Author and advocate Dyane Harwood shares her journey of treating postpartum bipolar disorder with a unique vegan ketogenic, metabolic therapeutic diet.

Dyane Harwood was diagnosed with postpartum bipolar 1 disorder in 2007, seven weeks after the birth of her second child. As a mother of two young daughters, she faced the dual challenges of an under-recognized diagnosis and treatment-resistant bipolar depression.

Although postpartum bipolar disorder is less common than postpartum depression, it still significantly affects many new mothers, especially those with a personal or family history of bipolar disorder.

A freelance writer from Santa Cruz County, California, Harwood captured her struggles with her postpartum mood and anxiety disorder in the 2017 memoir Birth of a New Brain — Healing From Postpartum Bipolar Disorder. The book was endorsed by Kay Redfield Jamison, PhD, a notable clinical psychologist whose work has centered on bipolar disorder.

“I had no idea that bipolar disorder could be triggered by childbirth. I wasn’t the only one — in the early 2000s, there was little awareness of postpartum bipolar disorder among medical professionals, even ob-gyns [obstetrician-gynecologists],” says Harwood.

“Thankfully, postpartum bipolar disorder is now recognized as a legitimate perinatal mood and anxiety disorder. It’s classified in the DSM-5 [The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition] as a bipolar disorder specifier: bipolar, postpartum onset.”

The Intersection of Diet and Mental Health

Today, after much research into metabolic psychiatry and personal experience, Harwood has her symptoms under control. And she’s spreading the word to help others with mental health challenges.

Metabolic psychiatry, as detailed by Stanford Medicine, is an emerging field investigating the potential of ketogenic diets to treat mental illnesses, including bipolar disorder. Researchers from renowned institutions are exploring the benefits of these diets, and their findings have been promising.

The keto diet, known for its high-fat, moderate-protein, and low-carbohydrate regimen — typically reliant on animal products like red meat and eggs — presented a dilemma for Harwood due to her vegan lifestyle.

Adopting a vegan ketogenic diet presents a unique challenge, as it diverges from the traditional keto diet’s reliance on animal fats. This innovative approach requires creativity and planning to fulfill nutritional needs with plant-based sources of essential fats and proteins.

Despite these challenges, Harwood has adeptly navigated this complex dietary landscape.

A Personal Mental Health Revolution

Her passion for this subject led to a significant milestone: Last year, she was invited to speak at the inaugural Ellenhorn Metabolic Psychiatry Conference in Cambridge, Massachusetts. This event gathered trailblazers from various fields, including renowned psychiatrists, mental health experts, nutritionists, and philanthropists.

“I’ve been able to do things I hadn’t been able to do since before my bipolar diagnosis, such as fly across the country, navigate an unfamiliar city alone, and speak in front of a large audience,” she shares. “I’ve been able to face my fears.”

Today, Harwood co-hosts a new podcast, Our Healing Journey With Metabolic Psychiatry, with her friend Michael Belanger. And she’s looking forward to the release of her forthcoming book, Birth of a Keto Brain, which delves deeper into the intersection of diet and mental health.

“Michael isn’t a vegan, so we share our different perspectives in our podcast,” says Harwood. “Our mission is to raise awareness that the ketogenic diet for bipolar disorder — whether it’s omnivore or vegan — isn’t to be taken lightly. And it’s not a fad.”

We recently caught up with Harwood to discuss her experiences with the vegan ketogenic therapy diet and the significant improvements to her mental health she attributes to this regimen.

Editor’s note: This interview has been edited for length and clarity.

bpHope: What were your initial thoughts about a vegan keto diet?
Dyane Harwood: I’d always associated the word “keto” with trendy. I thought it was a fad and a waste of time. I was a certified personal trainer in my twenties, so I’ve always been interested in fitness. However, I never purported to be a diet expert because my diet has always been really unhealthy. It has been basically chocolate! I also always associated keto with meat, so I didn’t know you could be on this diet as a vegan. One day, I Googled “keto” because I couldn’t lose excess weight, and that’s how I stumbled upon “vegan keto.” And it just went from there. I wound up losing 50 pounds — too quickly, but I was super stoked!

BPH: How long have you been a vegan?
DH: I’m 53 now, and I’ve been doing it for about six years, so I’m a late-in-life vegan. I was recuperating from a broken jaw when I watched a documentary on Netflix called What the Health. Two hours after watching it, I became a vegan. It was unexpected and unwanted, and it just happened very quickly.

BPH: Talk about the association between keto and bipolar disorder.
DH: A randomized control trial is in the works. Iain Campbell, PhD’s pilot study was published in the British Journal of Psychiatry, showing that nutritional ketosis [a metabolic state where the body is fueled mainly by fats and ketones] can improve bipolar symptoms. He presented at the last International Society for Bipolar Disorders conference in Chicago with Shebani Sethi, MD, and made an impression on many skeptical psychiatrists. There’s now a surge of ketogenic diet for bipolar studies underway worldwide.

BPH: How has this way of eating affected your bipolar symptoms?
DH: For me, I was stable when I started keto — it was hard-won stability — but I used to have crushing fatigue and needed a nap every day at 2 p.m. When I started keto, I no longer had to do that, and I no longer devoured a pint of ice cream every night. I was able to go out and take walks again. I stayed on my medications and am still on my medications. Some people can taper off while doing this diet, but I’m not doing that until I’m with a psychiatrist who’s experienced with that.

BPH: You like to use the term “ketogenic, metabolic therapeutic diet,” which is different from a regular ketogenic diet. How do they differ?
DH: What I mean by this is being very vigilant about the amount of carbs you have each day and macronutrients — the ratio of fats, carbohydrates, and protein. The apps that are out now are amazing and will calculate how many macronutrients you have each day on a visual pie chart. But it’s about being very careful. It’s about doing your research and being supervised by a professional.

BPH: What does staying under 20 net carbs look like for you?
DH: I have a smoothie in the morning with some MCT oil [medium-chain triglycerides], which is very potent and revs up the ketogenic process. You need a certain amount of fat daily; this liquid is a great way to get it if your gastrointestinal system can handle it. I might have kale at night with a vegan egg scramble, avocado, and olives. I measure foods. Dessert could be almond butter with cacao nibs, some chocolate chips, and MCT oil. I supplement with vegan forms of vitamin B12, a multivitamin, and omega-3 fatty acids. My vegan smoothie protein powder contains nine key amino acids.

BPH: Where’s a good starting place to learn more about diet and bipolar disorder?
DH: The No. 1 resource for anyone remotely considering doing this is Metabolic Mind on YouTube. It’s a very in-depth, extensive series that explains keto for mental health and bipolar, how to talk to your doctor about it, and everything you could possibly know about this. You also hear from people with lived experience. It’s just a gold mine.

There’s a great book called Brain Energy by Chris Palmer, MD, that explains the science of metabolic psychiatry. I like the vegan keto cookbook [Plant Forward Keto] by Liz MacDowell, with easy recipes. There are also keto tracker apps with recipes perfect for those who don’t know what they’re doing.

BPH: Why do you advise against rushing into a ketogenic diet?
DH: It is incredibly powerful. That’s a strength and also a weakness because it can cause hypomania right away. I had a little bit of that. I don’t think researchers know exactly why yet, but reducing the amount of net carbs you have every day does something to your brain. For most people, the hypomania seems to go away on its own, but you have to be mindful of it and have the people who are close to you be on the lookout just in case.

It can be a slippery slope because for many people, like with what happened to me, their mood increases. They’re happier. They’re not necessarily hypomanic, but with bipolar, that’s always something to be very concerned about because you don’t ever know what it really is until some time passes. The best thing to do is to run it by your psychiatrist — which I did, but he didn’t know anything about keto and mental health. He told me it sounded like the Mediterranean diet, which was good with him. As psychiatrists learn about the ketogenic diet, they can create a plan with their patients in case hypomania doesn’t subside.

BPH: What tips would you give to make starting a ketogenic diet easier for beginners?
DH: When you follow a well-formulated, vegan ketogenic diet, you aim for a certain range of ketone numbers in your blood, and you need to monitor that. Some people use urine strips, but that’s the least accurate method. There are also blood and breath monitors. This is a huge piece of the puzzle.

BPH: Have you experienced any side effects?
DH: At the beginning, aside from the hypomania, I was super thirsty all the time. You do have to make sure you have enough electrolytes, such as sodium, potassium, magnesium, and calcium. And not a lot of people talk about this one — my body odor was disgusting. But in a way, I was like, “Yay, this means something is happening!”

BPH: Despite detractors on social media, why do you remain committed to this lifestyle?
DH: When you combine “vegan” and “the ketogenic diet for bipolar” online, you really are swimming against the tide. I constantly encounter people who say what I’m doing is unhealthy or dangerous. But I feel healthy. I’m passionate about this stuff; no one can take that away from me.

Editorial Sources and Fact-Checking

• Metabolic Psychiatry Clinic. Stanford Medicine Department of Psychiatry and Behavioral Sciences.
• Campbell IH et al. Pilot Study of Ketogenic Diet in Bipolar Disorder. British Journal of Psychiatry Open. October 10, 2023.

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