Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-approved treatment for certain mental health conditions, particularly major depressive disorder. It is considered one of the few effective, non-invasive, non-pharmaceutical treatments for major depression – potentially effective at addressing even difficult to treat depression.
Bipolar disorder is also a form of depression and, while it can be treated, it can be resistant at times. That can cause people to wonder if perhaps TMS therapy might be another possible effective way for
However, its use in bipolar disorder is less commonly discussed, raising questions about its effectiveness for this condition. While TMS has not yet achieved widespread approval as a standard treatment for bipolar disorder, research has explored its potential benefits, with promising results in some cases.
How TMS Works
TMS uses magnetic fields to stimulate specific areas of the brain, particularly the prefrontal cortex, which is associated with mood regulation. By modulating neural activity, TMS aims to improve symptoms of depression and, potentially, other mood disorders – possibly like bipolar disorder.
Traditionally, TMS is focused on major depression. But in bipolar disorder, scientists are looking into whether TMS is effective if aimed at areas of the brain linked to depression, as well as also examining its effects on manic symptoms.
TMS sessions are conducted in a clinical setting without the need for anesthesia, making it a less invasive alternative to treatments like electroconvulsive therapy (ECT).
Research on TMS and Bipolar Disorder
Bipolar depression is often more challenging to treat than unipolar depression due to the risk of triggering manic episodes with conventional antidepressants. Several studies have investigated whether TMS can provide relief for depressive episodes in bipolar disorder.
- Positive Outcomes – Studies have shown that TMS can reduce depressive symptoms in individuals with bipolar disorder, particularly those who have not responded to other treatments.
- Safety – Unlike some medications, TMS does not appear to induce manic episodes when used appropriately, making it a potentially safer option for treating bipolar depression.
This would imply that there is a use for TMS for bipolar disorder, although – like most any treatment for depression or bipolar disorder – it would need to be evaluated on case by case basis.
TMS for Mania and Hypomania
Studies do suggest that TMS offers interesting potential for addressing depression from bipolar disorder. But of course, since bipolar disorder is not limited to depression, there is the question of whether or not TMS might help with the mania symptoms of the condition.
Research on TMS for mania is more limited, but preliminary studies suggest that it may help stabilize mood by targeting specific brain regions. Some studies have found improvements in manic symptoms, while others have shown minimal effects, highlighting the need for further research.
TMS could complement other mood-stabilizing treatments, but its effectiveness for mania is less established compared to its use for depression.
When We May Want to Consider TMS
Please keep in mind that we do not make any recommendations on this page. All personalized recommendations must be made by speaking with Dr. Sehdev of Aware Behavioral Health in Dallas, as only Dr. Sehdev can decide what course of treatment is best for you. With that said, some practitioners and psychiatrists do believe that, for individuals with treatment-resistant bipolar disorder, TMS offers a potential alternative to conventional therapies.
One possibility is that TMS may be used alongside medications such as mood stabilizers or antipsychotics to enhance overall treatment effectiveness. Studies suggest that maintenance TMS sessions may help reduce the frequency and severity of depressive episodes over time.
Benefits of TMS for Bipolar Disorder
Every situation is different, and while depression is treatable, everyone’s treatment plan has to be tailored to them. That’s why it is so important to make sure that you speak to someone about whether TMS is right, what other options have been tried, and what alternatives may be available. That said, should TMS benefit someone with depression, some of the benefits would include:
- Non-Systemic Treatment – Unlike medications, TMS does not involve introducing substances into the body, reducing the risk of systemic side effects.
- Customizable Protocols – TMS can be tailored to target specific symptoms or phases of bipolar disorder, such as depression or mood instability.
- Minimal Side Effects – Common side effects, such as mild headaches or scalp discomfort, are generally well-tolerated compared to the side effects of some medications.
Its ability to potentially be effective for those that have treatment resistant bipolar disorder may also be an added benefit, as it allows for the opportunity to provide yet another option for those that haven’t received the help they need.
Limitations of TMS for Bipolar Disorder
Still, we’re still learning and determining if TMS is right for bipolar patients, and there are going to be some limitations. For example:
- Limited Research on Mania – While TMS is relatively well-studied for bipolar depression, its effects on manic symptoms are less understood, requiring further investigation.
- Individual Variability – Not everyone responds to TMS, and its effectiveness can vary based on factors such as the severity of symptoms, brain structure, and concurrent treatments.
- Cost and Accessibility – TMS treatment can be expensive and may not be covered by insurance for bipolar disorder, as it is not yet universally approved for this condition.
While TMS shows promise for treating bipolar disorder, particularly depressive episodes, it is generally considered an adjunctive treatment rather than a first-line option.
Does TMS Work for Bipolar Disorder?
Research indicates that TMS can be effective for bipolar depression, offering relief for some individuals who struggle with treatment-resistant symptoms. Its role in managing manic episodes is less clear, and further studies are needed to fully understand its potential across the bipolar spectrum. For those considering TMS, consulting with a Aware Behavioral Health can help you determine if it is an appropriate option for you.
