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Many people are surprised to learn that numerous studies indicate that those with poor metabolic health, including impairments like insulin resistance, metabolic syndrome, pre-diabetes, or type 2 diabetes, have a significantly increased risk of serious mental illness such as bipolar disorder, major depression, or schizophrenia.

The correlation holds in the opposite direction as well; those with serious mental illness have a higher likelihood of having metabolic dysfunction. Clinical experience and emerging evidence suggest that improving metabolism through ketogenic diets–as well as smart approaches to nutrient deficiencies, sleep, exercise, and stress reduction–can create mental health. This is the connection we explore at Metabolic Mind.

Metabolic therapies for mental health are interventions or treatments that improve systemic metabolic and mitochondrial function to prevent, reduce, or eliminate symptoms of psychiatric illness. Typical therapies include nutritional ketosis, sleep management, movement/exercise, substance use management, meditation, and mindfulness. In addition, medications that improve insulin resistance are sometimes used to address psychiatric symptoms.

At Metabolic Mind, we are primarily focused on the most serious mental illnesses like major depressive disorder, bipolar disorder, schizophrenia, schizoaffective disorder, and anorexia nervosa. But in his book Brain Energy, Dr. Chris Palmer posits that if mental illness results from metabolic and mitochondrial dysfunction of the brain, then any disorder caused by disordered energy metabolism could benefit from these therapies. According to Dr. Palmer, the scientific literature has identified mitochondrial dysfunction in the following psychiatric conditions:

• schizophrenia
• schizoaffective disorder
• bipolar disorder
• major depression
• autism
• anxiety disorders
• obsessive-compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)
• attention deficit/hyperactivity disorder (ADHD)
• anorexia nervosa
• alcohol use disorder (alcoholism)
• marijuana use disorder
• opioid use disorder
• borderline personality disorder
• Alzheimer’s disease

Ketogenic therapy for mental illness is a sustained dietary strategy that improves metabolic function by inducing therapeutic nutritional ketosis to prevent, reduce, or eliminate symptoms of psychiatric illness.

There can be many different components of ketogenic therapy, but it often includes selecting a low-carb dietary strategy (what and what not to eat), establishing a target macronutrient ratio (typically 60% calories or more from fat), measuring ketones daily, and restricting timing of eating (when and when not to eat). Ketogenic therapy can also include tracking metabolic and mental health measures (see our sample lab order here), and supplementing with electrolytes, MCT oil, exogenous ketones, carnitine, Vitamin D, B12, and other nutrients.