Could cutting out carbohydrates be a new treatment for mental health issues? Early studies are showing that a ketogenic diet improves symptoms for people with bipolar disorder, depression and schizophrenia, conditions in urgent need of new treatments.
A trial by Stanford University followed 21 people with schizophrenia or bipolar over four months as they ate a keto diet (eating around 10 per cent of calories from carbohydrates, 30 per cent from protein and 60 per cent from fat). Three quarters of them showed clinically meaningful improvement, reporting better mood, sleep, energy and quality of life.
As surprising as it might seem, medical keto has been used to treat epilepsy, particularly in childhood, for over 100 years. It is prescribed by some NHS providers including Great Ormond Street Hospital. More research is needed, but researchers speculate that psychiatric conditions may stem from metabolic deficits in the brain. Dietary interventions can also help improve metabolic problems such as weight gain and insulin resistance, a common side-effect of some antipsychotic medications. Experts stress that the evidence is still in its early stages and dietary changes should always be discussed with a doctor.
Anecdotally, some patients are speaking up about the impact of keto on their mental health. Lauren Kennedy West, 34, from Alberta, Canada, says her quality of life has improved “drastically” since trying the diet to treat her schizophrenia.
Lauren, an ex-social worker and mental health advocate, was diagnosed with schizoaffective disorder in 2016, which means she has both schizophrenia and a mood disorder. Since her late teens, she has experienced depression, mania and psychotic episodes, which have led to many hospitalisations, and by her early 20s she started “really struggling with what was becoming pretty intense suicidal ideation and really intense mood struggles”.
When she was diagnosed, Lauren says: “It was really tough – it felt like a limit was placed on what I could expect from my life.
“One psychiatrist, when I was hospitalised one of the first times, had told me he thought I should be in hospital for the rest of my life.”
Lauren has tried a host of medications, and even electroconvulsive therapy. She could manage her symptoms: she got married in 2020, began caring for her husband’s two children from a previous relationship, she built a successful YouTube channel sharing her experiences. But she still struggled every day.
“I think the narrative was always that this is lifelong. This is chronic. You have to just focus on taking your meds and getting by, essentially,” she says. “But they never really fixed anything or improved my experience of life.”
Following a hospitalisation in 2019, Lauren’s husband read online about research on using the ketogenic diet to treat mental health issues. She tried it out briefly but was unable to stick to the diet without support.
Lauren could manage her symptoms: she got married in 2020 and began caring for her husband’s two children from a previous relationship, but she still struggled every dayIn mid-2023 she was hospitalised again, and following this she began doing more research into the theory.
Then she received a donation on a fundraiser linked to her social media from Jan – a philanthropist and the wife of the Roblox video game founder David Baszucki. The couple are funding research into mental health through their foundation, especially ketogenic therapies, after their son found it helped treat his bipolar disorder. The organisation has funded most of the small trials into using medical keto to treat mental health issues, including the Stanford study and one at the University of Edinburgh.
Lauren began medical keto again at the start of 2024. This time she worked with a coach with nutritional training, who guided her with daily plans – for breakfast, for example, having cauliflower and chicken bake with an avocado for added fat and coffee with double cream. Her meals are high in meat, while she snacks on nuts such as macadamias.
She says that her psychiatrists were initially sceptical, but the results were undeniably positive in her view. “Three weeks in or so, I started to realise that I wasn’t noticing symptoms anymore. I was not hallucinating.”
After three weeks, Lauren decided to try reducing her usual medication – she experienced withdrawal symptoms and says she relapsed somewhat in July 2025, blaming this on getting complacent with her diet.
She adds that the diet can also be “isolating” at restaurants and family gatherings – but is content with the idea she could be on it forever.
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“I’m not saying that this has cured me of my illness and it’s never coming back, but for right now, my quality of life has improved so drastically and I’m able to experience my life in such a fuller way.”
A ketogenic diet should never be started without medical advice. It has well documented side-effects, including constipation, diarrhoea and vomiting – and is too hard to stick to for some. In the Stanford study, only half the group were able to fully adhere to a keto diet over four months. Some bipolar patients shared in online communities how the diet brought no benefits for them.
Ketogenic diets also often lead to a lack of natural fibre and micronutrients like vitamin A, calcium and magnesium, so patients are often recommended to take vitamin supplements, as Lauren does.
In rare cases, a condition called ketoacidosis can occur, where the blood becomes acidic. This can cause serious illness, or even death.
Robin Williams is a professor of molecular cell biology at Royal Holloway University. He has studied how the keto diet can treat epilepsy and bipolar disorder and is positive about the potential future for this treatment.
“It’s changing the way our bodies work – rather than just taking a single molecule drug which will change one point in your biology,” he says. “It’s also important to realise that most medicines aren’t curative, whereas ketogenic diets can, on occasion, lead to an individual slowly weaning themselves off medications.”
The mechanism remains unclear, but Williams says one theory is that by changing the body’s energy source, burning fat instead of glucose, it increases the number of mitochondria – energy-producing “batteries” – in our brain cells.
This is thought to be the reason that the diet works for some people with epilepsy, as seizures can be caused by low energy levels in the brain.
Research continues in this field: in early 2025, scientists at University of Edinburgh conducted a similar pilot on 26 people with bipolar disorder. They found that for the 20 participants who stuck to the diet, there was improvement in their daily mood, energy, impulsivity, and anxiety.
Ohio State University recently led a trial looking at the impact of keto on depression. They found a 69 per cent decrease in depressive symptoms over a 10-week period among 16 students diagnosed with major depressive disorder. This is the first-ever peer-reviewed trial in the field.
Robin Williams, a professor of molecular cell biology, is positive about the potential future for using the keto diet to treat epilepsy and bipolar disorderWilliams says larger, longer-term studies are needed, and emphasises the importance of having expert support when trying medical keto.
“It’s very important that the public realise that they should not use the ketogenic diet through self-diagnosis and self-treatment.
“They should have expert help to ensure that they get the right nutritional balance, the right energy balance to remain healthy and to ensure that the diet is taken at a level where it will be effective.”
Some experts are more cautious. Professor Allan Young, chair of the academic faculty at the Royal College of Psychiatrists and head of the Brain Sciences department at Imperial College London, says it is common for new treatments in psychiatry to go through a period of “early evangelism, very often based on small results, which were done in studies that may have questionable methodology”.
He adds: “I think one of the fundamental problems is that psychiatric disorders by their nature are very complicated, and it’s very appealing to have a sort of simple solution.”
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He thinks caution is necessary because conditions like bipolar disorder can be episodic, meaning that people go through periods of acute symptoms and period where they feel more stable.
This means that treatments can appear to be fully effective over the short term, but illness can then return.
Young thinks that there is “some biological plausibility” that medical keto works for psychiatric patients, but also cautions against making sudden changes, such as coming off medications unsupervised.
“Making a radical change because suddenly you’ve discovered something that’s curative can be disastrous, particularly for bipolar disorder,” he says.
But patients like Lauren Kennedy West have found the benefits were worth it: “Especially given how good I feel on this diet and how life-changing it’s been, I wouldn’t entertain going back to eating the way I used to. It’s not a worthwhile trade off at this point.”
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