Some folks with HD are understandably depressed. Giving in to depression can shorten anyones life. See if you may be depressed by taking this test.

Dr. Horrobin found that the EPA in fish oil treats HD in a disease altering way. Now it has been found that fish oil may treat depression.

The HDL research team is meeting at Whitney Portal to develop a HDL cocktail. Alcoholic of course. Fizz creatine and a complement of vitamins and minerals are components. The challenge is to add fish oil and keep it yummy. Suggestions? E-mail me, Jerry@HDLighthouse.org. --Jerry 19-May-2001
Arch Gen Psychiatry. 2001 May;58(5):512-3. Antti Tanskanen, MD. University of Kuopio, Finland, Department of Psychiatry,

A recent double-blind, placebo-controlled trial of 30 patients with bipolar affective disorder demonstrated a significant benefit of omega3 fatty acid supplements on reducing episodes of severe mania and depression.

1. Omega3 Polyunsaturated fatty acids (PUFAs) are now regarded as a promising but untested treatment as mood stabilizers.
2. Consistent with these observations, several studies of patients with depression have reported depletions of omega3 PUFAs in plasma or cell membranes.
3. Previously, a cross-national comparison revealed a 50-fold lower annual prevalence of major depression, which was strongly predicted by higher fish consumption.
4. Since fish is the major source of omega3 fatty acids in the human diet, the frequent consumption of fish could lead to a high intake of omega3 PUFAs, thus decreasing the risk of depression.

Data was gathered on fish consumption, depression, and suicidality among a general population in Kuopio, Finland. A random sample of subjects (N = 3004) aged 25 to 64 years was drawn from the National Population Register. The study questionnaires were mailed in spring 1999, and 1767 subjects responded (59%). An ethical review board of the Kuopio University approved the study.

Depression was estimated with the 21-item Beck Depression Inventory (BDI). A person was considered depressed if the BDI score was greater than or equal to 10. One of the BDI items screens the severity of suicidal tendencies. Suicidality was considered to be present if there were any thoughts of harming oneself. Fish consumption was estimated with a food-frequency questionnaire, which has been reported to be comparable with a 7-day food record. (5) A subject was regarded as a frequent fish consumer if fish were consumed twice a week or more often.

Both the risk of being depressed (odds ratio, 0.63; 95% confidence interval, 0.43-0.94; P = .02) and the risk of having suicidal ideation (odds ratio, 0.57; 95% confidence interval, 0.35-0.95; P = .03) were significantly lower among frequent lake-fish consumers compared with more infrequent consumers in a multiple logistic model even after adjustment for sex, age, marital status, education, employment status, work ability, area of living, financial status, general health, smoking, alcohol intake, coffee drinking, and physical activity. These results are also consistent with a study of 265 000 Japanese subjects followed for 17 years, which found a decreased risk of suicide among subjects with daily fish consumption compared with nondaily consumption. (6)

Consequently, fish oils may alleviate depression and suicidal tendencies. However, large-scale intervention trials are needed before dietary recommendations to increase fish consumption or omega3 PUFA intake could be applied to depressed patients or people in the general population.

1. Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK, Marangell LB. Omega3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1999;56:407-412.

2. Stoll AL, Marangell LB. In reply. Arch Gen Psychiatry. 1999;56:415-416. Commentary on: Calabrese JR, Rapport DJ, Shelton MD. Fish oils and bipolar disorder: a promising but untested treatment. Arch Gen Psychiatry. 1999;56:413-414.

3. Maes M, Christophe A, Delanghe J, Altamura C, Neels H, Meltzer HY. Lowered omega3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res. 1999;85:275-291.

4. Hibbeln JR. Fish consumption and major depression [letter]. Lancet. 1998;351:1213.

5. Jain M, Howe GR, Rohan T. Dietary assessment in epidemiology: comparison on food frequency and a diet history questionnaire with a 7-day food record. Am J Epidemiol. 1996;143:953-960.

6. Hirayama T. Life-Style and Mortality: A Large Census-Based Cohort Study in Japan. Basel, Switzerland: Karger; 1990.

In reply:

Tanskanen and colleagues report that higher consumption of fish is associated with a reduced risk of major depression and suicidal ideation in a large, community-based sample in Finland. The authors mailed surveys that screened for major depression using the self-rated 21-item Beck Depression Inventory to 3004 randomly chosen individuals. The survey also asked about fish consumption, using a validated food frequency questionnaire.

This study has flaws inherent in this type of epidemiological survey (eg, association does not imply causation), and the strength of the statistical differences in depression risk and suicide risk were of a relatively low magnitude (P = .02 and P = .03, respectively). However, this data is consistent with the growing body of literature regarding omega3 fatty acids and major depression.

For example, a recent study reported that Icelanders have far lower rates of seasonal mood shifts than would be expected from countries of a similar latitude.(1) A separate interpretation of this Icelandic data (2) suggests that greater seafood consumption may prevent depressive symptoms by increasing dietary and thus brain omega3 fatty content.

In addition, the current report hints at possibly specific antisuicide effects, perhaps similar to the effects of lithium. This preliminary finding should be followed up in controlled studies. The emerging data on omega3 fatty acids in mood disorders is remarkable. However, we must await the results of well-controlled studies in both bipolar and unipolar mood disorders before reaching a definitive conclusion on the role of the omega3 fatty acids in mood disorders.

Andrew L. Stoll, MD
McLean Hospital
Harvard Medical School

1. Magnusson A, Axelsson J, Karlsson MM, Oskarsson H. Lack of seasonal mood change in the Icelandic population: results of a cross-sectional study. Am J Psychiatry. 2000;157:234-238.

2. Cott J, Hibbeln JR. Lack of seasonal mood change in Icelanders. Am J Psychiatry. 2001;158:328.