Bipolar Disorder – A Global Challenge
Bipolar disorder is the 6th leading cause of disability worldwide, according to the World Health Organization, cutting an average of nine years off life expectancy. Alarmingly, data from the National Institute of Mental Health (NIMH) shows that one in five patients with bipolar disorder dies by suicide.
Although most patients report satisfaction with their medical treatment, the side effects of psychiatric medications remain a persistent problem. This is why scientists are increasingly exploring nutritional interventions as supportive care options.
The Role of Omega-3 in Bipolar Disorder
A new study, presented at the American Society of Clinical Psychopharmacology (ASCP) 2020 Conference, found that patients with bipolar disorder may benefit from a diet high in omega-3s (EPA and DHA) and low in omega-6 fatty acids.
Dr. Erika Saunders, Chair of Psychiatry at Penn State Hershey Medical Center, explained that omega-3s may help with mood stability by:
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Incorporating into neuron membranes in the brain
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Supporting the production of signaling molecules that regulate mood and inflammation
This provides a biological rationale for why omega-3 supplementation could complement standard bipolar treatments.
Understanding Bipolar Disorder
According to the NIMH, bipolar disorder causes unusual shifts in mood, energy, activity, and concentration. It includes three main types:
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Bipolar I: Severe manic episodes lasting at least 7 days, often followed by depressive episodes.
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Bipolar II: A pattern of depressive episodes combined with hypomanic episodes (less severe than mania).
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Cyclothymic Disorder: Milder but chronic mood fluctuations, lasting at least 2 years in adults.
Symptoms often overlap, but what unites all types is a struggle to maintain emotional balance, making new supportive strategies valuable.
The ASCP Study: High Omega-3, Low Omega-6 Diet
In this 12-week study, 82 adults (ages 20–75) with bipolar disorder were divided into two groups:
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Intervention group (n=41): Consumed a diet high in omega-3 (salmon, tuna, omega-3-rich oils) and low in omega-6.
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Control group (n=41): Followed a diet typical of the U.S., with low omega-3 and higher omega-6 intake.
Both groups received dietitian support, meal plans, and recipes. Importantly, neither group knew whether their diet was high or low in omega-3.
Results: The omega-3-rich group experienced:
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Reduced mood swings
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Lower irritability and fatigue
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Improved pain scores
These findings suggest that omega-3 intake may be an effective adjunct to traditional bipolar treatment.
Other Research Linking Omega-3 and Mental Health
The bipolar study adds to a growing body of research on omega-3s for psychiatric conditions:
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Depression: Multiple studies show that a higher Omega-3 Index is linked to fewer depressive symptoms.
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Anxiety: Patients with depression and anxiety often have lower omega-3 levels compared to controls.
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Perinatal depression: Women with higher omega-3 blood levels during pregnancy are at lower risk of postpartum depression.
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Suicide risk: Research in both military and civilian populations shows that low DHA levels are associated with higher suicide risk.
A 2019 meta-synthesis of 33 randomized controlled trials (11,000 participants) concluded that omega-3s are one of the few nutritional supplements with strong evidence for mental health benefits, particularly for major depressive disorder (MDD).
Clinical Guidelines for Omega-3 Use in Psychiatry
The International Society for Nutritional Psychiatry Research (ISNPR) has issued recommendations for omega-3s in depression treatment:
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Effective formulation: EPA alone, or EPA/DHA blends with EPA:DHA ratio >2:1
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Recommended dose: 1–2 grams of net EPA daily
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Special populations: Safe for children, pregnant women, and the elderly when used properly
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Monitoring: Doctors should track gastrointestinal tolerance and overall metabolic health
While more studies are needed in bipolar disorder specifically, these guidelines highlight omega-3 as a safe, evidence-backed add-on therapy.
Looking Ahead: Omega-3 Index for Mental Health
The Omega-3 Index—a measure of EPA and DHA in red blood cells—has long been used in cardiovascular research. Now, scientists are investigating whether specific Omega-3 Index targets could also be set for brain health and mood disorders.
Just as there is an established Omega-3 Index cut point for heart protection, future research may define an optimal omega-3 level for mental health and cognition.
Key Takeaway
While medication remains essential for treating bipolar disorder, omega-3 fatty acids—especially EPA and DHA—show promising benefits as an additional therapy. By improving diet and targeting a higher Omega-3 Index, individuals may gain greater mood stability and long-term mental health support.