Fish Oil, ADHD & Mental Health | Dr. John Kruse
Fish oil has a complex relationship with ADHD. While early studies with kids didn't show benefits, more recent research has demonstrated positive effects. This pattern is actually the opposite of what happened with fish oil for heart health, where initial studies showed benefits but later ones didn't.
The scientific community sometimes focuses too much on recent findings without reconciling all available data. This recency effect doesn't give us the complete picture.
For depression, which has shown the most consistent benefits from fish oil, the typical recommendation is about 1,000mg of EPA (eicosapentaenoic acid) daily. If you're seeing some improvement but think there's room for more, it might be reasonable to double that amount. Some studies have used dosages as high as 7,000mg per day to treat conditions like mania, with such dramatic results that researchers had to stop the study early to give fish oil to everyone.
When it comes to types of fish oil, it's worth noting that in nature, omega-3s are found in about a 2:1 ratio of EPA to DHA (docosahexaenoic acid). As Kruse puts it, "Mother Nature is probably smarter than any Harvard professor." The brain particularly contains high levels of DHA in its membranes, so taking EPA alone doesn't make much sense. It's better to get both in their natural proportions.
For the gut microbiome and ADHD, the relationship is "complicated and probably important" but with so many variables that it's difficult to translate into practical daily recommendations. The basic approach is simply having a varied diet and eating at somewhat regular intervals.
Behavioral tools can help manage ADHD symptoms. Cognitive behavioral therapy (CBT) has been adapted specifically for people with ADHD. Though traditional CBT might seem like a poor match for ADHD because it requires repetitive homework and introspection, modified approaches have shown success.
The core of these ADHD-specific CBT approaches involves creating a system for scheduling each day - not micromanaging every minute, but having essential blocks of time planned out, combined with a consolidated task list. People with ADHD tend to be interest-driven rather than importance-driven, so a simple triaging system helps: category A for urgent and important tasks, B for important but less urgent tasks, and C for everything else.
Regarding video games for ADHD, there is one FDA-approved product, but FDA approval for devices mainly means they won't harm you, not necessarily that they're highly effective. These products typically show you can get better at the game itself and similar tests, but there's limited evidence they help with real-world ADHD symptoms.
To manage social media distractions, consider keeping social media apps on a separate device or using apps that can block access to distracting sites during certain times. For some people, physical lockboxes that restrict device access for set periods can be helpful. Engaging in activities very different from social media, like reading physical books or writing by hand, can also help create a healthier relationship with technology.