How the Ketogenic Diet Supports Mental Health
The ketogenic diet, or “keto,” is a way of eating that significantly reduces carbohydrates (such as bread, pasta, sugar) and increases healthy fats (such as olive oil, avocado, nuts). It began 100 years ago to help children with epilepsy, but today scientists are discovering that it can improve mental health in conditions such as depression, anxiety, bipolar disorder, schizophrenia, autism spectrum disorders, and eating disorders. How does it do this? Keto changes the way your brain gets energy and “calms” problems that affect your mood and thinking. Let’s see how it works in simple terms!
How Keto Helps Your Brain.
The ketogenic diet works like a “super fuel” for your brain. It helps your body and brain function better in seven key ways:
1. Metabolism: Better Energy for the Brain.
Usually, your brain gets energy from sugar (glucose) found in carbohydrates. When you eat few carbohydrates, your body burns fat and produces “ketones,” a type of clean energy that your brain uses more easily. This “fuel” helps the brain work better, which is important for mental disorders like schizophrenia, depression, or bipolar disorder, where the brain often has energy problems.
2. Inflammation: Reduces “Stress” in the Brain.
Inflammation is like an “internal stress” in the brain that can worsen depression, anxiety, schizophrenia, or bipolar disorder. The ketogenic diet reduces inflammation, making the brain calmer. This happens because ketones and low blood sugar calm the immune system. Studies show that this reduction in inflammation helps particularly in severe mental conditions.
3. Gut Microbiome: The Bacteria That Shape Your Mood.
Your gut has millions of tiny bacteria, the “microbiome,” that affect how you feel. These bacteria send messages to your brain. The ketogenic diet changes the gut bacteria, helping them produce substances that reduce anxiety and improve mood. This can help in conditions like depression, autism, or schizophrenia, where the gut and brain don’t “cooperate” well.
4. Neurotransmitters: The Brain’s “Chemical Messengers”.
Your brain uses chemicals, called neurotransmitters, to send messages. When these are out of balance, you may feel anxiety, depression, or other problems. The ketogenic diet helps regulate them:
GABA: Like a natural “calming pill,” it reduces anxiety.
Glutamate: Controls excessive excitement, which can cause mania or psychosis.
Dopamine: Helps with joy and movement, often out of balance in schizophrenia or bipolar disorder.
Serotonin: Linked to mood and well-being, positively affected in depression.
Norepinephrine: Provides energy and focus, helping with conditions like depression.
Studies show that keto regulates these substances, making the brain more stable for many mental disorders.
5. Mitochondrial Function: The Brain’s “Energy Factories”.
Mitochondria are like small “factories” inside your cells that produce energy. In mental disorders, such as bipolar disorder, schizophrenia, or autism, these factories often don’t work well, leaving the brain “tired.” The ketogenic diet helps them become stronger, providing more energy with ketones, which are like better “fuel.” Additionally, the diet works like a “cleaning crew” (mitophagy), throwing out old, damaged mitochondria, and helps the brain create new, more efficient mitochondria, and even more than before. These changes give the brain the energy it needs to address problems like depression, autism, or eating disorders.
6. Oxidative Stress: Clears the “Chaos” in the Brain.
Sometimes, your brain gets filled with harmful substances, like “trash,” called free radicals. This “chaos” (oxidative stress) worsens problems like depression, schizophrenia, or autism. The ketogenic diet works like a “broom,” reducing free radicals and protecting brain cells. Ketones act like natural “antioxidants,” keeping the brain healthier and helping with all mental conditions.
7. Neuronal Connectivity and Changes in Neural Cells: Better Communication in the Brain.
Your brain is like a huge telephone network, where nerve cells (neurons) “talk” to each other through connections called synapses. In mental disorders, such as depression, schizophrenia, or autism, these connections may be weak or not work well. The ketogenic diet helps make them stronger and more efficient, like upgrading your brain’s network. Recent studies show that the diet increases “synaptic plasticity,” meaning the brain’s ability to create new connections, which helps with learning, memory, and mood. It also promotes “neurogenesis,” the creation of new nerve cells, and increases BDNF, a substance that protects neurons, like a “shield” for the brain. Finally, keto reduces excessive neuron excitement, which can cause psychoses or mania, making the brain more stable. These changes help with conditions like bipolar disorder, anxiety, autism, and eating disorders.
The Science Behind Keto: Top scientists worldwide are studying how the ketogenic diet helps mental health. Dr. Athanasios Evangeliou, a professor of pediatric neurology at Aristotle University of Thessaloniki, was among the first to show that the ketogenic diet can improve autism symptoms, collaborating with leading institutions like Johns Hopkins. His studies suggest the diet reduces neuronal excitability and improves behavior in children with autism. Dr. Chris Palmer, a Harvard psychiatrist, has shown that the diet improves brain function in conditions like bipolar disorder and schizophrenia, strengthening mitochondria and reducing inflammation. Dr. Shebani Sethi, from Stanford, found in a 2024 study that people with bipolar disorder and schizophrenia had better mental and physical outcomes with the diet, partly due to reduced neuronal excitability. Dr. Iain Campbell, from the University of Edinburgh, showed that keto reduces glutamate in the brain, which can cause mania, and improves mood. Dr. Georgia Ede, an expert in nutrition and psychiatry, explains how keto helps with conditions like depression, autism, and eating disorders by regulating the gut microbiome and neurotransmitters. Dr. Dominic D’Agostino, from the University of South Florida, has shown that the ketogenic diet protects neurons, reduces oxidative stress, and enhances mitochondrial function, helping with conditions like autism, schizophrenia, and depression. Many top universities have started new studies on the ketogenic diet and mental disorders, with results expected to be announced in the coming months, adding even more evidence to the power of this therapy. Recent studies indicate that the diet promotes mitophagy, the creation of new mitochondria, reduced oxidative stress, and improved connections between nerve cells, helping even severe conditions, with many patients seeing their illness go into remission.
A New Path for Mental Health: The ketogenic diet is not just a way of eating – it’s like a “tool” that helps your brain work better. Whether you’re facing mild anxiety, depression, or more serious conditions like schizophrenia, bipolar disorder, autism, or eating disorders, keto can offer hope, especially if other treatments haven’t worked. With the right guidance from a specialist, it can help you feel calmer, stronger, and healthier.
Learn More Today: Want to learn how the ketogenic diet can help you or someone you love? Contact me to discuss how I can support you with personalized care. Let’s take the first step toward your mental wellness together!
Comprehensive Bibliography: Studies on the Ketogenic Diet and Mental Health Disorders
Below is the translated bibliography, exactly as provided in the Greek text, including the 23 studies covering mental health disorders (depression, bipolar disorder, schizophrenia, autism, eating disorders, anxiety) with clinical trials, case studies, reviews, and preclinical research, emphasizing neurotransmission where relevant. The list is in chronological order with full citations and DOIs.
1. Pacheco, A., Easterling, W. S., & Pryer, M. W. (1965). A pilot study of the ketogenic diet in schizophrenia. American Journal of Psychiatry, 121(11), 1110–1111. doi:10.1176/ajp.121.11.1110. Early study examining the ketogenic diet in 10 women with schizophrenia, showing symptom reduction after 2 weeks.
2. Erecinska, M., Nelson, D., Daikhin, Y., & Yudkoff, M. (1996). Regulation of GABA level in rat brain synaptosomes: Fluxes through enzymes of the GABA shunt and effects of glutamate, calcium, and ketone bodies. Journal of Neurochemistry, 67(6), 2325–2334. doi:10.1046/j.1471-4159.1996.67062325.x. Shows that ketones (beta-hydroxybutyrate and acetoacetate) increase GABA levels in synaptosomes, reducing neuronal excitability.
3. Yudkoff, M., Daikhin, Y., Nissim, I., Lazarow, A., & Nissim, I. (2001). Ketogenic diet, amino acid metabolism, and seizure control. Journal of Neuroscience Research, 66(5), 931–940. doi:10.1002/jnr.10043. Examines how the ketogenic diet increases GABA synthesis via glutamate conversion, reducing seizure activity.
4. Evangeliou, A., Vlachonikolis, I., Mihailidou, H., Spilioti, M., Skarpalezou, A., Makaronas, N., … & Vianey-Saban, C. (2003). Application of a ketogenic diet in children with autistic behavior: Pilot study. Journal of Child Neurology, 18(2), 113–118. doi:10.1177/08830738030180020501. Pioneering study examining the ketogenic diet in 30 children with autism, showing behavioral improvements in several cases.
5. Murphy, P., Likhodii, S. S., Nylen, K., & Burnham, W. M. (2004). The antidepressant properties of the ketogenic diet. Biological Psychiatry, 56(12), 981–983. doi:10.1016/j.biopsych.2004.09.019. Investigates the antidepressant properties of the ketogenic diet in mice, suggesting GABA regulation and glutamate reduction contribute to mood improvement.
6. Dahlin, M., Elfving, A., Ungerstedt, U., & Amark, P. (2005). The ketogenic diet influences the levels of excitatory and inhibitory amino acids in the CSF in children with refractory epilepsy. Epilepsy Research, 64(3), 115–125. doi:10.1016/j.eplepsyres.2005.03.008. Found that the ketogenic diet reduces glutamate levels and increases GABA in the cerebrospinal fluid of children with epilepsy.
7. Kraft, B. D., & Westman, E. C. (2009). Schizophrenia, gluten, and low-carbohydrate, ketogenic diets: A case report and review of the literature. Nutrition & Metabolism, 6, 10. doi:10.1186/1743-7075-6-10. Case study of a woman with schizophrenia showing significant symptom improvement with a ketogenic diet.
8. Juge, N., Gray, J. A., Omote, H., Miyaji, T., Inoue, T., Hara, C., … & Moriyama, Y. (2010). Metabolic control of vesicular glutamate transport and release. Neuron, 68(1), 99–112. doi:10.1016/j.neuron.2010.09.002. Shows that acetoacetate, a ketone, inhibits vesicular glutamate transport, reducing glutamate release and excitotoxicity.
9. Sussman, D., Germann, J., & Henkelman, M. (2015). Gestational ketogenic diet programs brain structure and susceptibility to depression & anxiety in the adult mouse offspring. Brain and Behavior, 5(2), e00300. doi:10.1002/brb3.300. Shows that a gestational ketogenic diet affects serotonin and dopamine neurotransmission, reducing susceptibility to depression and anxiety in offspring.
10. Bostock, E. C. S., Kirkby, K. C., & Taylor, B. V. (2017). The current status of the ketogenic diet in psychiatry. Frontiers in Psychiatry, 8, 43. doi:10.3389/fpsyt.2017.00043. Review of 15 studies on the ketogenic diet in psychiatry, covering anxiety, depression, bipolar disorder, schizophrenia, autism, and ADHD.
11. Calderón, N., Betancourt, L., Hernández, L., & Rada, P. (2017). A ketogenic diet modifies glutamate, GABA, and GLT-1 glutamate transporter in the hippocampus of a kainic acid model of epilepsy. Nutritional Neuroscience, 20(8), 466–473. doi:10.1080/1028415X.2016.1170647. Shows that the ketogenic diet increases GABA and reduces glutamate in the hippocampus, enhancing inhibitory neurotransmission.
12. Palmer, C. M. (2017). Ketogenic diet in the treatment of schizoaffective disorder: Two case studies. Schizophrenia Research, 189, 208–209. doi:10.1016/j.scores.2017.01.053. Two case studies of patients with schizoaffective disorder showing significant reduction in psychotic symptoms with a ketogenic diet.
13. Hernández, A. R., Hernandez, C. M., Campos, K., Truckenbrod, L., Federico, Q., Moon, B., … & Burke, S. N. (2018). A ketogenic diet improves cognition and has biochemical effects in prefrontal cortex that are dissociable from hippocampus. Frontiers in Aging Neuroscience, 10, 391. doi:10.3389/fnagi.2018.00391. Examines how the ketogenic diet affects neurotransmission in the prefrontal cortex, with changes in dopamine and serotonin improving cognition.
14. Palmer, C. M., Gilbert-Jaramillo, J., & Westman, E. C. (2019). The ketogenic diet and remission of psychotic symptoms in schizophrenia: Two case studies. Schizophrenia Research, 208, 439–440. doi:10.1016/j.schres.2019.03.019. Additional case studies showing remission of psychotic symptoms in schizophrenia patients.
15. Norwitz, N. G., Dalai, S. S., & Palmer, C. M. (2020). Ketogenic diet as a metabolic treatment for mental illness. Current Opinion in Endocrinology, Diabetes and Obesity, 27(5), 269–274. doi:10.1097/MED.0000000000000564. Review of mechanisms and clinical data on the ketogenic diet in mental health disorders.
16. Chmiel, I. (2022). Ketogenic diet in therapy of bipolar affective disorder – case report and literature review. Psychiatria Polska, 56(4), 807–818. doi:10.12740/PP/OnlineFirst/125802. Describes the use of the ketogenic diet in a patient with bipolar disorder, with a review of existing literature.
17. Danan, A., Westman, E. C., Saslow, L. R., & Ede, G. (2022). The ketogenic diet for refractory mental illness: A retrospective analysis of 31 inpatients. Frontiers in Psychiatry, 13, 951376. doi:10.3389/fpsyt.2022.951376. Retrospective analysis of 31 inpatients with severe mental illnesses (depression, bipolar disorder, schizophrenia) showing improvements with a ketogenic diet.
18. Sethi, S., & Ford, J. M. (2022). The role of ketogenic metabolic therapy on the brain in serious mental illness: A review. Journal of Psychiatric Brain Science, 7(5), e220009. doi:10.20900/jpbs.20220009. Review of the neurobiological mechanisms of the ketogenic diet in serious mental illnesses.
19. Needham, N., Campbell, I. H., Grossi, H., Kamenska, I., Rigby, B. P., Simpson, S. A., … & Smith, D. J. (2023). Pilot study of a ketogenic diet in bipolar disorder. BJPsych Open, 9(6), e176. doi:10.1192/bjo.2023.568. Pilot study showing improvements in patients with bipolar disorder on a ketogenic diet.
20. Chrysafi, M., Jacovides, C., Papadopoulou, S. K., Psara, E., Vorvolakos, T., Antonopoulou, M., … & Giaginis, C. (2024). The potential effects of the ketogenic diet in the prevention and co-treatment of stress, anxiety, depression, schizophrenia, and bipolar disorder: From the basic research to the clinical practice. Nutrients, 16(11), 1546. doi:10.3390/nu16111546. Review of the potential therapeutic effects of the ketogenic diet in various mental health disorders.
21. Laurent, N. (2024). From theory to practice: Challenges and rewards of implementing ketogenic metabolic therapy in mental health. Frontiers in Nutrition, 11, 1331181. doi:10.3389/fnut.2024.1331181. Examines the challenges and benefits of applying the ketogenic diet in mental health.
22. Longhitano, C., Finlay, S., Peachey, I., Swift, J.-L., Fayet-Moore, F., Bartle, T., … & Sarnyai, Z. (2024). The effects of ketogenic metabolic therapy on mental health and metabolic outcomes in schizophrenia and bipolar disorder: A randomized controlled clinical trial protocol. Frontiers in Nutrition, 11, 1444483. doi:10.3389/fnut.2024.1444483. Protocol for a randomized clinical trial examining the ketogenic diet in schizophrenia and bipolar disorder.
23. Sethi, S., Wakeham, D., Ketter, T., Hooshmand, F., Bjornstad, J., Richards, B., … & Saslow, L. (2024). Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: A pilot trial. Psychiatry Research, 335, 115866. doi:10.1016/j.psychres.2024.115866. Pilot trial of 4 months in 21 patients with bipolar disorder and schizophrenia, showing improvements in psychiatric and metabolic outcomes.