Using ketogenic and other metabolic therapies for mental health recovery is powerful. Thousands of people tell stories of suffering for decades without relief, feeling like they’d lost years from their lives, only to have clarity and mental health restored with things like therapeutic nutrition and lifestyle shifts.
But life can interrupt even the most solid routines. Acute stressors can take their toll, chronic nervous system dysregulation can throw you off balance. Or maybe it was a piece of birthday cake that knockedyou out of ketosis and out of your rhythm. The point is never perfection and these things happen. And it doesn’t mean the tools you’re using aren’t effective. It means you’re dealing with real life. What matters is how you respond.
In the context of metabolic psychiatry, setbacks are not failures. They’re part of the process. They offer a chance to pause, reassess, and re-engage, ideally with support, strategy, and self-awareness.
To better understand how people recover momentum and stay engaged with therapeutic lifestyle changes, we spoke with three respected leaders in metabolic psychiatry: Nicole Laurent, LMHC; Dr. Matthew Bernstein; and Dr. Georgia Ede. Each brings years of clinical experience and a shared commitment to using metabolic therapies to support mental health. Their insights reflect what truly helps people stay engaged, even when it’s hard. We also drew from the lived experience of Matthew Baszucki and Lauren Kennedy West: two individuals who have used ketogenic therapy to manage serious mental illness and have spoken publicly about both the rewards and realities of this path. Their personal reflections offer a grounded, honest view of what it’s like to navigate setbacks, cravings, and the emotional weight of recovery – insights that complement and humanize the clinical perspectives shared throughout this piece.
What Do Setbacks Really Look Like?
Setbacks aren’t always dramatic. They often show up in subtle, everyday ways and they’re nearly universal on the path to recovery.
Sometimes it’s a missed meal or a few days of disrupted sleep. Other times, it’s a more complex situation: an increase in psychiatric symptoms, a medication adjustment that impacts appetite or energy, or the emotional toll of navigating a high-stress period. Even positive life events like travel or celebrations can throw off your rhythm.
One of the most common challenges we hear about is complications with medication management. Changes in dosage, starting or stopping a medication, or dealing with side effects like weight gain, cravings, or sedation can quickly interfere with therapeutic nutrition efforts. This doesn’t mean the strategy isn’t working, it means the body is responding to multiple variables at once, and it needs support.
“The biggest challenge for me,” Matthew describes, “aside from coming off medication… is keeping my ketones up. It takes a lot of discipline because carbohydrates are very sneaky and they will sneak into many, many different kinds of foods. Other things that affect my ketone levels are stress.”
He emphasizes that ketone levels aren’t influenced by food choices alone. Stress, protracted medication withdrawal, and other physiological factors can all play a role, highlighting the complexity of maintaining metabolic stability.
Other common challenges include:
- Experiencing intense cravings or emotional eating
- Feeling overwhelmed by meal planning or tracking
- Facing skepticism or lack of support from family, clinicians, or peers
- Navigating mental health symptoms like low motivation, brain fog, or anxiety
The truth is, all of this is part of the process. Metabolic therapies are powerful, but they’re not immune to the realities of life with a psychiatric condition. Understanding the kinds of challenges that can arise makes it easier to meet them with strategy and self-compassion, not shame.
How to Bounce Back from Challenges and Setbacks
1. Reframe Setbacks Without Judgment
Nicole Laurent, LMHC
It’s natural to want to parktake in social gatherings that revolve around food. It can be especially tempting to eat what everyone else is eating when you’re feeling good.
When someone veers off course, Nicole Laurent encourages curiosity over criticism. “Social situations are a common challenge, especially when there’s real or perceived pressure around food,” she says. “What matters is how we make sense of those moments afterward.”
Instead of framing food choices as deprivation, Nicole suggests seeing them as part of a larger therapeutic goal. “It’s not about telling yourself you’ll never eat a certain food again. It’s about making decisions that support your brain over time. That framing makes a real difference.”
She also points out that food often plays an emotional role, and how processed foods can lose their appeal as your brain heals. “Many people use ultra-processed foods to regulate mood when their brain isn’t functioning well. As metabolic health improves, that dynamic starts to shift. Food becomes more about nourishment than coping.”
Lauren shared a similar reflection from personal experience. “I had been about a year and a half into using ketogenic therapy and in a sense kind of forgot why I needed to be so diligent because I just wasn’t experiencing symptoms…”
As her symptoms subsided, she became more relaxed – particularly with her supplement regimen. While not technically part of the ketogenic diet itself, supplementation can be a critical component of metabolic therapy. A few months later, symptoms began to return. Rather than seeing this as a failure, it helped her reconnect with the purpose behind the protocol.
“It ended up being a really good reminder of why it’s so important to remain so diligent and strict really with this as a medical intervention.”
2. Expect Setbacks and Prepare for Them
Dr. Matthew Bernstein
“Setbacks are part of life, especially in recovery,” says Dr. Matthew Bernstein. “They’re not a sign of failure. They’re something to prepare for.”
His advice: make a plan when things are going well. That means identifying early warning signs, knowing which tools are most helpful, and writing out a set of steps you can turn to when momentum dips. “Your support system is key here,” he adds. “People often underestimate how willing others are to help.”
To reduce overwhelm in challenging moments, Dr. Bernstein recommends creating a written recovery plan during times of clarity. Tools like the Wellness Recovery Action Plan (WRAP) or THINK+SMART worksheets can help people outline what keeps them grounded, what warning signs to watch for, and what actions to take when things begin to slide. “Having that roadmap ahead of time gives people something to lean on when clarity is harder to find,” he says. “It’s a way to stay anchored, even when things feel uncertain.”
Matthew echoed the importance of support, especially when providers or family members may not fully understand metabolic therapy. “Connecting with an online community, other people online who are doing this, watching Lauren’s videos, Metabolic Mind, talking to people, the Reddit group—it’s probably going to be where you’re going to find people who are also doing this. And it’s just going to be that much more important to have that support, especially if you have a psychiatrist who’s not 100% on board or a family that doesn’t quite understand it.”
Metabolic therapy can feel isolating at first—particularly if the people around you aren’t yet familiar with this emerging field. That’s why peer connection can be so powerful.
If you’re looking for community, education, or advocacy support, here are trusted places to start:
- Metabolic Collective – Peer & Family Support and Advocacy
- Social Groups & Discussion Platforms
- Community Support Groups
These spaces connect individuals and families navigating serious mental illness with others exploring metabolic approaches. While online communities can provide encouragement and shared experience, we always recommend working with a qualified healthcare professional when making changes to treatment.
You don’t have to do this alone. And you don’t have to have everyone fully understand your decision in order to begin exploring it thoughtfully and safely.
3. Use Quick-Start Tools to Regain Metabolic Momentum
Dr. Georgia Ede
When someone falls out of ketosis, Dr. Georgia Ede recommends focusing on physiology first. “The sooner you get back on track, the easier it usually is, especially for those with a history of food addiction,” she explains.
One of the most effective strategies? Intermittent fasting. “It lowers insulin levels quickly and allows ketone production to resume. Exercise can help as well, and so can simplifying meals for a few days.”
She often recommends a short-term “fat fast” – meals made up entirely of naturally high-fat, low-carb foods like eggs, avocado, or fatty cuts of meat. “They help regulate appetite and support ketosis without the need to weigh or track.”
But she also emphasizes mindset: “This isn’t about being perfect. If ketone levels are lower than expected, see it as information. Ask what may have contributed – stress, sleep, a new food – and adjust. It’s a process of learning, not a pass/fail test.”
Matthew learned that he feels his best when he maintains consistent nutritional ketosis. While some people use advanced monitoring devices, many track ketones using simple blood meters or urine strips. Others focus on symptom tracking alongside carbohydrate intake.
There’s no single “right” tool—what matters most is identifying a practical strategy that helps you understand how your body responds and supports long-term consistency.
4. Trust the Body and Foster Self-Compassion
Nicole Laurent, LMHC
For people living with mental illness, the relationship with their body can become strained, even adversarial. Nicole Laurent sees this often in her work and encourages a mindset shift that supports healing.
“I like to remind people – and I absolutely believe this is true – that their body is actually working towards optimal wellness,” she says.
“Any symptoms that they get, or difficulties that they have implementing some of these behavioral strategies… that really is just their body trying to put them back into balance, trying to get them to the exact place that they’re trying to go.”
She explains that when people view their body as something untrustworthy, or worse, as the source of their suffering, it compounds stress, which can disrupt metabolism and recovery.
“If I have developed a relationship with my body that says, ‘I can’t trust you. You create symptoms for me. You make it so I can’t function. You make it so I have trouble regulating’… that really turns it into an adversarial relationship. And it increases stress because you’re wrestling with the signals that go on in your body.”
Instead, Nicole encourages people to begin rebuilding trust: to see symptoms not as punishments, but as signals – a way the body communicates what it needs. Reframing this internal dialogue, she suggests, is a meaningful step in the recovery process.
This kind of trust-building often involves confronting deep emotional wounds. Matthew Baszucki reflected on the anger and trauma he carried after years in the conventional mental health system. “I had something really unfair happen to me for no good reason… dealing with the resentment towards the mental health care system, especially when I suffered this protracted withdrawal injury, was one of the hardest parts of the journey,” he shared. “But that healing process is in and of itself its own journey.”
Lauren Kennedy West also spoke to this emotional complexity: “There were a lot of unanticipated challenges that came about… including going through periods of anger or processing trauma from navigating the mental health care system for over a decade.”
Both emphasized that metabolic therapy, while transformative, often brings with it the need to grieve what came before, and to renegotiate one’s identity not just as a patient, but as a person reclaiming agency and self-trust.
Supplements That Support
Dr. Georgia Ede
While food and lifestyle changes are the foundation of therapeutic ketosis, Dr. Georgia Ede acknowledges that supplemental tools can be useful, especially in the short term.
Some individuals use exogenous ketones, MCT oil, or ketone esters to help ease symptoms like brain fog, low energy, or intense cravings during a setback. “They’re not a substitute for the work,” she notes, “but they can help some people bridge the gap when re-engaging with dietary changes.”
That said, she still prioritizes whole food strategies – like the fat fast – because they both regulate appetite and support long-term stability. “After falling out of ketosis, hunger can come roaring back. Choosing foods that naturally support ketone production helps manage that while keeping you on track.”
Final Thoughts
Setbacks don’t erase progress. They reveal where adjustments may be needed and offer an opportunity to reconnect with what works. Whether it’s refining food choices, reaching out for support, or adjusting your routines, what matters is re-engaging.
As each expert made clear, the work of healing doesn’t happen in a straight line. But with the right mindset and tools, it continues, even after a step back.
Matthew agrees that small setbacks don’t mean the strategies aren’t working. “It’s been so long since I’ve had a really bad episode. You know, I’ve been able to work. I’ve been able to have a relationship. I’ve been able to be happy. I mean, it’s incredible.”
