ketosis for depression

Depression is so common these days that it seems hard to meet anyone who hasn’t experienced it in some degree. While this has perhaps become the new normal, it doesn’t need to be. Our eating choices not only affect our physical health but our mental health as well—so if you’ve been wondering whether the ketogenic diet can positively impact your emotional state, read on for the use of ketosis for depression.

Diet and Depression

It’s no secret that most people are overworked, under-rested, and living on a poor diet. It’s also no coincidence that the modern advice to eat a diet high in carbohydrates, low in fat, and with constant snacking or small meals throughout the day has coincided with a rise in diabetes, obesity, and mental issues like anxiety and depression.

Let’s take a look at why this difference in diet could be causing these problems—and how ketosis and a ketogenic diet can help.

Ketogenic Nutrition and Depression

Most of us can agree that a high intake of sugar has a negative impact on mood. Just think of the sugar highs and crashes that result from eating high-carb foods. What follows is feelings of crankiness, low-energy, and maybe even depression.

Now, think about how a steady intake of fats from a ketogenic diet could have a positive impact on mood and endorphin levels. Many people who start eating keto have come from a background of eating the Standard American Diet and not exercising enough.

Starting a ketogenic diet, removing high-carb refined foods, losing weight, and eating whole foods is bound to help with mood and make you happier. This alone could have benefits for those with depression.

In addition, there are some interesting links between ketones and many conditions of the brain similar to depression, including epilepsy and Alzheimer’s, which we’ll explore below.

Ketones and Mood

There are a few other reasons the ketogenic diet may be beneficial in stabilizing mood:

  • The use of anticonvulsant drugs (traditionally used in the treatment of seizures, such as klonopin) has been used to help improve outcomes for those with mood disorders.
  • In people following the ketogenic diet, positive changes in brain-energy profile have been observed [1]. We also know that the ketogenic diet is an effective therapy for those with epilepsy.
  • Cerebral hypometabolism (when the brain isn’t able to use glucose as its primary fuel) is seen in the brains of people who are manic or depressed.
  • When the body is in ketosis, the extracellular changes that happen may decrease sodium concentrations within the cells. This is a common effect of the most popular mood stabilizers used.

As we can see from the treatment of epileptic seizures through the ketogenic diet, it’s clear that there’s something about ketones that helps the brain and the individual function more properly. Let’s look at how this also relates to excitement in the brain.

Neurotoxicity and Depression

GABA (gamma-aminobutyric acid) is a neurotransmitter responsible for countering the neurotransmitter glutamate. While GABA is known as a “downer” for the brain, glutamate is an “upper” that excites the brain. We need both of these for the brain to function correctly, so it’s a problem for mood when there’s an imbalance of too much glutamate.

In order to maintain balance, the brain must control the amount of the neurotransmitter glutamate that’s present. When there’s too much excitement (glutamate) in the brain, that’s known as neurotoxicity. At its extreme, neurotoxicity causes seizures as we see in those with epilepsy. However, depression also has links to neurotoxicity.

When the brain is able to use energy efficiently, it’s easier to pull glutamate back into the cells where it belongs. The ketones beta-hydroxybutyrate and acetoacetate have been shown in rat studies to decrease death of neurons and prevent negative changes caused by glutamate excitotoxicity [2].

Now, let’s look at another factor that can affect our health and our mood: inflammation.

Inflammation and Depression

Leaky gut is a condition in which tears in the lining of the intestines allow undigested and unwelcome food particles to enter the rest of the body and cause inflammation.  

We’ve seen that inflammation—like that caused by leaky gut—and depression fuel one another [3], and here’s how:

  • Depression can have an impact on the gut microbiome, thus increasing the amount of substances that get through the gut lining, which can then enhance inflammatory response.
  • A high level or long period of inflammatory responses can lead to poor mental and physical health results.
  • Plus, anti-inflammatory practices, such as exercise and consuming omega-3 fatty acids, have been shown to have a stronger effect on the moods of people with high inflammation [3]. So, if inflammation and depression are both present, treating them at the same time may help overall recovery.

A Note on the Keto Flu

While improved nutrition on the ketogenic diet and ketosis can have an overall positive effect on mood, it should be noted that when the body is initially adapting to burning fat instead of glucose, a period known as the “keto flu,” one might feel worse at first. It’s possible to experience lower mood during this time, but it passes once the body adjusts and is able to level out.

Elements to Assist you Through the Keto Flu

  • Omega-3 fats, which have been shown to enhance mood and are commonly helpful for those with depression [4]. Sources of omega-3 fats include grass-fed meats, eggs, wild fatty fish, and high-quality fish oil or flaxseed oil.
  • L-glutamine, an amino acid made by the body from glutamate that plays a part in many processes of the body, including brain development and function. Those suffering from depression may have lower brain levels of glutamine. You can easily get it naturally from foods like grass-fed beef, bone broth, cottage cheese, cabbage, wild fish, and spirulina.
  • Tryptophan, an essential amino acid used by the body to make serotonin, which acts as a natural mood stabilizer. Good sources of tryptophan include red meats, turkey, salmon, eggs, nuts, and cheeses.
  • Exogenous ketones are also helpful for getting the body into ketosis faster and quickly reducing or preventing any mood-related keto flu symptoms.

As you can see, many of the foods that are beneficial for addressing nutrition are also abundant in the ketogenic diet.

Take Away Message:

While there are likely many factors linked to depression and different severities require different levels of treatment, we do know that biochemical issues like imbalances in fatty acids, neurotransmitters, and carb to fat intake can play a role—which are all factors that can be helped by ketosis through a ketogenic diet.

Sources cited:

[1] El-Mallakh, R.s., and M.e. Paskitti. “The Ketogenic Diet May Have Mood-stabilizing Properties.” Medical Hypotheses 57.6 (2001): 724-26. Web.

[2] Maalouf, Marwan et al. “KETONES INHIBIT MITOCHONDRIAL PRODUCTION OF REACTIVE OXYGEN SPECIES PRODUCTION FOLLOWING GLUTAMATE EXCITOTOXICITY BY INCREASING NADH OXIDATION.” Neuroscience 145.1 (2007): 256–264. PMC. Web.

[3] Kiecolt-Glaser, Janice K., Heather M. Derry, and Christopher P. Fagundes. “Inflammation: Depression Fans the Flames and Feasts on the Heat.” American Journal of Psychiatry172.11 (2015): 1075-091. Web.

[4] Giles, Grace E., Caroline R. Mahoney, and Robin B. Kanarek. “Omega-3 Fatty Acids Influence Mood in Healthy and Depressed Individuals.” Nutrition Reviews 71.11 (2013): 727-41. Web.

Dr. Anthony Gustin is a board-certified sports chiropractor, functional medicine practitioner, entrepreneur, podcast host, and founder of Perfect Keto.

Over the last few years, he has treated thousands of patients with movement rehab, internal diagnostics, and natural interventions, including NFL, MLB and NBA champions. After growing his sports rehab and functional medicine clinics to six locations in San Francisco, he shifted his mission to help as many people as possible achieve optimal health and well-being.

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Responses (3)

  1. Thank you. Excellent information.
    The typical ‘American Diet’ is killing us. I am new to a Keto lifestyle. The improvements in my brain chemistry some may say “it’s a miracle”.

  2. Thank you for such a thoroughly investigated article that provides answers to all of my KETO questions!

  3. Keto has done for me what DECADES of therapy and meds could not do.

    It’s literally a Godsend.

    8months keto and I still nearly tear up with joy.

    I’m actually trolling all posts on the topic I can find to share my experience so perhaps others will try and find their relief too.

    You’ll know within 2 weeks of it will help you or not. For me, it was like a switch was flipped 4 days into it. But I also fasted for 3 days to speed up the process.

    It also cleared my ADHD and no longer take any medication for depression or ADHD 🙂

    Keto hasn’t cured the depression because it does return when I get knocked out of ketosis. The bottom line is my brain does not like carbs and loves ketones.

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