TMS therapy for bipolar disorder is being explored as a treatment for depressive episodes that haven’t improved with medication.
Research is still developing, but early studies suggest it may help reduce symptoms in some people with bipolar I or II.
Bipolar depression can be difficult to treat. Even with mood stabilizers and antipsychotics, full recovery isn’t always possible, and side effects can be hard to manage.
There’s growing interest in TMS, especially when standard options fall short. Some patients have added it to their treatment plan after trying several medications and therapies
Let us walk you through what you can expect from TMS therapy for bipolar disorder.
Bipolar depression can be especially tough to treat. Episodes often last longer, come back more often, and don’t always respond to typical medications.
Many people spend far more time depressed than manic, and those lows can deeply affect daily life.
Mood stabilizers and antipsychotics are important, but they don’t always fully relieve symptoms. Some combinations can cause side effects like weight gain, sedation, or cognitive fog, making them hard to stick with.
Antidepressants must be used cautiously due to the risk of triggering mania.
TMS takes a different route. It targets specific brain regions without affecting the whole body’s chemistry.
For people who’ve tried multiple meds without success or can’t handle the side effects, TMS could be a focused, non-drug option worth exploring.
TMS is a non-invasive neuromodulation technique that stimulates targeted brain regions with magnetic pulses.
It has established efficacy for treatment-resistant unipolar depression and is being explored for bipolar depression, especially given the limited pharmacological options and the risk of antidepressant-induced mania in bipolar patients.
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to target brain areas linked to mood.
It’s FDA-approved for major depression and now being studied in people with bipolar disorder who haven’t had success with medications.
Many studies, including one by Goldwaser et al. (2020), show that TMS can ease bipolar depression without triggering mania.
In the Goldwaser study, 77% of patients improved, and 41% achieved remission. People with Bipolar I responded better than those with Bipolar II, but they also had a higher chance of feeling overstimulated. Still, no one developed full-blown mania.
A newer version of TMS called Theta Burst Stimulation (TBS) delivers treatment in just a few minutes.
One case report by Tran et al. (2023) showed that TBS helped a patient feel clearer, calmer, and less depressed, with fewer side effects and shorter sessions.
TMS (Transcranial Magnetic Stimulation) uses focused magnetic pulses to activate specific regions of the brain involved in mood regulation.
Most treatments target the left dorsolateral prefrontal cortex (DLPFC), an area often underactive during depressive episodes. Stimulating this part of the brain can help rebalance activity and support more stable mood patterns.
For people with bipolar depression, the goal is to ease a low mood without triggering mania or agitation. TMS doesn’t involve medication, sedation, or electrical currents.
The pulses don’t enter the bloodstream or affect the entire brain. Each session is done while you're awake, seated in a chair, and typically lasts about 30 minutes.
Because the stimulation is focused and localized, it offers a more targeted approach compared to medications, which affect the whole nervous system and often come with broader side effects.
TMS is generally safe and well tolerated. Most people report only mild side effects like scalp discomfort, muscle twitching, or a brief headache after sessions. These usually ease over time.
In bipolar disorder, the main concern is the risk of triggering a mood shift. While rare, some patients may experience hypomania or agitation.
Careful screening, ongoing monitoring, and keeping mood stabilizers in place help reduce this risk.
When used with the right safeguards, TMS offers a non-invasive option with a strong safety record, even for those with complex mood patterns.
For many, the effects of TMS continue to build after the last session. But since bipolar depression can return, some people benefit from maintenance TMS.
The occasional sessions are spaced out over time to help keep symptoms in check.
Aftercare may also include medication, therapy, or regular check-ins. TMS works best as part of a long-term plan, not a standalone fix.
If you respond well, your provider may suggest a follow-up schedule or symptom tracking to help maintain stability.
TMS isn’t usually the first treatment for bipolar disorder, but it may help if depressive symptoms don’t improve with medication or therapy.
It’s often considered by people with bipolar II or treatment-resistant depression.
Ideal candidates are typically in a depressive phase, stable on mood stabilizers, and struggling with side effects or poor response to meds. A full evaluation helps determine if TMS fits your specific case.
It’s not for everyone, but for some, it becomes the turning point after years of trying other options.
TMS therapy is becoming a promising option for managing bipolar depression, especially when standard treatments haven’t worked well.
It targets brain activity directly without the broad side effects linked to many medications.
Early research and patient experience suggest it may ease depressive symptoms in carefully selected cases.
For those with treatment-resistant depression, TMS could be a practical next step, particularly when supported by experienced care and follow-up.
Our team at Universal Neurological Care provides personalized, evidence-based care for individuals living with bipolar depression.
If standard treatments haven’t brought enough relief, TMS therapy may be the next step worth exploring.
Schedule your consultation online to get started.
TMS uses magnetic pulses while you’re awake and alert. ECT involves electrical stimulation under anesthesia. TMS has fewer side effects and doesn’t cause memory loss.
In most cases, yes. Many people continue mood stabilizers or other prescribed medications throughout treatment. Your provider will guide you.
