Depression, or more technically Major Depressive Disorder (MDD), is a common and growing mental health concern, currently affecting 350 million people worldwide, making it one of the leading causes of global disability. Many people will be familiar with the symptoms of depression; low mood, loss of interest and enjoyment, disturbed sleep, change in appetite, low self-worth and fatigue, among others. This constellation of symptoms can rob sufferers of meaning from life, impair relationships and in severe cases lead to suicidal and self-harming thoughts and behaviours. Anybody who feels they might be experiencing these symptoms is strongly encouraged to talk to their GP about their symptoms and available treatments. Depression can be a very isolating experience but help is available and you are entitled to it.
A number of treatments have been shown to effectively treat depression including Cognitive Behavioural Therapy and Psychodynamic Psychotherapy. Anti-depressant medication can also be helpful if well tolerated, though side effects can be problematic for a number of patients. Recent research has started to identify other factors that can influence mood disorders or enhance the effectiveness of treatments. This week I will be presenting the latest research on lifestyle interventions that have been shown to alleviate the symptoms of depression.
The first in the series is the promising research on the efficacy of omega-3 fats in the reduction of severity of depressive symptoms. I have mentioned elsewhere the results of a meta-analysis showing that these fats have positive effects on depression. A new meta-analysis published in March this year builds on these results and addresses some of the limitations of previous papers.
In this latest analysis published in the journal Translational Psychiatry researchers reviewed the pooled results of over 1200 patients with a diagnosis of MDD. They found a significant beneficial effect of omega-3 supplementation on the depressive symptoms of MDD, comparable to the effects of anti-depressant medication. In particular, studies that included higher doses of the specific omega-3 eicosapentaenoic acid (EPA) showed the most benefit. Omega-3 supplementation also appeared to improve the effectiveness of antidepressant medication. The authors speculate that this effect might be mediated by EPA’s known anti-inflammatory action, though more research is needed to confirm this hypothesis. They also note that the long-term effects of high-dose omega-3 supplementation have not been fully analysed and should be before any clinical recommendations can be made.
The safest way to ensure you are getting enough omega-3 is through your diet. EPA is found primarily in oily fish such as mackerel, herring, trout, salmon and sardines. The body is able to convert it from the essential fat alpha-linolenic acid (ALA) but not very efficiently and only in small amounts; it is much more easily absorbed from marine sources. The NHS recommends that a healthy diet should include at least one serving of oily fish per week but the most recent National Diet and Nutrition Survey published by Public Health England showed that Britons are not consuming anywhere close to the recommended amounts. The research is encouraging but there is still work to be done. Until then trying to eat the recommended amounts of oily fish could be a useful adjunct to prescribed treatment.
Mocking, R. J. T., Harmsen, I., Assies, J., Koeter, M. W. J, Ruhé, H. G. & Schene, A. H. (2016). Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder. Translational Psychiatry, 6, e756; doi:10.1038/tp.2016.29
This information is provided for information purposes only and should not be taken as advice or instruction. This information does not replace the advice of your doctor. Please consult an appropriate health professional if you believe you are experiencing a mental or physical health concern.