After a lot of searching, I managed to find a single study investigating the effects of a ketogenic diet on depression in humans. Its loneliness in the literature was not lost on its author:
It is surprising, after so much clinical experience spanning a period of two thousand years, that this paper is the first [and last] by a psychiatrist describing the applications of the ketogenic diet in the treatment of anxiety, depression, and dysperception. Meanwhile, throughout this most advanced society of ours, in every modern psychiatric facility patients are exposed to an overdose of carbohydrates... It is time that the application of available knowledge in this field should be the rule rather than the exception. Ignorance and fear of controversy are no longer an excuse to withhold this basic and physiologically-oriented treatment from our patients.
In addition, there is one other study, perhaps better designed and conducted than the one above, observing similar results from the same treatment, but in rats. The near-absence in medical literature of what looks like a pretty obvious conclusion, given the evidence, is disappointing and almost surprising. There's no shortage of informal discussion in online forums, blogs and so forth about this phenomenon, but serious treatment is conspicuously scarce in peer-reviewed medical journals.
All the available evidence seems to point to dietary carbohydrates as the major causal factor in endogenous depression, but the specific reasons are elusive. As you might expect, all this is really complicated. For example, reducing dietary carbohydrates almost necessarily means increasing intake of something else, usually fat. It also means reducing serum insulin levels, losing weight, and a pile of other things, any or all of which might be relevant to depression. So do carbohydrates directly cause depression? Is it the insulin secreted in response to elevated blood sugar from carby meals? Is it the lack of dietary fat in high-carbohydrate diets, as suggested here? The lack of vitamin D? Is it caused by insulin resistance, diabetes, obesity?
Some of these ideas can apparently be ruled out in at least some cases, but the entire body of available evidence speaks with a single voice: either directly or indirectly, increases in carbohydrate intake increase both the risk and severity of depression with remarkable consistency. Given that, we would expect - and we do find - that reducing carbohydrate intake has the opposite effect. Taken to its logical conclusion, these facts suggest that a ketogenic diet would be a fantastically effective treatment for depression. Very little research has been done to confirm this, but what is available appears to be a strong confirmation of everything else we know.
Conclusion: dietary carbohydrates are the major cause of clinical depression, and a ketogenic diet presents itself as an ideal treatment.
Hi Rocco, I have to say it feels a bit of stretch to make it to your conclusion...show me the links to double blinded studies confirming carbs as the culprits and it would seem less like "new math". There are so many endocrinologic processes involved in digestion let alone neurotransmission it's hard to imagine that carbohydrates(glucose) are totally evil. That being said I think the FDA is bought and paid for by Pfizer et al and I definitely don't think the corn or potato industry cares about anything aside from the bottom line. Terri
ReplyDeleteTerri, Maybe I wasn't as clear as I'd hoped, that I didn't think carbs were directly the culprit, mostly for the reasons you mentioned. There's obviously a great deal of complexity, especially endocrinological complexity, in the long chain of events between carbohydrate metabolism and neurological changes. But it does seem to me, from the evidence I've cited, that there's a very clear link between high-carbohydrate diets and depression, and similar links between other conditions associated with such a diet, and depression. Which process is ultimately to blame is anyone's guess at this point, but the root cause does seem to be high-carbohydrate diets.
ReplyDeleteI once read "Carbohydrate Addicted Kids" and it definitely put the blame on carbs for ADD and ADHD, which have to do with your neurotransmitters. After seeing my grandson off of carbs for a week, I became a believer. I have no doubt that carbs can cause depression, anxiety, and probably most all of the other psychological problems. You won't hear that on the news though!
ReplyDeleteGee, Rocco, when's the next post??????
ReplyDeleteI know, I know - any day now!
ReplyDeleteI have taken anti depressants for 19 years now and recently felt like I would need to increase the dose as I felt lower than I had ever felt before (apart from the time I initially started taking them).
ReplyDeleteTwo days ago (unaware of the carb/depression connection) I commenced a low carb diet in order to loose weight. My spirits and energy levels have risen so much so that I wondered if any research had been done and found this web site. There has to be a link.
Thanks so much for the comment! I hope it continues to work for you, and good luck with the weight loss!
ReplyDeleteI just finished "Good Calories, Bad Calories", by Gary Taubes (writer for SCIENCE magazine). Great read. I'd recommend it for anyone who really wants to delve into all the studies done regarding hyperinsulinemia and all the other things that have been shown to be a result of processed carb intake. It's a loooooong book, but you won't come away from it with the same misconceptions about dietary fat/cholesterol = HBP/Heart Disease/Obesity that you've been spoon-fed all your life. It's truly uplifting. : )
ReplyDeleteI too am day 23 into a lower carb diet (almost no sugar, no flour etc) and I have noticed a dramatic decrease in anxiety and depression (I have been on them for 15 years) I made the dietary change to drop an extra 15 pounds I have been carrying, as my recent cholesterol panel was a little higher than the "optimal" that I had been used to. I am a physician, and also noted the paucity of literature looking at low carb diets and anxiety/depression. It certainly could be placebo effect, but I am planning to start weaning my antidepressants in the near future to see what happens.
ReplyDeleteWell I started a diet 3 months ago, No carbs no sugars and very little to no food with hours of exercise I have droped 38 pounds .Just about 2 weeks a go my body woke up in a panic thinking I was fainting and having a heart attack at this point the nerves were not letting me eat cause I kept wanting to vomit all the food so I just would not eat ..... I went 4 times to the emergency room and did EKG's blood work it was horrible I felt like I was dying it was something out of this world crying anxiety fear chills so much pain internal and external it was horrible my head wanted to burst ... Well all my blood work came back ok and kg potassium was good wasn't anemic and they just weren't able to figure out my horrible change , the night was even worst my body would go into complete shock of anxiety ..... :( through lots of prayer I finally got the answer god told me to look up no carbs and anxiety and well guess what my problem is ..... My body is going thru shock from not eating any carbs I just recently started to eat them even if I feel like vomiting I know that its from the nervousness but it won't go away untill I eat a lil carbs and my body recognises the carb I'm my body
ReplyDeleteHey you're not supposed to starve yourself. Of course your body's going to freak out. Almost every time I hear something like this, somebody's not eating carbs *and* not eating enough fat.
ReplyDeleteHi Rob,
ReplyDeleteYour blog is so informative and uplifting. I became a believer in the low carb diet when I read Taubes' GCBC in July of this year. Thank you for speaking the truth.
Hi Rocco - Sorry about addressing you as Rob in my previous comment.
ReplyDeleteI have suffered anxiety for ten years. my wife was on a low carb diet and lost a lot of weight so i followed suit. My anxiety went away within maybe 5 days.
ReplyDeleteNo whenever i eat a big carb meal like large chips it will return within about 12 hours...then goes away when i resume the low card diet.
The link is like clockwork for me. It is just so predictable. I googled carb n depression and found so many links. why is the mainstream media not talking about this?
Nath
Same reason mainstream academia isn't talking about it, is my guess. It's out of line with heart disease dogma among other things. I read a PubMed article not long ago where they found evidence a ketogenic diet could stop the progression of Alzheimer's but concluded they'll just have to find a drug that produces the same effects, since everybody knows the diet will just kill them with heart disease.
ReplyDeleteHello Rocco,
ReplyDeleteThanks for sharing this important information. I am wondering if you have noticed a distinction in your studies (as relating to effects on depression) between the ketogenic diet (which limits protein as well as carbs) and a diet such as Atkins (or others) that encourage high protein, fat, and fiber content. I'm not sure if the availability of protein for conversion would limit the necessity of the increased mitochondria production by neurons? Thanks, Rika
Well a ketogenic diet doesn't by definition limit protein. If you're prescribed one by a doctor it may be protein-limited, but it's really just a diet that puts you in ketosis, and you can eat all the protein you want and achieve that, as long as you avoid digestible carbohydrates.
ReplyDelete