Protecting Your Brain (and Your Heart) With Fish Oil

Protecting Your Brain (and Your Heart) With Fish Oil

Fish oil to protect brainA fascinating idea is how to protect your brain using simple nutrients. Can we protect our brains from depression, Alzheimer’s, even stroke using simple nutrients or over the counter supplements? I’ve written about the continuing search for predictors of Alzheimers here, but what if a simple nutrient could help prevent it?

The Wall Street Journal just published an interesting article about using fish oil to treat or prevent a variety of illnesses. They even summarize the findings with recommended doses of fish oil. For instance, to prevent heart disease, they recommend one gram of EPA or more per day. For optimum brain health, take one-half gram of DHA or more. Even Rheumatoid arthritis may respond to 2 grams or more of fish oil.

Fish oil contains omega-3 fatty acids, of which there are two main ones; EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Repeat after me if you want to really impress your physician: “eye-coh-sah-pent-ah-eh-no-ick acid” and “doh-coh-sah-hex-ah-eh-no-ick acid”. Now you see why articles always say EPA and DHA!

There is a very interesting tie in with DHA and Alzheimer’s disease, as explained by an article on medicinenet.com. It turns out that people with Alzheimer’s disease (AD) tend to have low levels of a brain protein called LR11, and about 15% of those with AD have a gene mutation that reduces LR11. LR11 works to clear the brain of amyloid proteins, which are implicated in the production of beta-amyloid plaque that clogs the neurons of those with AD. Scientists tested DHA in rodents and in cultures of brain cells and found that DHA causes a higher production of LR11.

So should you be taking fish oil capsules, and how many, and which brand? I’d say if you eat oily fish like salmon 3 times a week or more, don’t worry about it. But for the rest of us (all of us?), it may make sense to add fish oil capsules to our vitamin regimen. A 1999 Italian study found that adding 3 capsules a day reduces the incidence of sudden cardiac death by 45%! The subjects in this study mostly also took baby aspirin, which may work to increase the effects of fish oil.

I’d certainly talk to your doctor about it. Be sure to print out the Wall Street Journal article, which demonstrates that there were few if any side effects. Some doctors think taking fish oil will make you bleed more easily, but studies of very high doses haven’t found this. In fact, the main side effect is belching fish smells, but I have found this is dependent on the brand and type of capsules you take.

Here’s a quick rundown on what to look for in fish oil capsules. First of all, they vary as to how much of the essential ingredients they contain. Most capsules contain 1 gram of oil, but much less Omega-3 fatty acids EPA and DHA. Some contain as little as 200mg. of the Omega-3’s, which means you have to eat a LOT of capsules to get much EPA or DHA. Often the bottles will mislead you by citing the amount per serving, and when you look more carefully you will see that one serving is 3 or 4 capsules!

So you want as high a concentration of EPA and DHA as possible. You also want fish oil that has been molecularly distilled to remove any possible contaminants such as pesticides, dioxin, etc.

Although I rarely make product recommendations, I heartily recommend Trader Joe’s Fish Oil capsules. Priced at $7.99 for a bottle of 100 capsules, these capsules are molecularly distilled and contain 300 mg. of EPA, and 200 mg. of DHA per capsule. That means that 2 capsules make up 1 gram of Omega-3’s. So it is easy to take 1 or 2 grams of Omega-3’s per day, at an affordable cost. These compare favorably with much more expensive brands of omega-3 capsules. Another trick is to store these in the refrigerator, so the oil doesn’t turn, and occasionally break open a capsule and smell it. Although it may have a slightly fishy smell, it should smell rancid or strong.

So there you have it, a simple way to reduce heart disease, autoimmune disease, and inflammation, and improve brain health. Cost? About $0.16 per day for 2 capsules.

As always, as I am not a physician, and certainly not your physician, talk to your doctor and do your own research before consuming more than a capsule a day of fish oil.

Copyright 2008 The Psychology Lounge/ TPL Productions

All Rights reserved (Any web links must credit this site, and must include a link back to this site)

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

Suffer From Insomnia? Best Insomnia Drug Is Not A Drug, But Rather Cognitive Behavioral Therapy According to Consumer Reports

Do you suffer from insomnia? Have you tried sleeping pills? When a major consumer ratings agency such as Consumer Reports endorses cognitive behavioral therapy over drug treatment for insomnia, it is big news.sleeping dog

In the May 2017 issue of Consumer Reports (CR), there is an article entitled Why the Best Insomnia Treatment Is Not a Drug. In earlier versions of their articles on sleep and medications for sleep they had reviewed various different sleeping agents but in this updated article they conclude that at best, the newer sleep medications add only between eight and 20 minutes of sleep time, and don’t improve how people feel or operate the next day.

They also reviewed a recent systematic research study by the federal Agency for Healthcare Research and Quality (AHRQ) that compared multiple treatments for sleep problems including drugs, cognitive behavioral therapy, and alternative therapies. This study concluded that cognitive behavioral therapy (CBT) is a safe and effective way to treat insomnia, and is more effective and safer than other treatments.

So Consumer Reports’ Best Buy drug pick is actually not a drug at all! It is Cognitive Behavioral Therapy (CBT). They recommend at least one session and optimally suggest three to six sessions of CBT with a psychologist.

They also have a good description of how CBT works for insomnia. They explain how you meet with a psychologist and work on changing your beliefs about sleep, as well as changing certain behaviors that may contribute to insomnia. CR also includes a concise chart about bad sleep habits and how to fix them. They have an excellent description of CBT for insomnia here. If CBT was a sleep medication, promoted by a powerful drug company, it would be a multibillion-dollar product!

insomnia slide

I have previously written about CBT for the treatment of insomnia in the article Cognitive Behavioral Therapy for Insomnia (CBT-I) Outperforms Drugs for Insomnia, Want to Sleep Better? Get Brief CBT-I Therapy for Sleep Instead of Sleeping Pills, and Good News! You May Be Getting More Sleep Than You Think, Especially If You Suffer Insomnia! so I will just summarize some of the conclusions from those articles.

The bottom line for these articles was that Cognitive Behavioral Therapy for insomnia was safe, effective and long-lasting in its effects. What is clear from virtually every study of sleep treatments is that CBT may be the only treatment for sleep problems that doesn’t have side effects and negative impacts into the next day. According to a 2015 Consumer Report survey, 36% of people who took a sleeping pill felt drowsy the next day. They also report a study of 410,000 adults published in the American Journal of Public health which found that those who took sleeping pills were twice as likely to be in automobile crashes. The researchers in this study concluded that people taking sleep medications were as likely to have car accidents as people with blood-alcohol levels above the legal limit!

So what are the recommendations and interventions used in CBT for insomnia?

  1. Spend only seven or eight hours in bed, and don’t compensate for insomnia by lying in bed for ten or eleven hours, as that just teaches you to be an inefficient sleeper.
  2. Go to bed and get up at the same time every day.
  3. Don’t go to bed unless you actually feel sleepy. If you can’t fall asleep get out of bed and do something peaceful and relaxing until you are sleepy, and then go back to bed.
  4. Try to get regular exercise but don’t exercise in the evening.
  5. Use your bed only for sleeping (or sex), don’t read or watch TV or look at your smartphone in bed.
  6. Don’t nap.
  7. Reduce your intake of caffeine, nicotine, and alcohol, especially later in the day.

Now it’s time for my nap—no, my mid-day exercise!

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

Depression Often Misdiagnosed, and Untreated

The New York Times had an interesting article about how depression is often misdiagnosed in the US, and how most people who actually have depression don’t get treatment. They reference a research study just published in the JAMA Internal Medicine.Depression

This research study performed by Mark Olfson, Carlos Blanco, and Steven C. Marcus, looked at responses from 46,417 people on the Patient Health Questionnaire-2 (PHQ-2) which is a brief screening tool for depression. A score of over 3 indicates depression on this scale.

What did they find? They found that approximately 8.4% of all adults studied had depression, but only 28.7% had received any depression treatment in the previous year! That means 71.3% of the people who suffer depression got no treatment for this depression.

Of those who were being treated for depression, about 30% actually had depression based on the screening, and another 22% had serious psychological distress. That means that of the people in the study who were being treated for depression roughly 48% neither suffered depression nor did they suffer serious psychological distress, indicating inaccurate diagnoses by the treating professionals.

There were some interesting correlates of depression. About eighteen percent of those in the lowest income group suffered depression, while only 3.7% of those in the highest income group suffered depression. It pays to be rich!

Depression was more common in those who were separated, divorced, widowed, or who had less than a high school education. None of this is terribly surprising.

How did depression sort out by age?

In the 18 to 34-year-old group 6.6% suffered depression. In the 35 to 49-year-old group 8.8% suffered depression. Ten percent of the 50 to 64-year-old group suffered depression. Of those over 65, only 8.3% suffered depression. So at least in this sample the 50 to 64-year-old group was slightly more likely to suffer depression, and contrary to what many people think, the youngest adults were somewhat less likely to suffer depression.

Of those who were married only 6.3% suffered depression. Of those who were separated, divorced, or widowed, 13.3% suffered depression. Divorce is bad for mental health, with almost a doubling of rates of depression.

Most of the patients who were treated for depression were treated by general practitioners (73%), with roughly 24% receiving treatment by psychiatrists and 13% receiving treatment by other mental health specialists. (There was some overlap, that’s why the numbers add up to more than 100%.) This may explain the rather poor diagnosis and treatment of depression because general practitioners although competent and intelligent, are very busy and typically only have a few minutes to spend with each patient, not enough to do a good job diagnosing and treating depression.

CONCLUSIONS ABOUT DEPRESSION FINDINGS

What can we conclude from this research?

  1. Almost 10% of the adult population suffers from depression. Of those people who have depression less than 30% of them will get any treatment for depression.
  1. You are more likely to suffer depression if you are in the lowest income group, divorced, separated or widowed, or have no high school education. If you are married you have half the probability of being depressed.
  1. Many adults receive depression treatment even though they don’t really meet the criteria for depression. In this study, almost half of the people receiving treatment for depression were neither depressed nor were they even particularly distressed.
  1. Rates of depression by age groups were relatively equal, with the youngest age group having the least depression and the middle-aged group (50 to 64) suffering somewhat more depression. Married people are suffer half as much depression as divorced, separated, or widowed people.
  1. Most people received depression treatment from their general practitioner or internal medicine doctor, with a smaller number receiving treatment from a psychiatrist, and even a smaller number receiving treatment from psychologists. This also meant that most people who receive depression treatment were treated using medication, and very few people received psychotherapy, even though most studies comparing medication to cognitive behavioral therapy for depression have shown that therapy performs at least as well as medication and probably better over the long term, with less relapse.

Reading between the lines of this study, it suggests that many people who feel depressed would benefit from receiving an accurate diagnosis from a clinical psychologist, and might very well also benefit from receiving cognitive behavioral therapy for depression rather than medication. Even if medication is indicated, a psychologist could recommend it to the patient’s general practitioner, and then monitor more closely the results.

The study also suggests that many people receive antidepressant medication who actually are not depressed, which needlessly exposes them to side effects and also fails to provide the correct treatment for what troubles them.

And finally, since only about 30% of those who suffer depression received any treatment for it, if you feel depressed, be sure to pursue treatment for depression. Get an accurate diagnosis and then get treatment, ideally with a psychologist or therapist who practices cognitive behavioral therapy. If you want more information about depression, I’ve written extensively about it with a complete list of depression articles.

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.