Do licensed mental health professionals know that the ketogenic diet can be used to treat mental illness?

I really wanted to know the answer to the question:

Do therapists know you can use keto for mental health?

I didn’t know the answer so I decided I would just ask. I created the following survey on 11/4/21 and collected answers through 11/18/21. After sending hundreds of survey invitations, most of which were new connections, I received 130 completed responses.

I had a good return rate! I believe this was because I made it short and I didn’t collect any additional information about the people filling it out. I did this because I really wanted to increase the likelihood of participation. So I made a single-question survey using Survey Monkey that took participants about 16 seconds on average to complete.

I then used my LinkedIn connections to send it out to licensed mental health professionals such as Psychiatrists (MD), Psychologists (PhD & PsyD), Licensed Social Workers (LSW), Licensed Mental Health Counselors (LMHC), Licensed Professional Counselors (LPC), and Licensed Marriage and Family Therapists (LMFT).

The majority of the people I sent the survey to were practicing in Washington and Oregon. The people in Washington were mostly from the Vancouver and Greater Seattle Areas and the people in Oregon were primarily from Portland but also smaller areas. There may have been just a few from various places all over the US, but definitely not many. I made sure to not share the survey with people that I know already use ketogenic diets or nutritional therapies as part of their practices. I also shared the survey in Facebook groups of licensed mental health professionals in both Washington and Oregon.

Here was my question:

What is your current state of knowledge regarding the use of a ketogenic diet as a treatment for mental illness?

I then gave them three responses to choose from in the form of a drop-down menu that included:

I am not aware that a ketogenic diet can be used to treat mental illness

I am somewhat aware that it is used for that there is a research base to support it

I am very aware of the use of ketogenic diets as either primary or adjunctive treatment for mental illness

And here were the results of the survey, asking if various licensed mental health professionals even know about the ketogenic diet as an option in the treatment of mental illness.

This broke down to the following percents:

Yes, I see the typo I made in response number two! Darnit.

I was pleasantly surprised to see that many were beginning to be aware that ketogenic diets are being used and that there is a research base to support it. To be honest, I was expecting that answer to be endorsed less often.

But 70% of licensed mental health professionals were unaware it was even an option. It shows that we have a long ways to go in helping licensed mental health professionals understand that it is a viable option and why.

Why does it matter if licensed mental health professionals do not know about ketogenic diets?

Because our roles as therapists are very powerful in the journies that our clients take to treat mental illness. We may have a client that comes to us saying, “Hey, I think I might want to explore using a ketogenic diet for my depression.” or “I heard keto might help my anxiety, have you heard anything about it?”

And when that happens, our response needs to be measured and based on science.

If a therapist responds with general information that they may have seen on a website they may accidentally provide misinformation. If the therapist thinks ketogenic diets are only about weight loss they may assume the client is having body image issues. They may discourage the use of a “diet” when body image may not be the clients’ primary motivation.

An uninformed therapist may provide misinformation that it is somehow dangerous based on their own incomplete or personally biased understanding of the literature. This may discourage a client from potentially trying a treatment that may have successfully alleviated their symptoms.

An uninformed therapist may inadvertently discourage a client who would have used it as a complementary treatment to the psychotherapy they were already willing to engage in. Working with their prescriber a client could have used it to possibly need less medication. Or they could have used it in place of medication, if appropriate.

We don’t get very much training in nutrition, biochemistry, neurology, and metabolism as mental health practitioners. Sure, the psychiatrists get much more of those things but may also be lacking in the nutritional biochemistry component. We get neurology, especially if we are in programs learning neurological testing and we get basic understandings in neurobiology. But the intersection of nutritional therapies or dietary therapy in the treatment of mental illness is not part of our education. The intersection between what is happening in the body and what is happening in the mind is not a bridge that was adequately always explained.

I don’t know too many hard-working psychotherapists who have time to understand all the underlying mechanisms of how nutritional therapies and ketogenic diets in particular work. But I do think that therapists, who work with the mind-body connection, are some of the most open people when it comes to accepting that there are many ways to heal and many ways to complement psychotherapy. We all have clients who are not responding well to medications, or whose medications have stopped working well. We all have clients that are searching, and we all know we are an important presence during this search.

It is my sincere hope that we have open discussions as practitioners with one another about what we have seen work. That as research continues to accumulate for different diagnoses and populations and the use of ketogenic diets and other nutritional therapies, that we will excitedly share and debate these findings. As our understanding increases with additional research, it will help us address the need for lifestyle changes that improve the whole health of the whole individual sitting in front of us.

Our roles as healers need not be limited by conceptual fallacies that divorce what is going on in the brain from what is occurring in the body. We know that such a stance, is in fact, no longer supported by the literature.

If you are a licensed mental health practitioner, and reading this blog post, please feel free to comment below. I am curious to know your questions, concerns, preconceived notions, experiences, hesitations, and overall general attitude about patients’ use of a ketogenic diet to help treat the symptoms of mental illness.

Were you a survey responder? Are you surprised by the results, or are they generally what you would have expected? Had you ever heard of using ketogenic diets for mental health? What type of continuing education would you need to receive to feel comfortable with a client bringing up the ketogenic diet as a possible treatment? What kind of continuing education would you need to feel confident to suggest ketogenic diets or other nutritional therapies as a possible option for a client to improve their mental health or neurological condition?

Let’s do what we therapists do best. Communicate and learn from one another!

If you are a mental health seeker reading this post, you may want to read any of the following:

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