Fish oil is a highly publicized and increasingly popular supplement for people who have bipolar disorder. A growing body of clinical evidence supports its use for limiting the severity of depression in bipolar, something that is very hard to do with pharmaceutical antidepressants. Some brands of fish oil, however, help relieve depression, while other brands will actually make it worse.
What You Need to Look for in Fish Oil for Bipolar Disorder
Fish oil is a natural source of two anti-inflammatory omega-3 essential fatty acids, DHA and EPA. The human body cannot make either of these fatty acids "from scratch," although it can convert EPA into DHA. EPA seems to be more "anti-inflammatory," while DHA seems to be more useful for nerve cells creating protective linings.
It's important that fish oil for bipolar disorder contain more EPA than DHA. This means it would be better to use a high-EPA product, such as Omega-Brite, rather than a high-DHA product, such Xtend-Life.
It's also important to choose a product that has relatively low content of a non-essential fatty acid known as DPA, which is also high in Xtend-Life products. Clinical trials have found that DPA is associated with poorer control of depression.
Furthermore, it is important to use fish oil, not flaxseed oil. Flaxseed oil, although at a much lower rate than antidepressant medications, has been associated with "switching," the swing from the depressed phase of bipolar disorder to the hypomanic phase. Fish oil has not.
An Essential Fatty Acid to Avoid, Arachidonic Acid
Most clinical studies have also found that the omega-6 essential fatty acid arachidonic acid is associated with greater severity of depression. This fatty acid is essential, because the human body cannot make it from other nutrients, and it is the building block for hormones that activate the immune system and enable responses to stress.
Excesses of this fatty acid, however, cause inflammation in the brain that is associated with increased symptoms of bipolar disorder. They encourage activity of the same kinds of white blood cells in the brain, the Th2 cells that cause constriction of airways in asthma attacks.
Drugs such as lithium, carbamazepine, and valproic acid work by stopping the conversion of arachidonic acid into inflammatory compounds. When these compounds build up, depression may switch to mania. (read more about Fish Oil and Depression)
How do You Avoid Arachidonic Acid?
First of all, no person who has bipolar disorder should ever take an arachidonic acid supplement. These are products marketed to bodybuilders, clearly labeled as containing arachidonic acid.
It may also help to avoid foods that are high in arachidonic acid, such as meat, egg yolks, and fried shellfish. Any kind of meat product made with brains or liver is especially high in arachidonic acid (think sausage, baloney, and hot dogs). Catfish and tilapia have high levels of arachidonic acid, especially when they are fried.
How Much Fish Oil is Enough?
Most of the studies of fish oil for bipolar disorder have found the optimum dosage to be however much fish oil provides 2,000 mg of EPA per day. Since you want to avoid DHA and DPA, you need to choose a brand that is high in EPA and low in the other two fatty acids. I searched through various fish oil products and found Omega-Brite to be the best off-the-shelf fish oil supplement for bipolar disorder. It's very high in EPA and very low in DHA and DPA.
The owner of this site was not selling Omega-Brite at the time I wrote this article, by the way. We aren't just interested in selling you products.
One Other Supplement that May Help
One other supplement sometimes makes a big difference, and that's vitamin C. A single dose of 3,000 mg of vitamin C, taken no more often than once a day, may help resolve depression in bipolar disorder. There is even a vitamin C product in this dosage for depression and sexual dysfunction caused by antidepressant treatments approved for sale in Germany and Austria.
If you take this dosage of vitamin C for more than a week, don't stop taking the vitamin abruptly. Your body excretes excess vitamin C into the urine, and it can excrete too much vitamin C if your consumption goes down too suddenly. Reduce your dosage by 500 mg a day until you are taking 500 mg a day or less to ensure you don't induce vitamin-deficiency symptoms. Be sure to drink several glasses of water during the way to help your kidneys get rid of excess vitamin C when you take high doses.