Bipolar disorder can disrupt every part of your life, including your job and your relationships. Medicine and talk therapy can help control the severe high and low shifts in mood, depression, and mania symptoms. You might have also considered trying alternative therapies, like diet changes.

Although changing your diet won’t cure bipolar disorder, there is some evidence that certain food choices can help. One diet in particular, the ketogenic diet, has the potential to benefit people with this condition, according to limited research.

The ketogenic diet has been around since the 1920s. It’s a high-fat, low-carbohydrate diet that mimics the state your body would go into if you were fasting.

Normally, carbohydrates, namely glucose, supply your body and brain with energy. Glucose is the brain’s preferred source of fuel. When you cut carbs from your diet, fat takes over as your body’s primary energy source. The liver breaks down fats into substances called ketones, which are naturally higher in energy than carbohydrates. Ketones travel through your bloodstream to fuel your brain.

There are two variations of the diet:

  • On the classic ketogenic diet, you eat a ratio of 3:1 to 5:1 fats to protein plus carbohydrates. In other words, three to five times the amount of fat compared to protein and carbs combined. The bulk of your diet is made up of fats from foods like fish, such as sardines and salmon, butter, red meat, avocado, chicken, eggs, cheese, coconut milk, seeds, and nuts. Most of your carbs come from vegetables.
  • On the medium-chain triglyceride (MCT) diet, you get about 60 percent of your total calories from a type of coconut oil. You can eat more protein and carbs on the MCT diet than you would be able to on the classic ketogenic diet.

Research over the years has found that the ketogenic diet is helpful for certain brain conditions. A 2015 study further confirms that it can dramatically reduce the number of seizures in children with epilepsy, including in those children who do not respond to medications. Research also suggests that it might ease symptoms of neurodegenerative diseases like Alzheimer’s and Parkinson’s. Some very early evidence suggests that it could possibly help with bipolar disorder, too.

Epilepsy and the Ketogenic Diet

Anti-seizure medicines, the same drugs used to treat people with epilepsy, are fixtures of bipolar disorder treatment. This made researchers wonder if a diet that helps with epilepsy symptoms could also help people with bipolar disorder.

There’s reason to believe it can. During a depressed or manic episode, energy production slows in the brain. Eating a ketogenic diet can increase energy in the brain.

People with bipolar disorder have higher-than-normal amounts of sodium inside their cells. Lithium and other mood-stabilizing drugs used to treat bipolar disorder work, in part, by lowering sodium levels in cells. The ketogenic diet has the same type of effect.

In theory, the ketogenic diet might help with bipolar disorder. Yet it’s hard to know whether this diet can actually relieve symptoms of bipolar disorder because very little research has been done on the subject.

A 2013 study followed two women with type II bipolar disorder, which includes a pattern of depressive episodes followed by relatively mild episodes of mania. One of the women was on the ketogenic diet for two years, while the other was on the diet for three years. Both women experienced greater improvements in mood while on the ketogenic diet than they did on medication and experienced no side effects.

Although the results were promising, the study was extremely small. Much larger studies need to be done to confirm whether the ketogenic diet has any benefit for the greater bipolar disorder population.

Though the ketogenic diet is promising for bipolar disorder, there isn’t any firm evidence that it works. The diet is very limited, so it can lead to deficiencies in certain nutrients, such as vitamins B, C, and D, as well as calcium, magnesium, and iron. Some people also develop a change in breath odor, energy levels, and unpleasant digestive symptoms, like nausea, vomiting, and constipation. In rare cases, the diet has led to more serious side effects, such as abnormal heart rhythms, pancreatitis, weakened bones, and kidney stones.

If you’re interested in trying this diet, check with your doctor first. Your doctor and dietitian can tell you how to go on this diet in the safest possible way. Or, your doctor might advise against the ketogenic diet and instead suggest other, more proven bipolar disorder treatment options.