The people of Japan experience one of the lowest bipolar disorder rates in the civilized world. Compared to the 4.4 percent lifetime prevalence rate of bipolar disorder in the U.S., in Japan it’s just 0.07 percent. That’s no typo — that’s a crazy large difference.
The Japanese don’t live a less stressful lifestyle than people in the U.S. In fact, in the white-collar world, the stress levels are often higher and the people often work harder. The Japanese people live on a small, crowded island and rely heavily on imports to sustain their way of life. Japanese schools are results-oriented, and students spend an enormous time engaged in study.
So what gives? How come the Japanese have such a low rate of bipolar disorder compared with other high-income, developed nations?
In a word: fish.
The Japanese diet is focused on fish and it is their main source of protein. Forbes contributor David DiSalvo delves into whether fish — and fish oil — may help ward off mental health concerns like bipolar disorder. Each Japanese person consumes about 154 pounds of fish a year:
Collectively, they consume 12% of the world’s fish, but account for only 2% of the global population. Comparatively, the average American consumes about 16 pounds of fish and shellfish annually.
The result of consuming so much fish is that the average Japanese person has far higher levels of Omega-3 fatty acids in their brains than the average American (or average anyone-else, with the possible exception of the Chinese, who annually consume closer to Japanese levels of fish).
There is a good, solid set of research studies that examine the link between brain health and Omega-3 fatty acids. While these studies can, by and large, only speak to the correlation between these two things, findings from these studies are pretty stable — and growing:
In the past decade, at least 20 studies have shown positive correlations between consuming fish oil supplements and improved mental health. In October 2008, the Archives of Psychiatric Nursing published a systematic review of omega-3 fatty acids as a treatment for bipolar disorder. After collecting data from several well-designed studies, the authors of the review concluded that there is some evidence to support the notion that fish oil can reduce symptoms of bipolar disorder.
Some evidence is a start, but not conclusive. But if you’re looking for an inexpensive and fairly easy way to potentially help your mental and brain health, adding more fish to your diet is one thing to consider. (It’s healthier for your heart too!)
Ideally, you should get your Omega-3 fatty acids naturally — from eating fish (duh). But Americans like shortcuts and seem not to like eating fish as much as beef. So the nutritional supplement industry has complied with consumer demand for fish oil supplements. So what kind of daily dose of fish oil supplement is needed?
According to the National Institutes of Health, most fish oil studies have involved the use of 300 to 3,000 mg of the essential fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
Research suggests that DHA and EPA are only effective for bipolar disorder when they are used in combination. If you happen to be in a store that sells fish oil, read the label and check out the percentages of DHA and EPA — in theory, the higher these percentages are, the better.
Remember, the evidence isn’t at all conclusive at this stage. An increase in fish oil in a person’s diet appears to be related to positive outcomes in bipolar disorder and more generally, in mental health, in the limited research done.
But it’s one of those little things in life that you can do more of with little cost and a lot of potential benefit, so why not give it a try?
Read the full blog: The Fish Oil Debate: Great Brain Medicine, or Just an Expensive Placebo?
14 comments
Thanks for keeping fish oil in our awareness, Dr. Grohol. Fish consumption and/or fish oil (and perhaps some vegan/plant based forms of DHA found in the algae that fish consume) might be supportive to mental health when they are part of a balanced, healthy diet. Popping a pill, whether it be fish oil or psychiatric medication, is not the answer to most mental health issues.The Japanese also have other dietary pluses (and a few minuses in some cases) so that really has to be carefully looked at.Meanwhile, the essential fatty acids, individually and as a group, including all the individual Omega 3s are often in a state of imbalance in Western diets. Fish oil is not the only solution, rather addressing our consumption of fats and our diets in general is a good first step.Here are a couple of blog posts over at Therapy Soup on diet (including fish oil) http://blogs.psychcentral.com/therapy-soup/2011/03/omega-3s-schizophrenia/and http://blogs.psychcentral.com/therapy-soup/2012/05/diet-and-schizophrenia-more-important-link-than-you-think/
An informative article and it goes beyond doubt that fish oil is good for health but it came as surprise that it is good for bipolar,too.
I would want to know if ethnic Japanese *without* high fish diet have higher or lower incidence of bipolar disorder.
Since genetic factors are believed to be at least part of the etiology of bipolar, wouldn’t you suspect genetic differences *first*, when you note something unusual in a genetically distinct population?
Hi Greg you said,,I would want to know if ethnic Japanese *without* high fish diet have higher or lower incidence of bipolar disorder. Well Greg, i reckon if their in Australia or America, Yes, and if their in Japan, NO,And your right about the genetic factors, but that’s also going to depend upon, “who’s eyes are seeing” again, how they see, what they see, and what they think, find feel,towards and about their client will depend on where they were indoctrinated or trained, their culture, the amount of personnel misery in the see err,the prejudices of the see-err,the conscience of the see err,the morality of the see err,the upbringing of the see err, etc, remember!! what “you see” is what “you get”.. But one thing for sure, id love to look at the pictures of those(Japanese and Australian)both in japan, and those in Australia, to compare. I bet wed all be blown away by those, wed definitely know whose telling stories wouldn’t we.
Maybe it’s the fish oil, or maybe it’s the fact that antidepressants are not as widely used in Japan as they are in the United States. There is evidence that exposure to antidepressants can predispose a patient to developing more-chronic depression as well as bipolar disorder. (In other words, antidepressants can lead to iatrogenic illness.) See, for example, John Horgan’s blog post on this topic:http://blogs.scientificamerican.com/cross-check/2012/03/05/are-psychiatric-medications-making-us-sicker/
Good article Dr J, Maybe their not getting bi-polar, because bi polar is basically, up and down, and who isn’t up and down, sometime, and for some reason,and if theirs a reason as their always is, that the reason, and the answer is whats needed, not a pill and a tag, and in the “big picture”, that’s the way the people of japan think,(Including their doctors) and by that standard of thinking don’t buy it, Bi -polar, like other more susceptible nations where it is sold like Vegemite as an illness to its vulnerable, like in Australia, who simply follow America,and produce/create psychiatric-ally/mental health/media (made) sick,(sheep), who are really just insecure and vulnerable people, maybe its because in reality, its a disease, made by psychiatry, for psychiatry, that gets sold or shoved down throats (involuntarily) in western society.or maybe The difference here is that our doctors see, tag, and poison, up and down, where as in Japan they see it for what it is.
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I believe the fish oil hypothesis and I’m living testament that it works well in major depression- my conventional psychiatrist prescribed 15ml/day plus Vitamin D nearly 12 months ago and my bottom line mood level has been much better. A bonus has been that side effects from high dose Venlafaxine (600mg/day) have been totally eliminated- no brain-zapping, sudden muscle cramps, tingling, hotness or night sweats. However, Japanese stats on MDP are another matter- of course there is the genetic component and then there is the huge suicide rate: http://www.nytimes.com/1999/07/15/world/in-japan-mired-in-recession-suicides-soar.html. But there can be no harm in eating extra oily fish or popping some pills as long as the oil source is tested as extremely low in pollutants and poisons like cadmium & PCBs. Everyone should try to assure the source of their fish oil.
Just in relation to taking the fish oil.. I take a teaspoon a day of omega 3 fish oil along with 1000ug of Vitamin D with the past month and wonder how long does it take for it to kick in, I too take antidepressants…
I lived in Japan for several years. Japanese people eat fish daily. They have fishy dried snacks and eat it for breakfast. I can’t speak to the levels of bipolar disorder there but I do think there is a correlation between bipolar disorder, mental illness in general and the modern diet low in omega 3. For example, beef from grass fed cattle contain good levels of omega 3, but modern feed techniques reduce the content greatly. Our modern diet is obviously divergent from the historical diet of humans.
Make sure you get calcium with the fish oil. Fish oil raises the level of calcium your body can hold and it is the calcium that your neurons need to lower their excitability.
I am struggling with severe bipolar depression. There’s barely words to describe the torment of being alive. I began taking fish oils a month and a half ago and lithium orotate 2 months ago. I still wish for death than to live like this. Mental illness is toture
I did not realize the Japanese ate so much fish! The fact that they eat up to %12 of the worlds population of fish. Maybe if we all increased our intake of omega-3 we would have much better mental health here in the U.S.I also think that this could be a solution to someone struggling with bipolar disorder instead of being prescribed medications, just simply taking fish oil capsules.
Doctors and psychiatrists in the United States might think about using fish oil or adding fish to the diet to help patients dealing with bipolar disease. With Japan only having a .07 percent lifetime prevalence rate of bipolar disease and the main difference is their diet being mainly fish it would be worth a try.