Ketogenic diet and mental health

Ketogenic diets show promise for improving mood and research suggests that the diet may possibly benefit a number of mental health conditions such as:

  • Depression
  • Bipolar disorder
  • Schizophrenia
  • Dementia

In this guide, we look at the theory behind using a ketogenic diet for the treatment of these mental health conditions and how running on ketones can help stabilise mood.

Whilst research shows promise, there’s 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 is currently unproven.

How does the ketogenic diet work to improve mental health?

Ketogenic diets appear to affect the brain in a number of positive ways, such as:

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

Boosting 'feel good' neurotransmitters

Being in a state of ketosis has been shown to increase production of a common neurotransmitter in the brain called GABA. There is evidence that various anxiety disorders result from dysfunctional GABA activity.

Studies conducted on the use of the ketogenic diet in seizure disorders, for example, tend to show that a good balance of GABA leads to better mental focus, reduced stress and anxiety. [252] [253]

Bolstering brain power

Contrary to common belief that glucose is essential for the brain, ketone bodies produced from fat, such as beta hydroxybutyrate, can provide an alternative ready fuel for the brain. Research suggests that ketones may even be a more efficient fuel for the brain than glucose.

It is believed that ketones increase the number of energy factories (mitochondria) in brain cells, which boost the energy levels in those cells. This is important, as many mental disorders share one major problem – deficient energy production. [254] [255] [256]

Exerting potent antioxidant effects

Studies have suggested that the ketogenic diet may reduce oxidative stress and inflammation in the brain.

Researchers believe that lower levels of inflammation combined with enhanced energy with ketones used as fuel may contribute to improved brain function.

As it turns out, studies have shown that one way the ketogenic diet could work in treating seizures could be by increasing levels of a major antioxidant, called glutathione, that protects us against oxidative stress. [257] [258]

What the science says about ketogenic diets and mental health

Whilst there’s a lack of robust clinical studies into the effects of ketogenic diets, there’s been enough evidence to suggest that the diet could help a number of mental health conditions.

Depression

Recent studies in animal models have demonstrated that there may be a case for the use of a ketogenic diet in the treatment of depression. The mechanism of action of how the diet may work is currently unclear.

It is thought that the ketogenic diet has similar effects to conventional antidepressant drugs, but further studies are needed in humans to confirm it. [259] [260]

Bipolar disorder

Many of the drugs proven to help with bipolar have anti-seizure properties, which has established a link between the low-carb, high-fat diet and its effects on the brain.

The data supporting the use of a ketogenic diet as a treatment for bipolar is limited, but there are nonetheless a few recorded clinical cases which have shown promise.

A 2013 paper showed, for example, 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. [261] [262]

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 all the different mechanisms of action discussed previously, especially through the increase in GABA levels and bypassing the need of glucose as a fuel. [263] [264]

Dementia

Studies have shown that higher ketone levels may help with mild cognitive impairment (MCI), a condition that makes someone more likely to develop dementia.

One suspected cause of cognitive impairment is a high level of inflammation in the brain that stems from the build-up of amyloid plaques, like those seen in Alzheimer's disease.

Studies have shown that a ketogenic diet may be beneficial for reducing the formation of these plaques and inflammation. Further research will be needed to confirm this. [265] [266] [267]