The inkling emerged from an altogether ordinary observation: He felt peaceful, maybe even happy as he watched the trees along the road pass by.
"I didn't know what was going on at the time, but I thought this might be what it feels like to be normal."
Campbell had lived with bipolar disorder for much of his life. Mental illness runs in his family, and he'd lost loved ones to suicide. Over the years, he tried different treatments, but it had become "increasingly difficult to live with."
What had changed? A few weeks earlier, he'd started a new diet.
Campbell dealt with unwanted weight gain and metabolic troubles, a common side effect of psychiatric medications.
In an effort to lose weight, he drastically cut back on carbs and instead focused on protein and fat. It turns out he'd unknowingly entered ketosis: A metabolic state where the body switches from glucose as its primary energy source to ketones, which come from fat.
He started learning about the ketogenic diet, which is high fat and very low carb, on podcasts and YouTube videos. Soon, he was tracking his ketone levels, courtesy of an at-home blood test.
"I realized it was actually the ketone level that was making this shift in my symptoms in a way that nothing else ever had," he says. "It struck me as really significant, like life-changing."
A career-launching moment
How exactly was a diet performing this alchemy? Campbell decided to pursue a PhD in mental health at the University of Edinburgh, hoping to do his own research and learn if it could help others.
Campbell had lived with bipolar disorder for much of his life. Mental illness runs in his family, and he'd lost loved ones to suicide. Over the years, he tried different treatments, but it had become "increasingly difficult to live with."
What had changed? A few weeks earlier, he'd started a new diet.
Campbell dealt with unwanted weight gain and metabolic troubles, a common side effect of psychiatric medications.
In an effort to lose weight, he drastically cut back on carbs and instead focused on protein and fat. It turns out he'd unknowingly entered ketosis: A metabolic state where the body switches from glucose as its primary energy source to ketones, which come from fat.
He started learning about the ketogenic diet, which is high fat and very low carb, on podcasts and YouTube videos. Soon, he was tracking his ketone levels, courtesy of an at-home blood test.
"I realized it was actually the ketone level that was making this shift in my symptoms in a way that nothing else ever had," he says. "It struck me as really significant, like life-changing."
A career-launching moment
How exactly was a diet performing this alchemy? Campbell decided to pursue a PhD in mental health at the University of Edinburgh, hoping to do his own research and learn if it could help others.
In online forums, people with bipolar disorder were sharing similar anecdotes — they were finding improvements in their mood, increased clarity and fewer episodes of depression. (...)
In early 2021, he started working with the eldest son of Jan and David Baszucki, a wealthy tech entrepreneur. Their son Matt had bipolar disorder and had been on many medications in recent years.
Jan Baszucki enlisted Palmer's help as her son gave the ketogenic diet a try.
"Within a couple of months, we saw a dramatic change," she says.
Inspired, she started contacting clinicians and researchers, looking to bring more visibility — and funding — to the treatment. Since rigorous data on the diet is still lacking, she wants to see researchers conduct large clinical trials to back up anecdotes like her son's recovery.
Soon a big-time philanthropist was in touch with Campbell, ready to pay for his bipolar study – and others.
Now, around a dozen clinical trials are in the works, testing the diet's effect on mental illness, most notably for bipolar disorder, schizophrenia and depression, but also for conditions like anorexia, alcoholism and PTSD.
"The research and the clinical interest is suddenly exploding," says Dr. Georgia Ede, a psychiatrist in Massachusetts, who began using the ketogenic diet in her own practice about a decade ago.
From epilepsy care to the mainstream
The classic ketogenic diet contains an eye-popping amount of fat, roughly 90% of calories coming from that alone. Other versions have come along that dial down the fat and allow more room for protein and slightly more carbohydrates.
Scientists search for more clues
The effect of ketosis on the mitochondria is one hypothesis for why keto diets could work, but it may not be the whole story.
Much of the data on how the diet affects the brain come from research into epilepsy and other neurological diseases like Alzheimer's and Parkinson's.
Scientists find serious mental illnesses like schizophrenia, major depression and bipolar disorder share notable similarities with these conditions: Inflammation in the brain, oxidative stress, mitochondrial dysfunction, and issues with glucose and insulin.
Research suggests ketosis can be beneficial on these fronts, although human studies are limited. Some of the larger clinical trials now underway for keto diets will seek to pin down what's going on.
For example, Dr. Deanna Kelly is trying to determine if the diet's potential benefits emerge from the microbiome in the gut.
"You're potentially changing the way bacteria are functioning and that could affect your behavior and your brain," says Kelly, a professor of psychiatry at the University of Maryland, who's leading an inpatient trial on the ketogenic diet for schizophrenia.
Other scientists are studying the diet's effect on neurotransmitters like GABA — which acts as a kind of brake in the brain.
Dr. Mary Phillips, who has studied how dopamine affects the reward circuit in bipolar disorder, thinks that may help explain its therapeutic effects.
She hopes her clinical trial of bipolar and the keto diet, which launched recently, also gets at a very practical question:
"How do you know which people the ketogenic diet is going to work for?" says Phillips, a professor of psychiatry at the University of Pittsburgh, "It's not the easiest diet in the world to get started on."
Jan Baszucki enlisted Palmer's help as her son gave the ketogenic diet a try.
"Within a couple of months, we saw a dramatic change," she says.
Inspired, she started contacting clinicians and researchers, looking to bring more visibility — and funding — to the treatment. Since rigorous data on the diet is still lacking, she wants to see researchers conduct large clinical trials to back up anecdotes like her son's recovery.
Soon a big-time philanthropist was in touch with Campbell, ready to pay for his bipolar study – and others.
Now, around a dozen clinical trials are in the works, testing the diet's effect on mental illness, most notably for bipolar disorder, schizophrenia and depression, but also for conditions like anorexia, alcoholism and PTSD.
"The research and the clinical interest is suddenly exploding," says Dr. Georgia Ede, a psychiatrist in Massachusetts, who began using the ketogenic diet in her own practice about a decade ago.
From epilepsy care to the mainstream
The classic ketogenic diet contains an eye-popping amount of fat, roughly 90% of calories coming from that alone. Other versions have come along that dial down the fat and allow more room for protein and slightly more carbohydrates.
The diet's entrance into the mainstream has fed plenty of debate about its merits, with some medical groups raising concerns. Yet, there's also growing attention — and clinical trials underway — on its potential, not only for obesity but a variety of other conditions. (...)
Scientists search for more clues
The effect of ketosis on the mitochondria is one hypothesis for why keto diets could work, but it may not be the whole story.
Much of the data on how the diet affects the brain come from research into epilepsy and other neurological diseases like Alzheimer's and Parkinson's.
Scientists find serious mental illnesses like schizophrenia, major depression and bipolar disorder share notable similarities with these conditions: Inflammation in the brain, oxidative stress, mitochondrial dysfunction, and issues with glucose and insulin.
Research suggests ketosis can be beneficial on these fronts, although human studies are limited. Some of the larger clinical trials now underway for keto diets will seek to pin down what's going on.
For example, Dr. Deanna Kelly is trying to determine if the diet's potential benefits emerge from the microbiome in the gut.
"You're potentially changing the way bacteria are functioning and that could affect your behavior and your brain," says Kelly, a professor of psychiatry at the University of Maryland, who's leading an inpatient trial on the ketogenic diet for schizophrenia.
Other scientists are studying the diet's effect on neurotransmitters like GABA — which acts as a kind of brake in the brain.
Dr. Mary Phillips, who has studied how dopamine affects the reward circuit in bipolar disorder, thinks that may help explain its therapeutic effects.
She hopes her clinical trial of bipolar and the keto diet, which launched recently, also gets at a very practical question:
"How do you know which people the ketogenic diet is going to work for?" says Phillips, a professor of psychiatry at the University of Pittsburgh, "It's not the easiest diet in the world to get started on."
by Will Stone, NPR | Read more:
Images: Tina Russell/Katie Hayes
