As we have discovered previously, treating anger issues can involve taking conventional anger management medications e.g. antiolytics or antidepressants, and/or choosing a complementary or alternative approach. Examples of the latter may include utilizing various coping skills e.g. visualization techniques, or using essential oils, herbs or omega-3 fish oil supplements.
The following article about omega-3 fish oil anger treatment will cover:
- What is Omega-3?
- Omega-3 Function in the Body
- Sources of Omega-3
- Omega-3 Recommended Daily Allowance
- Omega-3 and Omega-6 Balance
- Omega-3 Research Involving Conditions Where Anger Can Be a Symptom
- Summary
What is Omega-3?
Both omega-3 and omega-6 represent families of polyunsaturated fatty acids (PUFA). The shortest chained fatty acids in their respective families are α-linolenic acid or ALA (omega-3) and linoleic acid or LA (omega-6).
These two polyunsaturated fatty acids are considered essential fatty acids i.e. necessary for body regulation, metabolism and cellular membrane manufacture and because mammals lack desaturase enzymes required for their production, they cannot be synthesized by mammals and must therefore be ingested.
Examples of some of the long chain polyunsaturated fatty acids found in these families include:
- Omega-3 e.g. Eicosapentanoic acid (EPA) or Docosahexanoic acid (DHA) etc.
- Omega-6 e.g. Gamma-linolenic acid (GLA) or Arachidonic acid (AA) etc.
Omega-3 Function in the Body
Compounds such as EPA and DHA are found widespread throughout the brain and have been associated with a range of functions e.g. cell membranes, fetal development, cardiovascular and cognitive function (Swanson et al. 2012 1).
Estimates of brain gray matter suggest 50% is made up of fatty acids, of which one-third is made of the omega-3 family (Rao et al. 2008 2).
Sources of Omega-3
Good food sources of omega-3 include:
- Land sources e.g. seed oils such as flax or kiwifruit, nut oils such as pecan or walnut, purslane, free-range eggs.
- Cold water fish e.g. oily seafood such as herring, mackerel, sardines, salmon.
Omega-3 Recommended Daily Allowance
Dietary Allowance
There is no formal ‘recommended daily/dietary allowance’ (RDA) for fatty acids such as omega-3.
However, various authorities do set a recommended ‘adequate intake’ (AI) but figures quoted can vary depending on the authority in question. The European Food Safety Authority (EFSA) 2009 recommendations for polyunsaturated fatty acids (PUFA) are:
- Omega-3 2g/day α-linolenic acid (ALA) and 250 mg/day EPA and DHA.
- Omega-6 10 g/day linoleic acid (LA).
Supplementation
Recommended omega-3 supplementation dosages typically vary from 1000 – 3000mg daily. Be aware though that EPA and DHA levels can vary significantly between products.
Omega-3 (fish oil) supplements should not be taken by those with an allergy to fish and although considered a safe supplement when taken appropriately, fish oil supplements can potentially interact with certain other medications e.g. blood thinners, birth control pills. Nonetheless, Bozzatello et al. 2016 3 observed that “several studies concluded that omega-3 can be considered safe and well tolerated at doses up to 5 g/day”.
Omega-3 and Omega-6 Balance
Both omega-3 and omega-6 are required for good health, however in general, whereas omega-3 fatty acids tend to help counter inflammation, omega-6 fatty acids tend to be pro-inflammatory in nature.
Typically, Western societies consume diets ladened with processed inflammatory foods resulting in a skewing of the omega-3 to omega-6 balance heavily in favor of omega-6. A low omega-3 to omega-6 ratio of between 1:1 to 1:4 has been recommended by various experts (e.g. Simopoulos 2002 4), unfortunately figures of 1:10 up to 1:30 are increasingly common in Western societies i.e. up to 30 times more omega-6 is consumed as compared to omega-3.
Interestingly, Bruinsma and Taren 2000 5 discussed how the imbalance in the omega-3 and omega-6 ratio (and/or a deficiency in omega–3 fatty acids) may account for why lowering plasma cholesterol by diet and medications contributes to depression. Irritability, mood swings and anger are some of the possible symptoms associated with depression.
Omega-3 Research Involving Conditions Where Anger Can Be a Symptom
There are numerous research papers discussing omega-3 role in neurological growth and function of the central nervous system as well as its association with attentional and physiological functions, decreasing anti-social traits, anger and anger-related triggers such as anxiety, depression and stress.
The following represents a brief summary of various research papers published in the last few decades concerning omega-3 and mood states or conditions associated with possible anger issues.
Stoll et al. 1999 6 examined whether omega-3 fatty acids exhibit mood-stabilizing properties in bipolar disorder. They concluded omega-3 “improved the short-term course of illness in this preliminary study of patients with bipolar disorder”.
Iribarren et al. 2004 7 study suggested that the decrease in likelihood of high hostility in young adulthood may be related to a high dietary intake of DHA and consumption of fish rich in n-3 fatty acids.
Although Joshi et al. 2005 7a study of children with Attention Deficit Hyperactivity Disorder (ADHD) used a supplement whose omega-3 was derived from flax oil (rich in α-linolenic acid or ALA) rather than fish oil, they noted that in combination with vitamin C, the test subjects symptoms improved significantly.
Fontani et al. 2005 8 found that after 35 days of omega-3 supplementation the mood profile of subjects “increased vigour and reduced anger, anxiety and depression states”.
In a separate study looking at various diets supplemented with omega-3 in healthy subjects, Fontani et al. 2005 9 found an increased POMS index (Profile of Mood States) occurred after omega-3 supplementation. POMS is a self-identifying psychological rating scale used to assess mood changes over time. Six mood states are considered, namely: Anger or Hostility, Tension or Anxiety, Fatigue or Inertia, Depression or Dejection, Confusion or Bewilderment, Vigor or Activity. Adjectives are graded on a 5-point scale ranging from “not at all” to “extremely” based on how they reflect the person’s mood at the time of taking the assessment. The number of adjectives graded depends on whether the assessment is short form (37 in total) or long form (65 adjectives).
Interestingly, Zeev et al. 2005 10 small scale study looking a omega-3 (fish oil capsule rich in EPA) supplementation effect on symptoms of post-traumatic stress disorder (PTSD) patients found that not only did the sample set not benefit from omega-3 supplementation but that deleterious effects were observed in some patients i.e. mild to moderate tendencies towards worsening of psychiatric symptoms such as anxiety, depression, hostility, paranoia etc. They commented that the results reinforced studies by Marangell et al. 2003 11 (unipolar depression patients and DHA) and Fux et al. 2004 12 (obsessive-compulsive disorder patients and EPA) whereby supplementation by omega-3 was “virtually ineffective”.
Appleton et al. 2006 13 review of trials investigating the effect of omega-3 on depressed mood noted the evidence at that time was both limited and heterogeneous in nature. They concluded “The evidence available provides little support for the use of n–3 PUFAs to improve depressed mood”.
Buydens-Branchey et al. 2006 14 found patients who received omega-3 (3g of n-3 polyunsaturated fatty acids -mainly EPA and DHA) for 3 months exhibited a “progressive decline in anxiety scores”. Anxiety scores remained significantly lower than a placebo group at both 3 and 6 months after treatment discontinuation.
Hibbeln et al. 2006 15 considered how nutritional deficiencies in omega-3 fatty acids may exacerbate aggressive and depressive disorders. They concluded,“Ensuring optimal intakes of omega-3 fatty acids during early development and adulthood shows considerable promise in preventing aggression and hostility”.
Lin and Su 2007 16 review of the antidepressant efficacy of omega-3 polyunsaturated fatty acids (PUFAs) noted that further studies were needed to address the shortcomings of available studies but concluded “significant antidepressant efficacy of omega-3 PUFAs”.
Benton 2007 17 review covering the impact of diet on anti-social, violent and criminal behavior found that “Supplementation with poly-unsaturated fatty acids decreased violence…”.
In conjunction with various other reports, Conklin et al. 2007 18 found high ω-6 (omega-6) and low ω-3 (omega-3) blood serum levels were associated with depressive symptoms and neuroticism.
In a separate study, Conklin et al. 2007 19 suggested that “omega-3 fatty acid status is associated with variability in affect regulation, personality and impulse control”.
Taylor and Connock 2007 20 concluded there was “insufficient evidence to either confirm or refute the hypothesis for the effect of omega-3 and fish oil on the behaviour, cognition and educational outcomes in normal school children”.
Grenyer et al. 2007 21 study into whether fish oil supplementation (tuna fish oil) benefited patients with major depression found “This particular dose and type of fish oil conferred no additional benefit to conventional treatment of depression in this sample”.
Buydens-Branchey et al. 2008 22 research concluded supplementing omega-3 (3g of n-3 polyunsaturated fatty acids) “benefits substance abusers by reducing their anger and anxiety levels”. Furthermore, they noted a strong correlation between higher plasma levels of EPA and lower anxiety scores, whilst higher plasma DHA was associated with lower anger scores.
However, Rogers et al. 2008 23 concluded, “substantially increasing EPA+DHA intake for 3 months was found not to have beneficial or harmful effects on mood in mild to moderate depression”.
Ross 2009 24 review of omega-3 and anxiety disorders noted “given that omega-3 PUFA supplementation may be effective in the treatment of major depressive disorder it is reasonable to propose that they may also possess anxiolytic [antipanic or antianxiety agent] properties.”
Kiecolt-Glaser et al. 2011 25 suggested “n-3 [omega-3] supplementation can reduce inflammation and anxiety even among healthy young adults” and subsequently, “The reduction in anxiety symptoms associated with n-3 supplementation provides the first evidence that n-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis”.
Antypa et al. 2011 26 study into the effects of omega-3 supplementation on mood and emotional information processing in recovered depressed individuals indicated that “omega-3 supplementation has selective effects on emotional cognition and mood in recovered depressed participants”. Small effects were noted for self-reported states of depression and tension and no significant effects were observed for depressive symptoms.
Hamazaki et al. 2011 27 review concerning fish oil and aggression concluded that a number of studies indicate that fish oils (or treating omega-3 deficiency) modulate aggression, most probably through a mechanism involving serotonergic neurons. Interestingly, they pointed out a statistic from Hibbeln and Salem Jr. 2001 28 paper that referred to an inverse correlation (relationship) between homicide (the ultimate deed of aggression) rates and seafood consumption across countries. In a later paper, Hibbeln et al. 2004 29 later went on to find “Greater apparent consumption of linoleic acid [omega-6] correlated with higher rates of homicide mortality”.
Liu et al. 2013 30 study concerning major depressive disorder with comorbid (presence of two chronic conditions in a patient) anxiety disorders concluded “The presence and severity of comorbid anxiety were associated with the lowest EPA and DHA levels”.
Politi et al. 2013 31 review of current literature concerning trials of omega-3 in Psychiatric disorders noted “the evidence suggests that these molecules have a potential preventive role in people at extremely high risk for developing psychosis”. Psychosis, characterized by an impaired relationship with reality, can have many symptoms including anxiety, depression and anger.
Long and Benton 2013 32 paper on the effect of DHA, vitamin and mineral supplementation, impulsivity and stress found DHA decreased aggressive behavior and impulsivity.
Giles et al. 2013 33 review of omega-3 influence on mood in healthy and depressed individuals noted that “Although there is some evidence to suggest that n-3 PUFA intake is associated with reduced depressive symptoms, particularly in females, these results are generally limited to epidemiological studies, whereas results from randomized controlled trials are mixed”.
Hibbeln and Gow 2014 34 review of the evidence for omega-3/omega-6 and military diets in reducing depression, suicide and impulsive anger found:
– Moderate to strong evidence that Mediterranean diet patterns reduce the risk of clinical depressions.
– Moderate to strong evidence that higher levels of omega-3 in tissue compositions are associated with a decreased risk of clinical depressions.
– Moderate to strong evidence of omega 3 supplementation containing >50% EPA resulted in significantly improving clinically depressive symptoms
– Moderate evidence that clinical depression increases when fish consumption decreases and omega-6 increases.
– Modest evidence of clinical efficacy of omega-3 supplementation for ADHD.
Dean et al. 2014 35 paper suggested “fish oil treatment [4g daily] does not improve aggression in children [7-14 years] with disruptive behavior disorders”. In fact, fish oil treatment was associated with a worsened secondary measure of aggression but an improvement in one hyperactivity rating.
Meyeer et al. 2015 36 study looking at omega-3, aggressive and attention deficit disorder (ADD) behaviors in adult prisoners concluded “inmates with lower omega-3 index were more aggressive and had higher ADD scores”.
Patrick and Ames 2015 37 proposed a mechanism to account for why supplementation with omega 3 and vitamin D improves cognitive function and behavior in various brain disorders such as ADHA, bipolar disorder, schizophrenia and impulsive behavior. The mechanism involves omega-3 fatty acids and vitamin D controlling serotonin synthesis and action.
Gajos and Beaver 2016 38 study to assess the relationship between omega-3 and aggression suggested “a small to large effect on reducing aggression” and that the “Potential for omega-3 fatty acid supplementation to reduce aggressive behaviors in child and adult populations appears promising”.
Bozzatello et al. 2016 3 review of literature data concerning omega-3 supplementation in psychiatric disorders found:
– Main evidence for the effectiveness of EPA and DHA relates to mood disorders, in particular in the treatment of depressive symptoms in unipolar and bipolar depression.
– Some evidence for the treatment of conditions characterized by a high level of impulsivity and aggression and borderline personality disorders.
– Small to modest effects for the treatment of ADHD. Most promising is use of high doses of EPA or the association of omega-3 and omega-6.
– Data regarding psychiatric disturbances is too scarce to draw conclusions e.g. anxiety disorders, obsessive-compulsive disorder.
Summary
Omega-3 fish oil is one of the most popular supplements taken (e.g. ConsumerLab survey) and it can be bought from supermarkets, health stores and online without the need of a prescription. There is strong scientific evidence of the use of omega-3 fatty acids in treating a variety of health conditions e.g. preventing coronary heart disease, high blood pressure and secondary cardiovascular disease etc.
Results from the various studies listed above concerning the use of omega-3 fish oil treatment for anger (mood states and anger-related conditions) are mixed i.e. unclear scientific evidence for its use at present. There are indications that it helps reduce aggression in certain conditions and regulates mood and impulse control. Further research is need to clarify the situation before firm conclusions are possible.
Although the majority of studies found omega-3 to be beneficial in some way e.g. Fontani et al. 2005 8, the results varied considerably depending on the stressor/medical condition in question e.g. Bozzatello et al. 2016 3. Also, some studies noted omega-3 treatment had little or no effect e.g. Rogers et al. 2008 23, whereas a minority raised the possibility that supplementation lead to a worsening of symptoms e.g. Zeev et al. 2005 10.
Overall, increasing one’s dietary intake of omega-3 though food or by supplement represents a relatively inexpensive and safe way to help improve the health of the majority of people. People taking certain medication e.g. blood thinners, should consult a qualified health practitioner before using omega-3 supplementation and of course, anyone allergic to fish should not take fish oil treatment.
Finally, although omega-3 supplements may not represent a ‘cure-all’ for aggression and other anger-related problems, it might be the thing that makes a positive difference.
Resources:
1. Swanson et al. 2012 Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life
2. Rao et al. 2008 Understanding nutrition, depression and mental illnesses
3. Bozzatello et al. 2016 Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data
4. Simopoulos 2002 The importance of the ratio of omega-6/omega-3 essential fatty acids
5. Bruinsma and Taren 2000 Dieting, essential fatty acid intake, and depression
6. Stoll et al. 1999 Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial
7. Iribarren et al. 2004 Dietary intake of n-3, n-6 fatty acids and fish: relationship with hostility in young adults–the CARDIA study
7a. Joshi et al. 2005 Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD)
8. Fontani et al. 2005 Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects
9. Fontani et al. 2005 Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids
10. Zeev et al. 2005 Possible deleterious effects of adjunctive omega-3 fatty acids in post-traumatic stress disorder patients
11. Marangell et al. 2003 A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression
12. Fux et al. 2004 A placebo-controlled cross-over trial of adjunctive EPA in OCD
13. Appleton et al.2006 Effects of n–3 long-chain polyunsaturated fatty acids on depressed mood: systematic review of published trials
14. Buydens-Branchey et al. 2006 n-3 Polyunsaturated Fatty Acids Decrease Anxiety Feelings in a Population of Substance Abusers
15. Hibbeln et al. 2006 Omega-3 fatty acid deficiencies in neurodevelopment, aggression and autonomic dysregulation: Opportunities for intervention
16. Lin and Su 2007 A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids
17. Benton 2007 The impact of diet on anti-social, violent and criminal behaviour
18. Conklin et al. 2007 High ω-6 and Low ω-3 Fatty Acids are Associated With Depressive Symptoms and Neuroticism
19. Conklin et al. 2007 Serum omega-3 fatty acids are associated with variation in mood, personality and behavior in hypercholesterolemic community volunteers
20. Taylor and Connock 2007 Effects of oily fish/omega-3 fatty acids on the behavioural, cogitative and educational outcomes of normal school children: A systematic review
21. Grenyer et al. 2007 Fish oil supplementation in the treatment of major depression: A randomised double-blind placebo-controlled trial
22. Buydens-Branchey et al. 2008 Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers
23. Rogers et al. 2008 No effect of n-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial
24. Ross 2009 Omega-3 polyunsaturated fatty acids and anxiety disorders
25. Kiecolt-Glaser et al. 2011 Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial
26. Antypa et al. 2011 Effects of omega-3 fatty acid supplementation on mood and emotional information processing in recovered depressed individuals
27. Hamazaki et al. 2011 Fish oil and aggression
28. Hibbeln and Salem Jr. 2001 Omega-3 Fatty Acids and Psychiatric Disorders – Current Status of the Field
29. Hibbeln et al. 2004 Increasing homicide rates and linoleic acid consumption among five western countries, 1961–2000
30. Liu et al. 2013 Omega-3 Polyunsaturated Fatty Acid (PUFA) Status in Major Depressive Disorder With Comorbid Anxiety Disorders
31. Politi et al. 2013 Randomized Placebo-Controlled Trials of Omega-3 Polyunsaturated Fatty Acids in Psychiatric Disorders: A Review of the Current Literature
32. Long and Benton 2013 A double-blind trial of the effect of docosahexaenoic acid and vitamin and mineral supplementation on aggression, impulsivity, and stress
33. Giles et al. 2013 Omega-3 fatty acids influence mood in healthy and depressed individuals
34. Hibbeln and Gow 2014 The Potential for Military Diets to Reduce Depression, Suicide, and Impulsive Aggression: A Review of Current Evidence for Omega-3 and Omega-6 Fatty Acids
35. Dean et al. 2014 A Randomized, Controlled, Crossover Trial of Fish Oil Treatment for Impulsive Aggression in Children and Adolescents with Disruptive Behavior Disorders
36. Meyer et al. 2015 Baseline Omega-3 Index Correlates with Aggressive and Attention Deficit Disorder Behaviours in Adult Prisoners
37. Patrick and Ames 2015 Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior
38. Gajos and Beaver 2016 The effect of omega-3 fatty acids on aggression: A meta-analysis
Disclaimer:
This article is for educational purposes only and has not been evaluated by the FDA. The information is not intended to diagnose, treat, cure, or prevent any disease.
