that proactive measures of supplementing with these important substances is helpful in protecting against the development of depressive disorders. Prospective findings from new research is showing how these anti-inflammatory molecules can prevent depressive symptoms in the first place and are helping us understand more clearly the link between inflammation and the development of depression (21-23).
- Ramakrishnan U, Imhoff-Kunsch B, DiGirolamo AM. Role of docosahexaenoic acid in maternal and child mental health. Am J Clin Nutr 2009, 89:958S-962S.
- Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007, 12:207-227.
- Stahl LA, Begg DP, Weisinger RS, Sinclair AJ. The role of omega-3 fatty acids in mood disorders. Curr Opin Investig Drugs 2008, 9:57-64.
- Hibbeln JR. Fish consumption and major depression. Lancet 1998;351:1213.
- Peet M. International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis. Br. J. Psychiatry 2004;184:404e8.
- Hibbeln JR. Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J. Affect Disord. 2002;69:15e29.
- Noaghiul S, Hibbeln JR. Cross-national comparisons of seafood consumption and rates of bipolar disorders. Am. J. Psychiatry 2003;160:2222e7.
- Raeder MB, Steen VM, Vollset SE, Bjelland I. Associations between cod liver oil use and symptoms of depression: the Hordaland health study. J. Affect Disord. 2007;101:245e9.
- Allen KL, Mori TA, Beilin L, Byrne SM, Hickling S, Oddy WH. Dietary intake in population-based adolescents: support for a relationship between eating disorder symptoms, low fatty acid intake and depressive symptoms. J. Hum. Nutr. Diet. 2013;26:459e69.
- Murakami K, Miyake Y, Sasaki S, Tanaka K, Arakawa M. Fish and n-3 poly-unsaturated fatty acid intake and depressive symptoms: Ryukyus child health study. Pediatrics 2010;126:623e30.
- Oddy WH, Hickling S, Smith MA, O’Sullivan TA, Robinson M, de Klerk NH, Beilin LJ, Mori TA, Syrette J, Zubrick SR, Silburn SR. Dietary intake of omega-3 fatty acids and risk of depressive symptoms in adolescents. Depress Anxiety 2011;28:582e8.
- O’Sullivan TA, Ambrosini GL, Mori TA, Beilin LJ, Oddy WH. Omega-3 Index correlates with healthier food consumption in adolescents and with reduced cardiovascular disease risk factors in adolescent boys. Lipids 2011;46:59e67.
- Swenne I, Rosling A, Tengblad S, Vessby B. Omega-3 polyunsaturated essential fatty acids are associated with depression in adolescents with eating disorders and weight loss. Acta Paediatr. 2011;100:1610e5.
- Blasbalg TL, Hibbeln JR, Ramsden CE, Majchrzak SF, Rawlings RR. Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century. Am. J. Clin. Nutr. 2011;93:950e62.
- McGrath-Hanna NK, Greene DM, Tavernier RJ, Bult-Ito A. Diet and mental health in the Arctic: is diet an important risk factor for mental health in circumpolar peoples? A review. Int. J. Circumpolar Health 2003;62:228e41.
- Gertsik L, Poland RE, Bresee C, Rapaport MH. Omega-3 fatty acid augmen-tation of citalopram treatment for patients with major depressive disorder. J. Clin. Psychopharmacol. 2012;32:61e4.
- Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, Jalali M, Peet M. Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder. Aust. N. Z. J. Psychiatry 2008;42:192e8.
- McNamara RK, Strimpfel J, Jandacek R, Rider T, Tso P, Welge JA, Strawn JR, DelBello MP. Detection and treatment of long-chain omega-3 fatty acid deficiency in adolescents with SSRI-resistant major depressive disorder. PharmaNutrition 2014;2:38e46.
- Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch. Gen. Psychiatry 2002;59: 913e9.
- Dalli J, Chiang N, Serhan CN. Elucidation of novel 13-series resolvins that increase with atorvastatin and clear infections. Nat. Med. 2015;21:1071e5.
- Groeger AL, Cipollina C, Cole MP, Woodcock SR, Bonacci G, Rudolph TK, Rudolph V, Freeman BA, Schopfer FJ. Cyclooxygenase-2 generates anti-inflammatory mediators from omega-3 fatty acids. Nat. Chem. Biol. 2010;6:433e41.
- Serhan CN. Novel lipid mediators and resolution mechanisms in acute inflammation: to resolve or not? Am. J. Pathol. 2010;177:1576e91.