Keto + Bipolar Disorder


Bipolar disorder, otherwise known as manic-depressive disorder, is a chronic illness of the brain. Bipolar disorder gets it original name, manic-depressive disorder, because it is characterized by strong changes in the affected person’s energy and mood which can severely hinder their functionality in day to day life. The high moods, mania and hypomania, may feel extremely good to the person but can have damaging effects on their lives. Hypomania literally means “less than mania” and is a lower high that may be highly productive and exciting to the individual, however if untreated hypomania can escalate into mania. Mania can last weeks and is accompanied by symptoms like: excessively high mood, extreme amounts of energy, little to no sleep, unusual substance abuse, unusual provocative or sexual behavior, and even psychotic episodes which lead to things like hallucinations and delusional thinking to name a few (1). The low side of bipolar disorder is characterized by depression which frequently has symptoms like: loss of interest or pleasure from activities, insomnia, excessive sleeping, hopelessness, suicidal thinking and irritability.

Bipolar disorder affects nearly six million American adults and usually has an onset during the late teen years or early adulthood (1). Children can be diagnosed with bipolar disorder, but it is uncommon as the onset age is usually much later and many doctors avoid diagnosing someone with bipolar disorder at a very young age as the diagnosis usually requires demonstrated mood swings over long periods of time (9). If bipolar disorder is not treated carefully the results can be severe upset of relationships and work, risky behaviors such as substance abuse, unusual risk taking, self harm and suicide. We advise that you always consult your doctor before proceeding with any major lifestyle changes to make sure the choice is wise for your health.

What Causes Bipolar Disorder?

Bipolar disorder’s exact causes are unknown at this time. There is a strong genetic link to show that bipolar disorder often runs in families with many families having multiple people with bipolar disorder or other mental illnesses like depression or substance abuse disorder. Bipolar depression is notoriously harder to treat than mania and many treatments like psychiatric medications, electroconvulsive therapy, and talk therapy don’t work well or they have negative side effects (2).

Can Bipolar Disorder Be Cured?

Unfortunately, there is no cure for bipolar disorder just chronic treatment to manage symptoms as well as possible. Bipolar disorder is shown to respond well to the same treatments as epilepsy particularly in medication choices. Epilepsy is well known to respond to the ketogenic diet which is what has led many to speculate at the possibility that bipolar disorder symptoms can be improved with it as well.

How Can The Ketogenic Diet Help With Bipolar Disorder?

One of the reasons the ketogenic diet may help with bipolar disorder is that acidosis through the ketogenic diet may lower intracellular calcium and sodium. Intracellular sodium and calcium are found to be elevated in those with bipolar disorder (3). Many mood stabilizing medications, like lithium, create the same effect of lowering intracellular sodium and calcium. Thus, it’s hypothesized that a ketogenic diet could very well stabilize a person’s moods through acidosis in place or addition to mood stabilizing medications.

Another positive benefit of the ketogenic diet is it’s well known for aiding in weight loss. During a recent study, it was found that adults with bipolar disorder were significantly more likely to be overweight or obese when compared to the control group of adults with no mood disorder diagnosis. When compared to the group of bipolar adults at a healthy BMI, the group of obese adults with bipolar disorder were more likely to have had depression in the last year, depressive episodes that lasted weeks longer than the other group, a lifetime anxiety disorder, hospilazations and ER visits for either depression or mania, and to be on more medications overall (4). This demonstrates that being at a healthy weight is especially crucial for those with bipolar disorder and can lower the intensity of certain symptoms.

Since adults with bipolar disorder are more likely to be overweight or obsese, it’s even more important for those suffering to find healthy ways to take care of their health and work towards maintaining or reaching a healthy weight. After getting into a state of ketosis, your body produces ketones to use as energy instead of carbohydrates. The ketones are created in your liver from fatty acids found in your food or your own body fat (5). This can be very helpful when trying to lose weight. If you or a loved one are struggling with bipolar disorder then dropping excess weight may lead to less mood swings, lessen the need for as many medications, and help you to avoid or decrease other symptoms.

How Glucose Affects Bipolar Disorder

Schizophrenia and bipolar disorder share many overlaps such as struggling with using glucose as energy properly. Research suggests that problems with energy metabolism and mitochondrial dysfunction are contributing to bipolar disorder symptoms (2). If this is so, the brain is not receiving or metabolizing adequate energy from glucose. The ketogenic diet takes away some need for glucose to run the body and brain. Instead the body begins to use ketones created from fat in the liver. If people with bipolar disorder process glucose differently and aren’t getting the proper energy metabolized from the glucose, then the ketogenic diet creates a different energy source for the brain to draw from. With proper amounts of energy, the brain cells are able to perform better, which could decrease some of the side effects of having bipolar disorder. Other possible side effects of this are beneficial changes in neurotransmitters and lower inflammation which is believed to be therapeutic to the body and brain (2).

Considerations Before Trying The Ketogenic Diet

As with any diet or lifestyle change consult your doctor to make sure the change is a good fit for you personally. If you are on medication, it’s even more pertinent to check with a doctor before starting as medications are affected by changes in diet. Some medications like lithium, a popular mood stabilizing medication for bipolar disorder patients, require a certain level of sodium in the body. Without proper sodium levels, lithium medication levels may drop or rise which may destabilize the user or cause lithium toxicity by having too high of a lithium level in the blood (8). Adjusting psychiatric medications on your own can be very dangerous and cause terrible side effects, so be sure to consult with your doctor. It’s also important to have a doctor on board to watch for any side effects of the diet that may occur whether good or bad. Medications could interfere with the results of the ketogenic diet as some elevate the blood glucose level. If your blood glucose level is elevated it can prevent you from entering ketosis and reaping the complete results you seek from the ketogenic diet (2).

Overall Thoughts On Bipolar Disorder And The Ketogenic Diet

The ketogenic diet can offer many benefits to bipolar disorder such as: weight loss to manage symptoms, lowering intracellular sodium and calcium creating a mood stabilizing effect, offering an alternative to glucose as energy for the brain, and lowered inflammation. The ketogenic diet’s effect on bipolar disorder is still being heavily researched, but from what we’ve seen so far there are many good potential side effects that make it something worth considering and talking over with your physician.

References

  1. https://ibpf.org/about-bipolar-disorder

  2. https://www.chrispalmermd.com/ketogenic-diet-bipolar-disorder-schizoaffective/

  3. https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00043/full

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157038/

  5. https://www.eatniketo.com/single-post/keto-health-benefits/do-ketones-really-matter

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/

  7. https://www.psychologytoday.com/us/blog/diagnosis-diet/201706/ketogenic-diets-psychi

atric-disorders-new-review

  1. https://www.nami.org/learn-more/treatment/mental-health-medications/lithium

  2. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t8/​