My Ketogenic Diet Journey with Bipolar Disorder

My Keto Journey with Bipolar Disorder

        Have you ever wondered how a diet can improve chronic mental health problems? Today I want to share my own journey with the ketogenic diet, which has improved my bipolar symptoms and allowed me to live a better, more vibrant life.

        My name is Oliver Seligman. I'm the author of Befriending Bipolar: A Patient's Perspective, and I'm currently studying a Masters at Edinburgh University in the psychology of mental health. I've lived with bipolar disorder for 30 years, tried many treatments and medications, and so far the ketogenic diet has had the most profound effect on my symptoms.

        How It Started:

      About a year and a half ago, I realised that although I had written a book on my experiences with bipolar, I had never been to a live peer support group for people with this mental illness. So, I decided to take at trip to the Bipolar Edinburgh charity, which runs talks, meetings and activities for people with bipolar, their friends, family and supporters. 

        I had a great time and met some lovely people. It felt very special to be surrounded by people who really understood me and had been through many of the same experiences. I had no idea that meeting people with bipolar could be so good for me. At the meeting I was told that Glasgow and Edinburgh Universities were looking for participants for the first pilot study of the ketogenic diet and its effects on people with bipolar. It was a trail specifically to see if people with bipolar (which can come with cognitive challenges) were able to follow the diet and benefit from it. I am someone who likes to say "yes" to life so I volunteered. 

The Modified Ketogenic Diet:

        It's a very low-carb, high-fat, normal-protein diet. I had four meals a day, limited to 40 grams of carbohydrate. No sugar, no grains, no pasta, no potatoes, no lots of stuff! Around 180 grams of fat daily (including olive oil, butter, cream) and a normal amount of protein. My mood, ketone levels, and blood sugar were regularly monitored for safety.

The Science Behind Eating Keto:

        Most people's metabolism (or energy system) runs on glucose. Most of us eat lots of carbohydrates which are turned into glucose in the body. We eat food, convert it to glucose, and our brain and body run on that. This glucose pathway is common, but can come with problems.  For some people it can cause blood sugar spikes and crashes, which in turn can contribute to insulin resistance. Insulin resistance is linked to more and more mental problems. On the ketogenic pathway, the body converts fats into ketones instead. It then moves into a state know as "ketosis". The theory is that for many people with bipolar, this leads to fewer mood swings and a much smoother ride emotionally.

        I used a device called a Keto-Mojo to test my ketone and blood sugar levels at home, which helped me confirm whether I was truly in ketosis. Many people think they're doing keto but aren't eating few enough carbohydrates to actually achieve ketosis — even something like a packet of crisps can quickly spike blood sugar and knock you out of it.

My Lived Experience:

        After a few days on the diet I experienced the "keto flu", which for me was fatigue, mild congestion, and feeling a bit grumpy. It wasn't pleasant but it only lasted a few days. I've since found that taking electrolytes and drinking plenty of water can reduce or even prevent it.

        After about three weeks I started consistently reaching ketosis. The mental effect was remarkable. I felt really calm for the first time in years. It was like my brain was taking a warm bath. I felt calmer, steadier, and more grounded. My mood improved significantly, the post-meal crashes disappeared, and my energy increased. This was looking hopeful!

     However, I soon hit a problem. One unexpected development was that the side effects of the medication that I take (lithium) began worsening. I got more fatigue and migraines. My brain got foggier and in many ways I felt as if I was going backwards. I later discovered this is actually quite common; many people on psychiatric medication find they need less of it on the keto diet. With my doctor's guidance I lowered my dose, and that's when I really started enjoying the benefits. Please note: never adjust medication without consulting your psychiatrist or doctor first.

The Challenges of Keto:

        Being on a high dose of lithium affected my cognitive function, making it difficult to measure food and remember what I could and couldn't eat. I was one of those people who, if I had had to do keto on my own, would have struggled to stick to the diet. But I was lucky. I have a loving and supportive wife who helped me measure out food, weigh it and stick to the diet. I also had a nutritionist and a psychiatrist who were provided by the study, which made everything very safe. Emotionally it was tough. I have an emotional relationship with food. It has been a real comfort and reward for me, and giving up sugar and carbs was tough at times. But, once I was in the swing of keto, I stopped craving carbs and now I can walk into a cafe, look at all the tasty pastries, and walk out without eating any!

The Biggest Result:

        My most significant outcome has been successfully lowering my lithium dose. The side effects were previously debilitating: migraines, exhaustion, cognitive difficulties, hallucinations, stiff muscles, emotional bluntness, really poor memory amongst others. Reducing my dose has been tough and taken 4 years. I would not recommend that anyone does this without professional support. However, it has transformed my quality of life in many ways. I'm starting to feel more, enjoy sensory pleasures again, and genuinely enjoy life in a way I couldn't before.

Does It Work for Everyone?

        No. It doesn't look like it. I want to be honest about that. Current research suggests it works really well for around a third of participants, works well for another third, and doesn't help or makes things slightly worse for the remaining third. The ketogenic diet is not a cure all for bipolar disorder. But it has made a tremendous difference to me personally.

A Final Word:

       If you're considering the ketogenic diet, please do so with the support of your doctor and/or a qualified nutritionist. It can occasionally trigger mild hypomania when first starting. I am not medically or nutritionally qualified to give advice. I am just sharing my personal story only. But it's a story that, so far, is going well. 

By Oliver Seligman (author of Befriending Bipolar: a patient's perspective). 

Oliver has a Youtube channel called: @livingbetterwithbipolar       

Here is the link: https://www.youtube.com/@livingbetterwithbipolar