Keto Diet and Brain Health: What Ketosis Does to Depression Symptoms

Mental Effects on Brain Function from the Keto Diet 

I’ll be honest. This is what kept me keto. It wasn’t the weight loss. It was the benefits of the keto diet and brain health. Certainly, I started ketosis because of my mother’s cancer, but its anti-cancer benefits aren’t the reasons I kept going.  

It’s hard to believe switching to a keto diet is going to improve your mental processes-especially during the initial transition from carbs to fat. As your brain adapts to using ketones for fuel instead of glucose, you get a woozy feeling. Often, this comes with a noticeable slump in your thinking. Your mood dips while your irritability goes up.

This can be rough. I have lost several patients to this slump when I failed to properly warn them that this gets better. As those first days lead you into your second week of ketone production, things change dramatically. The brain is one of the last organs in the body to adapt to using ketones. The cells in the brain tend to hang on to the quick and easy carbohydrate fuel.

When I first became a doctor, it was very hard for me to guess how medications I prescribed would affect patients. For example, when I would write out a prescription for an antidepressant, patients would ask how long before they feel better.

The Right Answer Was, “I Don’t Know.”

 Different people respond to medication differently. Also, the depths of one person’s depression looks quite similar on the outside but is indeed very different on the inside as compared to another.

Some get better in two months while others take much longer. At first, I over promised the way patients would feel. I told them they would notice improvement without properly understanding how poorly their brain was working and how little the medication would do. Years of experience have taught me to carefully answer that question based on many factors unique to each patient.  

When I first transitioned into producing ketones, I did not really expect it would improve my mental functions or emotional well-being. I didn’t suffer from depression or anxiety. Slept well. I, essentially, felt normal. Indeed, any claim I had heard regarding ketosis and mental improvement reminded me of those over promised expectations I spouted to patients two decades ago.

By the end of the second week, I wrestled with giving credit for my improved energy, focus, and mood to the ketones coursing through my veins. Since then, I have continued to see nothing but improvement in my brain function. I feel like I am 25 years old again. I can concentrate on complex tasks for hours straight.

Keto Diet and Brain Health on Reversing Depression Symptoms

Patients report their dreams became more vivid after successful keto-adaptation. Personally, I think many of these patients had a form of depression. Even if they resisted that depression ‘label’-and I don’t blame them for pushing back against the term-the improvement in their cognitive state mirrors that of recovering depression patients.

Watching a patient come out of the depths of depression teaches the observer how far the brain can sink and yet quickly recover and self-repair. If I could bottle the secret formula for that awakening, I would use it hundreds of times a month in the patients I see.

My severely, chronically depressed patients waddle in the sludge of darkness and brain fog for months-even years. They struggle to make decisions. When I insist they switch their diet, even their dog groans with disbelief. A successful behavior change appears too heavy of a burden. When they fall that far into the depths of brain-fog, they want a quick fix.  A pill. A jolt of “fix-me-doc.”

For these patients, I look to their caregiver. Their spouse, or parent, or even their child must lead the way to this new way of eating. Just like when I lead the way for my mom at 71 years old and suffering from a decade of cancer, the diet was just as helpful for me as it was for my mom.       

Whatever reason they started eating 80% fat, I don’t care. I am awestruck at how fast their brains become re-energized.

Prozac or no Prozac, I switch all of my depression patients to a keto diet. The results have been nothing short of impressive.

We know that remission of clinical depression is associated with normalization of inflammatory markers.  Although this does not link a cause and effect, the link matches what I see clinically.

Relationship Between Depression and Inflammation

Many disorders with root causes of inflammation include emphysema (COPD), heart attacks and strokes, multiple sclerosis, Parkinson’s disorder, as well as autoimmune disorders such as Rheumatoid Arthritis, Crohn’s disease, or some thyroid disorders. These inflamed situations all are linked to increased populations with depression.

Another example of inflammation and depression is the recent advances in Hepatitis C treatment. The miraculous interferon drug used to kill this nasty virus is infused into patients and sparks quite a spike in inflammatory markers.  One-quarter of those people develop major depression.

Just like other chronic problems, these problems don’t cause damage overnight. Similarly, recovering from years of swollen and damaged tissue takes time.

When you become fully keto-adapted, about 4-6 weeks into the production of ketones the evidence of improved brain function is clearly present. The journey over those several weeks has shown that this awakening occurs at different times for people. As you continue to practice the keto lifestyle, the list of symptoms related to chronic inflammation slowly fade away.  Sometimes reversal is so slow they don’t identify the fact that the symptoms have gone down until I question the specific symptoms.

Within 6 months of peeing on that first ketone stick, I have seen many of my chronic depression patients get off all of their medications. I did not think this was possible. This all started with a ketone.  

The longer you stay in ketosis, the more completely you remove the amount of extra fluid lurking between those brain cells. Some swelling is found WITHIN the brain cells. That takes even longer.  

At First Sign of Ketone Production

At the first production of a ketone, the easy water gets shed. This is the water weight often found in your legs or feet. The next time you take off your socks, take notice if there is a ring left by your socks. That is not caused by extra fat. That is caused by water hanging out where it shouldn’t. That the swelling that disappears first when you start peeing ketones. Next, I notice the reversal of the bloat in the gut. By the second week of ketones, they look at their tummy and clearly it is not as extended. Stop peeing ketones and BOOM, it comes back.

Over the next few months, you’ll experience water removal from places that are harder to reach:  your skin, joints, eyes, and even your brain.

What do I see in my three months follow up patients that tell me they have peed ketones for the better part of those 100 days? Glowing skin, better joint movements, reduced neck pain, improved eyesight, and a brain that seems much more resilient than it was then.

These positive improvements show up around the 3-6 month mark, precisely the time most patients’ migraines disappear.

The first transition into ketosis does have reports of depression, lethargy, and tiredness.  Especially if they are going from a heavy carb diet to a low carb diet. Some patients struggle with a rise in anger and anxiety when they transition.

Switching Fuel Sources

Switching fuel sources from carbs to fat affects all areas of the body especially the brain. That striking change is FOR THE BETTER. The transition is tough. I’m not going to lie. The good news? There are tools to help you get through the switch as quickly and successfully as possible.  

This video shares more insight into why I stay keto:

Learn more about which foods are good – better – and best options through our FOOD GUIDE or check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

1. Lowe, Aileen, et al. “Neurogenesis and Precursor Cell Differences in the Dorsal and Ventral Adult Canine Hippocampus.” Neuroscience Letters, vol. 593, 2015, pp. 107–113., doi:10.1016/j.neulet.2015.03.017
2. Maalouf, M, et al. “The Neuroprotective Properties of Calorie Restriction, the Ketogenic Diet, and Ketone Bodies.” Brain Research Reviews., U.S. National Library of Medicine, Mar. 2009, www.ncbi.nlm.nih.gov/pubmed/18845187
3. Masino, Susan A., et al. “A Ketogenic Diet Suppresses Seizures in Mice through Adenosine A1 Receptors.” Journal of Clinical Investigation, vol. 121, no. 7, Jan. 2011, pp. 2679–2683., doi:10.1172/jci57813
4. Seyfried, Thomas N., et al. “Metabolic Therapy: A New Paradigm for Managing Malignant Brain Cancer.” Cancer Letters, vol. 356, no. 2, 2015, pp. 289–300., doi:10.1016/j.canlet.2014.07.015