In 2016, Matt Baszucki was a freshman in college and taking engineering classes when he began experiencing manic symptoms.
“It was like sleeping less and less, having grandiose thoughts, rapid speech,” Matt Baszucki, 27, told NBC’s Kate Snow in a segment aired Feb. 21. “Going, going, going, spending, talking fast, not sleeping, doing all this wild impulsive behavior.”
Soon after, doctors diagnosed Baszucki with bipolar disorder, and he was hospitalized. Over the next eight years, he took 29 different medications, visited 40 doctors and was eventually told his condition was treatment-resistant.
He and his family didn’t want to accept this, and they began looking for experts who help people with treatment-resistant forms of mental illness. They found Dr. Christopher Palmer at Harvard Medical School, who had an unusual suggestion to mange Matt Baszucki’s bipolar disorder: eating a ketogenic diet. After three years on the diet, Baszucki feels better.
“It was so shocking. I almost couldn’t believe it,” mom Jan Baszucki, president of the Baszucki group, which invests in research relating to metabolism, mental health and more, told Snow. “I kept saying to my husband, could this really be keto?”
Life with bipolar disorder
While Matt Baszucki experienced stress and anxiety around school, he didn’t really show any signs of bipolar disorder until he was a student at the University of California, Berkeley. His parents noticed their son seemed different after a weekend home. Then he dropped a class. Then they didn’t hear from him for a few days.
“His behavior was completely different from anything we’d ever encountered. It was hard to know. Well maybe … he’s 19, he’s changing. He’s growing,” Jan Baszucki said. “I Googled his symptoms, and it said, ‘Oh manic episode.’”
By March 2016, Matt Baszucki was in a psychiatric ward in the hospital, where he stayed for two weeks. Doctors diagnosed him with bipolar disorder and prescribed him medication. But he didn’t take it.
“I refused the meds,” he said. “That was a trend that would plague me for the next couple of years.”
His unwillingness to reliably take medications contributed to worsening symptoms, and at one point, he was hospitalized again and was forced to take medication.
“I was so manic. I was so psychotic,” Matt Baszucki said. “I couldn’t even form a coherent understanding of what was going on with me.”
Jan Baszucki and her husband, David Baszucki, CEO and founder of Roblox, knew their son was struggling. For two years, they watched as he went in and out of hospitals and refused to take medication. After those two years, though, Matt Baszucki began to understand how ill he was.
“He didn’t get well,” Jan Baszucki said. “He got a little more stable.”
The next several years remained challenging as Matt Baszucki tried various medications, most of which didn’t work. Eventually, doctors determined he had treatment resistant bipolar disorder.
“You can’t even imagine what it’s like to be told your child has a treatment resistant form of one of the most serious mental illnesses and that this is going to be a lifelong battle,” Jan Baszucki said. “We thought he was going to be impaired for the rest of his life.”
Frustrated, Jan Baszucki began looking for experts in treatment-resistant mental illness.
“(We got) advice that we should work on acceptance ... that this was going to be his life and that ... our job as parents is to work on acceptance,” she said. “I was like, ‘No, we’re not going to accept this.’”
Someone the family knew introduced them to Palmer at Harvard at first because they were investing in mental health research. Around the same time, Matt Baszucki was making lifestyle changes, such as tracking his sleep and not drinking alcohol. Palmer suggested that Matt Baszucki try a ketogenic diet with exercise and medication.
“I was like, if this is a diet that is specifically designed or can be applied to this illness to stabilize my mood, then I’m ready,” he recalled. “I was taking all the medications as prescribed. I was doing therapy, basically everything that you can imagine in a 21st century mental health program designed by the establishment. I was doing it well. And I was still sick.”
Bipolar disorder and keto
Bipolar disorder is a mental illness characterized by changing moods, energy and concentration, according to the National Institute of Mental Health. People with bipolar disorder often fluctuate between manic periods, where they feel intensely energetic, and depression. Treatment usually includes medications and talk therapy. The exact cause isn't known.
Palmer works in Massachusetts at McLean Hospital, a psychiatric facility, and Harvard Medical School, specifically with patients who have treatment-resistant mental illness.
“I see the patients that other psychiatrists don’t want to treat because they’re too difficult,” he told Kate Snow.
Matt Baszucki fit that description.
“(The) medications weren’t working, his illness was severe and ... unlikely to get better,” Palmer said.
Palmer's approach is different, and he thinks of mental illness unconventionally.
“My understanding is that ... metabolism affects the way the brain works,” he explained. “The science is ridiculously complex. I don’t mean to say that it’s an easy problem to understand.”
While people might think of keto as simply a low-carb diet, it has been used historically to treat people with epilepsy.
“People (on keto) are eating very low carbohydrates, usually less than 20 grams a day," Palmer explained. "They’re eating a moderate amount of protein, and that gets determined by either a dietitian, nutritionist or the clinical treatment team, and they eat a lot of fat.”
Prescribing diet to treat mental illness isn’t usually part of the standard of care, and Palmer acknowledged that there are detractors to his approach.
“When I talk about using the ketogenic diet as a treatment for a serious, crippling mental disorder, people think that I’m a snake oil salesman,” he said.
Still, he believes there is a role for keto in helping people with mental illness.
“The ketogenic diet is an evidence-based treatment for weight loss, Type 2 diabetes and epilepsy. And there are clinicians and dietitians who know how to use this in a safe and effective way,” he said.
“The ketogenic diet can actually change neurotransmitters in the brain,” Palmer continued. “It can reduce brain inflammation, it can change gene expression, it actually changes the gut microbiome in beneficial ways that affect the brain. Everybody’s heard of the gut-brain connection, and those mechanisms are increasingly understood.”
Critics of the keto diet point to a lack of research and risks, such as nutrient deficiencies, heart disease and low blood pressure. Palmer stressed that he only uses this intervention for people who haven't responded to medication and that he would not recommend it to everyone.
Palmer added there are risks to a keto diet specifically. For example, many people who try it experience something called “keto flu,” where people feel sick when at first.
“I have seen their conditions get worse during this period of time,” Palmer said. “This adaptation period can, in fact, be dangerous, and that is one of the reasons I strongly recommend that people work with mental health clinicians if they’re going to try this.”
When Matt Baszucki switched to a keto diet in January 2021, his symptoms worsened at first. But if he made it through March — the time of year in the past when his symptoms were worst and he was often hospitalized — the family would know it made a difference.
“His family had said, ‘We won’t know if this diet’s working until we get through March Madness. If we can get through March Madness without a hospitalization, then we will know this is a real thing,’” Palmer explained. “Sure enough, he got through March without a hospitalization, without an episode.”
Matt Baszucki continued taking his medications while changing his diet. About six months after starting keto, Palmer noticed Matt Baszucki needed fewer pharmaceuticals to manage his symptoms.
“Matt has progressively reduced his medications,” Palmer said.
‘It was all worth it’
Come March 2021, Matt Baszucki kept looking for the telltale signs of mania. Yet, he had none.
“I had no symptoms. Zero,” he said. “It was night and day when I started the diet that year. Blatantly obvious.”
His parents also felt surprised.
“It was shocking to us,” Jan Baszucki said.
When he first started the diet, Matt Baszucki struggled when going out with friends and watching them enjoy things like pizza and beer. But the positive effects on his mental health keep him motivated.
“I was like, ‘Oh my God, I’m healthy. I’m getting my brain back,'” he said. “It was all worth it.”
After three years on the keto diet, he works as a project manager at Roblox and life feels “very normal.”
“(I) work full time, exercise, hang out with my friends, get good sleep,” Baszucki said. “My brain has been healing. … Having a normal life is unbelievable.”
Palmer said it’s “absolutely not” as simple as the keto diet fixes bipolar disorder or any other mental illness. “But I think the powerful news today is that dietary interventions can, in fact, be a powerful treatment.”
He emphasized the importance working with a mental health clinician if you’re struggling. And if your condition is serious, then ask if dietary changes might benefit you.
Sunny Choo contributed reporting.