Depression, by its very nature, is a difficult condition to cope with. That’s especially true for people who do not want to take antidepressant medication and those who cannot afford to get treatment through a doctor. At the same time, the treatment approaches that actually work for depression vary considerably from one person to the next.
One interesting area of discussion is the question: Is fish oil good for depression?
Like St. John’s Wort, fish oil is a natural product that is often promoted as an alternative way to treat depression. Both approaches seem to have some potential, but what does science have to say about fish oil and depression?
A recent study (Mocking et al., 2016) took a look at the various research studies that have been conducted over the years to see what evidence there was for this relationship.
The Study Itself
This particular study used a meta-analysis approach, which means that the authors were looking at evidence from a range of different studies in their field. They were specifically interested in the idea of, is fish oil good for depression, so the focus was on studies that tried to answer this question.
In selecting studies, the authors looked for ones that had involved adult patients and has assessed the level of depression via standardized clinical interviews. This approach helped to limit the amount of differences between the studies, which helped to make any observed relationships clearer.
Overall, the authors used 13 studies in their analysis. Collectively, those studies involved 1,233 patients. The authors looked at a number of different areas that could influence the observed outcomes, including: the amount of fish oil (specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), the year of the study and whether people were taking antidepressants.
The authors found that the observed results did differ from one study to the next, with some studies reporting that fish oil helped to decrease depressive symptoms while other studies did not find that.
However, when the authors took all of the studies into account, they found a significant relationship between fish oil and decreased depressive symptoms (P=0.006).
The observed results for each paper can be seen in the following figure:
In this figure, the box in the middle represents the means observed in the study, while the arms on either side represent the observed variation.
The authors also noted that higher doses of EPA were associated with improved outcomes (however, they did not note the specific levels). At the same time, stronger improvements in depressive symptoms were observed with patients who were also taking antidepressants.
Those outcomes suggest that supplementing with fish oil can help improve depressive symptoms and may also help to make antidepressants more effective.
Strengths and Limitations
There have been a number of other studies and meta-analyses in this field, but there were a couple of interesting things about this particular study that make it stand out.
For one thing, the authors of this study took publication bias into account during their analysis.
Publication bias refers to the way that a paper may be more or less likely to get published as the result of the view that it takes on a given subject. For example, in many cases, a study that supports a currently held scientific perspective is more likely to get published than a paper that does not. Likewise, studies on alternative medicine and natural supplements tend to be relatively rare in the scientific community. One reason for this is that it can be hard to get them published.
So, by taking publication bias into account, the authors of this study were able to provide a more accurate representation of the current state of knowledge surrounding fish oil and depression.
As a meta-analysis, this study was also able to look at information from a range of different studies. In doing so, the authors could provide a valuable overview of the field and the current balance of knowledge.
One final strength of the study was that the authors were specifically looking at randomized controlled studies.
Randomized controlled studies: These are often considered the ‘gold standard’ of research. They involve at least two groups of participants, where one group receives a placebo and the other group receives the treatment. The term randomized refers to the way that participants are randomly placed into groups. Studies of this kind can also have more than one control group and/or more than one treatment group depending on the nature of the study and the topic.
Randomized controlled studies are powerful, because they allow authors to test cause and effect. By doing this, the authors helped to ensure that the observed changes in depressive symptoms were caused by the fish oil supplementation, not by other factors.
However, there was one key limitation with this study, which was connected to the comparison with antidepressants.
To ensure sufficient statistical power, the authors combined all antidepressants into a single group. However, antidepressants do vary from one another and that approach means that any variation would not be observed. As such, more research is needed before we can truly know if the effects of fish oil are the same across different antidepressants.
Is Fish Oil Good for Depression?
The outcomes of this study suggest that yes, fish oil is good for depression, especially when used in conjunction with antidepressants. Other studies have also found similar outcomes, although there have been some variations.
For example, one observational study noted that a higher ratio of omega-3 fatty acids to omega-6 fatty acids was associated with a slower increase in depressive symptoms (1).
One study also noted that it was EPA rather than DHA that was connected to the relationship between fatty acids and depression (4), which corresponds to the observations that this current study found. , another meta-analysis also found that supplementation with fish oil could help to treat depressive symptoms in patients (5).
Finally, research has also indicated that eating fish may help to protect people against depression (6). That outcome isn’t surprising as the same compounds from fish oil are also present in fish.
Other blogs have also talked about the possible connection between fish oil and depression. For example, Examine.com summarizes the range of evidence and all of the current studies.
To get the health benefits from fish oil, including the implications for depression - finding a good brand of fish oil supplement is important. My list of 8 high quality fish oil brands is the perfect place to start and any one of those brands could be a way for your to improve your overall health.
You don't have to get your benefits from fish oil either. Instead, you can increase the amount of fish in your diet. There are many amazing recipes for doing so, including this list from Olive Magazine.
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What do you think? Would you try fish oil to combat depression?