"I noticed within a day or two the marked difference in my head," she recalled. "It felt clear for the first time in years and years."
That may seem like a surprisingly quick turnaround, but Jacka said it is not out of the question. "We know from animal studies and a human study that a poor diet can impair memory and attention within a week," she said.
The woman no longer takes the medication prescribed to treat her bipolar disorder, and she said she has remained stable for the past three years. She said she has sought out psychiatric and neurological researchers across the country, hoping to share her experience and to learn what they know, but has found little interest and few studies.
"It surprised me how little information was out there, because for me it was life-changing," she said. "I wanted to validate the experience I was having, and to make sure that everything I was doing was safe. That's how I found Dr. El-Mallakh."
El-Mallakh had hypothesized in 2001 that a ketogenic diet — a high-fat, moderate-protein and low-carbohydrate diet often used to control epileptic seizures and nearly identical to the diet adopted by the 32-year-old woman — could be helpful for bipolar disorder, because many of the medications that work for bipolar disorder have anti-seizure properties.
After being contacted by the woman, El-Mallakh found several other people with bipolar disorder who said they were benefiting from a ketogenic diet. Last year, he published two case studies of its apparent effectiveness. His report drew interest from people with the mental illness, but efforts at Stanford University to test the diet with a controlled trial failed to recruit enough participants.
Without such studies, El-Mallakh acknowledged that no one can say how the diet might quell the symptoms of bipolar disorder. With his own patients, he recommends it only alongside mood-stabilizing medications. Despite his own willingness to supplement mental health treatment with dietary changes, El-Mallakh remains skeptical that diet alone can heal the mind.