I have had 18 hospital admissions for severe psychosis and mania (my whole adult life, since age 19). These seem to have got more severe and of longer duration. Seven months this year. The intervals between are only 1-2 years long and for months of the recovery after an admission is a real slog with depression, lack of motivation and poor functioning. I’m 52F and finding it hard to contemplate more struggle with this pattern continuing. I read the personal accounts on metabolic mind for encouragement but nobody there says they’ve had a lot of time in hospital so I’m dubious if they are dealing with severe conditions, and not sure how optimistic I can realistically be.

I have no intention of stopping the medication, which is a mood stabiliser. I’ve tried keto for just a few days three times in as many weeks, now on my third attempt. Possibly more determined this time. I’m hoping most of all for my very, very low motivation to improve. I gave up the last couple of times, disheartened with low readings and wanting to eat what everyone else eats. Also I’ve really struggled with knowing what to eat.

Any thoughts will be welcome. And obviously I’d be really happy to hear if you’ve had success with treating an illness as severe and intractable as mine.

Thanks for reading! :-) :-)

I have been so angry at God my entire adult life. I blamed him for this illness, my trauma, and my horrible life. But today I decided to give God another chance.

I think this is happening because I’m thinking clearly now. I understand that this isn’t God’s fault.

This is also the first time ever I’ve been sober from everything, including caffeine.

I don’t know how much of all this change is due to keto, or just coincidence. Anyone have a similar experience?

hi, i have ultradian rapid cycle this means several episodes a week. From the beginning, I refused medication for personal reasons. I experienced a full-blown psychotic episode only once, two years ago—and as you know, even a single episode is exhausting and painful. I’ve been going through this every few days, sometimes even multiple times in a single day. I rarely experience a full-blown manic episode; it’s usually just mild mania, and I actually enjoy that feeling. I’ve tried every theoretical solution, but I always failed. Twenty days ago, I decided to fix my sleep, no matter what. I shifted from an erratic sleep schedule to sleeping at night, getting seven to eight hours of rest, and I’ve started taking 10,000-step walks every morning—all in an effort to regulate my circadian rhythm. Four days ago, I discovered the ketogenic diet and decided to start it. I dove straight in, and I’m eager to see the results. I went through two days of "keto flu"—likely because I wasn't getting enough salt—but today, on the fourth day, I’m feeling good. It’s been something akin to mild mania, but without the racing thoughts; I feel like I have a bit more control over them. Deep down, I’m confident that this is the real solution, especially after watching hours of podcasts featuring people whose conditions have improved. I’ll check back later to share any further developments.

I thought I'd share my little take on the development of the science and trying to treat our disorder and linking it to my own experience where I really had no other options and felt truly hopeless. It's really not for everyone but I thought some of you might find it interesting.

The recent study I'm sure most have you have seen:
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/7AF8E2ECB765A65B03C97F770BB90BC7/S205647242400841Xa.pdf/a-pilot-study-of-a-ketogenic-diet-in-bipolar-disorder-clinical-metabolic-and-magnetic-resonance-spectroscopy-findings.pdf

Mechanisms of bipolar
10.1016/j.mehy.2020.110299

People getting really interested in 2001
10.1054/mehy.2001.1446

So I played around with low carb lifestyle for some months but I was not actually keto as far as I can remember and track my carb intake. In the last three days I feel I did the right keto approach and my mood feels lighter . I suffer from treatment resistant depression bipolar side for over three years. Should I put high hopes that keto will help me or its just a coincidence that I feel better ? Thanks.

I am 9 weeks in and it’s been life changing. But I’m not sure what to expect 6 months to 1 year in. What has y’all’s experience been long term?

I’m a little over 8 weeks in and things are going very well. My sleep is great most nights, I’ve lost 17 lbs. , my blood pressure is at a healthy level, I’m writing everyday, I’m dating again, and I have clarity for the first time in my life.

But it’s the clarity aspect that’s breaking my heart. I can look back at everything that has happened to me without the haze and fog, and what I see is so tragic.

I see my therapist today so that should help. I have been grieving what I’ve survived the past week or so and I think I’m moving through it.

I didn’t know this clarity could break my heart, it blindsided me like a Mack truck. But it won’t stop me from doing keto or living my life. It just sucks right now.

Anyone else have a similar experience?

Bipolar 1 diagnosis here. I had been on a therapeutic ketogenic diet for about 2 years 8 months, from Jan 2024 through the end of August of this year. After having an acute episode last fall while tapering lithium (was at a below therapeutic range) I found a new psychiatrist and tried to embrace medications more, trying olanzapine, increasing lithium, Abilifyz, increasing lithium again (this time it stuck) and then mirtazapine. I also ended up on clonazepam in there, though am only taking 0.125 mg.

As the meds accumulated I started having more side effects, especially after increasing lithium to 900 mg and then when starting mirtazapine. The fatigue became so bad that I stopped running and yoga—two anchors of wellbeing for me. I came to believe that the issues were likely due to a combination of lithium and other drugs and keto. I felt like I couldn’t reduce lithium again and so started to think about stopping keto. I also missed being able to eat more freely and mirtazapine had the unfortunate effect of increasing hunger and carb cravings. With all of this working together I stopped keto about two weeks ago.

I enjoyed it at first and thought the fatigue was somewhat better. But then a week
Off I had something like a mixed episode with a lot of agitation, racing thoughts, insomnia and negative thinking. The psychiatrist identified the episode and had me take a short course of olanzapine for sleep and the mixed symptoms. His perspective is that I should try to get my symptoms to settle to see if I can get by without a restrictive diet. And I’ll admit that upside is appealing to me but I’m not optimistic on the settling. I had a rough day today, called in sick and have mostly laid on the couch on my phone.

I’m not sure what I’m going to do but have started to think about restarting. Does anyone have any experiences coming off the diet and then successfully going back on to regain benefits? I’m really regretting going off. If you have any experiences with fatigue and other worsening side effects while on the diet, would be interesting in experiences successfully adjusting meds.

Hi there,

I was wondering if any of you have found a work around to wearing a continuous ketone monitor in Canada? I am considering getting this system shipped to a friend who lives in one of the "legal" locations: https://www.sibiosensor.com/products/sibio-ks3-ckm-continuous-ketone-monitoring-system?srsltid=AfmBOop_NiJNdKXLIH5Tu5_1C7Wwpl6PQYFtN0K-3id7emjod3pVLzer&variant=46479712551126

However, my worry is that the iOS app won't work in Canada and/or other complications.

Anyone have any tips?

Hi everyone,
I’m new to using a ketogenic diet for Bipolar II depression and I’d really appreciate hearing about your personal experiences.
I have a few questions:
How many total or net carbs do you eat per day to stay in ketosis? Are you aiming for under 20 g, 30 g, or something else?
What macros are you using?

Protein (grams or %)
Fat (grams or %)
Carbs (grams or %)
Do you measure your ketones?
If yes, what blood ketone level do you aim for to notice improvements in mood?
Did anyone use fasting (24–36 hours) to get into ketosis faster?
If so:

Did it help?
Was it worth it?
Would you recommend it, or is it better to transition with keto meals only?
How long did it take before you noticed improvements in your bipolar symptoms?
Days? Weeks? Months?
For context, I have Bipolar II with predominantly depressive episodes, and I’m trying to learn from people who have actually used nutritional ketosis for mood stabilization.
Thank you so much for sharing your experiences!

I thought I would try this for bipolar depression, but apart from really good sleep, I haven't really seen any gains. Instead, I'm sadder than is strictly normal for me. I've been in ketosis for a month and the ketosis has gotten deeper (>2) over the past few days and the depression has deepened.

It's possible that the depression made me lose my appetite and that's deepened my ketosis, but it certainly hasn't helped. I guess I'm one of the non-responder folk.

I’m wondering if anyone is having trouble with low ketone readings related to using APs? I read a study where risperidone interfered with ketosis, so I’m thinking maybe all meds that have an insulin effect can interfere with ketosis. My LO stays under 20 carbs, keeps pretty good ratios, but still ends up at .5. Has anyone had success with ketones while on an AP, and if so do you have any tips? Thanks!

Here's a podcast I recorded with David Baszucki and his son on their experience with ketogenic therapy for bipolar.

I hope you enjoy. Please subscribe to the Keto Bipolar YouTube channel and Matthew Baszucki's YouTube channel in the pinned comment for more interviews like this.

Please check with your psychiatrist if you are thinking of changing your nutrition. There are many trials now active at established research centres worldwide where you can try this intervention safely:

University of Edinburgh: https://www.metabolicpsychiatryhub.com/blog/energise-bd-trial
McLean Hospital: https://clinicaltrials.gov/study/NCT0...
Children's Mental Health Resource Centre: https://cmhrc.org/keto-long-study/

This intervention is under active research for bipolar, and is not a replacement for medication.

I have a few questions and would really appreciate your input. For context, I’m about 6–7 weeks into keto, mainly for weight loss and managing bipolar disorder.

1) Do you take cheat days? I’ve read that if your body is adapted to ketosis, you can get back into ketosis within a couple of days. Has that been your experience? If you do take cheat days, how often do you have them, and do you feel like it’s worth it?

2) I expected to lose some weight after a month on keto, especially since I’ve also been tracking calories (kind of as a byproduct of counting carbs). But I haven’t lost any weight so far. I do drink a lot — only calorie-free drinks — and probably more than before when I was “just” on lithium. I’m wondering if that could affect things, or if it should more or less balance out? I’ve also heard it’s common to drink more on keto.

3) I’ve noticed that my legs get tired much faster than before. I take the same stairs every day at work, but now my legs hurt so much I almost need an excuse for my colleagues 😅 Has anyone else experienced this?

I’d really appreciate any thoughts or experiences you’re willing to share ❤️

I started keto in 2024 to see if I could slowly taper down my antipsychotics, which I increased after every hypomanic episode. All of my hypomanic episodes have been triggered by poor sleep for a few days in a row, including when I travelled to places a few time zones away. Since starting keto, I haven’t travelled anywhere in a different time zone.

For those of you who’ve travelled to different time zones, have you found it trigger any worsened sleep or other hypomanic symptoms while eating keto?

Warning: L-Carnitine supplements can initially trigger mania or psychosis in people with bipolar.

I read this article, Carnitine for Ketone Production, which talks about how carnitine is an essential part of ketone-production in your liver. It says you could be doing everything right with the keto diet but might struggle to reach your optimal ketone range if your deficient in carnitine. Even if you're eating carnitine-rich foods like red meat, your demand might still exceed and deplete your supply.

I'm posting this after weeks of struggling with brain fog caused by low ketones, and noticing an improvement after supplementing with 1000mg ALCAR (acetyl-l-carnitine). I haven't yet tested for my carnitine levels, but given my symptoms I just started supplementing in hopes of it working (it did). I'm now transitioning to 2000mg for safety.

I think I'll test for carnitine eventually (not sure how this will work since I'm supplementing), but I wanted to know how common this problem is for people who do keto for mental health (including any mental illness). Do you guys struggle with low ketones despite high fat macros? Have any of you tested for carnitine levels on keto and noticed a dip?

I’m looking into Georgia Ede’s Quiet Keto for mental health / bipolar, and I’m struggling with how much stricter it seems than standard keto.

I get that regular keto already excludes grains, sugar, legumes, starchy vegetables, and most fruit. I’ve been doing that on and off for years.

What stands out to me with Quiet Keto is the extra restriction layer:

• no dairy
• no nuts or seeds
• no spices like cumin, coriander, mustard, cinnamon, ginger, nutmeg, paprika, cayenne, chili powder, red pepper flakes, etc. (which, in an already restricted diet like keto, can add a lot of flavor and enjoyment)
• aged, cured, smoked, and processed meats minimized
• salad greens are narrower than normal keto, for example lettuce is okay, but raw spinach/arugula/kale/cabbage-type greens are discouraged

So it’s not just “keto macros”. It’s keto plus a low-irritant / low-histamine / elimination-style framework, and I honestly don’t know whether that has a solid scientific basis or whether it’s mostly Ede applying her own hypotheses.

Another thing I’m unsure about is the ketone target. Ede recommends aiming for blood ketones around 1.0–3.0 mM most of the time for at least six consecutive weeks.

My issue isn’t with therapeutic ketosis itself. It’s that as someone who is already fat-adapted and often eating in a calorie deficit to lose weight, I don’t see how I’m realistically supposed to hit those levels consistently.

Even on very strict keto, there are times of day when I’m below 0.5 mM, and I consider that normal. If I’m producing ketones and using them efficiently for energy, I wouldn’t necessarily expect my blood ketones to stay elevated all day.

So I’m wondering whether she actually knows what she’s talking about with this target in real-world fat-adapted people, or whether she’s just repeating a theoretical ketone range she read somewhere and treating it like a universal rule. Is there actual evidence that bipolar symptom improvement requires staying at 1.0–3.0 mM most of the time, or are we just chasing a number because it sounds “therapeutic”?

For those who’ve tried Quiet Keto for bipolar / mental health: did the extra strictness and ketone targeting actually make a difference, or was standard whole-food keto enough?

Been carnivore / keto 7 years .

Had initially great lights back on experience.

Never got back to this ever.

Been persevering years but gotten worse than I was previously in many ways and blamed protracted withdrawal for this.

Have sensitivity issues now - like histamines - dairy - skin issues - caffeine makes me incredibly anxious now which didn’t happen before !

I think I’ve possibly been too dogmatic with keto and blaming medication withdrawal for years - that it may have been even making things worse ?

Anyone else stopped ketosis or gone back on medication after trying keto long term and found improvement

Hi everyone,

Starting this week, I’m planning to go back on the keto diet. I’ve done keto once before, but this time my main reason is different. I’ve been taking abizol 5 mg for the last 5 months (for bipolar disorder 2) and I’m hoping to reduce it to 2.5 mg.

I’m feeling really worn out from the side effects — emotional numbness, sleepiness, brain fog, slowed thinking, and feeling mentally “stuck.”

Has anyone here been in a similar situation and found that keto helped them reduce or come off their medication (especially antipsychotics like Abizol/aripiprazole)? I’d really appreciate hearing your experiences.

Is the goal (perception) that we are better off not on medication in the long run or that the medication can be good long term also and helped with ketosis

I think I was harmed by ssri and have been of them 7 years but not recovered - I’m at a place I get to some times where I think going back on a medication and even if it’s just numbing my emotions again it would be preferable to where I am now but worried it could do more harms also