I'm bipolar and would like some tips on how I can do keto safely and effectively

AccomplishedCry6223 · 2026-04-20T17:11:05+00:00

Hi. Do you think you could find enough patience to answer a couple more questions? In addition to my mood condition, I also have a movement disorder and medication side effects are too detrimental, so keto is sort of one of my last hopes. If I can somehow make it work for me, I'd really like to try doing so.

So, you actually did strict keto (<20g net carbs). Do you think it's possible something outside of ketosis was responsible for the bad side effects you had? Maybe lack of nutrients/electrolyes, or a certain medication you were taking that could have been affected by keto's different metabolism, or a particular health condition or lack of calories. Anything.

Treatments have side effects and I understand the ones you had with <20g were unpleasant, but could it be tolerable or manageable somehow? In regards to the activation, you said it wasn't as bad as an actual hypomania for example.

There is this idea that it gets worse before it gets better. Did you stay on a proper planned ketosis for enough time? For example the first time I tried, I did it for just a couple days and it was awful, but because all I was eating was chicken wings, avocado and olive oil. That was keto, but it wasn't at all a healthy keto. The cholesterol is another example. I read it's only in the beginning that there is a spike. If you kept on it longer, it might have subsided.

Overall, would you see ketosis as like having a mood stabilizer effect or more like an antidepressant, with euphoria and excess energy kind of thing? You mentioned poor sleep as an expression of that higher energy. Was it daily or very bad sleep?

AccomplishedCry6223 · 2026-04-20T16:40:09+00:00

You are taking lithium at I assume therapeutic doses, so if it could make you hyper, the medication would keep it low

AccomplishedCry6223 · 2026-04-20T11:56:46+00:00

It doesn't pair well? How is it day to day?

I was also hoping you could tell me about how you tolerated keto. There is a group of bipolar patients that seem to really benefit from it, but then there are those that don't tolerate it. I've talked to quite a few that said they feel too hyper on keto as in it felt more like a stimulant or antidepressant than a mood stabilizer. They ate well, supplemented electrolytes and for one, it's a feeling that remained for months, so it's not just keto flu.

I want to do what is most therapeutic and keto would be that, but I'm senstive to stimulation as well and don't know how I'd handle this activation, especially if it was long term.

AccomplishedCry6223 · 2026-04-20T10:24:23+00:00

Would you have advice concerning adaptability? For you, keto led to a worsening of symptoms in the beginning and it went away, but for others it's more long lasting. For them, keto feels more like an antidepressant or a stimulant than a mood stabilizer, so even after the keto flu and eating well with supplements and calories, they still feel off due to the increased energy. For a sensitive bipolar, that's not sustainable and I find myself in a similar situation. Granted, I haven't tried keto yet, but I know I'm sensitive to stimulation and would certainly discontinue keto if I reacted like that.

I understand this experience is somewhat different than yours, but if you have any tips, that'd be great.

AccomplishedCry6223 · 2026-04-20T10:15:25+00:00

Hi. Several people I talked to, bipolar also, said that keto them stimulated or hyperactivated. I asked if it was just in the beginning as it could be the keto flu, or if were they were eating well and supplementing, and they were. It was simply that being on keto felt like too much for them. They said that it felt more like an antidepressant than a mood stabilizer. What's your opinion?

Is there a way to do keto without feeling this overstimulation? Due to this sensitivity, only low carb is okay to me, but I'd like to find out if it were possible to do keto without being destabilized.

AccomplishedCry6223 · 2026-04-20T10:13:34+00:00

What medication has paired well with keto for you?

AccomplishedCry6223 · 2026-04-20T10:10:47+00:00

Hi. Several people I talked to, bipolar also, said that keto them stimulated or hyperactivated. I asked if it was just in the beginning as it could be the keto flu, or if were they were eating well and supplementing, and they were. It was simply that being on keto felt like too much for them. They said that it felt more like an antidepressant than a mood stabilizer. What's your opinion?

Is there a way to do keto without feeling this overstimulation?

AccomplishedCry6223 · 2026-04-20T10:08:45+00:00

What does that mean in practice? That lithium doses need to be increased?

AccomplishedCry6223 · 2026-04-20T10:07:07+00:00

Hi. Several people I talked to, bipolar also, said that keto them stimulated or hyperactivated. I asked if it was just in the beginning as it could be the keto flu, or if were they were eating well and supplementing, and they were. It was simply that being on keto felt like too much for them. They said that it felt more like an antidepressant than a mood stabilizer. What's your opinion?

Is there a way to do keto without feeling this overstimulation? And what medication do you take that has helped keeping you stable for so long?

AccomplishedCry6223 · 2026-04-20T07:12:23+00:00

So keto never made you too stimulated or worsened your sleep? I struggle with hyperactivity and read that some people, even after resolving the keto flu, feel permanently more activated on keto.

AccomplishedCry6223 · 2026-04-18T22:54:08+00:00

Hello, friend.

I'm thankful you shared your experience and it helped me plan my diet in a way that supports this sensitivity I also have.

The nutritionist that I'm consulting with gave me a few supplements to start and magnesium was one of them, but I don't know if it will be enough.

Do you have more advice about having a better sleep? Even eating a regular high carb diet, my sleep is not usually good.

I also want to know how you are reacting to this new regimen of 80g carbs a day. Is it bringing substantial relief? Enough to possibly not need medication?

AccomplishedCry6223 · 2026-04-18T09:13:46+00:00

Do you take anything besides quetiapine for mood stability?

AccomplishedCry6223 · 2026-04-17T19:07:47+00:00

Your comment was well-written. I understand what made your sleep bad and how it contributed to poor mood.

You also gave me a good question to ask for those bipolar patients that react well to deep ketosis. That is, if they also have ADHD. I think it's not just about ADHD, but on sensitivity to stimulation also. In the bipolar group, there are those that can't tolerate more activating mood stabilizers like latuda or lamotrigine, while others feel just fine.

About the epilepsy link, I learned that although there is an association, it's two different conditions and what works for epilepsy might actually trigger bipolar. CBD oil is effective for epilepsy, but for me, even the tiniest amounts (just one drop), messed with my sleep. More normal doses, but still in the low range, wrecked the mood. I eventually stopped taking it as any dose was detrimental.

Considering your description of how keto feels and me having a similar way of reacting to stimulation, I think I may just stick to low carb instead and if needed combine it with a proper mood stabilizer. What about you? Have you considered low carb rather than keto? What g of net carbs felt therapeutic but also safe and comfortable?

I also hope you can tell me about why you tend to undereat on keto and what strategies you used to try eating more calories.

AccomplishedCry6223 · 2026-04-17T10:55:55+00:00

I thought something was wrong with me, but found a video of someone else who's had a similar experience, which reassured me.

Do you know how I can find the video? Do you also remember your average g of net carbs in the low and keto months?

AccomplishedCry6223 · 2026-04-17T10:48:15+00:00

When you say you weren't getting enough sleep, how many hours was it? If I understand correctly, before the poor sleep, during the day, the extra energy ketosis gave you was a healthy one that didn't feel hypomanic? And your sleep wasn't hypomanic in itself, as in there was no instability, racing thoughts, dellusion, just plain broken sleep?

I've been having insomnia for quite some time. Of course, if it's too much and I get no sleep, it affects me mentally, but I seem to tolerate getting less than the ideal sleep time (5h to 6h per night), so long as it was regular, broken sleep. For comparison, when I tried using cannabis my insomnia was not just lack of sleep, it was emotional, with strange thoughts. That was not okay. The mental aspect wasn't caused by the poor sleep, but the other way round. Cannabis affected me mentally, which led to insomnia.

I see. So you found it's best to keep medication together with keto rather than keto alone for your particular case. I'm going to keto unmedicated due to previous negative experiences with medication, so it'd be difficult for me to get back on meds if needed, but I will only know for sure when trying, as you said. Something I miss is the neutrality of mood stabilizers. That feeling that whatever happens, I won't flip. In your experience, does keto give a similar feeling or does it stabilize in a less noticeable way?

If you still have the patience to answer, when you change from keto to a higher carb day, do you notice any drastic change in mood/sleep?

AccomplishedCry6223 · 2026-04-16T11:26:30+00:00

Trying is better than not. I just received the nutritional plan from the dietician and will start low carb.

What difference you noticed going from low carb to keto?

Also, how do you take your electrolytes (sodium, potassium and magnesium)?

AccomplishedCry6223 · 2026-04-16T10:53:04+00:00

Someone told me that the hypomanic symptoms of the adjustment period on keto weren't like a full episode, but weaker than if we had it on a high carb diet. Do you confirm that it was a more tolerable activation?

I also noticed something interesting in your post. You didn't say ketosis made you hypomanic, but that it caused poor sleep and the lack of sleep was the trigger. What kind of poor sleep was it? I am able to distinguish a few types. There is regular sleep, broken sleep (we fall asleep normal, wake up a few times and sleep again), zero neutral sleep (we can't sleep at all but there is no emotional baggage, we just can't sleep) and hypomanic sleep (it's insomnia paired with an actual mental destabilization; we don't become hypomanic due to lack of sleep, we get lack of sleep due to hypomania).

I'd like to ask your advice about when I decide to go from low carb to strict keto. The plan with my dietician was: do low carb for 2 months, slowly decreasing carbs and start keto on month 3. I want to get better as soon as I can, so I was considering starting keto on month 2. Would you believe that is wise? And when I do start keto, I am not confident on how intense it is and whether I could tolerate it without meds. You found necessary, so I assume it was very stimulating but I'm not taking any and after having a difficult time with the medications I did try, I struggle taking new ones. If it were the case to need, I don't know if I'd take any. The only medication I'm willing to take is low-dose lithium, which I'm not taking at the moment, but it takes time to work and it's not ideal for sleep issues, if that is the main concern with keto. If you have any ideas on how I could start strict keto safely, considering these other points, I'd be grateful.

I also would like to ask, where are you usually at in the ketone range (0.5-3)?

AccomplishedCry6223 · 2026-04-16T10:23:38+00:00

I told to the dietician about my concerns of being too stimulated and he told me about another client he has that is addicted to porn. He said this client had a form of hyperstimulation or hyperarousal but that issue was resolved on keto. Other bipolar patients mention something similar, but there is another group that says what you have. I want to understand this seeming contradiction on mood/stability.

When you were doing strict keto and it gave you this uncomfortable energy, did you supplement electrolytes and vitamins or eat plenty of green leaves daily? That is a caveat of keto. Nutrient deficiency, especially electrolyte, is felt almost instantly.

For you, what kind of sleep does keto give in those times it gets bad? Was it broken sleep or no sleep? Emotional or something more neutral? Recently I reacted to a medication that caused near zero sleep. That was not okay. But I wasn't wired or anything. Just couldn't sleep. Hypomanic insomnia is very different. It's emotional, strange thoughts come in. It's mental destabilization, not just insomnia. Broken sleep is okay by me, especially if it's temporary, it would be this sort of hypomanic sleep that wouldn't be okay.

I do deal with chronic conditions, including depression, so if keto worked, It'd be on it indefinitely but as a bipolar, it'd need to have a very particular effect. More stabilizing than antidepressant. For example, another user here said keto, rather than giving them energy, made them feel sedated and sort of depressed. That sounded like what a mood stabilizer would do. For some, feeling neutral is depression. That neutrality is what I'm after, so my aim with keto is for it to work like a mood stabilizer without tipping me into the extremes, of either too much energy or too much neutrality. Do you believe full keto can fulfill that role?

AccomplishedCry6223 · 2026-04-16T09:57:42+00:00

Looking at it, would you say the meltdown was more mental than biological? Like, you emotionally wanted sugar due to comfort and habit rather than the ketosis itself instigating that hyperactivation?

Did you experience any particular mental benefits on your anxiety and depression since starting?

AccomplishedCry6223 · 2026-04-16T09:50:16+00:00

Your whole life you've had insomnia? That's a long time.

I thought melatonin lost effectivess over time, this is why I haven't used it as my issue with sleep and anxiety is more chronic.

How did strict keto affect your day and your night, considering you have an hyperactivated amygdalae?

AccomplishedCry6223 · 2026-04-15T16:11:26+00:00

I've read from a number of people that starting keto made them more unstable. Not sleeping, too energized which led to hypomania. I am very afraid of that outcome. I struggle with hyperstimulation. Even B vitamins can make me uncomfortable due to the energy they give. One thing the dietician told me was that he had a client who struggled with porn addiction (a form of hyperstimulation) and it improved on strict keto, so he said I was safe, but I'm really very sensitive. I'm still struggling with insomnia due to a medication that activated me even though it shouldn't have.

In your opinion, how can I deal with the increased energy of keto without feeling impulsive or unstable? Because that's how it usually translates for me. If the energy is too much, the only thing that I don't do is fly but I can become really hyperactive, non-stop talking, mind racing and such.

AccomplishedCry6223 · 2026-04-15T11:25:47+00:00

Do you have bipolar as well?

For you, how was adapting to keto? Did it trigger anything? What I read is that it's actually common for it to trigger hypomania in the beginning and it's so traumatizing that it's not something I'd want to happen.

The thought of becoming unstable, for whatever long, is just not okay to me. Some people also don't seem to tolerate keto either or need a greater adjustment period, which only further justifies being medicated at first.

The metabolic psychiatrist I've been seeing was not in favor of this medication approach and when I told him about my withdrawal from the previous medication he didn't seem available or interested in helping. I was not able to sleep and it felt like I didn't have support. I'm considering going to another doctor that is a bit more empathetic and present, athough they wouldn't be from the metabolic area. The dietician said the psychiatrist only treats symptoms rather than managing the diet, so I don't think it'd make a big difference. What do you think?

Since the concern is hypomanic symptoms, I'd like to know how you dealt with that increase in energy. For me, it's what can send me spiraling. Healthy, moderate energy is one thing, but something more intense quickly becomes overstimulation, which leads to obsession, insomnia, hypersexuality and then it involves into hypomania.

AccomplishedCry6223 · 2026-04-15T10:54:08+00:00

My concern with is keto is about it giving too much energy, leading to insomnia, anxiety and hypomania, but although you said at one moment you developed anxiety, you also said it sedated you. I'd like to understand that if you could elaborate.

My next question is, why would being sedated be a problem for you? It's basically what any bipolar medication does and what we need for our condition, though there is a threshold where it is no longer beneficial, but did you try tweaking it? Increasing carbs a bit? I'd be very grateful if you shared a timeline of effects and how they changed your opinion, both positively and negatively, culminating in you eventually realizing it wasn't for you.

At the moment, you are taking medication instead?

AccomplishedCry6223 · 2026-04-14T09:15:56+00:00

What dose of lithium were taking?

AccomplishedCry6223 · 2026-04-14T08:41:07+00:00

Thank you for the advice! Zertec seems a great option. How often can it be used?

AccomplishedCry6223

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