We present the case of Mr CD, who presented to the psychiatric services about 12 years ago with features of Affective instability (short periods of elation, longer periods of depression); Significant self harm and suicidal behaviour; dysfunctional coping mechanisms ; non-compliance with treatment and alcohol dependence. His predominant complaint was that he was unable to feel any emotions. He described his symptoms as “Narcasm” (described by himself as a sense of narcissism and a lack of emotions).

He was resistant to treatment with conventional psychotropics.

He was investigated and discovered to have abnormalities on MRI scanning. The MRI brain scan showed - Mild global cerebral atrophy, small focal areas of sub-cortical and basal ganglia high signal as well as cerebral white matter lesions, particularly in the right frontal regions. These lesions had progressively worsened between 2006 and 2009.

It was formulated that he was suffering from a complex neuropsychiatric illness, which would not fit into any definite diagnostic criteria.

He finally improved on a combination of an antipsychotic (Quetiapine) and Essential Fatty Acids (EFAs).

Several research papers have demonstrated the role and importance of EFAs in mental illness.

It is evident that there are a large number of studies that support the growing evidence of the importance of EFAs in the management of mental disorder. In the case that we have presented, it can be seen that even in complex neuropsychiatric illnesses, EFAs can play a significant and beneficial role in treatment and prognosis.