Mental Illness and the Ketogenic Diet

Larry A. Law

In November of 2022, Dr. Christopher Palmer, a professor of psychiatry at Harvard University, highlighted his discoveries in a book, Brain Energy. Dr. Palmer theorizes that mitochondrial disorders are the root cause of all mental illnesses. Mitochondria are the power stations in each cell of the body. They provide the energy or power for the cell to operate correctly. If those mini-power plants become damaged, the cell is unable to perform at 100%. His pivotal insight came in 2016 when he helped a patient with schizoaffective disorder lose weight. The patient suffered from severe mental illness and low self-esteem due to his weight gain experienced while on psychotropic medication. Palmer initially couldn't believe that switching to a low-carbohydrate, ketogenic diet could stop auditory hallucinations and paranoid delusions. But he quickly began using this intervention in other patients and found equally dramatic results. This experience put him on a path investigating how a change in diet could alter severe mental illness.

Mitochondrial Dysfunction

Drawing from decades of research on metabolism and mitochondria, Dr. Palmer believes that mental disorders are metabolic disorders of the brain. That means these mental conditions are not permanent defects. They can be corrected by identifying and addressing their root cause. This insight goes against the prevailing medical paradigm that schizophrenia and bipolar disorders are lifelong defects. 

When mitochondria are not operating correctly, various health problems can manifest; these include cancer, cardiovascular disease, hypertension, obesity, and Type 2 diabetes. Palmer is the first to note that this mitochondrial dysfunction can also lead to mental disorders like anxiety, depression, bipolar disorder, and schizophrenia. The brain needs a huge amount of energy to work effectively. When mitochondria are not producing enough energy, it can lead to abnormalities in the structure and function of the brain, which in turn may manifest as mental illness. Mitochondrial dysfunction can produce fluctuations in neurotransmitter levels, oxidative stress, and inflammation. 

Ketogenic Diet

Common-sense lifestyle changes like diet, exercise, stress reduction, and adequate sleep make us feel better. But one intervention was the most impactful of them all. The ketogenic diet dates back to 1920 when it was first used to treat epilepsy. The diet is high in fat, moderate in protein, and low in carbohydrates. Studies over the years have documented how this diet increases the number of mitochondria and enhances their function. One way it does this is through the production of ketones. When the body is in ketosis (starved of glucose), it produces ketones from stored fat as an alternative, more efficient energy source. These ketones provide the energy the cells need, including brain cells which rely heavily on mitochondria for energy. Mitochondria also assist in the production of neurotransmitters like serotonin and dopamine, which are chemicals that influence mood and behavior. These neurotransmitters are directly related to mental health.

The ketogenic diet also improves insulin resistance in Type 2 diabetes because it is low in sugar. Insulin resistance impairs the creation of new mitochondria. Insulin resistance results in dysfunction of the mitochondria, which reduces energy production, and causes cellular damage limiting the ability of that cell to function as it should. 

Hope for the Future

Though helpful in the short term for some patients, psychiatric medications often cause side-effects ranging from reduced libido and weight gain to increased risk of suicide. Cognitive behavioral therapy (CBT) is also one of the standard treatments used today for mental disorders. Both of these approaches can sometimes manage symptoms, but often fail to cure the disease long term. 

A ketogenic diet offers real hope for a life-long cure. Dr. Palmer states, "We have hundreds of cases of people with bipolar disorder and schizophrenia putting their illnesses into remission. Scientists are pursuing this. We have at least 10 controlled trials of the ketogenic diet for serious mental illness underway now. One is getting ready to publish their pilot trial results soon. There is a lot of momentum behind this. This groundbreaking theory opens up entirely new ways for us to conceptualize and treat mental illness going forward ... you can have real results in real people today."

​The power of health has always been in wholesome, real food, properly eaten. I address the ketogenic diet in my book, There's an Elephant in the Room—Exposing Hidden Truths in the Science of Health (page 208).