I was diagnosed with postpartum bipolar I disorder in 2007 after my second daughter was born. I had treatment-resistant bipolar depression, and I tried over 20 meds to no avail. After my father died, I asked for ECT (electroconvulsive therapy) which saved my life. (I wouldn’t hesitate to get ECT again if I needed it.)
Fast forward to 2013.
I was stable but I was still depressed. My psychiatrist added the MAOI tranylcypromine (Parnate) to the lithium I was taking, and this combination lifted my treatment-resistant bipolar depression within a week. I wrote about these experiences in my 2017 memoir Birth of a New Brain—Healing from Postpartum Bipolar Disorder endorsed by Kay Redfield Jamison and numerous mental health luminaries.
But I hadn’t yet discovered that a ketogenic diet specifically for bipolar disorder existed and could help me with ongoing physical and emotional struggles – that discovery took place in August, 2022. Read on for details!
What did you used to think about when you’d hear about keto diets?
Dyane Harwood: I never liked the word “keto” – it just bugged me! “Keto” sounded suspicious. Before I was diagnosed with postpartum bipolar, I was an American Council on Exercise (A.C.E.) certified personal trainer and while I loved to work out, I had a crappy diet. I loved anything chocolate and I knew nutrition was my Achilles heel. I also thought keto was only for people who ate meat. I didn’t know you could be on this diet as a vegan.
In 2022, I was 50 pounds overweight due to perimenopause and binge eating disorder. A friend the same age as me told me keto was helping her lose weight, so on a whim, I googled “vegan keto” and I spotted a link that mentioned “keto and bipolar disorder” so I went down the rabbit research hole. I wound up losing 50 pounds—I lost it a little too quickly, but I was thrilled!
When did you become a vegan?
I’ve been a vegan for seven years. I was recuperating after I broke my jaw while foolishly looking at my cell phone while walking my dog Lucy. I tripped and landed on my face on a concrete tennis court. I watched a documentary on Netflix called
What the Health which was so powerful and convincing that I became a vegan right after I saw it.
What were some immediate benefits you experienced besides the weight loss.
Before I began vegan keto for bipolar in 2022, I had to take a nap each afternoon. My need to nap disappeared. My sugar cravings and night binges went away too which was nothing short of miraculous. I felt motivated to go on walks again. However, I did not taper my bipolar medications and I still take them. Some people are able to taper or even go off their medications but they need to work with an experienced psychiatrist in order to do that.
What do you eat? And what’s all the talk about net carbs?
I have a smoothie in the morning with two tablespoons of MCT oil [medium-chain triglycerides], which is very potent and revs up the ketogenic process. I wouldn’t just start downing MCT oil because it will give you a stomach ache and other gastro distress! Try it in small increments and see how you react. You need a certain amount of fat every day, and MCT oil is a great way of getting it if your system can handle it. At night, I might have a cup of kale with a vegan egg scramble, an avocado, and olives. I measure foods and use the Carb Manager app to track “macronutrients” which is a specific ratio of proteins, carbohydrates, and fats. Dessert could be almond and macadamia nut butter with cacao nibs, and a tablespoon of MCT oil. I supplement with vegan forms of vitamin B12, a multivitamin, and omega 3s. My vegan smoothie protein powder contains nine key amino acids.
What are your favorite resources for exploring ketogenic diets for mental health?
The number-one resource for anyone remotely considering doing this is Metabolic Mind website and its YouTube series. It’s an inspiring, amazingly extensive series that explains keto for mental health and bipolar and other severe mental illnesses, how to talk to your doctor about trying keto, and everything you could possibly know about this modality. It also features people with lived experience.
There are two excellent books that have been published the past couple years: Change Your Diet, Change Your Mind by psychiatrist Dr. Georgia Ede which explains the nuts and bolts of using a ketogenic diet for mood disorders and brain health, and Brain Energy by psychiatrist Dr. Chris Palmer that explains Metabolic Psychiatry’s science. (Metabolic Psychiatry is the exciting field associated with ketogenic diets for mental health.) Liz MacDowell wrote a bestselling recipe book called Vegan Keto that has all kinds of yummy recipes and general information about vegan ketogenic diets.
Are the problems changing to a ketogenic diet right away?
I would say consider keto as medicine – that’s how powerful it is.The ketogenic diet can cause hypomania right away. When you lower the amount of net carbs in your diet, chances are high you will experience profound changes. For most people, hypomania subsides quickly, but you have to be keenly aware of the possibility.
I suggest talking with your psychiatrist before you start this diet. Metabolic Mind has outstanding videos about how to do this, as well as information you can download and share with your doctor on the website. My psychiatrist was unaware of this diet but he encouraged me to use common sense and research it, and keep in touch with him. Psychiatrists can collaborate with their patients to make sure they check for hypomanic signs, and have their families or friends observe them as well..
Do you need any special tools when doing this diet?
When you’re following a carefully planned ketogenic diet, vegan or not, you want to be in ketosis, which means your blood will have a specific amount of ketones in it at the therapeutic level, not just the weight loss level–and you need to monitor that. Tracking doesn’t have to be a pain – it can even be kind of fun! (By the way, ketones are a type of chemical that your liver produces when it breaks down fats.) Some people use urine strips, but that’s the least accurate way. There are also blood monitors and breath monitors. This topic is essential to learn about and once again, Metabolic Mind can help with that as well as Keto-Mojo, where I bought my blood ketone monitor. It fits in the palm of my hand.
What are some of the side effects you had from doing a vegan ketogenic diet for bipolar?
At the beginning, I was super thirsty all the time. Make sure you have enough electrolytes such as sodium, potassium, magnesium, and calcium. I did wonder if I was a little hypomanic the first few days after I started it. I was dropping more weight than I expected the first week, I had more energy, and my mood was more upbeat. I think there’s a fine line between feeling better and hypomania and I didn’t cross that line. I had (and still have) a PRN medication on hand just in case I feel hypomania coming on.
What are some challenges you’ve faced since beginning the vegan ketogenic diet?
The word “vegan” seems to always ruffle feathers with some people, even in the area I live which is home to famous vegetarians such as the author John Robbins (Diet for a New America), and the headquarters of the vegan magazine VegNews. If you tell people you’re using a ketogenic diet for bipolar, the skeptics will come out.. But there is solid research going on worldwide that’s producing irrefutable evidence that ketogenic diets for bipolar disorder are effective and they have extraordinary potential.
What’s next for you?
My friend Michael Belanger and I created the Our Healing Journey with Metabolic Psychiatry podcast. Michael is an omnivore, so it’s great we can share our different perspectives. I’m also writing my second book Birth of a Vegan Keto Brain about metabolic psychiatry and using a vegan ketogenic diet for bipolar disorder
Dyane Harwood
Twitter @DyaneHarwood
Instagram: @DyaneHarwood
Birth of a New Brain-Healing from Postpartum Bipolar Disorder book:rb.gy/1ks4bi
Bipolarcast Interview with Dyane Harwood, Dr. Iain Campbell and Matt baszuckiSeries with lived experience interviews and medical professionals who discuss using ketogenic diets for bipolar disor
https://www.youtube.com/watch?v=98PEvo9Rh0A&ab_channel=Bipolarcast
Dyane’s International Bipolar Foundation article:My Life-changing Vegan Ketogenic Diet for Bipolar Disorder
