Everything You Need to Know About TMS for Bipolar Disorder

Living with bipolar disorder can often feel like an emotional rollercoaster alternating between intense heights and deeply challenging laws. While many people find relief through medications and therapy, these approaches aren’t always effective or well-tolerated for everyone.

Transcranial Magnetic Stimulation (TMS) is emerging as a compelling treatment option, particularly for the depressive episodes associated with bipolar disorder. FDA-approved for major depressive disorders, TMS is non-invasive, drug-free, and generally well-tolerated making it an exciting option for those seeking alternative care.

In this article, we’ll explore how TMS works, its benefits for bipolar disorder, and what the research says about its effectiveness.

Understanding Bipolar Disorder

Bipolar disorder is a complex mental health condition marked by extreme mood swings from episodes of mania or hypomania to periods of depression. These shifts can be intense and disruptive, affecting relationships, careers, and daily life.

According to the National Institute of Mental Health, about 2.8% of U.S. adults live with bipolar disorder. While it often appears in late adolescence or early adulthood, it can also emerge later in life.

Looking for Bipolar Treatment NJ? HWS Wellness Center offers personalized care options to help manage and stabilize mood episodes with compassion and expertise.

Types of Bipolar Disorder

There are three main types of bipolar disorder:

• Bipolar I: Characterized by at least one full manic episode, often lasting a week or more. Depressive or hypomanic episodes may also occur.

• Bipolar II: Involves at least one hypomanic episode and one major depressive episode. There are no full manic episodes, but depressive episodes can be more frequent and severe.

• Cyclothymia: Involves ongoing mood swings with milder symptoms that don’t meet full criteria for mania or major depression, lasting at least two years in adults (one year in children).

Key Symptoms

Bipolar disorder is typically diagnosed based on patterns of mania, hypomania, and depression.

Mania

• Elevated mood or irritability

• Rapid speech and racing thoughts

• Impulsivity (e.g., reckless spending or risky behaviors)

• Decreased need for sleep

• Inflated self-esteem or delusions of grandeur

Hypomania

Like mania but less severe, hypomania may enhance energy or productivity. Often, others notice the changes before the person experiencing it does.

Depression

• Persistent sadness or hopelessness

• Fatigue and low motivation

• Sleep disturbances

• Appetite and weight changes

• Suicidal thoughts or ideation

The key distinction between bipolar depression and unipolar depression is the presence of manic or hypomanic episodes.

Conventional Treatments for Bipolar Disorder

Treatment typically includes a mix of medications, psychotherapy, and sometimes advanced therapies like Electroconvulsive Therapy (ECT) or Transcranial Magnetic Stimulation (TMS).

Medications

• Mood stabilizers (e.g., lithium, valproate)

• Antipsychotics (e.g., quetiapine, risperidone)

• Antidepressants (used cautiously and often alongside mood stabilizers)

• Combination medications like Symbyax (fluoxetine + olanzapine) for bipolar depression

Only Symbyax, quetiapine, and lurasidone are FDA-approved specifically for bipolar depression.

Electroconvulsive Therapy (ECT)

ECT is reserved for severe cases that don’t respond to medication. It involves brief electrical stimulation to the brain to trigger therapeutic seizures. Though historically misunderstood, ECT is a safe and effective treatment.

What is TMS and How Does it Work?

Transcranial Magnetic Stimulation (TMS) uses magnetic pulses to stimulate specific brain regions involved in mood regulation particularly the left prefrontal cortex. It is:

• Non-invasive

• Medication-free

• Well-tolerated, with minimal side effects

Types of TMS

• Repetitive TMS (rTMS): The most common form, using repeated magnetic pulses over 20–30 minutes.

• Theta Burst Stimulation (TBS): Delivers faster, high-frequency bursts to shorten session time.

• Deep TMS (dTMS): Reaches deeper brain structures for potentially greater efficacy.

• Accelerated TMS (aTMS): Multiple sessions per day, typically over 1–2 weeks.

TMS for Bipolar Depression: What Research Shows

TMS has shown promise in treating bipolar depression, especially in individuals who haven’t responded well to medications.

• A 2019 review found TMS significantly reduced depressive symptoms across multiple studies.

• In a 2020 analysis, 77% of participants saw a 50% or greater improvement in depressive symptoms. Among those who completed 25+ sessions, 41% achieved full remission.

TMS has received FDA Breakthrough Device Designation for bipolar disorder a recognition of its potential and an expedited path toward formal approval.

Benefits of TMS for Bipolar Disorder

• Improved mood and energy

• Better sleep regulation

• Reduced feelings of hopelessness

• Enhanced concentration and decision-making

• Decreased suicidal ideation

What to Expect During TMS Therapy

TMS therapy typically includes 36 sessions over several weeks. Each session lasts around 20–30 minutes. Here's what the process looks like:

1. Initial Consultation & Brain Mapping
   Your provider will identify the optimal brain region and stimulation intensity.

2. Treatment Sessions
   You’ll sit comfortably as a magnetic coil is placed against your scalp. Magnetic pulses stimulate brain activity most people feel only mild tapping or tingling.

3. Post-Treatment
   There’s no downtime you can drive yourself and resume daily activities immediately.

4. Follow-up Plan
   Your response will be monitored, and sessions may be adjusted to suit your needs. Most patients continue their current medications unless advised otherwise.

Potential Side Effects of TMS

TMS is generally safe, with only minor side effects for most individuals:

• Mild headaches or scalp discomfort

• Lightheadedness

• Tingling or twitching sensations

• Fatigue or drowsiness

Seizures are extremely rare but let your provider know if you have a history of neurological issues.

Who Should Avoid TMS?

TMS may not be suitable if you:

• Have epilepsy or a history of seizures

• Are pregnant or breastfeeding

• Have had a brain injury, tumor, or stroke

• Take certain stimulant medications

TMS is also not recommended for people with metal implants in the head or neck, such as:

• Cochlear implants

• Deep brain stimulators

• Aneurysm clips

• Vagus nerve stimulators

• Shrapnel or bullet fragments

Dental work and braces are safe and won’t interfere with treatment.

Explore TMS Therapy at HWS Wellness Center

If you're seeking an alternative or complementary treatment for bipolar disorder, TMS therapy could be a life-changing option. At HWS Wellness Center, we offer TMS in our comfortable New Jersey clinics, supported by a compassionate team of mental health professionals.

To learn more or schedule a consultation, contact us today. Let’s work together to find the right treatment path for you.

Looking for Bipolar Disorder Treatment NJ? HWS Wellness Center provides innovative, non-invasive care options like TMS therapy to support your mental health journey.