My Strict Keto Diet Is Helping Me Through This

‘In the anxiety of this moment, I deeply appreciate the calm and resilience I’ve found since changing the way I eat.’

Close up of unrecognizable woman cracking an egg for breakfast while putting it in a frying pan.

Normally, having an article of mine tweeted by Bernie Sanders would have been all I could talk about. But on the day it happened, my doctor told me something that made the career high pale in comparison: “I’ve never had any patient stay on a low-carb diet this long.”

That was six months ago; I’ve now passed the two-year mark as a strict adherent of the ketogenic diet. Originally used as a treatment for epilepsy, keto (as it’s commonly known) involves cutting out virtually all carbohydrates and instead eating a moderate-protein, high-fat diet so that your metabolism flips from burning carbohydrates to burning fat as its primary source of energy. And although it has required storing a daunting volume of bacon and beef in our pandemic prep freezer, the Covid-19 crisis has made me appreciate keto more than ever.

In the anxiety of this moment, I deeply appreciate the calm and resilience I’ve found since changing the way I eat.

What started as a weight loss practice has become much more about wellness. Even more than it’s transformed my waistline, keto has transformed my mental health — and in the anxiety of this moment, I deeply appreciate the calm and resilience I’ve found since changing the way I eat.

This shift began in March 2018, when I committed to limiting my carbohydrate intake to 20 grams a day. That’s equivalent to four carrots (I haven’t eaten a carrot in two years), two peaches (I had half a peach one day last summer with very careful planning), or half a slice of challah (I recently had a tiny bite of my kid’s homemade challah, and it was pretty much the most delicious thing I’ve tasted this decade).

Sounds like a crazy way to eat? From an evolutionary point of view, it’s perfectly normal for our bodies to regularly go into ketosis, aka starvation. “Imagine living on the plains of Africa,” says Dr. Rif El-Mallakh, director of the University of Louisville’s Mood Disorders Research Program. “In real nature, before agriculture, food is hard to find and hard to get. For two or three or four days, you have nothing to eat, then you find something or someone hunts something, and then you’ve got something to eat. Ketosis is not necessarily something weird we are creating. We are just creating a normal physiology.”

That’s the logic that made keto appealing to me in the first place. I started this discipline with a clear goal: to lose the 45 pounds I’d gained over three years and do it before I hit menopause and found weight loss even harder. In past efforts, I’d never needed to do much more than follow the classic food pyramid, cut back on treats, and increase my exercise a little. But at age 46, weight loss was proving to be a bigger challenge.

So when a bunch of friends suggested keto, I did a bit of research and decided to try it.

I never thought that two years later, I’d still be a freaky low-carber.

The reason I’ve stayed with the ketogenic diet is because it’s transformed my mental well-being. After a lifetime of struggle with anxiety and mood swings, I am now a relatively relaxed, calm, and stable human. My energy levels are through the roof: Now that my metabolism burns fat instead of carbs, I sleep one or two hours less each night than I used to, and I rarely feel tired or need an alarm to wake up. And I’ve gone from being a nightly pot smoker to being 100% sober.

I’m not alone. A growing body of research suggests that many people experience significant mental health benefits from keto based on how it changes our underlying physiology. A 2017 review article on the status of the ketogenic diet in psychiatry noted studies suggesting that ketogenic eating could help manage disorders including depression, bipolar disorder, and schizophrenia. A 2019 laboratory study suggested keto may reduce the behavioral responses to drug use and thus holds promise as a treatment for drug addiction. And a 2007 study of children with treatment-resistant epilepsy found that the ketogenic diet improved sleep quality and reduced total sleep time.

“Since psychiatric conditions are brain illnesses too and share many of the same underlying abnormalities as neurological illnesses, it stands to reason that ketogenic diets may be helpful with mood, thinking, and concentration problems as well,” says Dr. Georgia Ede, a nutritional psychiatrist.

It helps that every time I “cheat,” the consequences are immediate and severe. I get a mild headache if I go a tiny bit over my carb limit. “For most people in the first year of the keto diet, if they break the diet, they feel like shit,” says Dr. Christopher Palmer, a psychiatrist and the director of McLean Hospital’s Department of Postgraduate and Continuing Education. “They have a hangover, or they have a bit of a headache.”

Experiencing keto as self-care is the reason I’ve been able to sustain it so consistently for two years and why I plan to keep on going. At a moment like this, it’s great to have any self-care practice.

The pain of cheating mirrors what I (and others) experience when we first shift to ketogenic eating as our bodies go through a metabolic transformation. Palmer warns his patients that the first six weeks are challenging for anyone: “You’re going to be really irritable, cravings, hangry; just plan on that.” But then something shifts.

I know the first six weeks were the hardest for me, in part because I had to figure out how to replace that morning granola, lunchtime sandwich, and plate of pasta at dinner. By the end of that six weeks, however, I’d figured out a dozen or so meals that offered me enough variety but kept me within my carb limits.

Typically, that looks like:

  • A two-egg scramble with spinach, mushrooms, bacon, artichoke hearts, and cheese for breakfast (with a week’s worth made up in advance)
  • For lunch, an assortment of cold cuts, cheese, and Whole Foods parmesan crisps along with a piece of celery and peanut butter
  • And for dinner, a little variety: a Caesar salad with a cut-up rotisserie chicken from the grocery store, burrito bowls with Mexican spiced cauliflower rice as the base, steak or salmon with roasted broccoli, or take-out Indian food with (again) cauliflower rice

Going keto meant a fundamental paradigm shift from seeing food as a social and hedonistic experience to treating it as fuel.

At first, I hated laying my trip on an innocent waiter or, even worse, accepting a dinner invitation with the caveat that I might need to bring my own meal or amend the host’s meal plan. Then I realized that when it comes to my friends with similar issues, like a serious food allergy or keeping strict kosher, I never expect them to apologize.

I still enjoy eating: Indeed, part of what makes keto sustainable is that it’s hard to feel deprived when I eat bacon, cheese, (unsweetened) chocolate, and whipped cream every single day. But pleasure is no longer the driver: I now think of food as fuel, first and foremost, and prioritize how it’s going to make me feel in an hour or a day over how it’s going to taste for five minutes.

I may not have to live this way forever. Palmer reports some patients with epilepsy stay seizure-free after they discontinue the diet; it seems like two to five years of keto may permanently change their brains. Perhaps the same will be true for me, and I’ll be able to return to a life of moderate carb eating without adverse effects.

But I’m in no hurry to test that out because I’m reluctant to put those mental health benefits at risk. The daily practice of prioritizing my mental health at every meal is a constant reminder to value my emotional well-being over the convenience of an easy meal.

If my tale of food-induced calm sounds like just what you need to survive the strain of this pandemic, be aware that many people require at least some medical supervision to safely undertake the diet. “The ketogenic diet is a powerful intervention,” Palmer notes.

He advises people to try keto in consultation with a psychiatrist if they have ever been manic, suicidal, psychotic, or hospitalized for a mental health issue. For those who don’t require medical support or who are already following a ketogenic regime, the pressures of the present moment may make it more valuable than ever.

Experiencing keto as self-care is the reason I’ve been able to sustain it so consistently for two years and why I plan to keep on going. At a moment like this, it’s great to have any self-care practice.

Author, Remote Inc: How To Thrive at Work…Wherever You Are. Tech speaker. Writer & data journalist for Wall Street Journal, Harvard Business Review & more.

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