When I was pursuing my education as a psychiatry resident, I discovered a fascinating area known as metabolic psychiatry, which specifically centers on ketogenic approaches for addressing psychiatric disorders. Currently, this is an emerging field, lacking extensive clinical trials similar to those available for conventional medications, though a few small studies exist. I’ve had patients who have chosen to follow ketogenic diets (not prescribed by me), which have led to notable improvements. These individuals are now in remission from their bipolar disorder symptoms and continue to meet with me for regular management of their minimal doses of ongoing psychotropic medications.

Intrigued, I decided to embark on the keto diet myself, aiming to gain insights into the modifications in behavior and lifestyle, how it affected me physically, and to enhance my understanding of the potential challenges patients might encounter when trying to implement a keto diet as a long-term solution for their psychiatric conditions. I anticipate that keto will significantly increase in popularity as a treatment option in the future landscape of psychiatric practice.

I adhered to a “high-protein” keto diet for this week-long experiment, with my daily intake comprising 20 grams of net carbohydrates (by subtracting fiber and sugar alcohols from total carbohydrates), between 0.5 and 1 gram of protein per pound of ideal body weight, consuming fats otherwise. In this context, my emphasis was not as much on fat or protein consumption as it was on strictly limiting carbohydrates. Here are the changes I observed in myself by the end of the week:

Reduced appetite and cravings

My signals of hunger were considerably dulled. While I still experienced instances of hunger, they never escalated to cravings or irritable feelings. I managed to go longer periods between meals and started eating smaller servings of food. I found myself indifferent to the prospect of sweets, even when they were easily accessible during social events, and I never craved them. The feeling of “satisfaction” from enjoying a tasty meal also diminished significantly, which I attribute to metabolic adjustments from consuming high levels of carbohydrates throughout my life, similar to many Americans. It feels like my body is now functioning as it was originally intended to, prior to the high-carb diet dominating my metabolism from a young age.

Enhanced energy and mood

I observed a notable increase in my energy levels throughout the day, even though I unintentionally consumed over a thousand calories less than normal during most days of the week. I continued to attend the gym and worked with my personal trainer. Most importantly, I did not experience any of the energy dips in the afternoon during work hours that I often faced in the past.

An unusual improvement I noticed was a greater motivation to get up and be active after lying down comfortably during breaks, whereas I typically would remain there longer than necessary with low motivation to rise. Suddenly, being more spontaneous and navigating up and down the stairs to complete additional tasks felt effortless. There was no sense of laziness, dread over a long to-do list, or irritability regarding minor daily issues. I certainly did not anticipate feeling revitalized in this manner, particularly so soon into the diet.

Improved sleep

My sleep during the “keto week” was noticeably more restorative each night, and I found it much easier to rise in the morning without feeling groggy, even after a shorter night’s sleep. I stopped taking daytime naps and felt alert throughout the day. I was falling asleep quickly, staying asleep, and waking up ready to embrace the new day.

Skin issues resolved

Given that it was summer when I tried the keto diet, I typically struggled with eczema. I’ve dealt with heat rash my entire life, regardless of the season. Remarkably, I found that both conditions completely disappeared while on the keto diet, an outcome I attribute to the diet’s anti-inflammatory effects. I noticed eczema patches transforming into plain dry skin without any adverse effects, and despite rigorous exercise or prolonged sun exposure, I couldn’t trigger heat rash again. I was astonished that such long-standing issues could vanish within just a few days on this diet.

Challenges and resolutions

However, the keto diet was not without its challenges. Precisely tracking 20 grams of net carbohydrates daily was quite labor-intensive. Eliminating traditional rice and bread from my meals was perhaps the most considerable sacrifice—not due to cravings (which I had none), but due to the feeling of loss knowing these comforting foods would no longer be part of my diet. I also inadvertently chose to start this keto week during the Fourth of July week, so I