As 2025 comes to a close, I want to pause and reflect—not just on how much work has been done, but on what it represents.
For decades, we’ve approached mental illness largely as a disorder of neurotransmitters, psychology, or social context. Those perspectives matter—but they haven’t been enough. Rates of depression, anxiety, bipolar disorder, ADHD, and suicide continue to rise, despite enormous investment in treatment and prevention strategies.
This year brought meaningful progress toward a more complete framework—one that treats mental illness as a systemic, whole-person condition and opens the door to new, testable, and genuinely hopeful interventions.
Advancing the Science
2025 brought important advances in how we understand the biology of mental illness. A landmark Nature genetics study examining 14 major neuropsychiatric disorders again found substantial shared genetic risk across diagnoses—supporting the idea that these conditions are biologically more similar than different, often described as a general psychopathology or “p-factor.” Rather than distinct disease-specific mechanisms, the findings point toward common underlying vulnerabilities.
Converging genetic, cellular, and systems-level research increasingly implicates energy metabolism, mitochondrial function, and cellular stress pathways as upstream contributors to brain dysfunction. Together, these discoveries help explain why psychiatric disorders are highly comorbid, overlap with metabolic illness, and often respond incompletely to symptom-based treatments.
Taken together, these findings reflect a meaningful shift: metabolism is no longer a fringe consideration in psychiatry, but an increasingly rigorous and unifying area of investigation.
Several important research milestones for ketogenic therapies were also reached this year, thanks in large part to the generous funding and leadership of the Baszucki Group:
- A clinical trial of ketogenic therapy for depression in college students was published, addressing one of the most common and disabling psychiatric conditions worldwide.
- A systematic review and meta-analysis of ketogenic interventions for depression and anxiety was published in JAMA Psychiatry, helping bring metabolic therapies into mainstream scientific discourse.
- Two randomized controlled trials of ketogenic therapy for schizophrenia were completed, representing a much higher standard of evidence. Results are not yet published but are expected in 2026.
Supported by a $3 million gift from Mr. Lew Sanders, I continue to direct McLean Hospital’s Metabolic & Mental Health Program, where we expanded our research efforts to include nine active projects examining the role of metabolism and mitochondria in neuropsychiatric disorders across cell models, animal models, and human studies. Key initiatives include investigating autoantibodies that may impair nutrient transport into the brain in people with schizophrenia; studying microplastics in the human brain and their potential role in brain metabolism and neuropsychiatric illness; examining metabolic and mitochondrial mechanisms in stress-based mouse models; and exploring ketogenic and other novel therapies that act through mitochondrial pathways.
From Theory to Care
This year also marked an important transition from theory to real-world clinical practice.
Along with an extraordinary team of more than 20 clinicians and staff, I launched MH² (Mental Health & Metabolic Health) in Wellesley, Massachusetts. Our goal is to provide comprehensive, evidence-based mental health care fully integrated with metabolic health care and lifestyle medicine—treating the whole person. In less than six months, we’ve already worked with more than 100 individuals, many of whom traveled from across the country—and the world—to receive care. We’ve expanded our reach and can now work via telehealth with people in Massachusetts, Florida, Vermont, and Rhode Island.
Building a Broader Movement
Scientific progress doesn’t happen in isolation. This year saw growing collaboration across disciplines and sectors:
- I continued to speak at conferences around the world on brain energy, metabolism, mental health, and ketogenic therapies.
- The Baszucki Group launched the Coalition for Metabolic Health with a $50 million gift, bringing together clinicians, researchers, advocates, and organizations committed to advancing metabolic approaches to chronic disease—including mental illness.
- My own partnerships expanded with nonprofits, educators, and researchers who recognize that today’s mental health crisis requires new models of care, not just new medications.
Looking Ahead
The most important lesson of this year is not that we’ve found all the answers—but that better questions are finally being asked:
- What if treatment-resistant mental illness isn’t truly resistant, but simply hasn’t been treated with the right approaches?
- What if remission and meaningful recovery require improving physical and mental health together, rather than suppressing symptoms alone?
- What if the prevention of serious mental illness is possible, using biomarkers that already exist today?
These questions now have scientific traction—and that matters.
Thank you to everyone who has read, questioned, critiqued, shared, and supported this work. Progress in medicine is slow—until it isn’t. This year felt like momentum.
I’m looking forward to an even more vibrant year ahead.
— Christopher M. Palmer, MD
Dr. Christopher Palmer is a Harvard psychiatrist and researcher working at the interface of metabolism and mental health. He is the Founder and Director of the Metabolic and Mental Health Program and the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School. For almost 30 years, he has held administrative, educational, research, and clinical roles in psychiatry at McLean and Harvard. He has been pioneering the use of the medical ketogenic diet in the treatment of psychiatric disorders—conducting research in this area, treating patients, writing, and speaking around the world on this topic. Most recently, he has proposed that mental disorders can be understood as metabolic disorders affecting the brain, which has received widespread recognition in both national and international media outlets.
