Omega-3 — what they are and why it is worth supplementing them

What are Omega-3 acids (EPA and DHA)?

We often hear about omega acids in advertising, but from a medical point of view two matter above all, found in oily sea fish and algae:

• EPA (eicosapentaenoic acid) — has a strong anti-inflammatory effect and plays a key role in treating mood disorders.
• DHA (docosahexaenoic acid) — the main building block of neuron cell membranes, affecting their structure and function.

Plant sources of Omega-3 (for example flaxseed, walnuts) contain ALA. The body can convert ALA into the valuable EPA and DHA only to a small degree (often below 5%), which is why supplementation with fish or algae oils is usually needed for therapeutic purposes.

How does Omega-3 act on the brain?

The brain is one of the "fattiest" organs — fats make up about 60% of its dry mass. Omega-3 acids serve functions in it that go far beyond nutrition alone:

• Cell-membrane fluidity: DHA makes neuron membranes more flexible, which eases the passing of signals between cells and affects the circuits responsible for, among other things, mood control.
• Anti-inflammatory effect: many mental health conditions (including depression) are linked to chronic low-grade inflammation; EPA curbs the production of pro-inflammatory cytokines.
• Neurogenesis and neuroprotection: Omega-3 supports the formation of new nerve connections and protects existing cells from oxidative stress.

In which conditions does Omega-3 have a proven effect?

Clinical studies and meta-analyses confirm the effectiveness of Omega-3 as an adjunctive treatment — an addition to standard therapy — in several areas.

Depression

Here the evidence is strongest. The guidelines of the International Society for Nutritional Psychiatry Research (ISNPR) indicate that Omega-3 can effectively support antidepressants — especially in people with co-existing inflammation (for example obesity, autoimmune diseases) or when medication alone does not bring full remission. It is important that EPA predominates in the product.

Anxiety disorders and chronic stress

People with generalised anxiety, panic attacks or social phobia often feel constant tension that also has a biological basis. High doses of Omega-3 can have an anti-anxiety effect, probably by calming excessive inflammation. With strong symptoms, doses above 2000 mg a day can help — but it is always worth agreeing them with a doctor.

Bipolar disorder

Omega-3 can ease depressive symptoms in the course of bipolar disorder. The evidence for preventing mania is weaker, but because of their safety and benefits for the heart these acids are often recommended.

Personality disorders

Psychotherapy remains the basis of treatment, but Omega-3 is increasingly considered as biological support. It can ease impulsivity and aggression and — by stabilising neuron membranes — slightly cushion sharp mood swings.

Schizophrenia

Omega-3 does not treat psychosis, but it can be a valuable addition to therapy: it can ease negative symptoms (withdrawal, lack of motivation) and protect against metabolic disturbances after antipsychotics. In young people at high risk it may also delay the onset of the first psychotic episode.

ADHD

Children and adults with ADHD often have a lower blood level of Omega-3. Supplementation can moderately improve concentration and reduce impulsivity, although it works less strongly than stimulant medication.

Not only the mind — benefits for the whole body

• Heart and circulation: Omega-3 lowers triglyceride levels and helps regulate blood pressure — which matters for patients taking medication that affects metabolism.
• Immunity: the anti-inflammatory effect supports the body’s general immunity.
• Pregnancy and development: an adequate supply of DHA is essential for the development of a baby’s brain and may reduce the risk of postnatal depression.

Dosing: not every product helps

This is the most common mistake patients make. The cheapest supplement from the supermarket usually does not work therapeutically, because it contains too small a dose.

1. Therapeutic dose: for treating depression, 1000–2000 mg (1–2 g) of EPA and DHA combined per day is usually recommended. Note: "1000 mg of fish oil" is not the same as "1000 mg of Omega-3 acids".
2. Ratios: for mood disorders, look for products in which the ratio of EPA to DHA is at least 2:1 (for example 700 mg EPA and 300 mg DHA).
3. Regularity: the effects are not immediate — the acids have to be built into the cell membranes, which usually takes 8 to 12 weeks of regular use.

Safety

Omega-3 is safe and well tolerated. Caution is only needed when combining it with blood-thinning medication (for example warfarin, acenocoumarol) and in the period before a planned procedure — high doses can slightly lengthen clotting time.

Omega-3 acids do not replace medication or psychotherapy, but they form a solid biological foundation for effective treatment. It is worth discussing supplementation with a doctor.