Anxiety disorder can make you feel broken, depressed and lonely. It’s a really tough thing to live with.
But we do know a lot about anxiety, and now have lots of very effective ways to tackle it.
Here we are going to cover the most common nutritional approaches to anxiety problems. In particular the B vitamins, as well as how fish oil can help with anxiety due to it’s high quality Omega 3 content.
So let’s get started:
IMPORTANT: if you are suffering with any anxiety disorder the most important thing to realise is that you are certainly not alone, AND that there is a LOT you can do about it.
Nearly 1 in 5 adults in just the USA have some form of anxiety disorder. So do not feel like an outcast, or think there is nothing you can do about it. Anxiety disorders are highly treatable!
What Is Anxiety?
The definition of anxiety is simply a general feeling of worry or being nervous.
The physical symptoms of anxiety can range from an increased heart rate and sweating at the minor end. Right through to physical pain in the chest or stomach or even feeling faint or vomiting.
Feeling stressed or anxious is a normal part of life. It happens to us all at some time. Tight work deadlines, exams or relationship problems can all cause us to feel anxious.
But this is normally a temporary feeling. If that feeling continues or worsens over time this is where anxiety becomes an anxiety disorder. It can greatly affect our normal daily lives and limit our ability to cope with even seemingly normal everyday tasks.
It is not something that you can just shake off, and should be taken seriously.
There are a number of different forms of anxiety disorder, ranging in severity.
Here’s a few to help clarify how sufferers are affected:-
Phobias – this is a form we are all most familiar with, or at least the idea if not from personal experience. Phobias are an intense, usually irrational fear of something specific. They are so common we even have names for most of them. You’ve probably heard the term arachnophobia to describe a phobia of spiders. But it could be anything from fearing flying, clowns or holes. Each is no less terrifying to the sufferer no matter how odd it may appear to an outside observer.
Generalized Anxiety Disorder – almost the opposite of a phobia, there may be nothing in particular to cause feelings of anxiety. But they are there all the same. This generalized disorder can mean months of excessive worry, all without being unable to identify anything specific that is a reason to worry. It can also lead to sleep issues, irritability and difficulty concentrating.
Panic Disorder – many of us have heard of the term panic attack. This is panic disorder. The sufferer is hit with intense periods of fear. These arrive out of the blue and can be highly debilitating. They come with all the genuine feelings of real intense fear, but without any visible real reason to feel like that. The attacks themselves can then lead to greater feelings of general anxiety about when it might happen again.
Social Anxiety Disorder – as the name suggests, this form of disorder is all about other people. It centers around a fear of normal social situations. It can manifest as fear of being with people and struggling to interact with them. There may be expectations of being judged, rejected or embarrassed. It can lead to avoiding contact with people or feeling anxious even weeks before an occasion that will involve being around other people.
Celebrities With Anxiety Disorders
Remember, these disorders are common. 40 million adults in the USA alone suffer with a disorder. Thankfully we are more willing to talk about these things nowadays. And with that awareness comes better understanding and treatment.
So it’s a good thing that a number of celebrities and famous people have been happy to publicly talk about their own experiences. Anxiety disorder can affect anyone.
It is not a sign of weakness of any kind – people with all kinds of personalities, backgrounds, ages and financial situations are affected.
World famous singer Adele suffers anxiety about performing. It seems all the more incredible when you think this is in front of thousands of adoring fans. Yet she has such feelings of panic, she says it feels like her heart could explode. And all because she never feels like she will be up to delivering what she actually excels at.
Britney Spears says she is not good in groups of people, and that she makes everything awkward. Which sounds just like social anxiety disorder. Kirsten Stewart says she was ‘constantly anxious’ for 5 years. She would feel physically ill or be so inhibited that she would feel completely debilitated. Johnny Depp, Scarlett Johansson and Emma Stone have all spoken publicly about their panic attacks.
So even being beautiful, famous and rich with countless adoring fans does not guarantee you any safety from anxiety. Anyone can be affected.
Natural Anxiety Relief
There are many causes and things that contribute to anxiety disorders. Just as there are also many ways to try and correct nutrition related imbalances or treat other root causes. A lot of sufferers look to natural remedies for anxiety first. It is of course always wise to consult a doctor if symptoms persist however.
There are two natural treatments that most people have heard about. Firstly vitamins for anxiety, and secondly Omega 3 (or fish oil). But do either of these really work?
Vitamin B For Anxiety
Let’s look at vitamin B first. A lot has been said for the benefits of the various B complex vitamins for helping with depression and anxiety. And there are certainly cases where correcting a deficiency in vitamin B can have dramatic benefits.
Note however that we are talking specifically about a deficiency here. That is, people with a severe lack of e.g. vitamin B12. You would have to have either a pretty bad diet not to get enough, or suffer from a condition such as Celiac disease resulting in poor absorption.
Vegans can be at risk of deficiency, but are also likely to be well aware they need to get B12 either from fortified foods or a supplement.
A good quality multivitamin will probably rule out any general deficiency related problems – but taking big doses of a specific B vitamins to help with anxiety and depression is probably unwise without talking to a doctor.
There have been numerous studies to find vitamins that help with anxiety, but they remain inconclusive at best. Particularly as to whether additional B vitamins in someone who is not deficient have any benefit at all.
Fish Oil / Omega 3 For Anxiety
The research here is much more promising. Not only have studies shown that getting Omega 3 in your diet regularly reduces your chances of depression. But also people who already suffer with either anxiety or depression see their symptoms improve when taking an Omega 3 supplement.
Now there are different types of Omega 3, so we need to briefly understand those before you rush out and buy a supplement that may not contain what you really want. Not all Omega 3 supplements contain the good stuff – you don’t need to spend much, you just need to choose the right products.
The main Omega 3 fatty acids are ALA, EPA and DHA. These all have much longer fancier names, but these short names are normally all you need to know and should be listed on supplement bottles. If they aren’t listed, that’s an immediate red flag!
DHA is important for all sorts of brain related functions – it is a key building block of your brain after all, making up 15%-20% of your entire brain.
But it’s EPA that appears to be the star performer when it comes to depression – potentially even as effective as the commonly prescribed antidepressant Prozac!
Sources Of EPA & DHA
These two key fatty acids, EPA and DHA are found mainly in seafood sources. That means the so-called ‘fatty’ fish, mollusks (such as green lipped muscles), krill and algae.
There are also some ‘enhanced’ (or fortified) foods that have had these Omega 3’s added in some way, such as Omega 3 eggs.
We also get some EPA and DHA from converting ALA. On the one hand that’s good because ALA is much easier to find in food sources – it’s in nuts, seeds, dairy, eggs and dark green leafy vegetables. But on the other hand our bodies are really not good at that conversion process.
It’s estimated we convert at best only 10%, and possibly as little as 1% depending on the person and other factors. The other 99% is just lost in the process.
How Much Omega 3 Do We Need?
There is no formally agreed recommend daily amount. The experts are still working to figure that one out.
For healthy adults however, numerous health organizations (such as the WHO, ISSFAL and EFSA) recommend 250-500 mg of EPA and DHA combined every day.
That’s for healthy adults. Specifically for anxiety and depression however, the studies suggest a dosage anywhere from 200 mg to over 2,000 mg per day.
Doctors generally advise starting low, and increasing slow.
In terms of safety, there have been two guidelines published. The FDA has recommended that we do not exceed 3,000 mg per day of EPA/DHA – with up 2,000 mg of that from supplements. The European Food Safety Authority (EFSA) however have concluded that up to 5,000 mg of EPA and DHA combined per day for adults is not a safety concern.
Incidentally, if you are using any blood thinning medications – even aspirin – you need to talk to a doctor first. Fish oil also has that useful blood thinning effect which you don’t want too much of overall!
Can You Get It From Food Alone?
It’s technically possible, but very tricky. If you eat the right kind of fish, plenty of vegetables, nuts and seeds, then maybe.
What makes is so difficult is that the amount of Omega 3’s varies dramatically between different types of seafood. Even between similar types of fish.
For example, a serving of canned tuna may have as little as 80 mg of EPA, and 250 mg of DHA. A portion (3 oz) of the right kind of Atlantic farmed salmon can be as high as 600 mg of EPA and 1,200 mg of DHA. But choose Pacific chum salmon and the figures plummet to just 400 mg of EPA and 250 mg of DHA. Pacific cod has only 50 mg and 110 mg for a portion, whereas Atlantic cod is far lower.
And if you wanted to reach higher levels you’d need to be eating the right kind of fish all day long.
And probably shouldn’t.
Because there is also the disturbing recommendation by the FDA that pregnant women and young children should avoid certain types of fish completely, and limit consumption of others. This is simply down to polluted oceans and concerns over levels of mercury and other toxins in fish. Shocking, but that is the reality we live in.
So too much seafood comes with other risks and concerns attached.
What About Supplements For Anxiety And Depression?
This is one of the very few occasions where a supplement can make a lot of sense.
It’s near impossible to get the daily ‘maintenance’ amounts from food alone that experts recommend for healthy people. At least not without worrying about toxins from too much seafood!
And to see benefits in terms of reducing anxiety you may need to go far higher than this anyway.
So using a good quality Omega 3 supplement can offer the best of both worlds for most people.
How To Choose An Omega 3 Supplement For Anxiety
These are the most important things you should look for:-
- EPA/DHA content
We already know we’re looking for good levels of EPA and DHA. A capsule that says it is 1,000mg of fish oil or Omega 3 oil does NOT mean it contains anywhere near that much EPA and DHA. You need to check the label to find out specifically how much is in there. Typically it will be 30% of that total, at best. If it does not say, do not trust it.
Purity is important for fish oil in particular because toxins build up in fish due to ocean pollution. It is perfectly possible to filter out toxins without damaging the oils, so there is no excuse for manufacturers not to do it. Find the manufacturers website and read up on their production processes.
Freshness is also critical here, because oils are delicate and easily damaged. Oxidation (or damage from exposure to air) is very common. As many as 7 out of 10 brands have significantly less EPA and DHA than stated on the bottle, and only 8% of brands meet international recommendations – due to oxidation. Manufacturers should be proud to explain their processes and how much effort they take to get those oils protected in capsules as quickly and as carefully as possible. If not, why trust them.
The company I buy from have incredibly strict standards on freshness and quality – way beyond anything required, or anything I’ve seen from other companies.
They also filter way beyond the most stringent international standards (GOED & CRN). And the level of DHA and EPA per capsule is extremely good. All at a price that is far cheaper than the expensive brands!
A Word On Vegetarian/Vegan Options
Whilst I personally use a fish based Omega 3 oil, it is now possible to get supplements that use oil extracted from algae or krill sources.
Firstly, be aware that krill are NOT a vegetarian option. Krill are a type of crustacean like a small shrimp.
Algae however is suitable for vegetarians and vegans. While algae is technically different to land based plants, it’s not an animal or animal by-product. So algae oil based supplements are a very good option for vegans. I still recommend reading the label carefully however.
I don’t personally use these alternatives however as they do cost more. Krill oil is also not considered as sustainable as originally thought. So right now and probably for the next few years fish oil gives the ‘best bang for your buck’.
Kessler, Ronald C., et al. “Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.” Archives of general psychiatry 62.6 (2005): 617-627.
Quoc Lu’o’ng, Khanh Vinh, and Lan Thi Hoàng Nguyen. “The impact of thiamine treatment on generalized anxiety disorder.” International Journal of Clinical Medicine 2.4 (2011): 439.
Hintikka, Jukka, et al. “High vitamin B12 level and good treatment outcome may be associated in major depressive disorder.” BMC psychiatry 3.1 (2003): 17.
Malouf, R., J. Grimley Evans, and A. Areosa Sastre. “Folic acid with or without vitamin B12 for cognition and dementia (Cochrane Review).” The Cochrane Library 1 (2004).
Grosso, Giuseppe, et al. “Omega-3 fatty acids and depression: scientific evidence and biological mechanisms.” Oxidative medicine and cellular longevity 2014 (2014).
Lin, Pao-Yen, and Kuan-Pin Su. “A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids.” Journal of Clinical Psychiatry 68.7 (2007): 1056-1061.
Sublette, M. Elizabeth, et al. “Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression.” The Journal of clinical psychiatry 72.12 (2011): 1-478.
Ginty, Annie T., and Sarah M. Conklin. “Short-term supplementation of acute long-chain omega-3 polyunsaturated fatty acids may alter depression status and decrease symptomology among young adults with depression: A preliminary randomized and placebo controlled trial.” Psychiatry research 229.1 (2015): 485-489.
Kiecolt-Glaser, Janice K., et al. “Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial.” Brain, behavior, and immunity 25.8 (2011): 1725-1734.
Osher, Yamima, and R. H. Belmaker. “Omega‐3 fatty acids in depression: A review of three studies.” CNS neuroscience & therapeutics 15.2 (2009): 128-133.
Mozaffari-Khosravi, Hassan, et al. “Eicosapentaenoic acid versus docosahexaenoic acid in mild-to-moderate depression: a randomized, double-blind, placebo-controlled trial.” European Neuropsychopharmacology 23.7 (2013): 636-644.
Jazayeri, Shima, et al. “Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder.” Australian and New Zealand Journal of Psychiatry 42.3 (2008): 192-198.
Albert, Benjamin B., et al. “Fish oil supplements in New Zealand are highly oxidised and do not meet label content of n-3 PUFA.” Scientific reports 5 (2015).
Marangell, Lauren B., et al. “A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression.” American Journal of Psychiatry (2003).
Stoll, Andrew L., et al. “Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial.” Archives of general psychiatry 56.5 (1999): 407-412.
Bradbury, Joanne. “Docosahexaenoic acid (DHA): an ancient nutrient for the modern human brain.” Nutrients 3.5 (2011): 529-554.
Cunnane, S., et al. “Recommendations for intakes of polyunsaturated fatty acids in healthy adults.” ISSFAL Newsl 11.2 (2004): 12-25.
US Food and Drug Administration. “What you need to know about mercury in fish and shellfish: 2004 EPA and FDA advice for women who might become pregnant, women who are pregnant, nursing mothers, young children.” (2004).
US Food and Drug Administration. “FDA announces qualified health claims for omega-3 fatty acids.” US Department of Health and Human Services (2004).
EFSA, J. “Scientific opinion on the tolerable upper intake level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA).” Parma (Italy) 10.7 (2012): 2815.