Nervous tension, restlessness, and other symptoms of anxiety are experienced differently by everyone. According to the Center for Addictions and Mental Health (CAMH), anxiety disorders consist of irrational or excessive fears, feelings of apprehension, difficulty managing daily tasks, anxious thoughts, and avoidance of situations which bring about anxious feelings.1  

Some of the more common types of anxiety include:2 

  • Generalized Anxiety – chronic anxiety, worry, and tension out of proportion to everyday stress.
  • Obsessive-Compulsive Disorder – unwanted thoughts (obsessions) and repetitive behaviors (compulsions) such as hand washing, counting, checking, or cleaning. Compulsions are often performed with the hope of preventing obsessive thoughts or making them go away. Compulsions provide only temporary relief, and not performing them markedly increases anxiety.
  • Panic – unexpected and repeated episodes of intense fear as well as physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
  • Post-Traumatic Stress Disorder – can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include assault, natural or human-caused disasters, accidents, or military combat.
  • Social Anxiety – overwhelming anxiety and excessive self-consciousness in everyday social situations. It can be limited to a specific situation or anytime a person is around other people.  

Some common physical symptoms of nervous tension include increased heart rate, nausea, diarrhea, headaches, chest pain, sweating, fatigue, shaking, and tingling sensations in the limbs. 

Nervous tension is a common symptom with approximately 5% of households impacted. It is often comorbid with mood disorders and is associated with lower health-related quality of life and increased risk of mortality.3,4

Standard conventional care for the management of anxiety symptoms typically consists of a combination of psychological interventions and antidepressant administration. Two mechanisms, neuroprotection and anti-inflammation, have been found to be associated with the action of antidepressant drugs.4 Omega-3 polyunsaturated fatty acids share this common biological mechanism of anti-inflammation and neuroplasticity with antidepressant agents.5 Omega-3 fatty acids in the brain also have roles in neurotransmission, cell membrane fluidity, mood, and cognition.3 

The omega-3 fatty acids EPA and DHA are essential nutrients that may have potential preventive and therapeutic effects on symptoms of anxiety or nervous tension.6

Evidence for omega-3 fatty acids in nervous tension

  • In a systematic review and meta-analysis which looked at omega-3 fatty acid supplemented participants versus those without treatments, the authors discovered an association between clinical anxiety symptoms among participants with omega-3 PUFA treatment.6 The anxiolytic effect of omega-3 PUFAs was significantly better than that of controls only in subgroups with a higher dosage (at least 2000 mg/d) and not in subgroups with a lower dosage (<2000 mg/d).6
  • In a study looking specifically at female athletes, both plasma and dietary omega-3 fatty acid levels were correlated with general anxiety during the off season.7 There was a negative correlation between omega-3 fatty acids in the blood with the Beck Anxiety Inventory.7
  • In a placebo-controlled, double-blind 12-week randomized controlled study, omega-3 fatty acid supplementation was compared with a placebo treatment in medical students.8 The students received either 2.5 g/d omega-3 fatty acids (2085 mg EPA, 348 DHA) or placebo capsules that mirrored the proportions of fatty acids in the typical American diet. Those who were given omega-3 fatty acids had reduced anxiety symptoms as well as reduced inflammatory markers.8

Patients given either omega-3 fatty acids or placebo within 10 days of an accident, saw a reduction in PTSD symptoms after 12 weeks.9 Participants discussed their traumatic event using script-imagery while researchers monitored their heart rate and skin conductance. Analysis found heart rate was significantly lower in the omega-3 group than the placebo group during the imagery exercises while HR was similar at rest.9 

AquaOmega High EPA Omega-3

Take 1.5 tsp of High EPA Omega-3 (3380 mg EPA and 670 mg DHA) once per day for 6 to 12 weeks

Ingredients: Anchovy oil, natural flavour, monk fruit extract, green tea extract, rosemary leaf extract, mixed tocopherol concentrate.

AquaOmega High EPA Omega-3 – Capsules

Take 4 capsules of High EPA Omega-3 daily (2650mg EPA and 530mg DHA) once per day for 6 to 12 weeks

Ingredients: Anchovy oil, natural flavours, green tea extract, rosemary extract, monk fruit extract, mixed tocopherol concentrate. 

Key Features: EPA is an essential fatty acid responsible for reducing inflammation in the body. AquaOmega’s high dose of pharmaceutical-grade Omega-3 EPA formula is up to 5 times more concentrated than the other leading brands of high EPA products on the market. It contains no artificial colouring or sugars.

References

  1. 20105 Anxiety Disorders [Internet]. CAMH. 2020 [cited 24 October 2020]. Available from: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/anxiety-disorders?gclid=CjwKCAjwoc_8BRAcEiwAzJevtWje0749Y8ukNNkjDBR8KP90IcbHa2UPzGSPy7HOszb9EDsYfldngBoCFvYQAvD_BwE
  2. What are the five major types of anxiety disorders? [Internet]. HHS.gov. 2020 [cited 24 October 2020]. Available from: https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html
  3. Stein MB, Roy-Byrne PP, Craske MG, Bystritsky A, Sullivan G, Pyne JM, Katon W, Sherbourne CD. Functional impact and health utility of anxiety disorders in primary care outpatients. Medical Care. 2005 Dec 1:1164-70.
  4. Tolmunen T, Lehto SM, Julkunen J, Hintikka J, Kauhanen J. Trait anxiety and somatic concerns associate with increased mortality risk: a 23-year follow-up in aging men. Annals of Epidemiology. 2014 Jun 1;24(6):463-8.
  5. Su KP, Matsuoka Y, Pae CU. Omega-3 polyunsaturated fatty acids in prevention of mood and anxiety disorders. Clinical Psychopharmacology and Neuroscience. 2015 Aug;13(2):129.
  6. Su KP, Tseng PT, Lin PY, Okubo R, Chen TY, Chen YW, Matsuoka YJ. Association of use of omega-3 polyunsaturated fatty acids with changes in severity of anxiety symptoms: A systematic review and meta-analysis. JAMA network open. 2018 Sep 7;1(5):e182327-.
  7. Wilson PB, Madrigal LA. Associations among omega-3 fatty acid status, anxiety, and mental toughness in female collegiate athletes. Journal of the American College of Nutrition. 2017 Nov 17;36(8):602-7.
  8. Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain, Behavior, and Immunity. 2011 Nov 1;25(8):1725-34.
  9. Matsumura K, Noguchi H, Nishi D, Hamazaki K, Hamazaki T, Matsuoka YJ. Effects of omega-3 polyunsaturated fatty acids on psychophysiological symptoms of post-traumatic stress disorder in accident survivors: A randomized, double-blind, placebo-controlled trial. Journal of Affective Disorders. 2017 Dec 15;224:27-31.

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The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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