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TMS for Bipolar Disorder: How It Works

Bipolar disorder is a mental illness that affects a person’s mood and can cause episodes of depression, mania, or both. While conventional treatments such as medication and psychotherapy are often used to manage bipolar disorder, many people are now turning to an alternative treatment option known as Transcranial Magnetic Stimulation (TMS) therapy.

Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive, non-drug, and FDA-cleared treatment with zero downtime that is safe and effective for a range of conditions affecting mental health and cognition. TMS was FDA-cleared for major depressive disorder in 2008, for migraine in 2013, for OCD in 2018, and for cigarette cessation in 2019. Although TMS has not yet been FDA-approved for the treatment of bipolar disorder, research has indicated TMS as an effective “off-label” treatment for bipolar depression, anxiety, and cognitive impairment.

TMS for Bipolar Disorder: Is it Effective?

There is no cure for bipolar disorder, but its symptoms are treatable with TMS therapy. TMS uses magnetic pulses to target brain structures affected by bipolar disorder. Specifically, TMS stimulates the prefrontal cortex of the brain to increase neuronal activity and stabilize mood. As a result, symptoms of bipolar disorder may become more controllable.

Why TMS for Bipolar works Better than Traditional Treatments

Bipolar Disorder sometimes referred to as manic depression, is a psychiatric condition that is characterized by extreme mood swings from emotional highs (manic or hypomanic) to lows (depression). These episodes may last for weeks or months if untreated, and can greatly impact patients’ relationships, work or school performance, and quality of life. About 5.7 million Americans or 2.6 percent of the population age 18 and older have the disorder.

Conventionally bipolar disorder is managed by a cocktail of drug therapies, including antidepressants and mood-stabilizing medications. However, there is an ongoing clinical debate regarding the effectiveness of these treatments. Recent studies suggest that antidepressant medications may even exacerbate the intensity and frequency of manic episodes. This is not to mention the potential side effects caused by these drugs, including nausea, fatigue, weight gain, cognitive impairment, and sexual dysfunction.

By contrast, TMS offers a safe and non-invasive alternative treatment that can be used to replace or augment conventional drug therapies. The therapy stimulates the prefrontal cortex of the brain, causing increased activation of the neuronal circuitry related to the disorder. While TMS therapy for Bipolar Disorder is only part way through the long regulatory process of getting FDA-approval, the treatment has been demonstrated to be effective both in a clinical setting and in placebo-controlled studies. For example, a recent double-blinded Brainsway study achieved a 70% response rate.

How Does TMS Help Treat Bipolar Disorder

Transcranial magnetic stimulation (TMS) uses gentle magnetic pulses to stimulate specific areas of the brain responsible for mood. TMS is non-invasive (does not require surgery), non-systemic (does not affect the entire body), and well-tolerated. TMS therapy can be used alone or in conjunction with talk therapy and medication.

During TMS treatment, patients recline in a treatment chair and remain awake and alert. A TMS magnet is positioned over the patient’s head to deliver gentle pulses to specific areas of the brain. Patients report that the pulses feel like taps on the head. Each treatment session lasts about 20 minutes, after which patients can immediately return back to their daily routines.

There are several potential benefits of using TMS for treating bipolar disorder. Not only does it offer relief from depressive episodes but there are also some indications that it may reduce mania symptoms as well. Additionally, due to its non-invasive nature, there are fewer side effects than other therapies such as electroconvulsive therapy (ECT).

TMS is well tolerated. There are little to no side effects of TMS therapy. Sometimes patients experience mild scalp discomfort or mild headache during treatment.

How Fast Does TMS for Bipolar Disorder Work?

Some people with bipolar disorder are able to achieve symptom remission with medication alone. However, it may take up to 10 weeks after starting an antidepressant to notice improvement, and even then, symptom improvement only occurs in about one third of patients.

It has also been shown to produce faster results than traditional therapies such as cognitive behavioral therapy (CBT). Finally, since it does not require any sedation or hospitalization it allows individuals to continue working while they receive treatment without disrupting their lives too much.

TMS therapy is an alternative treatment for bipolar disorder that can be used with patients who are on a mood stabilizer. Most people experience noticeable symptom relief after two weeks of TMS treatment (8-10 sessions).

What Is Bipolar Disorder?

Bipolar disorder is a real, treatable mental health disorder. There are four types of bipolar disorder: Bipolar 1, Bipolar 2, Cyclothymia, and Rapid Cycling Bipolar. Depending on the type, patients may experience a combination of:

  • Manic episodes: Intense feelings of euphoria
  • Hypomania: Less severe manic episodes
  • Depressive episodes: Feelings of depression or loss of interest

Signs of mania or hypomania include:

  • Excessive excitement
  • Difficulty with falling and staying asleep
  • Engaging in dangerous behaviors
  • Easily irritated

Signs of depressive episodes include:

  • Suicidal thoughts
  • Lack of energy
  • Difficulty with falling and staying asleep
  • Memory loss

Bipolar disorder often co-occurs with other mental health conditions like anxiety and substance use disorders.

Different Types of Bipolar Disorder

The four types of bipolar disorder include:

Bipolar I

This type of bipolar disorder is where at least one of the mood swings between mania and depression is rather severe. The severity of the episodes usually means at least one lasts for a week or longer or becomes so severe that hospitalization is required. 

Bipolar II

This type of bipolar disorder is where the episodes are milder. The person switches back and forth between episodes but never experiences the highly-intensive, severe episodes found with Bipolar I. 


When someone suffers from cyclothymia, their bipolar episodes are briefer. As they move between episodes, they can go weeks or even months feeling normal. 


Rapid-cycling is where someone cycles through mania and depression episodes over the course of a week or two. Some people can experience both cycles in a matter of days. The extent of their symptoms when rapid-cycle depends on the severity. 

Signs and Symptoms of Bipolar Disorder

The signs and symptoms experienced depend on whether one is having a manic episode or a depression episode. A person will usually experience 3 or more symptoms during a specific episode.

Mania Symptoms

  • Extreme Energy
  • Euphoria
  • Impulsive Decision Making
  • Engaging in Risky Behaviors
  • Extremely Talkative
  • Sleeping Very Little
  • Overly Confident
  • Constantly Active

Depression Symptoms

  • Excessive Sleeping
  • Suicidal Thoughts
  • Changes in Eating Habits 
  • No Energy
  • Feeling Worthless
  • Isolation
  • Feeling Irritable
  • No Enjoyment in Hobbies and Activities
  • Refusing to Make Decisions or Being Indecisive

TMS Treatment for Bipolar Disorder in Los Angeles, CA

For more information about TMS for bipolar disorder or to schedule your initial consultation, please contact us or call 1-877-847-3984 today.

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