r/NutritionalPsychiatry

Hey everyone, I was hoping to hear from anyone who has tried the keto diet and found true success - like it really made a massive change/impact in your mental health.

I have tried different meds from antidepressants, to mood stabilizers, to antipsychotics, to stimulants, to interventional approaches like TMS and spravato. Some meds helped in certain ways, but always with many negative side effects, and never truly helped me feel like life is worth living again. For the record, I have been diagnosed with ADHD, OCD, Generalized Anxiety, and Major Depression - all of which I have struggled with for most of my life as a 25 yr old man.

Some time ago, I came across the whole metabolic psychiatry movement online, mainly through Dr. Christopher Palmer. Him and many others believe that mental health issues are really metabolic issues, and that a keto diet is a true intervention to address the cellular metabolic dysfunction at the source. Lucky enough, I happen to reside 20 minutes from his practice here in Massachusetts, and actually had an intake with his clinic. They want me to continue to use the keto diet as a mainline of treatment, which I’ve actually already been on for about a month. Which leads me to my point….

I’ve been on the diet for about a month now, and quite frankly, it’s been kicking my ass. I will admit that I haven’t been perfect at it: I have tried to give up my reliance on weed but have given in at times with an edible (mostly because my mood is even worse now), and also had a few days where I had a few extra carbs and my ketone levels dropped the next day (never below 0.5 tho). But overall, I have been pretty adherent, eating Whole Foods of proteins and non starchy vegetables with fats, and my ketone levels average around 1-1.5 or so. I also have been taking vitamins and electrolytes every day. But I feel like overall, everything has gotten worse. I already was struggling with bad chronic depression, low drive, anxiety, executive function issues. Now, all of those are doubled. I feel like all of the energy has just been sucked out of me mentally and physically, but the only energy left has been diverted to amplifying the anxiety and rumination. I’ve been really irritable and emotional at times too. It’s so hard to sit down and focus, let alone muster the drive or energy to do so. Yet, the clinic tells me I need to give it at least 3-4 months. I want to because Ive already tried the medication roulette of psychiatry, and want a holistic treatment that can truly heal the mind/body. But damn, I feel like absolute shit. Has anyone had a similar experience and come out better? Has anyone had an initial rough patch (especially long) but had it turn around and end up feeling amazing? How long did you have to give it? What was the journey like? Asking for any input or stories here, because idk if I can keep this up for months on end if it keeps up like this. Thanks
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In his bestselling book, Yuval Noah Harari proposes a bold theory: the most successful species on Earth isn't humans. It's wheat. We didn't cultivate wheat; wheat cultivated us. Here is how it might have happened:

When we consume gluten-containing foods, they don't break down into amino acids entirely. Instead, protein fragments persist as opioid peptides known as gluteomorphins. Meanwhile, gliadin- another component of the wheat grain- compromises the delicate gut lining, opening a direct pathway for these opioid compounds into the bloodstream.

The intestinal wall nor the blood-brain barrier is completely leak-proof. Under certain conditions (such as gastritis, dysbiosis, or SIBO), that single-cell-thick barrier breaks down, dumping raw stomach contents straight into the bloodstream. Imagine your immune system suddenly encountering last night's dinner.

Because gluten structurally mimics human tissue, this is where many autoimmune conditions likely originate. Particularly Hashimoto’s and autoimmune encephalitis.

I am currently working with my mother whose gluten reactions occur within just a few hours, which inspired me to write this post

I've been reading research suggesting that a lot of what is diagnosed as depression is actually driven by dopamine issues. This often in mammals occurs after abandonment (or perceived abandonment) because the body gives up as a way of protecting us from continuing to hopelessly seek our caregivers with the risk of attracting predators with our cries for help. That protective response drives a drop in dopamine and motivation, which results in symptoms that can occur in both ADHD and depression.

In particular this theory comes from the work of neuroscientist Jaak Panksepp, as described in detail by the wonderful and highly praised book The Hidden Spring. There are many things that I could link to in this post and I'm happy to share in the comments if needed but this is the core foundational work that has revolutionized the thinking of neuroscientists about the origins of human consciousness and our core motivational drives.

This very much aligns with my experience, as I was on various antidepressants for many years with little benefit but responded much more immediately to ADHD medication.

I have been wondering about the possibility that if we look beyond the labels of depression and ADHD, a lot of the treatment-resistant depression that ketamine is helpful in treating might actually be driven by issues with dopamine rather than serotonin.

This is also relevant to me because I've been reading in other posts in the subreddit that many clinics recommend skipping your ADHD medication on the day of your ketamine treatment because the effects on blood pressure can compound.

Since anxiety increases are something has been a challenge for me on ADHD medicine and as I navigate through trying to benefit from ketamine treatment, I've learned that blood pressure increases can also increase anxiety. For me this seems like further evidence that what I might actually be dealing with are dopamine issues that are being driven by what ketamine is targeting (glutamate).

I've reached out to the psychiatrist where I've been doing my ketamine treatments (and also getting my ADHD prescription) to discuss skipping my ADHD medication on the days of treatment as well as possibly reducing my dose of ADHD medicine to see if perhaps ketamine is sufficient for me in addressing the symptoms that are most concerning for me (the difficulty with finding the will to fully pursue life).

I've read mixed results from people also in the subreddit who have ADHD on the impact of ketamine treatment. Again I think it might depend on whether those diagnoses are driven by that same system of dopamine-induced depression or some other driver of ADHD.

I'm not a professional scientist or doctor but I feel like this hypothesis is worth exploring (and worth discussing in this community). I think that many of our diagnoses are based on old hypotheses about how the brain works that need to be updated by more current research. Dopamine-related depression might actually be separated out as possibly a third category that could overlap heavily with treatment-resistant depression.

Again this is consistent with the experiences of many people on this subreddit who have stated that as their depression has improved, their anxiety has increased. This could represent the seeking system coming back online after being shut down for protective reasons during periods of abandonment.

I would love your thoughts. I am not attached to any theory. I am interested in seeking the truth and healing.

Hi! I was in remission from OCD after several months of keto, then only slowly returned. I saw a keto nutritionist and she had me test my ketone levels. My free carnitine was low while my carnitine was normal. My esterified/free carnitine ratio was high. My GP is unwilling to treat it and the metabolic psychiatrist my nutritionist sent me to prescribe it ended up not qualified despite claiming to be a metabolic psychiatrist. My endocrinologist won't help, nor will anyone at my hospital's endocrinology department. Out of desperation, I tried to supplement on my own, but I don't tolerate l-carnitine or alcar. I can't have anymore protein or I'll go into glycogenesis. Any idea on where I turn at this point? Has anyone been in this position before? I don't want to have to pay out of pocket/ I want the person I see to be covered by insurance. Please no ai for answers, because I've already used AI for answers and it led to nowhere.

I recently developed DPDR out of the blue, and it hasn’t gone away for 3 months and I’m starting to get upset on what I can do. I don’t have trauma, anxiety, panic attacks, or have even smoked weed or done psychedelics. I have this feeling of just being brain dead. I feel like I’m on autopilot 24/7, just watching my life from a far. I’ve done all the things like ignoring it, and trying to live life but it’s extremely difficult when I don’t know the root cause that could potentially be fueling this feeling. To me it feels like really bad brain fog, mixed with chronic fatigue, but it does sometimes fall in between the lines of DPDR. I have a severely low vitamin d level with my number being 11 ng/mL. I had an even worse reaction to the 50,000 IUs of d3 my doctor prescribed me, so I’m struggling to get my numbers up. I also had a borderline low b12 sitting at 356 pg/mL. I’ve recently gotten a GI map done by a functional doctor, and she found some gut dysbiosis caused by an overgrowth of yeast. I’m afraid I’ll never get my life back and feel normal again. I feel like I’ve lived the same day for 3 months. Can someone please give me some good news, that these issues might be fueling this problem. I’ve tried posting in the Vitamin d forum, but they banned me for not specifically saying my lab numbers. Posting it here to see if anyone can relate. What biological issue caused your DPDR and how did you fix it??