The keto diet is a low carb, high fat, moderate protein diet that was originally used by people with epilepsy to help manage seizures (1).
However, itâ€™s now widely used as a weight loss tool. Being in a state of ketosis, in which your body burns fat instead of carbs for energy, imparts some benefits that make it easier to stay in a calorie deficit (2).
Yet, because the diet can affect the brain and nervous system â€” as it does with epilepsy â€” it may also affect your mood (3).
This article reviews how the keto diet may relieve or cause depression, and steps you should take if youâ€™re on keto and feeling depressed.
How keto may affect mood and relieve depression
The keto diet exerts some positive effects on the brain and nervous system. It not only appears to have beneficial effects for epilepsy but also migraine, other seizure disorders, and Alzheimerâ€™s dementia (4, 5).
Whatâ€™s more, some scientific evidence supports the use of the keto diet to help treat mood disorders, including depression, as the diet may positively affect your brain and nervous system in several ways (3, 6, 7).
Below are some of the ways in which a ketogenic diet may improve depression. However, note that much of the supporting research has been conducted in animals, and more human studies are needed.
May increase GABA
Gamma-aminobutyric acid (GABA) is a neurotransmitter that plays key roles in managing stress, anxiety, and mood. Low GABA levels have been linked to clinical depression (8).
Animal studies have found that following a ketogenic diet may increase circulating levels of GABA, potentially improving depressive symptoms. However, more research is needed (3).
May improve mitochondrial function
Mitochondria are cellular components that generate the energy cells need to function. Mitochondrial dysfunction â€” such as producing inadequate amounts of energy for the cell to function properly â€” has been implicated in depression (3).
People with depression have lower levels of adenosine triphosphate (ATP) â€” an energy-providing compound â€” in their brain than people without depression (9).
However, ketogenic diets may make it easier to produce ATP in people with mitochondrial dysfunction (10).
May decrease oxidative stress
Oxidative stress refers to cellular damage caused by free radicals. These are unstable compounds youâ€™re exposed to in your daily life, and they can damage cells if they build up in your body (11).
Oxidative stress is associated with numerous diseases and health conditions. High levels of this stress have also been noted in people with depression (12).
However, following a ketogenic diet may improve markers of oxidative stress, improve your antioxidant status, and help reverse some of the damage caused by free radicals â€” potentially helping improve depressive symptoms (13).
May regulate insulin function
Insulin, a hormone that helps manage your blood sugar levels, may also play a role in depression and mood.
Some people, especially those who eat a diet thatâ€™s high in sugar and refined starch, can develop insulin resistance â€” which is when their body doesnâ€™t respond to insulin as well as it should (14).
Insulin resistance is not only linked to weight gain, type 2 diabetes, and heart disease but also depression (15, 16).
However, following a ketogenic diet, which limits sugar and starch and helps your keep your blood sugar levels stable, may improve your insulin sensitivity (3).
May decrease inflammation
Chronic inflammation has been linked to depression. Itâ€™s a dysfunctional immune response that can make you susceptible to many other problems, including insulin resistance, oxidative stress, mitochondrial dysfunction, and GABA suppression (3, 17).
However, the ketogenic diet has some anti-inflammatory properties and may improve chronic inflammation. This may be because using ketones for energy generates fewer pro-inflammatory compounds called reactive oxygen species than using glucose for energy (18, 19).
There are several ways in which keto can affect your brain and potentially help manage mood disorders. The diet may increase GABA levels, improve mitochondrial function, regulate insulin levels, and decrease inflammation and oxidative stress.
How keto may cause depression
On the other hand, the keto diet may cause depressive symptoms or exacerbate depression in some people.
Keto can be difficult to adjust to, and some common early symptoms of your body switching into ketosis â€” known as the â€œketo fluâ€ â€” can be difficult to manage. The keto flu can involve headaches, sleep disturbances, cramping, and fatigue (22).
However, symptoms occasionally resolve if fluid and electrolyte intake is increased (22).
Regardless, dealing with these symptoms may make you feel depressed.
Additionally, the diet is extremely restrictive for most people, requiring you to avoid sugar, starch, legumes, and carb-rich fruits and vegetables.
This excessive restriction may cause you to feel depressed â€” be it from avoiding â€œcomfortâ€ foods, making a significant, abrupt change to your regular diet, or even a nutrient deficiency.
Not getting enough zinc, magnesium, or selenium in your diet may contribute to depression. Additionally, one study in over 90,000 people found that the exclusion of any food group from the diet was linked to depression (23, 24).
There may also be a social isolation component, especially if many of your social gatherings revolve around food. If youâ€™re cooking at home more often to stick to your keto diet, you may experience some depressive episodes if youâ€™re more socially isolated as a result.
Keto can be restrictive and potentially socially isolating, and some of the symptoms â€” especially when you first start the diet â€” can be difficult to manage. This may cause you to feel depressed.
Tips if youâ€™re feeling depressed on keto
Itâ€™s important to remember that thereâ€™s a difference between feeling depressed occasionally and having a depressive disorder. Itâ€™s normal to feel sad sometimes, but if itâ€™s affecting your ability to live your life normally, you should seek professional help.
If you feel that the diet itself is causing you to feel depressed because itâ€™s excessively restrictive, has unpleasant side effects, or is contributing to social isolation, you should discontinue it.
Keto is not the only successful weight loss diet, and you can find weight loss success on other, less restrictive programs. However, if youâ€™re using the diet to manage your blood sugar or epilepsy, you should consult your healthcare provider for further guidance.
If you want to continue the diet, here are some strategies you can consider:
- Wait out the keto flu. If youâ€™ve only recently transitioned to the keto diet, your symptoms may be tied to the keto flu. Waiting out the first few days and making sure to drink plenty of fluids and supplement with electrolytes, will make the transition easier.
- Focus on high quality protein and veggies. If youâ€™re not getting enough mood-supporting nutrients, try including more high quality, whole foods in your diet. Magnesium-rich foods like avocado, almonds, and low sugar dark chocolate may help with depressive symptoms (23).
- Try cyclical keto dieting (carb cycling). This technique allows you to load up on carbs one day per week, which may make it easier to stick to the diet over the long term without sacrificing your favorite foods or eliminating carbs.
If youâ€™re not sure if your depression was caused or worsened by the keto diet, you should strongly consider pursuing help from a qualified mental health professional.
If you feel that being on keto is making you feel depressed, you should discontinue the diet. You should also consider consulting a healthcare provider if you believe you have clinical depression.
The bottom line
Keto is a popular diet for weight loss and blood sugar management, but it was intended to treat epilepsy. It can also have other powerful effects on the brain and may play a role in managing mood disorders.
Emerging evidence suggests that keto may help with depression in several ways. However, the restrictive nature of the diet may leave some people feeling depressed.
If youâ€™re concerned you may have depression, you should seek help from a qualified mental healthcare provider.
Moreover, if you want to try the keto diet to see whether it may help relieve depressive symptoms, talk to your healthcare provider first.