When I was in my studies as a psychiatry resident, I learned about an interesting field called metabolic psychiatry, which focuses specifically on ketogenic therapies to treat psychiatric conditions. This is a nascent field at this time, with no extensive clinical trials like we have for medications, though some small trials exist. I even have some patients who have been on ketogenic diets (not prescribed by me) that they elected to maintain, and with significant effect. These patients are in remission from their symptoms of bipolar disorder and followed with me for routine management of their small doses of standing psychotropic medications.

Curious, I wanted to try the keto diet myself, just to see what insights I could gain about making these behavioral and lifestyle modifications, how it would feel physically, and so I could better understand the challenges patients may face in implementing a keto diet for their lifelong treatment of psychiatric conditions. I personally expect that the keto diet will grow exponentially as a favored treatment option in the coming era of psychiatric practice.

I maintained a “high-protein” keto diet for this one-week experiment in which my daily consumption included 20 grams of net carbohydrates daily (subtract fiber and sugar alcohols from total carbs), between 0.5 and 1 gram of protein per pound of ideal body weight, and was otherwise eating fats. In this case, I did not focus as much on the fat or protein intake as I did on the strict limits of my carbohydrate intake. Here are the changes I noticed in myself by the end of the week:

Lower appetite and cravings

My hunger signals blunted significantly. I would still have bouts of hunger that came on, but nothing that ever got to the point of having cravings or becoming “hangry.” I was able to hold on longer between meals. I was eating smaller portions of all foods. I suddenly felt an indifference to the idea of having sweets, even if they were readily available as part of a social gathering, and I never went for them. The feeling of “satisfaction” from having a good-tasting meal was also heavily blunted, but I interpret this to be part of the metabolic recovery from having so many daily carbohydrates my whole life, like the majority of Americans. I feel like my body now functions the way it was naturally intended to, before the high-carb diet took over my metabolism at a young age.

Improved energy and mood

I noticed significantly improved energy throughout the day, despite actually being in an unintended calorie deficit this week by over one thousand calories on the majority of days. I was also still going to the gym and working with my personal trainer there. Most notably, I was no longer having any energy crashes in the mid-afternoon during my workday like I often would before.

One very odd improvement I also noted was that I had more motivation to get up and be active when I was lying down comfortably for a break, whereas I would normally stay down longer than I should and have low motivation to get up at all. Being more spontaneous, and going up and down the stairs to get extra chores done throughout the day, all seemed like second nature all of a sudden. There was no feeling of laziness. There was no dread about having multiple tasks piled up to do in the day. There was no irritability about small things in the day. I certainly did not expect feeling better to manifest this way, especially after only a few days into the diet.

Better sleep

My sleep was more restful each night of my “keto week,” and I found I was getting up much more easily in the morning and without grogginess, even if I had less sleep than usual that night. I was no longer taking naps in the day and felt fresh throughout the day. I was getting to sleep quickly, staying asleep, and waking up ready to start the next day.

Skin problems resolved

Since it was the summer when I trialed keto, I was naturally having some problems with eczema. I also have had heat rash all of my life, regardless of the season. Remarkably, I found both of these conditions to completely resolve with the keto diet, an effect I attribute to the anti-inflammatory properties of the diet. I witnessed spots of eczema suddenly transform into simple dry skin, with no side effects, and could not induce heat rash again no matter how hard I exercised or how long I stayed in the sun. I was amazed that such persistent issues that I have dealt with for so many years were suddenly gone in just a few days on the diet.

Challenges and solutions

The keto diet did not come without challenges though. Tracking exactly 20 grams of net carbohydrates per day was incredibly meticulous. Entirely removing traditional rice and breads from my diet was probably the most difficult sacrifice, not because of carb cravings (I had none), but because of the sense of loss from knowing I would no longer have these satisfying foods in my diet. I also somehow decided to do this keto week during Fourth of July week, so I missed out on some of the best BBQ treats.

I learned about a free app called Carb Manager, which I use today to track carbs more easily. I have also now replaced breads with low-carb tortillas and keto-labeled breads available at the grocery store, which at least still give the texture and feeling of real bread without any of the guilt. Cauliflower rice replaced traditional rice for me, with a similar outcome. While I sacrifice flavor with these changes, the extra meat allowance and creativity in spices makes up for it.

This one-week trek on the keto diet was incredibly insightful and valuable to me personally and professionally. I would encourage almost everybody to consider a ketogenic diet for their medical issues, provided they are doing it under the recommendation and supervision of their primary care doctors. Think of it like riding a new roller coaster; you do not know how you will like it until you try.

Zane Kaleem is a psychiatry resident.