Bipolar disorder is a complex mental health condition that causes dramatic shifts in mood, energy, and activity levels. People living with bipolar disorder experience episodes of mania or hypomania (periods of high mood, energy, or irritability) and depression (periods of sadness, hopelessness, or low energy). These mood swings can make daily life, relationships, and work incredibly challenging.
While bipolar disorder cannot be “cured,” treatments such as mood stabilising medication, therapy, and lifestyle changes have long been the standard approach. However, many people continue to struggle with depressive episodes despite these treatments. That’s where Transcranial Magnetic Stimulation (TMS) offers new possibilities.
At Smart TMS, we are helping patients with bipolar depression find real, measurable relief.
Bipolar depression is one of the most debilitating aspects of bipolar disorder. Symptoms often include:
Feeling persistently sad, hopeless, or irritable
Lack of energy and difficulty concentrating
Loss of interest in activities once enjoyed
Feelings of emptiness or worthlessness
Difficulty sleeping or changes in appetite
Suicidal thoughts
These episodes can arrive abruptly and severely impact work, relationships, and overall wellbeing. Research suggests that many cases are diagnosed before the age of 30, affecting men and women equally.
Traditional treatments for bipolar disorder often involve:
Medication – such as lithium, valproate, antipsychotics, or antidepressants
Therapy – such as cognitive behavioural therapy (CBT)
Lifestyle support – sleep regulation, exercise, and stress management
While these treatments help many people, they are far from optimal. Side effects are common, and many patients continue to experience severe depressive episodes despite following recommended treatment plans.
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses targeted magnetic pulses to stimulate the dorsolateral prefrontal cortex—the part of the brain responsible for mood, motivation, and social functioning.
Instead of dampening emotions, as medication sometimes does, TMS works by resetting brain activity patterns, offering a direct approach to tackling depressive symptoms.
At Smart TMS, a typical treatment course includes:
30 sessions over 3–6 weeks
Sessions lasting around 30 minutes
No anaesthetic, no hospitalisation, no downtime
Minimal side effects compared with medication
Clinical research consistently shows that TMS is effective for bipolar depression:
McGirr et al. (2016) and Mutz et al. (2018) found that TMS significantly reduced depressive symptoms in patients with bipolar disorder across multiple randomised controlled trials.
Nguyen et al. (2021) confirmed higher response rates with TMS compared to sham treatment, particularly with high-frequency stimulation over the left dorsolateral prefrontal cortex.
Importantly, TMS is not used for the manic phase of bipolar disorder, but it is a safe and effective option for treating depression in those living with the condition.
At Smart TMS, we analysed outcomes from 33 patients treated for bipolar depression with TMS. Our results are highly encouraging:
60.6% achieved at least a 35% improvement in depressive symptoms (measured by PHQ-9 scores)
48.5% reached remission and no longer met the clinical threshold for a depressive disorder
21.2% experienced near-complete abolition of depressive symptoms
These outcomes are even stronger than those reported in published clinical trials, highlighting the effectiveness of TMS treatment delivered at Smart TMS.
| Treatment | Benefits | Challenges |
|---|---|---|
| Medication | Can stabilise moods, widely prescribed | Side effects, trial-and-error with dosage, not always effective |
| Therapy (CBT, etc.) | Builds coping strategies and long-term resilience | May not ease severe depression alone |
| Lifestyle changes | Improve overall wellbeing | Cannot address acute or resistant depression |
| TMS | Safe, non-invasive, no systemic side effects, effective for bipolar depression | Requires a course of sessions, not designed for manic phases |
For patients whose depression has not improved with traditional methods, TMS offers a proven, evidence-based alternative. At Smart TMS, our data demonstrates that TMS can significantly reduce depressive symptoms and, in many cases, bring about remission.
Patients should always follow the NICE Guidelines for the treatment of bipolar disorder. However, for those experiencing persistent or treatment-resistant depressive episodes, TMS is an option well worth considering.
📞 Contact Smart TMS today to learn more about our TMS treatment for bipolar disorder and take the next step towards recovery.
McGirr, A., Karmani, S., Arsappa, R., Berlim, M. T., Thirthalli, J., Muralidharan, K., & Yatham, L. N. (2016). Clinical efficacy and safety of repetitive transcranial magnetic stimulation in acute bipolar depression. World Psychiatry, 15(1), 85–86. https://doi.org/10.1002/wps.20300
Mutz, J., Edgcumbe, D. R., Brunoni, A. R., & Fu, C. H. Y. (2018). Efficacy and acceptability of non-invasive brain stimulation for the treatment of adult unipolar and bipolar depression: A systematic review and meta-analysis of randomised sham-controlled trials. Neuroscience & Biobehavioral Reviews, 92, 291–303. https://doi.org/10.1016/j.neubiorev.2018.05.015
Nguyen, T. D., Hieronymus, F., Lorentzen, R., McGirr, A., & Østergaard, S. D. (2021). The efficacy of repetitive transcranial magnetic stimulation (rTMS) for bipolar depression: A systematic review and meta-analysis. Journal of Affective Disorders, 279, 250–255. https://doi.org/10.1016/j.jad.2020.10.013
Blum, K. (2023, February 8). New research on treatment for bipolar depression. BrainWise, Johns Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org
National Institute for Health and Care Excellence (NICE). (2023). Bipolar disorder: Assessment and management (NICE Clinical Guideline CG185). Retrieved from: https://www.nice.org.uk/guidance/cg185