Although keto is now considered a go-to for people who need to improve their blood sugar levels or shed some excess weight, its roots are actually in brain health.
The keto diet is an extremely effective therapeutic option for people with medication-resistant epilepsy, which has left researchers wondering if the diet can also be helpful for other brain and nervous system-related disorders, like depression.
In this article, we’ll review the evidence on keto for depression, along with a few ways to succeed at keto while supporting your mental health.
How Does the Keto Diet Impact Mood and Depression?
Keto may impact the brain in several key ways that affect mood and depression symptoms. These include:
- Reduced neuroinflammation: Keto has powerful anti-inflammatory properties and may help ease inflammation in the brain, which can contribute to depression, other mood disorders, and cognitive decline (1).
- Supporting neuron structure: The high fat content of the keto diet may help optimize the health of brain cells, or neurons. Neurons contain a fatty protective layer called the myelin sheath, and dietary fat is essential to help the body create these structures (2).
- Improved physical health: Keto may help improve other aspects of physical health — like your weight or your blood glucose control. This alone could help to improve your mood and depression symptoms, since less-than-optimal physical health can have a significant impact on mental health.
- Better gut health: A well-planned keto diet that’s rich in high-quality fats and fiber-rich vegetables, nuts, and seeds can help to support your gut microbiome. Surprisingly, there is a lot of “cross talk” between the brain and the gut via the gut-brain axis — so improved gut health could translate to better brain health, too (3).
- Increased gamma-aminobutyric acid (GABA): Ketogenic diets may increase levels of the neurotransmitter GABA, which could help some antidepressant drugs to be more effective (4).
Is the Keto Diet Effective for Reducing Depression Symptoms?
Currently, it’s hard to definitively say that keto can reduce depression symptoms.
Most of the studies investigating this possibility have been done in animals, so it’s a stretch to say that these findings would definitely hold true in humans.
However, there is a great deal of anecdotal evidence to support keto for depression. Online, many people report that keto has been great for their mental health. Additionally, several healthcare practitioners support ketogenic diet therapy for mental health and neurodegenerative disorders.
You can learn more about this at Metabolic Mind, which is a non-profit organization dedicated to “metabolic psychiatry.” This organization — comprised of several healthcare professionals — advocates for the use of the ketogenic diet to improve mental health.
Studies Supporting the Use of Keto for Depression
The effect of diet on mental health isn’t something that’s easy or straightforward to study.
One meta-analysis (that is, a review of several studies) on low-carbohydrate diets for depression and anxiety found that there appeared to be no effect. However, this analysis included low-carbohydrate diet studies in addition to ketogenic diet studies. Because many low carb diets are still high enough in carbs to prevent ketosis, well-designed studies specifically on ketogenic diets are still necessary to understand their effect on depression (5).
A lot of the current research we have on the effects of ketosis on the brain comes from animal studies. These studies indicate that there are several different pathways through which ketosis can positively impact brain function, but it’s important to remember that this might not always translate to the same effect in humans (6).
In rodents with depression, a ketogenic diet has been shown to significantly reduce “depression-like behaviors (7).”
Potential Side Effects When Using the Keto Diet to Manage Depression
The keto diet can cause side effects, especially in the first few weeks of the diet when your body is making a huge metabolic shift from burning carbs to burning fat for fuel.
In the first two weeks to one month of following a keto diet, you may experience a cluster of symptoms nicknamed “keto flu.” While this isn’t actually a contagious illness, it has some flu-like symptoms (8):
- Muscle aches
It’s thought that the keto flu is caused by changes to the way your body stores electrolytes and fluid when it is shifting into ketosis. Supplementing with electrolytes — like Perfect Keto Daily Electrolytes — may help to lessen these symptoms.
How Long Does It Take to Notice Improvements in Mood
How long until you see improvement in your symptoms can vary based on several factors, including your level of ketosis, your use of medication, sleep quality, exercise, and stress levels.
It’s important that you stick to keto for at least one or two full months — but preferably more — to see how it works for you once your body has had time to adjust to ketosis.
Tips for Managing Depression with Keto
These tips may be helpful if you’re interested in keto for depression management.
Give It a Fair Try
You probably won’t get immediate results from switching to keto. For this reason, it’s important to stick to keto consistently for at least one to two full months before you write it off as a failure — possibly even longer.
Focus on Food Quality
Ultra processed foods, which are made with industrial ingredients like dyes, chemical additives, and artificial sweeteners, have been linked to depression (9).
Unfortunately, there are hundreds and possibly thousands of highly-processed “keto-friendly” foods and drinks on the market.
If your diet contains a lot of these foods, you may not see improvement. Try to choose minimally-processed foods and cook at home as much as possible, from whole food ingredients.
Manage Stress and Sleep Quality
When trying to manage your depression, it’s important to focus on stress and sleep as well as your diet choices. Most adults need between seven and nine hours of sleep per night, and it’s important to limit the stressors in your life as much as you’re able to.
Some activities that may help with stress management include yoga, stretching, journaling, meditation or prayer, and spending time outdoors.
Exercise can also help with stress, anxiety, and depression symptoms — and it makes a great complement to the keto diet too (12).
According to the Physical Activity Guidelines for Americans, adults should aim for the following (13):
- 150 minutes of moderate-intensity exercise per week (such as walking, dancing, or sports)
- Two resistance exercise sessions per week (such as weightlifting, barre, or bodyweight workouts)
- Regular mobility and flexibility exercises (such as stretching or yoga)
Consult With a Healthcare Professional Before Starting Keto for Depression
Before you make any significant changes to your diet, it’s important to speak with your healthcare provider.
Keto can have powerful effects on brain function and mood, but also on weight, blood glucose, and blood pressure. For these reasons, it’s extremely important for your healthcare provider to be aware — especially if you have any medical conditions or if you are taking any prescription medications.
The Bottom Line
Although human studies on ketosis for depression are scarce, animal studies and a wealth of anecdotal reports suggest that keto could be extremely helpful for reducing depressive symptoms.
If you want to give keto a try to see if it improves your mental health, make sure you stick with the diet long enough to give it a fair chance. You may also want to try to improve other lifestyle factors that can affect depression, like stress, sleep, and exercise.
Finally, be sure to keep your healthcare provider informed on any diet changes you make — especially if you have any pre-existing medical conditions.
Attaye I, van Oppenraaij S, Warmbrunn MV, Nieuwdorp M. The Role of the Gut Microbiota on the Beneficial Effects of Ketogenic Diets. Nutrients. 2021 Dec 31;14(1):191. doi: 10.3390/nu14010191. PMID: 35011071; PMCID: PMC8747023.
Włodarczyk A, Cubała WJ, Stawicki M. Ketogenic diet for depression: A potential dietary regimen to maintain euthymia? Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110257. doi: 10.1016/j.pnpbp.2021.110257. Epub 2021 Jan 23. PMID: 33497756.
Varaee H, Darand M, Hassanizadeh S, Hosseinzadeh M. Effect of low-carbohydrate diet on depression and anxiety: A systematic review and meta-analysis of controlled trials. J Affect Disord. 2023 Mar 15;325:206-214. doi: 10.1016/j.jad.2022.12.030. Epub 2022 Dec 28. PMID: 36584702.
Morris G, Puri BK, Carvalho A, Maes M, Berk M, Ruusunen A, Olive L. Induced Ketosis as a Treatment for Neuroprogressive Disorders: Food for Thought? Int J Neuropsychopharmacol. 2020 Jun 24;23(6):366-384. doi: 10.1093/ijnp/pyaa008. PMID: 32034911; PMCID: PMC7311648.
Bostock ECS, Kirkby KC, Taylor BV, Hawrelak JA. Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Front Nutr. 2020 Mar 13;7:20. doi: 10.3389/fnut.2020.00020. PMID: 32232045; PMCID: PMC7082414.
Lane MM, Davis JA, Beattie S, Gómez-Donoso C, Loughman A, O’Neil A, Jacka F, Berk M, Page R, Marx W, Rocks T. Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta-analysis of 43 observational studies. Obes Rev. 2021 Mar;22(3):e13146. doi: 10.1111/obr.13146. Epub 2020 Nov 9. PMID: 33167080.
Yang L, Zhao Y, Wang Y, Liu L, Zhang X, Li B, Cui R. The Effects of Psychological Stress on Depression. Curr Neuropharmacol. 2015;13(4):494-504. doi: 10.2174/1570159×1304150831150507. PMID: 26412069; PMCID: PMC4790405.
Pandi-Perumal SR, Monti JM, Burman D, Karthikeyan R, BaHammam AS, Spence DW, Brown GM, Narashimhan M. Clarifying the role of sleep in depression: A narrative review. Psychiatry Res. 2020 Sep;291:113239. doi: 10.1016/j.psychres.2020.113239. Epub 2020 Jun 16. PMID: 32593854.
Gujral S, Aizenstein H, Reynolds CF 3rd, Butters MA, Erickson KI. Exercise effects on depression: Possible neural mechanisms. Gen Hosp Psychiatry. 2017 Nov;49:2-10. doi: 10.1016/j.genhosppsych.2017.04.012. PMID: 29122145; PMCID: PMC6437683.