TMS Therapy for Bipolar Disorder

Bipolar disorder can deeply affect a person’s ability to maintain relationships, work consistently, manage emotions, and sustain a stable daily routine. For many, the depressive episodes are especially debilitating, marked by fatigue, hopelessness, disrupted sleep, and loss of motivation. These symptoms often persist even with mood stabilizers and antidepressants, leaving individuals searching for additional options.

At NeuroHealth Treatment Centers, Transcranial Magnetic Stimulation (TMS) is offered as a non-invasive therapy to help reduce depressive symptoms and support mood stabilization in individuals living with bipolar disorder. TMS uses targeted magnetic pulses to stimulate brain regions involved in mood regulation, without the systemic side effects associated with many medications.

TMS Treatment for Bipolar Disorders

Bipolar disorder is a complex mood condition that can involve episodes of depression, mania, hypomania, or rapid mood fluctuations. For many individuals, managing bipolar disorder requires a multimodal approach that extends beyond medication alone.

At NeuroHealth Treatment Centers, Transcranial Magnetic Stimulation (TMS) is used as a non-invasive treatment option to help stabilize mood, reduce depressive symptoms, and support long-term recovery.

TMS delivers focused magnetic pulses to areas of the brain involved in mood regulation. It is well-tolerated, does not require anesthesia, and does not interfere with daily activities. Patients typically receive treatment in a series of sessions over several weeks, with each session lasting less than 30 minutes.

We offer TMS as part of an individualized care plan tailored to each patient’s bipolar subtype and clinical history.

Bipolar I Disorder

Bipolar I disorder is diagnosed when a person has experienced at least one manic episode, which may be preceded or followed by depressive episodes. Manic episodes involve elevated mood, increased activity, or irritability lasting at least one week and often require hospitalization.

The manic phase can be highly disruptive, leading to impulsive behavior, strained relationships, financial or legal trouble, and loss of insight. However, the depressive episodes that follow are often longer-lasting and can be more functionally impairing.

Common symptoms of bipolar I depression include:

• Persistent sadness or hopelessness
• Fatigue or lack of energy
• Sleep disturbances (insomnia or hypersomnia)
• Difficulty concentrating
• Loss of interest in daily activities
• Thoughts of death or suicide

TMS is used to target depressive symptoms between or following manic episodes. In supervised clinical settings, TMS has shown promising results in reducing depression severity without triggering mania. It is most effective when integrated into a broader treatment plan that includes mood stabilizers and psychiatric oversight.

Bipolar II Disorder

Bipolar II disorder is characterized by recurrent depressive episodes and at least one hypomanic episode. Hypomania is a milder form of mania that does not include psychosis or require hospitalization.

Bipolar II is often underdiagnosed or misdiagnosed as unipolar depression. The depressive phases are typically more chronic and impairing than the hypomanic episodes, making it difficult for individuals to function consistently in their personal and professional lives.

Common symptoms of bipolar II depression include:

• Low self-esteem or worthlessness
• Loss of interest or pleasure (anhedonia)
• Psychomotor slowing or agitation
• Social withdrawal
• Fatigue or indecisiveness
• Feelings of guilt or shame

For individuals with persistent depressive episodes that don’t respond to standard medication, TMS can offer a well-tolerated alternative. Clinical studies, including meta-analyses, have shown that repetitive TMS (rTMS) is effective in alleviating depressive symptoms in bipolar II, with no significant increase in manic switching.

Cyclothymic Disorder

Cyclothymic disorder is a chronic, milder form of bipolar disorder involving frequent mood fluctuations between hypomanic and subclinical depressive symptoms over a period of at least two years (one year in youth). Although individual symptoms may not meet the full criteria for mania or major depression, the chronic instability in mood can disrupt sleep, interpersonal functioning, work performance, and overall emotional regulation. Many patients experience these ups and downs as unpredictable and exhausting.

Common symptoms of cyclothymic disorder include:

• Periods of elevated energy alternating with low motivation
• Chronic irritability or agitation
• Trouble sleeping or irregular sleep cycles
• Difficulty maintaining stable routines or commitments
• Emotional sensitivity and impulsivity

TMS may help reduce the frequency and severity of depressive lows and improve emotional stability. While research on TMS in cyclothymia is limited, clinical experience suggests benefits when used as part of a comprehensive care plan for patients with mood instability and treatment-resistant depressive symptoms.

Rapid Cycling Bipolar Disorder

Rapid cycling refers to the occurrence of four or more mood episodes (depressive, manic, hypomanic, or mixed) in a 12-month period. This specifier can apply to either bipolar I or II diagnoses.

Rapid cycling is associated with a more difficult course of illness, higher rates of treatment resistance, and increased suicide risk. The fast pace of mood changes can prevent individuals from regaining emotional stability, leading to functional decline and frequent hospitalizations.

Common symptoms of rapid cycling bipolar disorder include:

• Abrupt mood shifts within days or weeks
• Cycles of severe depression and irritability
• Periods of overactivity, followed by emotional collapse
• Cognitive fatigue and disrupted sleep
• Poor response to medications or frequent medication adjustments

TMS may help manage the depressive phases in rapid cycling patients and improve overall stability. In select cases, it has reduced the burden of depressive symptoms without exacerbating cycling patterns. Because of the complexity of this subtype, close clinical monitoring and individualized planning are essential.

Great practice! First impression means a lot and my first point of contact was with Anthony. He seems to do everything there and he’s great at his job. I wasn’t really sure what I was doing and Anthony walked me through the process. This made me feel great going into my meeting with the doctor. The Doctor asked all the right questions and his ideas and the prescription he offered was a game changer. Highly recommended!

– Doug R.

What Is TMS Therapy for Bipolar Disorder?

Bipolar disorder is traditionally treated with mood stabilizers, antipsychotics, and psychotherapy. Unfortunately, many patients continue to experience lingering symptoms, especially during depressive episodes.

Transcranial Magnetic Stimulation (TMS) offers a non-medication-based option to help alleviate bipolar depression and improve overall emotional regulation. It is not intended to replace comprehensive psychiatric care, but rather to enhance treatment outcomes for those who have not found sufficient relief through medication alone.

TMS may be considered for individuals with:

• Persistent depressive symptoms despite pharmacologic treatment
• Difficulty tolerating medication side effects
• A desire to explore non-invasive treatment options
• A history of mood stabilization with clinical oversight

At NeuroHealth Treatment Centers, we use TMS alongside psychiatric evaluation, medication management, and therapeutic support to offer a comprehensive, patient-centered approach. Treatment protocols are adjusted based on the specific bipolar subtype and current phase of illness.

Side Effects and Safety of TMS Therapy

TMS is generally well-tolerated and considered a safe intervention for individuals with mood disorders, including those on the bipolar spectrum. Unlike medications, TMS does not circulate through the bloodstream or affect other organ systems, which means it typically avoids many of the side effects associated with antidepressants, antipsychotics, or mood stabilizers.

Common side effects of TMS may include:

• Mild to moderate scalp discomfort at the treatment site
• Headache during or after sessions
• Temporary facial muscle twitching during stimulation
• Lightheadedness or fatigue, particularly during early sessions

These effects are usually transient and resolve shortly after treatment. Most patients are able to return to their normal activities immediately following each session.

While uncommon, some individuals with bipolar disorder may experience emerging symptoms of hypomania or agitation. At NeuroHealth Treatment Centers, we mitigate this risk through close clinical monitoring and by integrating TMS within a broader mood stabilization strategy.

A Comprehensive Approach to Bipolar Depression

Bipolar disorder presents in many forms (bipolar I, bipolar II, cyclothymic disorder, and rapid cycling), each with its own diagnostic features and challenges. For many individuals, depressive symptoms remain the most persistent and functionally impairing aspect of the illness, even when medications and therapy are in place.

NeuroHealth Treatment Centers recognize that there is no one-size-fits-all solution to bipolar disorder. That’s why each TMS treatment plan is tailored to the individual, accounting for their specific diagnosis, current symptoms, treatment history, and therapeutic goals. Whether you’re facing ongoing depressive episodes, frequent cycling, or long-standing mood instability, our team is here to help guide your next step forward.

Contact NeuroHealth Treatment Centers or call 954-417-7575 to schedule a FREE consultation and learn whether TMS therapy is right for you or a loved one living with bipolar disorder.