Can a Keto Diet Help People Suffering from Depression? - with Dr. Erin Bellamy

everybody can benefit from either a short or long stint in ketosis because of the increase in brain energy we could all do we could all do with a a bout of it however I think those people that have the atypical subtype depression or the treatment resistant depression seems to um respond more favorably to the ketogenic diet or not more favorably but more quickly could ketogenic therapies rooted in a ketogenic diet help with symptoms of dep depression and how would that be similar or different to

symptoms of say bipolar disorder or schizophrenia or other serious mental illness well let's find out with this interview with Aaron Bellamy so welcome back to metabolic mind we're a nonprofit of bazooki group where we share information and resources at the intersection of metabolic health and mental health and metabolic therapies like ketogenic therapies as treatment for mental illness I'm Dr Brett Sher and today we're joined by Aaron Bellamy who recently uh completed her PhD focusing on ketoge

n genc therapy for depression you can find her on Twitter or X at aonl Bellamy or in our new website IKR t.org for integrative ketogenic research therapies so let's get into this interview with Aaron Bellamy but first before we begin please remember our channel is for informational purposes only we're not providing individual Group Medical or Health Care advice or establishing a provider patient relationship many of the many of the things we talk about can be very dangerous if done without prope

r clinical supervision so always consult with your Healthcare team before changing your diet or your medications or your lifestyle specifically to treat a medical condition all right so with that uh as the disclaimer let's hear this interview with Aaron Bellamy well Aaron Bellamy thank you so much for joining me on metabolic mind thank you it's great to be here yeah now I'm really curious to hear more of your story and your experience because you started your PhD program and looking into using k

etogenic therapy for depression like all the way back what like 2016 where you know there was I guess you could say a very small movement beginning at that point but pretty small so you were really on the Forefront of this so I'm curious why don't you start by just filling Us in on what got you interested in this why you wanted to do a PhD and what was your experience like in the beginning yeah absolutely so it has been a long time 2016 is a lifetime ago I feel um so my background is psychology

and in the UK in order to become a psychologist you have to go into the NHS and get some experience working with people who have mental health conditions and so during my undergrad and my masters I always had an actually an interest in Eating Disorders so I was always reading research about diets the latest diet you know the Mediterranean diet and what they were doing for people and around 2015 2016 I came across the Atkins the new Atkins from for a new U book um and Akin diet low carbohydrate d

iet ketogenic diet I did a little bit of research and I saw that some research was going on within the diabetes community and that the low carbohydrate diet ketogenic diet seems to be showing some promising results alongside that I had moved into the NHS the National Health Service and I was working on acute impatient psychiatric units um to try and gain some experience and you know some of the listeners might might be familiar with these Services it's where people go when they're really quite u

nwell really unsafe in the community they need some extra support and people can stay there for a couple of days couple of weeks couple of months even up to a couple of years and you know I I was helping to look after these people and I was using my psychology experience and and gaining psychology experience um while working with them and I was was looking at their diet and I was thinking about you know what I had been reading um about the ketogenic diet and diabetes and you know a lot of the pe

ople that I was working with had type two diabetes and so I was you know putting two and two together and thinking well you know maybe it might help their diabetes but at the same time I thought I wonder if there's any research on ketogenic diets low carbohydrate diets and mental health so I went digging um and I think for anybody who's spoken to me over the past 6 to eight months I've probably already told this story but I found that one study from 1965 where they put h a group of females who h

ad schizophrenia on a ketogenic diet and all of their symptoms improved and then they reintroduced the standard diet and all of their symptoms um the their symptoms came back there delusions and hallucinations and I thought oh my gosh I've hit the jackpot this is the research I'm looking for brilliant let me find some more went digging thought I was a terrible researcher because I couldn't find anything right and you would assume there would be right if you see like this one study with such grea

t results you'd be like why isn't there a follow-up study so you probably were like what am I missing what happened here exactly I was putting in all my my Search terms going what what where is it 1965 was a long time ago right what happened I couldn't find anything and I started thinking okay you know auntie psychotic medications came in in the 70s maybe maybe you know the lead just kind of went dry I wasn't quite sure and I thought well I can see what is happening within the diabetes Community

people are improving with this so at least the people the patients that are on my war that I'm working with they have side effects that is cing causing metabolic syndrome and they they have increased risks of um diabetes it could at least work for them and then perhaps even have some mental health improvements but you know I'm a psychology graduate I can't do anything with this information if the research isn't there it's just a nice idea um and so I couldn't go down the Clinical Psychology rou

te because if I was to then start working with um individuals what am I going to say you know here's a diet there's no research only this one study in 1965 so I thought okay well the only way to do this is to actually go and do the research myself um so that's why I did in 2016 um when there were a couple of people around the world starting to think about this for mental health but we hadn't been connected yet I reached out to um diabetes.co.uk who had this uh online platform where they were uh

taking people on a low carbohydrate diet for their type 2 diabetes um and I asked if I could collaborate with them and create an online digital intervention using uh the ketogenic diet low carbohydrate diet for depressive symptoms and for depression they agreed I found a university that would support me I self-funded it did it part-time alongside my work in the National Health Service and then ultimately alongside my clinical work and off I went it took me seven years but I've just come to the e

nd of it now um and it's been a long road and you know a lot has changed a lot has changed over the years yeah I mean it's a great origin story especially how I mean it's great and depressing right you had to be so much of a selfstarter you had to do all this work on your own and create it because it didn't exist so I mean that's that's amazing but the other hand it's sort of frustrating that why didn't it exist but now we're seeing sort of a different environment so I guess that's one thing whe

n you when you look back to how you started in 2016 to how the environment is now how have you seen it changed it's incredible you know first of all I felt like I was in my little Silo I felt like I was in an echo chamber drumming the drum and nobody was listening you know I think the people around me were just totally Fed Up of listening to me talk about ketogenic diets and and mental health um but then you know gradually over the years finding this community and the community growing both with

clinicians researchers but also just you know lay people members of the public that are try have been trying this and have actually found that maybe they started doing it for weight loss and they found that actually their their mental health improved and they were starting to feel better and that group of people have just they are so enthusiastic I think because of what they have experienced that it it's just incredible it just seems to be growing exponentially and then of course with you know

with uh Dr Christopher Palmer's book Brain energy and Dr George eid's book coming out in January I think really we've got this fantastic movement then of course metabolic mind that's kind of navigating and coordinating everything as well um really I just think it's a bit quite Unstoppable but maybe I'm maybe I'm exaggerating because I'm you know still so passionate about this area I'm not sure but you know it's just grown Leaps and Bounds you know over the past couple of years he has yeah and I

think your experience shows a lot about what I guess you could say the field is going through and one the the realities of how hard it is to do nutrition high quality nutrition studies especially without a lot of funding available um recruiting patients and you know making sure the intervention are equivalent but you know with different diets and how they do I mean it takes money it takes time it takes effort it takes support it's not easy to do and I think maybe your study showed a lot of that

but then also the the amazing clinical benefits people are seeing and so trying to you know where does the research catch up with the clinical benefits and how do you handle that so tell us from the clinical side you've been working with patients for a while now like what are I guess what are some of the main surprising benefits you've seen or maybe some and then some of the challenges just give us a little bit more about your experience there yeah definitely I think one of the something that ac

tually came out of my research and I have seen it then also clinically which I was most surprised about is that you can see benefits in mental health symptoms and physical health symptoms of course but mental health symptoms even with low level ketosis and simply cleaning up the diet moving into like a low carbohydrate approach before you even get to ketosis I'm seeing people's mental health improve which I didn't not that I didn't think about that previously but I really thought you've got to h

ave the ketones it's the ketones that are doing you know they're providing that energy that they are the little nuggets that we need and we need lots of them let's get them and though I think that is very true uh for many many people I've kind of Switched in the way that I practice now and some people want to jump straight ahead and go straight into ketosis fine but I like to start slow and just clean up the diet move to low carb start you know start getting people comfortable with the process a

nd they start to see improvements with that low carb approach and then gradually we move into ketosis and start to build up the ketones and then start to monitor you know for more improvements that way so I think that was the biggest surprise for me and um and then in terms of difficulties I think the difficulties still remain the same you know the same that I saw in my research and still the same that uh you know that maybe I had read in the research previously which is you know lifestyle obsta

cles uh you know birthdays Christmases things like that getting into ketosis initially for some people is a little tricky but I think what we have now which we didn't have before is we have ways to overcome these obstacles so there are you know we know how to use electrolytes to manage the the keto flu or moving into ketosis we know what to expect we can set those expectations with people with uh you know social situations you know just educating people around owning their dietary choices you kn

ow it's very easy to say you know I'm a vegan I'm a vegetarian I'm gluten-free okay well sure I just don't eat carbs right now and that's you this is what I'm doing so we can still go out and have a great time and I'm can pick what I want to eat and it's going to be fine so we have ways to manage those difficulties now whereby I think previously maybe we didn't we were just kind of stabbing in the dark to see what worked so I think they're they're the the biggest things at the moment definitely

yeah so many good points in in there and and I think you're right and you bring up a good point that for a lot of people just cleaning up your diet is going to help but then the question is is that you know going to help the maximum amount or can you achieve more by going into ketosis and that's why I think I like your approach of being you know going in a stepwise manner one because it makes getting into ketosis a little easier to tolerate for a lot of people but two you start to see the benefi

ts and then you can see is there a difference with with higher ketones because as you know Ian Campbell showed in in his research study higher ketones did tend to correlate with improved mood but clinically experiencing improved mood even without Ketone show it doesn't have to be ketosis that you can have improvements before that so I think that's that's a really important finding that you related and and in terms of the challenges yeah I can just think in 2016 if your reaction was you know I do

n't eat carbs I eat a keto diet there'd be probably a bigger eye roll to that from most people than there would be in 2023 so times certainly have changed from that standpoint definitely definitely and I think I think now people are well I I think with all of us talking about it Non-Stop and trying to to push this movement forward people are a little bit more open to the fact that nutrition can impact mental health and so therefore you know we got a lot of work to do but therefore people are mor

e open to the fact that okay the ketogenic diet or other diets may impact mood and we need to be appreciative of that it's not just ketogenic diet for diabetes or ketogenic diet for epilepsy you know the ketogenic diet can be used in this way and therefore you know you just got to keep pushing forward with this to tell more more people so that they feel open about it and accepting of it yeah but a lot of people will maybe hear about it and say how do I get started what do I do like my doctor's n

ot on board my therapist isn't on board how do I go about starting this and and so you've come to the point where you've now said I'm going to do something about it so you started ik KRT .org integrative ketogenic research and therapies um so tell us about that and what your goal is there and sort of what your experience has been so far yeah absolutely so it is a bit of a tongue twister as I said to you earlier but um that's just how it is IKR is much easier H to say so I have always planned to

work with um you know with individuals to improve their mental health that was always my goal I just had to take the Sidetrack to go and do the research and then come back um and so setting up IKR I just wanted to have a place where people could come they could work with me directly and also work with a very trustworthy dietitian that I have um to implement ketogenic metabolic therapies not just the ketogenic diet for for weight loss ketogenic metabolic therapy specifically for mental health con

ditions and so just like you said you know people are saying I'm trying I'm waiting for a metabolic psychiatrist I can't find one what do I do how do I how long do I have to wait and you know we're trying to train people right now we are but it's going to take some time and uh people don't people that are not feeling well right now don't have the time to wait and if they can work with a professional who knows what they're doing and who's working with uh other professionals who are also in this a

rea they have a much better chance of being able to implement this safely and effectively to monitor uh you know their mental health symptoms and see if they improve and so with IKR that's what I do so from the very beginning somebody comes to me we run all the Baseline blood tests um you know go through all the medical history go through all of the symptoms discuss what good mental health would look like for them because it depends um and then work with them to implement the ketogenic diet or w

ork with them to clean up the diet move to low carb and then into ketogenic diet track the ketones remotely daily so that we're correlating how and tracking mood as well and other symptoms and correlating how or how they correlate with each other um and tracking those over time and then using a couple of different like psychological measures to track those mental health symptoms to see if they're improving and then alongside that collaborating with their mental health Team now in the UK not ever

ybody has a psychiatrist some people own work with the GP and they have anti-depressants from the GP they haven't seen a psychiatrist other people do have a psychiatrist and so I will work with the GP or the psychiatrist um I don't believe right now though it would be ideal it would be fantastic if there were tons of metabolic psychiatrists out there but that's not the case right now um so their psychiatrist doesn't have to be you know gung-ho about a ketogenic diet I will give them all of the i

nformation that they need need and as long as they're supporting their um their patient you know with the medical side of things with the um medications and they're aware of what to change and when if necessary well then we'll work closely together over that 12-week period to implement it help them through any lifestyle obstacles and things like that and track the changes over time so I think a lot of people think that oh it you know you're just implementing a ketogenic diet for fat loss with pe

ople you know what are you doing whereas actually it's a lot more complicated than that but I try my best to make it as easy as possible for the individual and just support them the whole way um you know because sometimes ketones might be up and they feel great other times the ketones might be up and they feel a little bit wobbly but it could be because the electrolytes are off and so just helping to educate them to spot those issues so they know that for themselves H so they you know ultimately

can be independent and be able to maintain this long term if they are feeling good so yeah that's where we are with IKR good and and I like how you mentioned about coordinating with the care team because I think that's so important especially as you know until more clinicians are trained in this like to have somebody who can speak the language you can speak the language of the therapist speak the language of the psychiatrist speak the language of the patient and help coordinate the care to make

sure everybody's on the same page I think that that's so important one of the things you've also mentioned though is is sort of expectations and um I guess how to phrase this question can everybody expect to improve similarly right like you talked about a study in schizophrenia we have ongoing studies for bipolar disorder um depression probably gets talked about a little bit less in terms of uh ketogenic therapy so do you think a patient who diagnosis is depression can can stand to benefit as m

uch as someone whose diagnosis is phrenia schizo effective disorder bipolar disorder and and sort of what have you seen for the time frame of improvement if that's the case yeah absolutely so this is great and it's really something that I I talk to with my clients about because I think expectations are all over the place with bipolar disorder and schizophrenia you know we have some fantastic case studies and some fantastic research results coming through now showing you know great improvements i

n quite a short period of time and perhaps that could be due to the the mechanis Ms of the ketones and you know how uh the mechanisms are are working on the mechanisms of bipolar disorder or schizophrenia um maybe they're a little bit different perhaps to how they work within depression but then when you look at depression on the whole unfortunately we have uh This what I like to coin an umbrella term I think um depression is an umbrella term because underneath it there are subtypes you know we

have melancholic depression atypical depression some other different types of depression and they all have different symptomatologies and different symptoms and within that for example within atypical um depression the symptoms might be increased hunger uh increased hunger and Cravings increase in weight as well but then with melancholic depression still under depression it's complete absence of hunger you know losing weight and so I think we're in a sticky situation there because you have two p

eople with depression just with different subtypes and they have very different symptomatologies and very different experiences with the atypical I think there's a lot of I don't think there is research to show that the um there's a lot of overlap with metabolic syndrome and so I think if people out there have depression with a typical uh subtype you know they may lean more favorably for a ketogenic diet however we know from the work um of Dr Chris Palmer and Dr Ian Campbell and so on that um ov

erall these K these ketones are improving our metabolic Health you know on the surface they're improving our metabolic Health on the whole um and providing us with energy and so when you look at depression you have to look at the individual and their subtype and what they're experiencing and so I think everybody can benefit from either a short or long stint in ketosis because of the increase in brain energy we could all de we could all do with a about of it however I think those people that have

the atypical subtype depression or the treatment resistant depression seems to um respond more favorably to the ketogenic diet or not more favorably but more quickly um however again with the time frame as opposed to bip poar schizo affective disorder or schizophrenia I have seen clinically that depression takes a little bit longer but still within that 12 12 week Mark I'm not seeing results very quickly but maybe after about four five six weeks I'm starting to see improvements some things impr

ove quickly but generally speaking improvements are coming four five six weeks the energy Improvement is coming almost instantly which I think is consistent with what most people see uh because of that uptake the increase in ketones increase in energy um but the anxiety the mood is slowly improving over a period of time so to round up I suppose long story short is don't think don't get disheartened if you don't see the results straight away it's not that you're not doing something right or you'r

e doing something wrong it may just be that you need it's just going to take a little bit longer and as long as you're working with somebody who's monitoring everything with you and is looking out for the right things then you know just stick with them and and monitor over time and look for that gradual Improvement yeah such an important point to really set expectations and and I I like how you describe the subtypes of depression because we can't think of depression as one thing right just like

cancer isn't one thing or but we often do we think bipolar is one thing schizophrenia is one thing depressions but it's not and as as Dr Chris Palmer has talked about is the you know the the criteria it's a billing criteria that we try and sandwich people or squeeze people into these these um diagnostic criteria when really it's it can be a constellation of different symptoms that is far more important to understand than just the the diagnosis and and that may um affect how quickly somebody resp

onds or how somebody responds so I think that P um perspective is is really important especially for someone to say like like oh I have depression therefore maybe I will or will not respond well no we need to know a little bit more than that and and so I like how you you walk through some of those specific criteria yeah and also you know we're all so different and we all have our own experiences and you know how did we get to Depression was it bereavement was it an adverse life event during chil

dhood was it you know inflammation maybe I have an autoimmune condition that's then you know or arthritis and it's then triggered depressive episode so there are so many roots I I still think there are some we probably don't even know yet that then come together to to to show the symptoms of depression and though I think that then lends to the fact that this is such a personalized approach so I don't think we will ever have a cookie cutter this is the ketogenic diet that you're going to do and y

ou're going to expect these benefits it doesn't work like that just like cancer therapy or any other therapy is personalized to the individual ketogenic metabolic therapy has to be personalized to the individual because you may also have some comorbidities for example where you overlap with another condition you may even have you maybe you have um you know a combination of of two mental health conditions and then maybe you also have some anxiety thrown in or some Seasonal effective disorder so a

ll of those things need to be considered for you as the individual and then you know a plan is is put in place generally speaking you're still looking for ketones right but once you have the the ketogenic diet as the foundation then you start adding the other things that you think might be able to help that individual that's personalized to them yeah yeah and the other part of personalized care is it doesn't you know ketosis ketogenic therapy isn't meant to completely replace medication or compl

etely replace therapy or replace other you know treatment interventions um so is that something you see is it using it as a sort of adjunctive therapy to what what someone's already getting or experiencing yeah absolutely and I think you've raised such a good point this is something that I come AC come across time and time again is and I I understand because if I was on medication for anything and I if I didn't feel like I needed to be on it or if I felt like you know I didn't want to be on it I

would want to get off it as quickly as possible and I would want to if I if there was even the idea that I could try something else I would try something else and then try and come off it that's that's exactly what I would do and so when people come to me with that that same need I have to explain to them listen you know first of all we're going to do this alongside your St current standard of care there's going to be no medication changes for the three months you're doing this because we're ch

anging this one thing your psychiatrist will change medications but most likely it's is going to stay the same for this period of time and then if you are starting to see improvements then you can talk to your psychiatrist about maybe reducing some of the medications tapering the medications in the way that only they know how with you and that can take a very long time you know a very small amount at a time sometimes you need to go up sometimes you need to come back down but you can't just come

off your medication and just do the ketogenic diet because it's it's not safe not going to work with you if you do that either it's not safe at all but also what I like to say to people is listen the long-term goal is for you to feel better and to live the life that makes you happy you need to be able to have the energy to do the things you want to do in life and if that means being on a ketogenic diet and still being on some medication but you're feeling good you're doing everything that you yo

u want to do you're getting out with your kids you're getting up in the morning you're doing your degree whatever it is if you're still able to do those things and you're still on a perhaps a low level level of medication and the rest is the ketogenic diet well then that's not so bad you know and some people might be able to come off their medication completely other people might not you know or it might just take them a longer a longer time so it really is about just setting those expectations

and the the main goal is just for people to feel better and if that does include some medications well then so be it and then just putting in all these other lifestyle interventions around them to support them you know metabolically yeah such a great perspective that you know the medications don't have to be the bad guy especially if they're making you feel better but using them in conjunction with ketogenic therapy can really help help you just get to that point of Vitality um well so we've cov

ered a lot and you've given a lot of great advice but if you were going to boil it down to sort of your your Quick Pitch for someone who's thinking about this considering it where what would you tell them to do to sort of get started or what should they consider first I know there's a lot to a lot to say so it's hard to boil it down sometimes but I'm curious how you would yeah you know I think you have to you have to go you have to look at it as you're playing the long game okay and you need to

look at this this is an overall this is a an intervention that is going to or a therap itic approach that's going to help you physically and mentally overall is going to hopefully improve all of these aspects of your health and so in order to do that you need to find somebody that you can connect with and work with who knows what they're doing okay and if you can't find that person you need to ask around to see if somebody will give you recommendations to find that person um and then slowly work

with them to clean up your diet and you know slowly clean up your diet and move to maybe a low carb approach and into a ketogenic diet and so that would be the first thing if somebody came to me and said how do I do this that's why I say you need to find somebody you can work with that you get on with that you feel you can trust and that's going to support you and then gradually work with them to get yourself to that point of a ketogenic diet and then go from there to monitor your symptoms yeah

and I think with with you provide such a great example of is that person doesn't have to be a psychiatrist that person doesn't have to be a dietitian or even a therapist it could it could be any one of those things or it could be someone like you who can who can help coordinate care through all that and help somebody and help somebody through this process so well I'm really excited to see you as sort of a shining star in this in this field and um to see what you've been through and and and wher

e you are now to really help people so thank you for joining us and um I encourage people to check you out at IKR t.org and Aon L Bellamy on Twitter or X so thank you so much for joining us thank you so much Brett it's been an absolute pleasure and yeah brilliant thank you