Can TMS Help Treat Bipolar Disorder?

Bipolar disorder refers to an illness that is characterized by dramatic, sudden changes in behavior, energy, and mood. Previously known as manic depression, this condition causes depressive (extremely low) and manic (extremely high) mood episodes that last for days or weeks at a time. These episodes interfere with relationships, school and work performance, and day-to-day functioning.

There are numerous medications and other treatments for bipolar disorder. However, they are not always effective. Patients may quit taking medications due to the side effects. This has led doctors to look for other types of treatment for the disorder.

Transcranial magnetic stimulation (TMS) is a treatment that is FDA-approved to treat depression and obsessive-compulsive disorder (OCD). Emerging research suggests that TMS may be helpful in treating bipolar disorder.

In 2020, the FDA granted breakthrough device designation to TMS for treating bipolar disorder. However, this is not a formal approval and TMS is not yet approved by the FDA to treat bipolar disorder. Still, some doctors use TMS off-label for bipolar disorder.

Let’s look at TMS and what the research says about its effectiveness in treating bipolar disorder.

What Is Transcranial Magnetic Stimulation (TMS)?

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that is FDA-approved to treat several conditions, including depression and obsessive-compulsive disorder. It is also approved to help with smoking cessation.

A typical TMS series consists of five sessions per week for 36 sessions. However, most people start to feel better after just 10 to 15 sessions. Treatment is performed in an office and does not require anesthesia or sedation.

During a TMS session, an electromagnetic coil is placed on a patient’s scalp. The magnet stimulates specific areas of the brain that are involved in mental health symptoms. This stimulation helps rewire the brain’s circuitry, restoring normal function.

Can TMS Help with Bipolar? What Science Says

TMS is a promising approach for treating patients with bipolar who have not responded to psychosocial or pharmacological treatment, according to the research. One 2019 study on TMS for bipolar disorder found that TMS helped with both depressive and manic symptoms. Another study, this one conducted in 2021, found that there is sufficient evidence that support the use of TMS for bipolar disorder.

New research on TMS for bipolar is coming out all the time. Researchers at Johns Hopkins Medicine are currently looking at whether or not TMS results in more rapid improvements for patients with bipolar compared with traditional treatments. The researchers hope that patients will achieve a quick improvement in depressive symptoms.

There is another research study at the Mayo Clinic also examining the use of TMS for bipolar depression. The study’s authors say that there is growing evidence for the use of TMS in bipolar depression.

When to Consider TMS for Bipolar?

Generally, TMS is considered a treatment option if medications and other treatments for bipolar disorder are not working.

Research has found that TMS is helpful for depressive symptoms of bipolar.  Studies of TMS for mania have resulted in mixed findings.

If you have bipolar disorder, here are some signs that your medications and other treatments may not be working:

  • Your mood changes from feeling energized or happy to depressed and sad.
  • You do risky things like engage in unprotected sex without thinking.
  • You feel despair or hopeless.
  • You can’t fall or stay asleep, or you feel as though you don’t need to sleep.
  • You are arguing a lot more than usual with friends and family members.
  • You feel like other people are out to get you.
  • You have extremely low motivation or energy.
  • You feel irritable most of the time.
  • Your mood is chronically low.

Important:

 If you are hearing voices or have thoughts of harming yourself, it’s important to go to an emergency room right away.

TMS May Help

If you are experiencing the above symptoms despite taking medication or other treatments for bipolar, you may want to consider adding TMS to your treatment regimen. TMS often works pretty quickly, and the side effects are typically mild.

Benefits of TMS for Bipolar

Transcranial magnetic stimulation (TMS) may benefit bipolar by:

  • Reducing feelings of hopelessness, sadness, or emptiness.
  • Improving sleep.
  • Improving concentration.
  • Reducing suicidal ideation.
  • Reducing fatigue.
  • Improving decision-making.
  • Enhancing cognitive functioning.

In addition, TMS has few side effects, and the side effects that can occur are generally mild. This makes TMS particularly helpful for people with bipolar who haven’t responded well to other treatments.

How Long Do the Effects of TMS Last?

Patients may experience a relief in symptoms for up to nine months after treatment. The benefits of TMS tend to be greater for patients who follow appropriate lifestyle and medication choices.

Who Should Not Have TMS?

TMS is not for everyone. There are some contraindications for TMS. Generally, you should not have TMS if you:

  • Have an implanted medical device or metal in the body. Examples include pacemakers and stents.
  • Have a history of seizures, epilepsy, or have had a brain injury.
  • Have severe or frequent headaches.

Risks and Side Effects

TMS is associated with mild side effects. It is a non-invasive treatment that has a short recovery period.  However, there are a few side effects that can occur. These include:

  • Tingling in the scalp or face
  • Hearing difficulties (these are temporary)
  • Mild headaches
  • Mild discomfort or pain
  • Lightheadedness

There is a slight risk of seizures with TMS. That is why people with a history of epilepsy or seizures should not have TMS treatments.

What If TMS Doesn’t Work for Me?

At TMS Institute of Arizona, we are committed to your health. There are always treatment options to help you feel better. If TMS doesn’t work for you, we may recommend another treatment such as esketamine. As difficult as your journey may be, we are confident that we can help you better manage your symptoms and live a happier, healthier life.

How to Try TMS

TMS is an effective treatment that has a lot to offer for those struggling with bipolar disorder with depression. If you are in the Phoenix metropolitan area and you have bipolar disorder, contact us to determine if you are a candidate for TMS.