The ketogenic diet is a high-fat diet that supplies adequate quantities of protein and restricts carbohydrates. The diet was originally developed as a treatment for epileptic seizures in pediatric patients. Because of the increase in available anti-seizure medications, the diet is now primarily used to treat patients who do not respond to conventional medical treatments. Researchers speculate that a ketogenic diet can also be effective in alleviating the symptoms of bipolar disorder. However, trials of the ketogenic diet in the treatment of bipolar disorder are needed to confirm this.
The Ketogenic Diet and Glucose
Russell Wilder, M.D. of Mayo Clinic developed the ketogenic diet in the 1920 as a way to treat seizures in epileptic children. The special composition of the diet forces glucose, or blood sugar, levels to drop significantly. Only carbohydrates, protein and the glycerol-component of dietary fat can convert into glucose. Protein is converted last because it is needed for building and repairing cells. As the ketogenic diet restricts carbohydrates to an absolute minimum and keeps protein at minimally adequate levels, the diet severely restricts possible sources of glucose, causing glucose levels to go down.
The Effect of Low Glucose on the Brain
Most body cells can use fatty acids as an energy source, but fatty acids cannot transfer from the blood to the brain. As the body deprioritizes the use of amino acids -- the building blocks of protein -- as a fuel, the brain will exclusively use glucose to function. When glucose is severely limited, the brain switches its metabolism from glucose to ketone bodies, a byproduct of fat burning. Ketone bodies are a compact energy source. So, the cells need more mitochondria, or cellular fuel burners, to use ketone bodies as a fuel. The increased number of mitochondria in the neurons has a strengthening effect on the brain. This prevents neurons from becoming overly excited and the brain from going into a seizure.
Bipolar Disorder
Bipolar disorder, also known as manic-depressive disorder, consists of episodes of depression and at least one episode of mania. Most bipolar patients, however, regularly alternate between phases of depression and mania. According to "Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders," symptoms during depressed phases are very similar to the symptoms of major depression. They include low energy, fatigue and a lack of motivation and interest. Manic episodes, on the other hand, can give rise to heightened motivation, obsession, creativity and extremely high energy but also agitation, irritability and bad decision making.
Ketogenic Diet To Treat Bipolar Disorder
The ketogenic diet has long been suspected to have a positive effect on bipolar disorder. According to a study in the December 2001 issue of "Medical Hypotheses," bipolar disorder is characterized by decreased brain metabolism in the outer layers of the brain. Because ketone bodies are efficient sources of energy, the researchers suspect that a ketone body metabolism may increase blood transfer to the affected brain regions. The report also suggests that ketone body metabolism may decrease the salt levels in neurons, which is a property that most mood stabilizers share in common. Since then, a study published in the December 2004 issue of "Biological Psychiatry" showed that the ketogenic diet has anti-depressive effects in rats. But, as of 2011, no studies of this effect in humans have been completed.
References
- Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders"; Linda Seligman and Lourie W. Reichenberg; 2007
- "Medical Hypotheses"; The ketogenic diet may have mood-stabilizing properties; El-Mallakh RS, Paskitti ME; December 2001
- "Biological Psychiatry"; The Antidepressant Properties of the Ketogenic Diet; Murphy P, Likhodii S, Nylen K, Burnham WM; December 2004
- Johns Hopkins Medicine: The Epileptic Diet Center
- Natural Physiques: History of the Ketogenic Diet, by Lyle McDonald
