A revolutionary study published in BJPsych Open has revealed compelling evidence that a ketogenic diet can have a major impact on mental and physical well-being in bipolar disorder patients. The study, conducted by Dr. Iain Campbell, PhD, Baszucki Metabolic Psychiatry Research Fellow at the University of Edinburgh, investigates how a metabolic-based intervention might represent an exciting new strategy for treating this serious mental illness.
The research is the first in Europe to use neuroimaging methods, namely magnetic resonance spectroscopy (MRS), to investigate changes in brain metabolism in people with bipolar disorder after a ketogenic diet. The imaging findings revealed decreases in excitatory neurotransmitters, which are normally increased in bipolar disorder. This indicates that the ketogenic diet can stabilize brain activity, possibly reducing mood swings and other symptoms of the condition.
The trial involved 27 participants diagnosed with bipolar disorder, 20 of whom successfully completed the 6-8 week program. A staggering 91% of these individuals maintained ketosis, the metabolic state where the body primarily burns fat for energy instead of carbohydrates. Those who provided consistent daily ketone and mental health assessments reported notable improvements in mood, energy levels, anxiety, and impulsivity.
Dr. Campbell, who personally adheres to a ketogenic diet himself in order to treat symptoms of bipolar disorder, discussed the importance of these results:
"We saw indicators of diminished excitotoxicity in the brain regions most implicated in bipolar disorder. These findings are consistent with the metabolic overdrive hypothesis that postulates energy dysregulation within the brain as central to the disorder. Treating the dysregulation by means of a ketogenic diet could be a game-changer in treatment-resistant patients.
Aside from the scientific evidence, personal accounts of study participants underscore the life-altering effect of a ketogenic diet.
"Quite literally, for the first time in years, I felt like my brain was finally fueled correctly," explained a participant.
Another participant called the diet "a lifeline, restoring my energy and sense of hope. I felt like I was finally healing my mind, not just coping with my bipolar symptoms."
One of the very vivid accounts described the impact of ketosis in terms of a relaxing mental atmosphere:
"Applying a ketogenic diet is akin to giving my mind a nice warm bath. The edginess disappears. I am more calm, more clear, and my brain function is restored again."
Aside from the psychological benefits of the study, the ketogenic diet was also seen to have beneficial effects on participants' physical health. Nineteen out of the 20 trial completers lost a total of 9.3 pounds (4.2 kg) on average and showed improvements in body mass index (BMI) and blood pressure.
These results are noteworthy in that numerous treatments for bipolar disorder, such as mood stabilizers and antipsychotic medications, have been linked to metabolic side effects of weight gain and risk of cardiovascular disease. In contributing to the reduction of such risks, a ketogenic diet may provide a double dividend for patients with bipolar disorder.
Although the ketogenic diet has previously been known largely for its utility in treating epilepsy that is treatment-resistant, it is a somewhat new area to explore in conditions of psychiatry such as in bipolar disorder. It has come to be known that metabolic imbalance is an underlying factor in causing psychiatric disorders as energy production deficiencies have been recognized to contribute towards neural excitability and mood disruption.
One of the important findings of the study is that people with bipolar disorder tend to have sodium levels higher than usual within their cells. Lithium, a standard mood stabilizer, acts partly by reducing these sodium levels. The ketogenic diet seems to do the same thing, offering a metabolic explanation for its beneficial effect on mood stabilization.
The ketogenic diet is a high-fat, low-carb diet that changes the body's main source of energy from glucose to ketones. As carbohydrate consumption is significantly decreased, the liver breaks down fats into ketones, which can be used as a substitute fuel by the brain and body.
First developed in the 1920s as a therapy for epilepsy, the ketogenic diet has been researched for its therapeutic applications in a variety of neurological and psychiatric disorders, including Alzheimer's disease, Parkinson's disease, and most recently, bipolar disorder.
There's a critical need for bigger replication studies and well-designed randomized clinical trials to follow up on these findings," added Dr. Campbell. "Our findings indicate that a ketogenic diet may be a useful adjunctive treatment for bipolar disorder, bringing new promise to patients who have difficulty with standard therapies.
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