Down in the dumps? Help might be hiding in your fridge.
A new, first-of-its-kind study suggests a controversial diet could ease severe, drug-resistant depression — with improvements showing up in as little as six weeks.
That’s a potential lifeline for patients who’ve run out of other options. An estimated 30% of Americans with Major Depressive Disorder don’t respond to standard treatments, leaving them with lingering, often worsening symptoms that can upend everyday life.
Enter the ketogenic diet, a high-fat, moderate-protein, low-carb eating plan that’s designed to push the body into a state called ketosis, where it burns fat instead of sugar for energy.
That metabolic shift produces ketones, an alternative fuel source for the brain and muscles.
Scientists have long suspected ketones could benefit the brain. Previous research suggests they may provide a steadier energy supply, help regulate mood-related neurotransmitters like serotonin, reduce inflammation and even improve gut health — all factors linked to depression.
To test the theory, researchers recruited 88 adults aged 18 to 65 who had with treatment-resistant depression. They’d all scored at least a 15 on the 9-item Patient Health Questionnaire (PHQ-9), a depression screening tool that goes up to 27 points.
They were then split into two groups. The first went all-in on keto, eating three prepared meals a day, plus snacks, and using test strips to measure ketone levels in their urine.
The other followed a “phytochemical” diet, incorporating one differently colored fruit or vegetable in their meals each day and swapping saturated animal fats for unsaturated plant oils.
Both diets lasted six weeks. At the end, researches saw improvements across the board: Depression scores dropped by an average of 10.5 points in the keto group, compared with about 8.3 points in the phytochemical group.
Urine tests showed most keto participants successfully stayed in ketosis during the intensive support phase. But sticking with the diet proved tough.
Once the prepared meals and weekly support ended, just 9% of participants continued eating keto.
“The main take away message from the study basically is that the ketogenic might have some value when well done, but it’s a very hard measure to take,” Dr. Raphael Braga, the physician in charge of the Center for Treatment and Research in Bipolar Disorder at Northwell Health’s Zucker Hillside Hospital, who was not involved in the study, told the Post. “It’s very restricted.”
Exactly why keto might help severe depression isn’t fully understood, but metabolism appears to play a role, he noted.
Research suggests ketones may help fix underlying metabolic problems tied to depression — like insulin resistance and mitochondrial dysfunction — by fueling brain cells more efficiently. But food likely wasn’t the only factor at play.
“One of the possible reasons why patients throughout the study got better, either the ketogenic diet or the control diet that the study used, is probably because they had a lot of support,” Braga explained.
The participants got prepared meals, regular check-ins, help tracking their progress and weekly counseling sessions.
“Those are very important for patients, especially with the treatment of severe presentations of depression,” Braga said.
“The more we can do to help patients engage socially with family and friends or programs,” he continued, the better.
Keto, of course, is best known as a weight-loss and fat-burning tool, popular with athletes, bodybuilders and celebs like Halle Berry and Kourtney Kardashian.
But it’s not without downsides. Some studies have linked keto to poorer overall diet quality and spikes in LDL “bad” cholesterol.
One 12-week study found participants had higher cholesterol, increased apolipoprotein B — which contributes to artery-clogging plaque — and lower levels of Bifidobacteria, the gut bacteria that help digest fiber, absorb nutrients and support immunity.
Braga says other lifestyle changes can also make a meaningful difference for people whose depression hasn’t improved with standard treatments, including weight management, exercise or routine management.
“If a patient at this stage is taking care of their own health and losing weight or maintaining a healthy weight, this would be in itself a major gain and that would be very effective on its own,” he said.
