Therapeutic
I only see a psychiatrist who did not provide any assistance with keto but was willing to assist with tapering (and I still had to taper way slower than she suggested) when I was getting more stable. I took mirtazapine, lithium carbonate and Seroquel. We managed to fully remove mirtazapine and Seroquel (I use the latter in tiny portions in turbulent periods in life), and I am for now staying on a small dose of lithium just for safety.
Integration
I did not do any lab testing. I tracked ketone levels almost constantly in the first 6 months and am now tracking them from time to time when I can afford CKMs; I have a phobia of needles, so unfortunately finger pricking does not work for me.
Nutritional
It is very easy for me to adhere to the keto diet and the less flexible it is, the easier it is for me :D I am on a near-carnivore keto diet (I include dairy and occasionally nuts), two meals a day and no snacking (in stressful periods I do snack sometimes but I try to get that back under control ASAP). I still have some sweeteners such as diet sodas and chewing gums because I realized that cutting them out is too stressful, and I end up binging on them later, so it's better to have 1 soda a day for me than trying to ban them completely. I tried many times and failed. I try to aim for a 2.5:1 fat to protein ratio, at least 2:1. My net carbs are consistently under 5g per day, so the main problem is trying not to get too much protein, which is sometimes challenging, but now, I at least do lots of strength training so the protein is used better. I track them with ChatGPT, asking it to give me recipes based on what I have in stock and the desired 2.5:1 ratio, or I tell it what I ate and it counts the macros.
Ketosis
I wore CKMs. I aimed at 1.5 mmol or higher. Sometimes I had great periods when this was always the case, but most often they are rather between 0.5 and 1.5 :(
