Can a ketogenic diet successfully treat Bipolar Disorder?

Dr. Chris Palmer

Psychiatrist with a clinical practice at McLean Hospital in Belmont, Massachusetts. Director of Department of Postgraduate and Continuing Education, and Assistant Professor of Psychiatry at Harvard Medical School.  He has been using the ketogenic diet to treat his patients for more than 15 years.

22 Responses

  1. Patty says:

    I have been following the ketogenic diet to treat my bipolar disorder for 2 years. I have spent a lot of time researching it. I have Bipolar 1. I worked with my psychiatrist to wean off of all my medications. At the time I was taking Ativan, Vistaril, and Lithium. I can tell you from my personal experience the keto diet has helped me more than any medications I have taken. It does require some discipline but it helps with anxiety and bipolar. I really hope that more doctors start considering this as an option. Right now there just isn’t enough research on it. But, I can say for me it has worked very well.

    • Cecile Seth says:

      Patty,
      Thanks for sharing! Great to hear that you are finding keto and exercise to be useful parts of your tool kit on your path to better brain health! We’ve got more exciting insights in the pipeline. You may want to subscribe to our email list as well. I look forward to perusing your website in greater detail.

      Great thanks your doctor partnered with you. We would love to help move the needle on the research!

      Cecile

  2. Mary says:

    I would love to be a part of any clinical studies that might be upcoming. I’m dx’d with Bipolar Depression. I’ve been low carb for about 18 months now, mostly being in a low ketosis state. To be able to get rid of my meds would be exciting.

  3. Mary says:

    I would love to be a part of any clinical studies that might be upcoming. I’m dx’d with Bipolar Depression. I’ve been low carb for about 18 months now, mostly being in a low ketosis state. To be able to get rid of my meds would be exciting.

  4. Dorothy Krause says:

    I am 70. Been on Lithium fot 25 years.
    On Ketogenic diet for 3 years. Have reversed T2D, goal weight 2 yrs ago.
    I had a GP for 15 years who knew nothing about Keto. When I first started Keto he reduced my Lithium because I was toxic.
    My brain is a lot healthier but I feel the Lithium and Keto are too much together. In the last 3 months ive had several TIAs. My blood panel is all normal, I’m healthy, walk 20 km a week. I just feel that I need my Lithium reduced or removed.
    I’m really scared but don’t know where to turn.
    Even change from Lithium Carbonate to Lithium Orotate.
    Have changed doctors but they are reluctant to change because of good levels.

    • Cecile Seth says:

      Dorothy, I’m so glad to hear that your brain is feeling healthier and that you’ve been able to reverse your T2D and reach your goal weight! Congratulations!

      The TIA’s must have been frightening. Luckily, on our Ketogenic Clinicians Page we have 5 MD’s who are willing to see Keto-for-Psych patients. Four are psychiatrists and three are based in the US. Several see patients remotely or could consult with your existing prescribers. You’ll need to scroll down to the middle of the page.

      The literature reports that reducing psychiatric medications is tricking so I’m glad that you are looking for a doctor to help rather than trying to do it on your own. Please be careful and stay safe.

  5. T says:

    What else ya got to sell?

    “They each did the ketogenic diet..”

    “did?”

    • Cecile Seth says:

      “Did” refers to the time period which the case report describes. It does not try to cover what happened after publication.

      Many individuals report symptoms returning within 24-48 hours of eating carbohydrates again. That’s part of the reason we refer to symptoms being in remission rather than a cure. Perhaps carbohydrate addiction is similar to alcohol or opioid addictions. Currently there are clinical trials underway investigating just this fact.

  6. Earle Barker says:

    I am bipolar 1. I have struggled with alcohol and abusing prescription medication for about 25 years. I always end up quitting my meds because I cannot stand the way I feel on them and turning to alcohol, pain killers and benzos.
    A few years ago I began another one of my many health kicks and started experimenting with intermittent fasting staying in ketosis constantly. Those several months I stayed on a fasting focused routine while working out hard with weights is the best I’ve felt and looked since I was in high school. I eventually fell victim to myself and the old habits that are so familiar and going down a bad path.

    I’ve now been sober 3 weeks and am on my first 72 hour fast. I’ve been feeling really bad lately, down, no energy, sad, anxiety and obsessing over things.
    This morning I woke up feeling great! I’m in an awesome mood!
    I checked my keto strip and it was significantly pink and this made me wonder and worry if fasting might bring on a bout of mania and I came across this great article.
    I hope to abstain from alcohol indefinitely and remain on a fasting focused lifestyle.

    From the short history I have with ketosis, I can say for sure, it seems to make a huge difference in my energy levels and mood.

    • Cecile Seth says:

      Thanks for your note! Great to hear that you are feeling so much better!

      Please stay safe! I strongly encourage you to include your medical team, especially during the fat adaptation period, because symptoms can get worse before they get better. This journal article gives you a sense for both how effective ketosis can be and the minority of folks who self-reported adverse symptoms along the way. In this article 8 out of 165 individuals reported “mood destabilization.” Campbell, I. H., & Campbell, H. (2019). Ketosis and bipolar disorder: Controlled analytic study of online reports. BJPsych Open, 5(4), e58. https://doi.org/10.1192/bjo.2019.49 You can download a full pdf of the article for free.

      In addition to fasting, you might want to consider the version of the medical ketogenic diet used in pediatric epilepsy. The 3 dietitians on this list are very experienced and can work with you remotely.

      Please consider working with your healthcare provider to have your results published as a case study! That is the best way to change the medical establishment and help them to adopt this therapy and keep patients safe! Here’s an overview of the process. Why write medical case reports about unique cases? While there are many anecdotes of fasting helping bipolar, it would be great to have case studies in peer-reviewed literature. I (Cecile) can help support your healthcare provider if they have questions. They will be more likely to be comfortable writing a case study if you involve them along the way.

      Sounds like you are successfully figuring out how to make fasting work for you! If you have questions, then The Fasting Method is a quality source of information.

      Keep up the great work!

  7. Meredith Thomas says:

    Hello-I am so excited about this research & this nutritional intervention. I have been carnivore for 7 months and it has cured my autoimmune diseases-rheumatoid arthritis and Hashimoto’s. What I didn’t anticipate was that my fat-fueled brain would be so even and that I would feel so sturdy emotionally! My son has been diagnosed bipolar and is on the various meds. I would love to introduce him to a doctor that could help him with the keto diet and possibly titrating off of the meds. However, I couldn’t find that source of ketogenic doctors on your site. Could you help me out by directing me to other doctors? I do know of Dr. Georgia Ede. Thank you

  8. I think the Keto diet is horrible in terms of cholesterol, saturated fats and cardiac health. We are meant to run mostly on glucose, not fat. We are herbivores, not carnivores. I tried Keto for a year, lost 10 lbs and my cholesterol rose to 264. I then transitioned to plant based and have been happily Vegan two years. My moods are even and my sleep improved. I am Bipolar II and am lucky lithium works for me or I might be faced with the Keto option. I think it’s a dangerous one physically.

    • I’m glad to hear that you’re doing well on a Vegan diet. Overall, the long-term studies of health outcomes on the ketogenic diet have shown that overall cardiovascular risk is actually reduced, even though LDL does sometimes go up. Cardiovascular risk is more complicated than just LDL. It includes blood pressure, triglycerides, HDL cholesterol, levels of insulin resistance, levels of inflammation, etc. All of these other metrics tend to improve with the ketogenic diet, so that overall risk decreases. But again, I’m happy to hear that you’re doing well. For others who aren’t doing well despite trying innumerable treatments, the ketogenic diet should be an option.

  9. Josh says:

    I’ve been on low carb for about 10 days now and I’ve seen significant improvements on cognition and mood. In terms of mood, I’ve been very stable and motivated, and cognitive wise my memory and attention has improved. I also experience less dissociation. There is definitely a connection between low carbs and bipolar disorder that is underlooked.

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