Keto's Impact: Mood Stabilization Timing And Effects

The ketogenic diet is a high-fat, low-carbohydrate, and adequate-protein diet that triggers a metabolic process called ketosis, causing the body to burn fat instead of carbohydrates for energy. The diet has been proven to be beneficial in treating migraines, epilepsy, and Alzheimer's disease. There is some evidence that the diet may also help to relieve symptoms of depression and bipolar disorder.

A pilot study from Stanford Medicine found that a ketogenic diet improved metabolic health and psychiatric conditions in patients with serious mental illness. The researchers hypothesize that the diet improves the brain's metabolism, providing ketones as an alternative fuel to glucose for a brain with energy dysfunction.

A new study from Northumbria University in Newcastle-upon-Tyne, England, found that following a ketogenic diet may be linked with better mental and emotional health in the general population, with benefits increasing over time. The study reported better psychological well-being among ketogenic diet followers, including superior mood states, reduced anxiety and depression, and fewer feelings of stress and loneliness.

However, it is important to note that not everybody adjusts well to ketosis, and the diet may cause side effects such as headaches, sleep disturbances, cramping, and fatigue, which can lead to depression. The keto diet has also been linked to other issues such as nutrient deficiencies, kidney problems, liver issues, constipation, and mood swings.

Ketogenic diet may help with bipolar disorder

Bipolar disorder is a mental health condition characterised by severe mood swings, from manic highs to depressive lows. While medication can help manage these symptoms, it often comes with side effects, and there is currently no cure for the disorder.

The ketogenic diet is a high-fat, moderate-protein, and very low-carbohydrate diet that has been used to treat drug-resistant epilepsy since the 1920s. The diet triggers a metabolic state called ketosis, where the body uses alternative fuels (ketones) instead of glucose for energy.

There is growing interest in the potential benefits of the ketogenic diet for various neurological and psychiatric disorders, including bipolar disorder. While there is limited evidence to support its use as a treatment for bipolar disorder, some studies suggest that it may help stabilise mood and improve depressive symptoms.

The TheoryResearchers believe that the ketogenic diet may alleviate bipolar symptoms for several reasons:

• Many mood stabilisers are also anticonvulsants, and lithium has mild anti-seizure activity.
• Electroconvulsive therapy (ECT) increases the seizure threshold and is effective for treating mania and depression.
• Artificially stimulating the peripheral vagus nerve – an anticonvulsant procedure – helps manage depressive and bipolar symptoms.

These observations suggest that epilepsy and bipolar disorder may share disrupted neurobiological pathways that can be targeted by the ketogenic diet.

The ketogenic diet is thought to work by reducing the amount of sodium that enters neurons after stimulation, decreasing their ability to transmit information. In bipolar disorder, where neurons tend to be overly excitable, this reduction in activity can be beneficial. The diet also decreases the level of excitatory neurotransmitters, further dampening neuronal activation.

The ketogenic diet may also improve bipolar symptoms by enhancing energy production in the brain. Patients with bipolar disorder often show deficient glucose metabolism, and the ketogenic diet increases energy production by changing the fuel source from glucose to ketones.

The Evidence

To date, there have only been a few clinical case reports and small studies investigating the use of the ketogenic diet for bipolar disorder. While some of these reports suggest potential benefits, others found no improvement or even negative outcomes.

In one case report, a 49-year-old woman with drug-resistant bipolar disorder showed no improvement in symptoms after following a ketogenic diet for one month. Interestingly, researchers could not detect any urinary ketones, weight loss, or changes in liver function, indicating that the patient may not have entered ketosis.

Another case report presented more encouraging results. Two women with Type II Bipolar Disorder, who had previously responded poorly to medication, followed a ketogenic diet for two years. One woman was able to lower and eventually stop her medication and control her symptoms with the diet alone. She reported improved mood and a sense of calm, confidence, and kindness. The other woman, who had previously used the diet to control flare-ups of irritable bowel syndrome, also reported improved mood and stabilisation of her bipolar symptoms.

A 2019 observational study analysed online forum posts from people with bipolar disorder who were following a ketogenic diet. It found that 56.4% of posts reported remission or significant mood stabilisation, compared to 14.9% of posts from those following a vegetarian diet or omega-3 supplementation.

A 2022 retrospective cohort study of 31 psychiatric in-patients with bipolar disorder, schizoaffective disorder, or major depressive disorder found that a ketogenic diet significantly reduced symptoms of depression, psychosis, and overall clinical severity. The number or dose of psychotropic medications was also reduced in 64% of participants.

A pilot study led by Stanford Medicine found that a ketogenic diet improved metabolic health and psychiatric conditions in patients with serious mental illness, including schizophrenia and bipolar disorder. The participants reported improvements in energy, sleep, mood, and quality of life. On a psychiatrist rating of mental illness, three-quarters of the group showed clinically meaningful improvement.

While there is limited evidence to support the use of the ketogenic diet for bipolar disorder, some studies suggest that it may help stabilise mood and improve depressive symptoms. However, further research, including large-scale, randomised control trials, is needed to fully understand the potential benefits and risks of the ketogenic diet for bipolar disorder.

It is important to note that the ketogenic diet may not be suitable for everyone and can cause side effects such as constipation, dehydration, and micronutrient and electrolyte deficiencies. Anyone considering the ketogenic diet, especially those with pre-existing health conditions, should speak to their doctor before starting.

Ketogenic diet may help with epilepsy

The ketogenic diet is a high-fat, low-carbohydrate diet that has been used to treat epilepsy since the 1920s. The diet is thought to work by producing ketone bodies, which are formed when the body uses fat for energy instead of carbohydrates. Ketone bodies are thought to have a stabilising effect on mood, and the diet has been found to be particularly helpful for some epilepsy conditions, including infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency.

The ketogenic diet has also been found to be a good alternative for non-surgical, pharmacoresistant patients with epilepsy of any age. The diet has been found to be more beneficial for some epilepsy-related syndromes than others. For example, the reduction rate of epileptic seizures is higher in patients suffering from Dravet syndrome or infantile spasms when the ketogenic diet is introduced.

The ketogenic diet has also been found to have some antidepressant and mood-stabilising properties. However, there is currently no clinical data to support this. The diet has been found to be effective in some epilepsy syndromes and ineffective in others.

Ketogenic diet may help with schizophrenia

The ketogenic diet is a high-fat, moderate-protein, and very low-carbohydrate diet that triggers a metabolic state called ketosis, in which the body uses alternative fuels instead of glucose. The ketogenic diet has been used to treat drug-resistant epilepsy since the 1920s, and there is increasing evidence that it may be beneficial for other neurological disorders.

Ketogenic Diet and Schizophrenia

There is emerging evidence that schizophrenia may be associated with compromised glucose and energy metabolism in the brain, which can affect the excitability of neurons. The ketogenic diet provides an alternative fuel source for the brain and has been found to normalize schizophrenia-like behaviours in mouse models.

Case studies have shown that the ketogenic diet can improve psychiatric symptoms, metabolic dysfunctions, and body composition in patients with schizophrenia. A 2009 case study reported that a 70-year-old woman with lifelong schizophrenia no longer experienced hallucinations after starting a ketogenic diet. She was able to stop taking psychotropic medications, lose weight, and live independently.

A pilot study led by Stanford Medicine found that a ketogenic diet improved metabolic health and psychiatric conditions in patients with schizophrenia or bipolar disorder who were taking antipsychotic medications. The participants reported improvements in energy, sleep, mood, and quality of life. On a psychiatrist rating of mental illness, three-quarters of the group showed clinically meaningful improvement.

However, it is important to note that the evidence for the effectiveness of the ketogenic diet in schizophrenia is still limited, and larger, controlled clinical trials are needed to confirm these findings.

Ketogenic diet may help with anxiety

The ketogenic diet has been shown to have a positive impact on mental health. Research suggests that the diet may benefit a number of mental health conditions such as anxiety, bipolar disorder, schizophrenia, and attention deficit hyperactivity disorder (ADHD).

The ketogenic diet appears to affect the brain in several positive ways:

• Providing a 'feel good' effect
• Bolstering brain power
• Having antioxidant effects
• Boosting 'feel good' neurotransmitters

The Ketogenic Diet and Anxiety

The ketogenic diet has been shown to increase the production of a common neurotransmitter in the brain called GABA. Evidence suggests that various anxiety disorders result from dysfunctional GABA activity. Studies conducted on the use of the ketogenic diet in seizure disorders tend to show that a good balance of GABA leads to better mental focus, reduced stress, and anxiety.

The Ketogenic Diet and Bipolar Disorder

The data supporting the use of a ketogenic diet as a treatment for bipolar is limited, but there are a few recorded clinical cases which have shown promise. A 2013 paper showed that two women with type II bipolar disorder, who went on a ketogenic diet for more than two years, both achieved better mood stabilisation with the diet than with medication.

The Ketogenic Diet and Schizophrenia

Low-carbohydrate diets and ketogenic diets have been shown to relieve symptoms of schizophrenia in animal studies and small-scale human studies. The diet may help manage schizophrenia through the increase in GABA levels and bypassing the need for glucose as a fuel.

The Ketogenic Diet and Mild Cognitive Impairment (MCI)

Studies have shown that a ketogenic diet may be beneficial for reducing the formation of amyloid plaques and inflammation, which are suspected causes of cognitive impairment. Further research will be needed to confirm this.

Whilst research shows promise, there is currently a lack of robust clinical studies that have investigated the effectiveness of a ketogenic diet on mental health. Therefore, the benefits on mental health of ketogenic diets are currently unproven.

Ketogenic diet may help with depression

The ketogenic diet is a high-fat, low-carbohydrate, and adequate-protein diet that triggers a metabolic process called ketosis. This causes the body to burn fat instead of carbohydrates for energy. The diet was initially developed to manage seizures in people with epilepsy.

How the Keto Diet Might Reduce Depression

• Increasing substances that play critical roles in managing stress, anxiety, and mood.
• Improving mitochondrial function.
• Decreasing oxidative stress.
• Regulating insulin function.
• Decreasing inflammation.

How the Keto Diet May Cause Depression

Not everybody adjusts well into ketosis. Sometimes, your body may experience symptoms that are difficult to manage, including headaches, sleep disturbances, cramping, and fatigue. Although this may resolve by increasing your fluid intake, dealing with such symptoms can lead to depression.

Other Issues Caused by a Keto Diet

• Nutrient deficiencies.
• Kidney problems.
• Liver issues.
• Constipation.
• Mood swings.

Strategies to Consider if You Want to Continue With the Keto Diet

• Focus on high-quality protein and vegetables.
• Take your time and hydrate well.
• Try cyclical keto dieting (carb cycling).

Precautions

Since other weight loss methods exist, you should discontinue keto if you notice new feelings of depression. However, if you're using the diet to manage your blood sugar or epilepsy, then consult your doctor for further guidance.

Bottom Line

The keto diet may help with depression, but it is not a recommended treatment option. If you are unsure if your depression was caused or worsened by the keto diet, consider getting help from a qualified mental health professional.

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