Should a psychiatrist recommend a diet? (Keto)
Edit: TLDR; First appointment with a psychiatrist and she was extremely adamant about starting the keto diet and going to the gym, even though she didn’t ask me about my diet/eating habits. Is this normal? (I am not overweight)
Kinda long, sorry! Scroll to paragraph 3 if you don’t want the background!
I have been in therapy for about a month, and my therapist recommended I see a psychiatrist. I had a strong inkling there is more going on than anxiety and depression, which I am already diagnosed, so I gladly agreed. Our first meeting was today, via TeleHealth. My therapist shared her “notes” with the psychiatrist so she had a little background of what’s been going on.
She starts with the typical questions about my moods and behaviors. My impulsive moods, my seemingly unmanageable and flippant emotions, my depressive episodes, etc. Essentially all of the DSM questions, and a few more to dig deeper.
We start talking about how I am always low energy and can’t find the motivation to do much above the necessary. I sometimes have trouble sleeping, with nightmares, can’t muster up the energy to cook or eat at times, don’t have the willingness to do much more than doomscroll or laundry on my days off, I tend to abandon my hobbies.
She then asks about my physical activity. I’m on my feet majority of the day but I don’t work out. I told her that I was interested in working out, but again, lack of motivation to do absolutely anything. She asked about my diet, which can be pretty mixed when I decide to eat. I’m not a healthy person per se, I do enjoy fast food which is a lot easier for me, but when I have the energy I do like to make homemade meals with whole foods. I’m not picky.
I’m 5’1 and 110 pounds, for reference. I feel that’s a very average weight for my height, so it’s not an obesity issue. After we talk about my physical activity and diet, she steers toward me putting in the effort to start working out, because it will help with my sleeping issues. I told her I’ve tried and always lose motivation, but she persists that it’s something I need to do, even if I don’t want to. I need to get into the habit and once I’ve gotten used to it, set fitness goals for myself. Once I start seeing progress, I will be happier with myself and have more energy. That, and the exercise will improve my appetite. That, I do understand. Feeling better physically will improve my mental health, but that is not why I am here. It is a nice suggestion, but now feels like something I have to incorporate before our appointment next month, or I will be doing something wrong. Also, I do have an appetite, which I told her. I just cannot muster up the will to leave my bed.
After the working out conversation, she asks me if I am familiar with the keto diet. I tell her I’ve heard of it, but am not really familiar with it. She explains what it is to me, and that me eating healthier will also help with my energy levels and aid in the fitness “journey”. Obviously I do know this. Working out, eating healthy, generally taking better care of myself physically, will help me feel better. I just thought this was odd, because the only mention of food before this was that I don’t eat often because cooking exhausts me. She never asked about fast food consumption, what kinds of food I’m eating/making at home, how much sugar I consume. For some reason, it just left a bad taste in my mouth.
After about 10 minutes of diet and exercise conversation, the session ended. She prescribed me two meds, one SSRI and one for panic attacks. No suggestion of getting back into my other hobbies or suggestions of better things to do with my time. No advice on coping mechanisms or things I should try to keep my emotions in check, besides journaling and starting DBT. No indication of what she is thinking I may have (which I know can take time), but it all just felt very cold and kind of band-aid-y? She didn’t even ask how I was feeling afterward, or give any words of encouragement.
I was hoping to have a better understanding of myself or my issues after leaving, but I am feeling more confused and frustrated than when I showed up. I appreciate the suggestions but I don’t want to feel like a customer being fed ads for the gym and the keto diet when I am here for something that feels all-consuming. She seemed so passionate advising this to me, and didn’t seem to care much about much else.
Is this normal, or a regular occurrence? I am willing to give it a try because I am in a place where I am willing to try almost anything, but I can’t help but feel like I am missing something here. Can anybody give me some input? Thank you for reading.