Ask the Pharmacist

Q) My friend told me that eating more fish might help with my anxiety. Is there any truth to this?

A) There have been a number of articles recently looking at alternative solutions to treating anxiety beyond the traditional prescription drugs and cognitive behavioural therapy that most are exposed to when they first seek help.

There is no question that these treatments are safe and effective options for many, but some people do not respond as well or would simply prefer a more “natural” approach than prescription drugs and talk therapy.

A quick Google search will provide a multitude of natural solutions for anxiety but the vast majority contain very little information that is unbiased and most articles wind up being well disguised advertising rather than an honest attempt to inform and help people in need. However, the role of Omega 3 fatty acids (the ingredient in fish which is believed to provide most of its health benefits) in helping those with anxiety seems to be an exception to this.

Numerous legitimate sources (one example being Harvard’s Medical School) are touting Omega 3’s as having at least some degree of evidence to support this and they have the additional benefits of being inexpensive and very safe to take. Before examining this, let’s take a quick refresher on just what anxiety is.

The first thing to remember, is that anxiety is normal and can be very helpful when it helps motivate you to complete a task or meet a challenge that is of some degree of importance to you. One should not seek to live a life without anxiety, but rather to make sure you use it rather than allowing it to cripple you. This may seem like a simple sounding goal but like many things in life, it is a task much easier said than done for many of us. Anxiety is simply a feeling of apprehension about the future.

As I have just said, but perhaps it needs repeating, this is normal. What is not normal is when the degree of the response to these worries is out of proportion leading the individual to be afraid/ worried much of the time or to feel repeatedly panic stricken. It, along with its frequent companion depression, are the most commonly diagnosed psychiatric conditions and it has been estimated that 1 in 3 adults will experience an anxiety disorder in their lifetime.

The symptoms that go along with this disorder have a major detrimental impact on all aspects of an individual’s life and suffering from an anxiety disorder has been linked to an overall increased risk of mortality.  As such, finding as many different solutions as is possible is of immense importance given how socially devastating and common anxiety disorders seem to be.

Omega-3 supplements as a treatment approach have been generating a lot of buzz since a review of them was published in September of 2018 in the JAMA Network Open. This report looked at 19 different studies that had been previously conducted over the years involving thousands of people from 11 different countries.

When the studies were collectively looked at, researchers found that people who took high doses of omega 3’s (up to 2,000 mg a day) seemed to have the most reduction in their anxiety symptoms.

Based upon what we know about the human brain, the fact that omega’s may have some positive effects makes sense. Brain membranes contain a very high proportion of these fats and some researchers hypothesize that they play an important role in reducing low levels of inflammation within the brain. It is speculated that inflammation can cause a disruption in the signalling that goes on between brain cells leading to possible neurological and/ or cognitive dysfunction.

The typical Canadian diet is very high in chemicals (such as the omega 6 fatty acid arachidonic acid) that increase low level inflammation within the brain. Vegetable oils are a prime culprit and we ingest these in large amounts with every processed food product we eat.

At the same time, the Canadian diet has been phasing out fish for decades now for many reasons, not the least of which is the expense. This gradual and growing imbalance between omega-6’s and 3’s may help explain why anxiety is becoming increasingly prevalent within our society. Overall, while the evidence for omega-3’s is far from conclusive it does look promising and is at present being further studied by a number of research teams throughout the world.

In the meantime, it seems to be a fairly harmless and bank account friendly option for those struggling with overwhelming amounts of anxiety. The key is to make sure you take enough (aim for 2 grams per day of eicosapentaenoic acid or EPA which will require reading the small print as 1000mg of salmon oil does not necessarily mean it contains 1,000,mg of EPA) to give it a fair shot and to do the other lifestyle measures such as increasing your exercise and sleep that have been proven to be beneficial for just about all anxiety sufferers.