Client was referred by a psychiatrist and on medication upon presentation. Client experienced intense feelings of irritability and impatience and reported feeling overwhelmed very easily and would avoid seeking out new experiences. Functioning was low in that client did not work to avoid negative feelings and encounters in a work setting. Client was essentially isolated except for an occasional outing with a single friend and online interactions. Some improvement occurred using mindfulness and behavior therapy on avoidance targets. We discussed nutrition and the ketogenic diet as a mental health intervention along with some supplementation and sleep hygiene protocols.  After the adaptation phase client stayed on their medication but reported feeling significantly less overwhelmed and began to branch out to new experiences including new friendships, social interactions and began working again. Client reported being additionally delighted with the weight she lost in the process.   – Middle-age, female; bipolar disorder