Dyane Harwood

At the age of fifty-two, I didn’t expect I’d make one of the best decisions of my life.

I began a well-formulated (i.e., carefully planned) vegan ketogenic diet specifically for bipolar disorder. I discovered this option serendipitously through a simple Google search. Previously, I had no idea this dietary option existed, let alone that it would be a wonderful, empowering experience.

I remained on my bipolar medications, for they had been lifesaving and kept me stable. But I learned first-hand a vegan ketogenic diet would vastly improve my quality of life in a myriad of ways while taking my bipolar medications.

In 2007, after I was diagnosed with postpartum bipolar one disorder, I started taking several bipolar medications. My weight fluctuated with my moods over the years, but for most of my life I had an average-sized stomach. Then perimenopause hit me. I began eating a pint of vegan ice cream every day, and I started night bingeing. I had no desire to exercise, either. I developed a big belly, and my clothes didn’t fit.

Yes, my diet was crappy, so it’s no surprise that I felt crappy too!

Then I visited my friend Christine, who mentioned she was doing a ketogenic diet for weight loss, and it was working well! After seeing her results, I wanted to try the ketogenic diet too, but I thought it was exclusively for meat eaters.

I did a Google search and discovered that a vegan ketogenic diet was possible, and it could be safe and effective.

Then came the kicker: I learned I could reap physical and mental benefits from a ketogenic metabolic therapeutic diet (which is very different than a regular ketogenic diet) to help my bipolar one disorder!

I was in.

What I’m about to share is the tip of the iceberg in terms of what I’ve learned the past year.

Ketogenic diets have been used to treat epilepsy in children and adults for over 100 years. As epilepsy and bipolar disorder share some of the same medications, that was reason enough for researchers to explore ketogenic diets for bipolar disorder.

The field of Metabolic Psychiatry includes ketogenic diets geared specifically for mental illnesses. Ketogenic diets for bipolar disorder (and other mental illnesses) are being studied by psychiatrists and researchers worldwide at universities including Stanford University, The University of Edinburgh, UC San Francisco, and James Cook University. The research, to date, is very promising.

At the 2023 International Society for Bipolar Disorders annual conference, Dr. Shebani Sethi, Dr. Georgia Ede, and Dr. Iain Campbell presented “The Ketogenic Diet for Bipolar Disorder: Theory, Evidence, and Clinical Practice” session. Dr. Sethi is the founding director of the world’s first Metabolic Psychiatry Clinic at Stanford University which provides treatment for patients with psychiatric illness and metabolic abnormalities, i.e. insulin resistance, pre-diabetes, and unhealthy excess body weight. Moreover, Dr. Sethi is the lead researcher on the Stanford University pilot trial “The Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients with Bipolar or Schizophrenia Illness”, while Dr. Campbell is one of the researchers on a pilot trial of ketogenic metabolic therapy for bipolar disorder at the University of Edinburgh.

In 2022, Dr. Campbell was awarded the first Baszucki Brain Research Fund’s Research Fellow in Metabolic Psychiatry. Dr. Campbell was awarded $380,000 for a four-year-long fellowship to expand his current research program on ketogenic metabolic therapy for bipolar disorder at the University of Edinburgh; this program will include mechanistic (i.e., designed to understand the physiology of a disease) clinical trials.

When I first considered trying a ketogenic diet for bipolar disorder, I sought advice from my psychiatrist. He gave me the go-ahead, although he didn’t know much about ketogenic diets, so he advised me to do as much research as I could. I began using the Carb Manager app. This app made all the difference for me since nutrition has never been my strong point! Carb Manager tracks “macros” (short for macronutrients) which consist of the three categories of nutrients you eat the most. These nutrients are fats, proteins, and carbohydrates which provide you with most of your energy. In order to enter the state of therapeutic ketosis, it’s vital to monitor your macros. The Carb Manager app was an easy way to count my daily intake of macros through tracking the grams of fats, proteins, and carbohydrates.

I’ve learned that what we eat affects our physiology and our mental health more than I had ever imagined was possible. Therefore, it’s essential to hold off before diving into this powerful diet; first check out reputable resources on ketogenic diets for bipolar, make sure you’re taking adequate electrolytes, and get blood levels done. (I include my favorite resources below.)

The outstanding YouTube video series Metabolic Mind features episodes on how to talk to your doctor about the ketogenic diet, how you can transition to this diet safely, and much more. I encourage you to watch the first few episodes to learn about Metabolic Psychiatry and how a ketogenic diet can help your bipolar symptoms while you’re still taking bipolar medication. There are a variety of ketogenic professionals including psychiatrists, nutritionists, health coaches, and therapists on Dr. George Ede’s website Diagnosis Diet’s Clinical Directory. (Some of these clinicians offer a sliding scale; I recommend you ask for a reduced fee if your budget is limited.)

Here are some of the benefits I’ve experienced the past year on a well-formulated vegan ketogenic diet: a 50-pound weight loss, improved mood and energy, and a desire to exercise again. My need to take a daily nap vanished, my appetite was diminished, and my perimenopausal symptoms disappeared as did my night binges. I was shocked my sugar and carbohydrate cravings were gone. (The eradication of my cravings has been miraculous for this lifelong chocoholic/ sugarholic/carb queen!)

I can think more clearly and creatively, and I feel empowered and much happier with my body. Life remains stressful, but I feel far better since I’ve been practicing a vegan ketogenic diet.

I’ve remained on my bipolar medications, while some people with proper psychiatric supervision can taper their medications or even go off them completely. Virtually all the experts I’ve followed emphasize the importance of remaining on your medications when you start the ketogenic diet, and it’s imperative to be under a skilled psychiatrist’s care.

This is not a “perfect” nor easy diet/lifestyle by any means, and it’s a modality you must take very seriously if you have bipolar disorder. There is much to learn about ketosis, the state you need to be in for the metabolic effects to occur. But the ketogenic diet is doable and very rewarding when done correctly.

At the beginning, most everyone experiences side effects ranging from minor (thirst) to serious (hypomania/mania). You can get something called keto flu, which is temporary. It’s not a dealbreaker, however, and symptoms can range from mild to moderate. There are also things you can do to ease keto flu, and the Metabolic Mind videos and the Keto-Mojo website are ideal resources for how to avoid or ameliorate these symptoms.

In the early days you need to be on top of your moods far more than usual, and work closely with your psychiatrist if you notice any ramping up of mood.

Recently I was a guest on the cutting-edge YouTube podcast Bipolarcast about using a vegan ketogenic diet for my bipolar disorder. This podcast is hosted by Dr. Iain Campbell and ketogenic advocate Matt Baszucki. Dr. Campbell and Matt both have bipolar disorder, and since they each began the ketogenic diet, they’ve experienced incredible results. Bipolarcast features pioneering doctors, nutritionists, and people with lived experience of bipolar disorder and their success using ketogenic diets.

Check out Bipolarcast episode #23 in which I discuss my journey with postpartum bipolar disorder, and my vegan ketogenic diet experience. Much of our discussion applies to using any type of ketogenic diet, i.e., carnivore or vegetarian, and anyone who has bipolar disorder can benefit from our conversation.

Harvard psychiatrist Dr. Chris Palmer, author of Brain Energy, is one of the world’s experts on using ketogenic diets for the management of bipolar disorder. His website has a wealth of resources. The Charlie Foundation website is a preeminent website for learning about the ketogenic diet in general. While The Charlie Foundation was created due to a young boy’s epilepsy and his treatment with the medical ketogenic diet, it’s an incredibly useful resource for learning about the different kinds of ketogenic diets. Check out the “Therapies” video – while there is no bipolar section, I highly recommend visiting this site.

Bestselling author/bipolar advocate Julie A. Fast has a first-rate keto for bipolar section on her website. Julie also created an educational, inspiring Instagram video series available on @ketobipolar. I loved listening to Julie’s engaging videos during my daily walks. She has a talent for breaking down ketogenic information so that anyone can understand it, and she’s an exceptional speaker. Julie is currently conducting a ketogenic research project, and she’ll return to her Instagram @ketobipoalr account this October with exciting updates.

Lastly, there’s a free, biweekly online Keto Lifestyle for Mental Health Meetup led by Donika Hristova, a graduate of Dr. Georgia Ede’s “Ketogenic Diets for Mental Health Clinician Training Course.” Donika is a highly knowledgeable, supportive facilitator and in this group, attendees (most of whom have bipolar disorder) help one another to succeed in using the ketogenic diet.

It’s intimidating to contemplate this dietary change, to say the least. I was highly skeptical when I started this diet, but the benefits far outweigh the challenges. I encourage you to take your first step by watching some Metabolic Mind and Bipolarcast videos. You’ll learn the nuts and bolts of using the ketogenic diet for bipolar disorder and be inspired!

 

Dyane Harwood graduated with a degree in English and American Literature from the University of California at Santa Cruz. She has been a freelance writer for over two decades, and has profiled bestselling authors including Kay Redfield Jamison, SARK, and Anthony Bourdain. Dyane is also the host of Our Healing Journey with Metabolic Psychiatry. Learn more about Dyane here.