Can a Keto Diet Cause Hypomania, and How Can It Be Avoided?

Ketogenic therapy, commonly in the form of a keto diet, is often known for having more “side benefits” than “side effects.” However, it is a powerful medical intervention and, as such, not entirely without risks. In some instances, individuals transitioning onto a keto diet to treat a mental health condition, like bipolar or schizophrenia, can experience symptoms of hypomania.

There are many strategies to increase the safety of keto and mitigate potential risks, including slowly easing into a ketogenic diet, monitoring sleep, having a bridge medication available, and always having expert guidance from a clinical care team.

In this interview, Dr. Bret Scher discusses the risk of hypomania with two experts in the metabolic psychiatry field: Harvard-trained psychiatrist and author of the groundbreaking book, Change Your Diet, Change Your Mind, Dr. Georgia Ede, and Nicole Laurent, LMHC, a counselor who trains non-prescribers on assisting patients with ketogenic therapy. According to Dr. Ede, hypomania and other unwanted psychiatric symptoms are uncommon when implementing ketogenic therapy. She recommends that people not allow these risks to dissuade them from trying this form of treatment.

Featured in this video:

Georgia Ede, MD
Twitter: @georgiaedemd

Nicole Laurent, LMHC
Twitter @KetoCounselor

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

About us:
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

Timestamps
0:00 Introduction
2:38 How often does hypomania occur with ketosis?
3:55 What the science says about a ketosis causing hypomania
5:03 Signs of hypomania to look for
6:14 How quickly should you transition to a keto diet?
7:54 Using bridge medications while transitioning to keto
10:25 Talking to your doctor about ketogenic therapy
11:49 Conclusion

#MetabolicMind
#KetoForMentalHealth
#MetabolicPsychiatry
#BipolarDisorder
#MetabolicNeuroscience
#KetogenicMetabolicTherapy
#NutritionalKetosis
#MentalIllness
#AlternativeTreatment
#Obesity
#MedicationSideEffects
#Schizophrenia
#Hypomania

[niki]

I experienced a Hypomanic Phase after i started the ketogenic diet for 2 weeks. It lasted for about 2-3 days. My anxiety and depression completely was gone and i was full of Drive and Euphoria. I couldn't believe it first and was skeptical. After a few days it normalised. It was mindblowing because i haven't felt like this for years. It gave me a light at the end of the tunnel. My Mind showed me that it is possible to feel completely different with a diet change even if it was just a short overreaction.

[sadtosuccess]

I have bipolar 2 and I also experience hypomania in the transition to keto. The first time I intentionally went keto I transitioned slowly and didn't have any issues. I fell off the diet for a couple of months and ended up depressed. I decided to retry the diet, that time I went to my doctor to get my PRN, but before I took that I tried keto. On that occasion I did flip from depression to hypomania, it was a happy hypomania not a negative hypomania (which antidepressants do to me) but it only lasted for about 3 days. Once I was back in ketosis the symptoms subsided. I didn't need to take the medication.

I think people do need to work with their doctor, however, their doctor doesn't have to be a low carb doctor, just a doctor willing to work with them to manage medication and symptoms. The latter is much easier to find than a metabolic psychiatrist.

[kenadams]

Going low carb before full keto, is the smoothest way .

[cherylcore]

Thank-you for this! My son has started a keto diet to hopefully help with his bipolar 1 condition. We are in Canada, our dr will not help in this area, so we are cautiously and carefully helping him. He is still taking his medication, which is lithium, and he does have a strong sleep aid medication if need be. He is a week and a half into it, so far other than the keto flu symptoms, he seems to be on track!! I am reading Dr. Ede’s new book, and also have it on audible! I’am hopeful for the first time in many years! THANK YOU to all of you!!🙏

[emilwilczewski]

My diagnosis is bipolar type 2, but since I started the ketogenic way of eating 6 years ago, I haven't had any hypomanic episodes. Although I used to have them before that.

[pisquiatria.metabolica]

Great content. As a psychiatrist working with the ketogenic diet for tha past 4 years, I haven seen this happen in a very small number of cases, and in all of them it was not hard to manage at all. I agreee with Dr. Ede 100% that this should not stop anyone from experimenting with the diet.

[shanerichard]

Thankful Dr. Ede has taken the steps to train other clinicians....critically important....

[lancedethian]

I would love to see a video addressing the topic of socializing on the keto diet. So much of the human experience is predicated on "breaking bread" with others and there's got to be a psychological impact on having to navigate not eating the foods that everyone else is consuming at a wedding, dinner party etc.. i particularly have wrestled with this and wondered if the therapeutic effects would still be felt if one were to break out of ketosis one evening a week, fast the next day and get back into ketosis for the remainder of the week. This is the case for me as i have a bible study group once a week where a different person each week opts to cook dinner for the group. I don't want to forfeit the social, and often times mental, benefits of fellowshipping with friends and church goers but on the other end of that coin in breaking out of ketosis

[mindysueeppley]

I was just wondering out loud with my husband today if I was actually then this was posted! oh jeez

[rahayuniw]

I really love this channel. It gives me a lot of insight that I've been searching for. I've been on bipolar 2 since 2013. I used to be on a keto diet, but when I felt better, I moved to another town. I wasn't on a keto diet anymore, but still on medications. Moving to a new place really makes me realize that depression and anxiety happen almost often. Now, I've been on keto diet again for almost a month, I still have mood fluctuations, but I think I'm getting better.

[pjayadeep]

I also had a hypomanic episode when I went on a high fat diet, more like paleo than ketogenic. So I had to abandon that effort and now trying to slowly move up the fat content in my diet. One mistake I probably did was to go off lithium cold turkey, now I'm reducing the dosage slowly.. and being very very cautious

[jackschitt]

I think I experienced hypomania many years ago while taking the antidepressant Zoloft. I got fired because of behavior caused by it. At the time I just didn't have enough knowledge about this stuff. The doctor who put me on it committed suicide many years ago. Married with young kids and catholic school...I still think about him/it from time to time.

[kiwikim]

I can get this if I add too much fasting into the mix.

[lifebytadlock]

vegan keto made me extremely hypomanic when I tested it (no question it was hypo mania but you could call it mild and able to function). maybe I didn't to it correctly and had some inflaming foods or was not high enough in ketones. I tested it several times for 3-6 weeks, . Whole food plant based no gluten or fruit high carb well cooked starches leaning macrobiotic keeps my bipolar out of my life...we used to say about macrobiotics you get "macro mellow"....(I am vegan 35 years and oil free vegan like the founder of whole foods market and others are..mayor of NYC for example. I have been off meds for 25 years now...Not saying it's perfect but there are other ways to heal bipolar with food.

[karenohanlon]

Is the hypomania in any way linked to being on meds and the two things keto and mood change drugs working against each other.

[lexamdelac]

If you are in ketosis and having hypomania/mania on keto, can it be more mild? Like, do the ketones help you get through it? I'm almost three months into keto with therapeutic ketones, and since the last 2/3 weeks I am newly having insomnia and I don't want mania/hypomania/psychosis. I am working with my prescriber, but it's almost like my usual antipsychotic has stopped helping me sleep (just lowered from 5mg to 4.9mg), even when taking the extra doses prescribed - melatonin seems to help more than the extra doses that do not make me sleepy. Super scary. And I wonder if instead of potentiation, my medication is being made less effective by keto or if trouble sleeping is a new side effect?

[csmrfx]

Off the bat seems like a ridiculous proposition! 😅