Can TMS Help with Bipolar Depression?

Can TMS Help with Bipolar Depression?

Transcranial magnetic stimulation (TMS) isn’t cleared—either by the U.S. Food and Drug administration or health insurance carriers—to treat bipolar disorder. However, research shows promise for the use of TMS to address the depressive symptoms associated with bipolar depression. 

Bipolar depression is a complex diagnosis, which is why it’s important to use a trusted, experienced TMS provider who can determine which treatment is appropriate for you. 

What is Bipolar Disorder?

Bipolar disorder is a mental health condition that used to be known as manic-depressive disorder. It’s not as common as major depressive disorder. About 2.8% of American adults have a bipolar diagnosis, compared to 7.1% of adults with depression. 

As the name implies, bipolar disorder is typified by drastic shifts in mood and energy—they’re so extreme, in fact, that these mood swings disrupt normal life. Highs, referred to as hypomania or mania, are periods of excessive euphoria. The lows, or depression, are similar to what you’d experience with major depressive disorder: intense sadness, lack of motivation, hopelessness, isolation, and, in serious cases, thoughts of self-harm or suicide. 

Trauma or stress, brain function, or family history may all play a role in whether someone has bipolar disorder, although there isn’t one known cause at this time. Manic or depressive episodes can last at least a week or more, but symptoms and frequency of mood swings may be less for one person than another. 

There are three main types of bipolar disorder:

• Bipolar I is marked by a manic episode, in which an uncontrollable high lasts for at least a week. It alternates with either depression or hypomania, a milder form of mania that is more subdued and lasts only a few days.
• Bipolar II alternates between depression and hypomania, without a more intense manic episode.
• Cyclothymia characterized by spells of milder depression and manic-like symptoms.

Signs of Bipolar Disorder

Given the marked contrasts between depressive and manic episodes, it’s understandable that they have very distinct symptoms. During depressive states, people may experience:

• Weight gain from overeating. Or, sometimes weight loss from loss of appetite.
• Exhaustion from too much or too little sleep.
• An inability to mentally focus or accomplish simple tasks.
• A loss of interest in hobbies, relationships, and normal activities that they used to find pleasurable.
• Feelings of worthlessness or self-loathing.
• Suicidal ideation.

During manic states, patients may experience:

• Decreased need for sleep.
• Excessive talkativeness.
• High energy.
• Euphoria, or an unusual level of happiness.
• Irritability.
• Racing thoughts and speech.
• Trying to accomplish several tasks at once.
• Risky behavior that could harm themselves and/or others.
• An elevated sense of self.

What is the Difference Between Bipolar Disorder and Depression?

The most important difference is that depression is considered a unipolar condition. Instead of cycling between high and low states as people do with bipolar disorder, a major depressive disorder only triggers the lows. Treatment plans will differ depending on whether someone is diagnosed with bipolar disorder or major depressive disorder. It’s important to have a qualified professional make the correct diagnoses to ensure your treatment plan will be effective. TMS can be a valuable treatment option for someone suffering from the symptoms of bipolar depression.

Is TMS Approved for Bipolar Disorder?

As of now, there is not enough research data to recommend TMS therapy for bipolar disorder, according to the FDA. For now, using TMS to treat bipolar disorder is “off-label” because it is not approved by the FDA.

What Are the Treatment Options for Bipolar Depression?

Bipolar depression, like unipolar depression, can be treated with medications and psychotherapy. Medications can include antidepressants, mood stabilizers, or antipsychotic drugs, depending on the patient’s condition. Psychotherapy modalities include cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT). 

TMS therapy for bipolar depression is another option. This is an effective, FDA-cleared treatment for major depressive disorder, as well as obsessive compulsive disorder, smoking cessation, and anxiety symptoms related to depression. 

Magnetic technology is the foundation for how TMS works. An electromagnetic coil is placed on a patient’s scalp near the left temple. This allows targeted areas of the brain to be stimulated with magnetic pulses. These pulses become electrical currents that activate the brain’s nerve cells to restore proper function and alleviate depression symptoms. 

TMS is non-invasive and doesn’t require sedation. In other words, there’s no downtime or recovery period. A course of treatment usually lasts six or more weeks, starting at five sessions per week, with five sessions per week. Each session lasts 18 to 40 minutes, so there’s minimal disruption to your daily schedule. 

More than 62% of TMS patients experience significant reduction in symptoms, with 42% of those patients achieving complete remission, according to the Journal of Clinical Psychiatry. Preliminary studies indicate TMS treatment for bipolar depression can be helpful. 

Greenbrook TMS does not treat patients specifically for bipolar disorder, but rather for symptoms associated with bipolar depression. Find out if TMS therapy is right for you or a loved one. Schedule your free consultation.