College can be a time of rapid growth, but also intense pressure. For many young people, college is the first time they are setting out on their own. With new academic pressures, evolving social and financial landscapes, and the responsibility of managing their own health and nutrition, college can be a jarring and overwhelming experience.
In recent years, depression has quietly become the leading barrier to academic success in college, surpassing even financial stress and coursework[*,*]. During the COVID-19 pandemic, rates of depression among college students skyrocketed. Today, nearly half of all college students report symptoms of depression[*].
While current treatment options like medication and psychotherapy can be effective, their success varies significantly between those affected[*]. Plus, many students face challenges with access, affordability, residual symptoms, and unwanted side effects. As a result, there’s an urgent need for complementary approaches to the existing college mental health care model.
Metabolic psychiatry is an emerging field exploring the role of metabolism in mental health, and ketogenic therapy stands out as its most promising intervention—a therapeutic nutritional approach increasingly studied for its potential to improve outcomes in serious mental illnesses like bipolar disorder, schizophrenia, and major depressive disorder[*,*].
A new pilot study from The Ohio State University, funded by Baszucki Group and led by Jeff Volek, PhD, RD, a metabolic health expert and co-founder of Virta Health, and Ryan S. Patel, DO, FAPA, Senior Staff Psychiatrist at The Ohio State University, along with PhD candidate and research assistant Drew Decker, offers encouraging evidence that a well-formulated ketogenic diet (WFKD) may support young people struggling with depression.
The KIND Study: Redefining Depression Treatment for Students
The Ketogenic Intervention in Depression (KIND) study is the first peer-reviewed pilot study of ketogenic therapy in a population with major depressive disorder (MDD). The trial was designed to test the feasibility and effects of a ketogenic diet in college students with clinically diagnosed MDD. This approach stems from the growing field of metabolic psychiatry, which views psychiatric conditions like depression, bipolar disorder, schizophrenia, OCD, and more, not as chemical imbalances but as arising from dysfunctional brain energy metabolism.
Researchers hypothesized that ketogenic therapy, which shifts the body’s primary fuel source from glucose to ketones and which has been used to treat seizure disorders for more than a century, could improve mental health in young adults living with depression.
Ketones are energy molecules produced when the body burns fat instead of carbohydrates. They’re known to improve mitochondrial function, reduce oxidative stress, stabilize neurotransmitters, and decrease inflammation, all of which are believed to play a role in major depressive disorder[*].
College students, in particular, often face poor dietary options, increased alcohol consumption, irregular sleep patterns, and high stress, all factors that can compromise metabolic function. The KIND study aimed to determine whether improving brain metabolism through nutritional ketosis was practical and could offer a meaningful boost to existing psychiatric treatment in students with MDD.
A Well-Formulated Ketogenic Diet
To help ensure that participants followed a version of the ketogenic diet that would offer therapeutic benefits, the research team provided education and support centered on a well-formulated ketogenic diet (WFKD). This approach is distinct from popularized keto eating styles for weight loss that may rely heavily on ultra-processed, low-carb convenience foods.
Instead, a WFKD is designed to sustain nutritional ketosis while providing nutrients that support long-term health. Participants filled their plates with a wide range of whole foods, emphasizing nutrient density in selections such as unprocessed meats, fatty fish, non-starchy vegetables, low-glycemic fruits, nuts, seeds, and full-fat dairy.
Participants were also given electrolyte supplements to support the increased mineral needs associated with being in ketosis.
Can College Students Stick With Keto?
A common critique of ketogenic therapy is that it’s too restrictive, especially for busy, stressed-out college students. One of the primary goals of the KIND Study was to test that assumption: Could young adults with major depressive disorder realistically follow a ketogenic diet alongside their academic and personal responsibilities?
The findings suggest they can.
Of the 24 students who enrolled, 16 completed the full 10-12 week intervention. Among the eight who discontinued, seven withdrew for reasons unrelated to the diet itself. Only one participant cited the dietary changes as the reason for stepping away.
It’s also worth noting that for some, the burden wasn’t the diet, it was the study. Showing up for visits, completing regular assessments, and participating in cognitive testing added layers of responsibility to already packed schedules.
Despite these challenges, those who completed the study maintained nutritional ketosis 73% of the time, as measured by daily ketone testing—an impressive level of adherence, given the demands of student life.
These results suggest that ketogenic therapy is not only feasible for college students with depression but also potentially empowering, particularly when structured support, education, and flexibility are part of the process.
Early and Dramatic Improvements
Participants began to experience noticeable mental and emotional shifts after only two weeks. On average, the data showed a 37% improvement in self-reported depression (PHQ-9) and a nearly 2-fold increase in perceived wellness (WHO-5) at the two-week mark.
By week 6, that progressed into a 59% improvement in clinician-assessed depression scores (HRSD). By the end, study completers saw a 69-71% improvement in depression scores (PHQ-9 and HRSD, respectively) and a nearly 3x improvement in wellness.
This wasn’t a case of one or two “responders” skewing the results. The shift was collective and fast—100% of students who completed the study had clinically significant improvements in depression.
While the data from this study is undoubtedly compelling, its true impact lies in the personal stories of participants who experienced life-changing improvements during the intervention.
Joe’s Story
Joe was diagnosed with major depressive disorder at just 14 years old. Through high school and college, he carried an invisible weight, moving through the world feeling sad, hopeless, and alone. He poured himself into academics, using schoolwork as a lifeline. But no matter how hard he tried, he couldn’t climb his way out. “I was trying to find a reason to live.”
His first year at Ohio State, he started therapy. He tried medication. Still, the heaviness lingered. Then he heard about the KIND Study. What began as a process that felt like an overwhelming amount of structure became something Joe looked forward to and realized he needed in his life.
After just one week, something shifted. He woke up at 7 a.m., naturally. And for the first time in years, he didn’t want to crawl back into bed.
Midway through the study, Joe was running, lifting at the gym, and feeling like himself again. “I noticed I wasn’t slipping into those dark thoughts.”
And by the end, the shift wasn’t just physical. “Before I started the keto study, I was living every day like it was a challenge. Now, I have a reason to survive and things to look forward to, and dreams to fulfill.”
Sarah’s Story
“When I get depressed, I just kind of stop functioning… Like brushing my teeth, eating all my meals, or going to bed on time becomes really hard.”
Sarah, too, first experienced depression around age 14. She cycled through doctors’ offices and prescriptions, but the side effects of medication often left her feeling worse and less hopeful.
In college, the depression continued. Despite trying multiple therapies, the root of the problem remained. “It’s humiliating to feel so inadequate all the time and also fight a brain that won’t function.”
When she saw a flier for the study, she decided to give it a shot. “I didn’t have anything to lose. I’d tried everything else.”
She had concerns, specifically about her sensitivity to dairy, but the study team offered guidance and flexibility. “They helped me make a really solid game plan,” she said, working with her to tailor the diet around her food sensitivities.
And as she found her rhythm, the process became unexpectedly enjoyable. “I found I was staying full on my meal plan and actually enjoying it.”
Like Joe, Sarah quickly felt the shifts.
Beyond Mood: A Full-Body Transformation
The improvements in depression symptoms were rapid and robust, but as Dr. Volek points out, “that was complemented by improvements in other aspects of their metabolic health.”
Comprehensive metabolic and cognitive improvements:
- -6.2% body mass reduction, a shift that can support overall health and may also contribute to greater confidence and self-esteem.
- -13.0% fat mass decrease, further reinforcing these physical health benefits.
- +32% increase in brain-derived neurotrophic factor (BDNF), a protein that supports neuroplasticity and resilience, signaling the brain’s capacity for repair and growth.
- -52% decrease in leptin, a hormone often elevated in obesity and linked to both hunger and mood dysregulation. Lower leptin levels may also make it easier to avoid overeating and help stabilize mood.
- Improved performance on cognitive tasks involving memory, processing speed, and attention, critical skills for academic success and everyday functioning, especially for college students.
How Does This Work? The Metabolic Link to Depression
According to emerging research in metabolic psychiatry, many psychiatric conditions, including depression, are driven by metabolic dysfunction affecting the brain[*]:
- Glucose hypometabolism (meaning the brain has a harder time using blood sugar for energy): People with depression often show reduced glucose use in brain regions involved in mood, like the prefrontal cortex[*].
- Insulin Resistance: When the brain becomes less responsive to insulin, glucose hypometabolism occurs, making insulin resistance a key part of the brain energy model of mental illness. It’s commonly seen in people with depression and is linked to poorer responses to treatment. Even if someone isn’t insulin resistant throughout the rest of their body, their brain alone can be. Finding ways to address these energy issues, whether by enhancing insulin sensitivity or utilizing ketones instead of glucose, could help support mood and brain function[*].
- Inflammation: People with depression who also have metabolic issues often show higher levels of certain immune chemicals, like IL-6 and TNF-alpha. These can increase stress in the body and disrupt how the brain functions[*].
- Reduced BDNF: People with major depressive disorder often have lower levels of brain-derived neurotrophic factor (BDNF), a protein that supports the growth and connection of brain cells. When BDNF is low, the brain may struggle to regulate mood, form new pathways, and recover from stress[*].
- Excitatory-inhibitory imbalance: Changes in key brain chemicals, especially glutamate and GABA, can lead to an imbalance between excitation and inhibition in the brain. This may disrupt emotional regulation and increase the risk of mental health symptoms[*;*].
- Mitochondrial dysfunction: Mitochondria make the energy (ATP) and chemicals (neurotransmitters) that brain cells need to work properly. If mitochondria don’t function well, energy drops and inflammation increases. This makes it harder for brain cells to communicate and deal with stress.[*].
By shifting the brain’s primary fuel source from glucose to ketones, a ketogenic diet may offer a powerful way to bypass some of these brain energy roadblocks. Ketones can serve as an alternative, more efficient energy substrate when glucose metabolism is impaired, supporting neuronal function even in the presence of insulin resistance or mitochondrial dysfunction. But their role goes beyond fuel.
Ketones may also help calm neuroinflammation, restore balance between excitatory and inhibitory neurotransmitters, and boost the expression of BDNF. They’ve even been shown to reduce oxidative stress and promote healthier mitochondrial function, potentially stabilizing brain networks involved in mood regulation[*,*,*].
This is why a ketogenic diet, long used to treat epilepsy, is gaining attention as a promising intervention in psychiatric care. As our understanding of the brain’s metabolic needs deepens, ketogenic therapy represents a hopeful, biologically-rooted strategy for individuals living with depression, especially those who have not responded to traditional treatments.
While further research is essential and ongoing, the emerging science points to a compelling possibility: nutritional ketosis could help restore balance in a brain pushed off course by metabolic dysfunction.
A common concern with ketogenic therapy is its potential impact on cardiovascular health, largely due to its higher fat content. This concern is understandable, as traditional guidelines have linked saturated fat with elevated cholesterol and heart disease. However, current evidence suggests that ketogenic diets are not inherently harmful to heart health—and in many cases, they may improve key markers such as triglycerides, blood pressure, HDL cholesterol, and blood sugar. For a comprehensive breakdown of the data, please visit our Safety Hub.
Ketogenic Therapy: A Powerful Adjunct with Emerging Possibilities
The KIND pilot study was not designed to test ketogenic therapy as a replacement for conventional treatments, and it’s important to be clear about that. All participants remained under psychiatric care through the college mental health service during the study, and many continued with their prescribed medications and/or therapy. Of the 16 students who completed the study, 9 were not taking any psychiatric medications at baseline, while 7 were.
That said, the findings highlight ketogenic therapy as a compelling adjunctive option; one that may help individuals respond more effectively to existing treatments or potentially reduce their reliance on medications associated with unwanted side effects.
However, it’s also important to point out that ketogenic therapy isn’t just for those who aren’t responding well to existing treatments.
This doesn’t necessarily mean that ketogenic therapy should be universally considered a first-line treatment, but it does highlight the importance of continued research into its role, not only as a complement to standard care, but as a potential stand-alone strategy for some individuals.
Keto is a low-risk intervention that can be explored alongside existing treatments, ideally in collaboration with a supportive care team. For some, it may enhance what’s already working. For others, it may open the door to healing where other strategies have fallen short. And finally, for others, it might provide an alternative to beginning prescription medications.
How KIND Study Results Compare to SSRIs
While it’s important to acknowledge that ketogenic therapy doesn’t necessarily mean foregoing medication, it’s equally important to recognize how dramatically the KIND study’s results compare to traditional treatments, particularly SSRIs.
Most antidepressants work for roughly half[*] of those who take them, and even when they’re effective, they often come with tradeoffs: fatigue, weight gain, emotional blunting, and in some cases, increased anxiety or suicidal ideation[*,*,*,*]. Their positive effects also tend to wear off over time as the brain adapts[*].
In contrast, EVERY participant in the KIND study saw meaningful reductions in both self-reported and observer-rated depression scores.
And unlike many conventional treatments, there were no serious adverse effects reported. All participants either maintained or lost weight, cognitive function improved across multiple domains, and blood markers, like leptin and insulin, moved in a favorable direction.
While the KIND study wasn’t a randomized controlled trial, and there was no direct comparison to SSRIs, the universal response provides a compelling signal that ketogenic therapy may play a valuable role in the future of depression care, especially when traditional treatments fall short.
Implications and Next Steps
The KIND Study is the first peer-reviewed pilot study of ketogenic therapy in a population with MDD as their primary condition, ever. So while the study was small, and larger controlled trials are needed to fully understand the mechanisms behind ketogenic therapies for mental illness, the findings are undeniable. Ketogenic therapy is a feasible option for young adults with depression, and for some, it may be a life-changing intervention.
The research team at OSU is already planning follow-up studies to explore longer-term outcomes, subgroup analyses (e.g., insulin resistance versus non-insulin-resistant participants), and comparisons with other dietary interventions.
In the meantime, a growing body of published evidence already supports the use of ketogenic therapies for major mental illnesses, with KIND being the 3rd published pilot trial funded by Baszucki Group.
Pilot Study of a Ketogenic Diet in Bipolar Disorder
A pilot study out of the University of Edinburgh examined the effects of a ketogenic diet in 20 individuals with bipolar disorder who were not in an active mood episode. Over the course of 6-8 weeks, participants who stayed in solid ketosis experienced better mood, more energy, and less anxiety and impulsive behavior. Brain scans showed lower levels of glutamate and glutamine—chemicals that, when elevated, can overstimulate brain cells and contribute to emotional instability.
Researchers also saw a drop in something called myo-inositol, a molecule involved in insulin signaling. That’s important because high levels of myo-inositol in specific brain regions have been linked to metabolic dysfunction and mood disorders. A reduction may signal healthier brain metabolism and improved mood regulation.
Physically, participants also experienced meaningful health improvements, including weight loss, lower body mass index (BMI), and better blood pressure control.
These results point to ketogenic therapy as a promising tool for improving both psychiatric and metabolic outcomes in serious mental illness, warranting larger clinical trials.
Read the entire study here, or visit our breakdown here.
A Ketogenic Diet May Improve Both Metabolic and Psychiatric Health in Bipolar and Schizophrenia
In a 4-month pilot trial conducted at Stanford University, individuals living with schizophrenia or bipolar disorder and co-occurring metabolic dysfunction experienced notable improvements after adopting a ketogenic diet. Participants saw significant reductions in weight, insulin resistance, and visceral fat, all hallmarks of metabolic syndrome. Psychiatric improvements were equally compelling, with 79% of participants showing meaningful improvement. Overall, clinical impressions and quality-of-life indicators, such as sleep and life satisfaction, also improved.
Read the whole study here, or visit our breakdown here.
To learn more about the available evidence for ketogenic therapy for bipolar disorder and schizophrenia, visit our Bipolar and Schizophrenia Resource Hubs.
A Message of Hope
In a time when mental health crises are becoming the norm on college campuses (and beyond), this study offers something too often missing from the conversation: hope.
When there’s hope that you’re not broken and you begin to believe that simple, strategic nutritional changes can reshape your life, healing transforms from a distant ideal into a tangible, actionable path forward. With the right knowledge and tools, you’re no longer a passive victim of your circumstances. You become an active participant in your recovery, empowered to take control of your mental health and rewrite your story.
As study participant, Joe beautifully put it,
Metabolic psychiatry is still an emerging field, but its trajectory is clear. And the KIND study represents a pivotal early step on that path; a reminder that sometimes, healing begins with what’s on your plate.
Learn More About The Study
- Read the full study
- Podcast interview with Dr. Jeff Volek and Drew Decker
- Podcast interview with Dr. Ryan Patel – COMING SOON
- Podcast interview with Dr. Georgia Ede & Drew Decker – COMING SOON
Metabolic Health Resources
Looking for professional support on your metabolic mental health journey? For families, teens, and young adults, our Youth Mental Health Hub offers age-appropriate resources and tools to explore metabolic strategies for serious mental health challenges.
Our Get Help section on the site provides clinician directories and metabolic mental health practices to help you connect with healthcare providers who are familiar with ketogenic therapy and other metabolic interventions.
Whether you’re just starting to explore this approach or ready to take the next step, we also offer a range of additional free tools to guide you. THINK+SMART is our metabolic-mental health email course and workbook, offering a community-inspired framework that is both practical and evidence-based, helping you navigate metabolic strategies safely and effectively.
