With the efficacy of transcranial magnetic stimulation on depressed individuals becoming known, a new question has been sparked — can TMS treat bipolar disorder? If a depressive state is also part of bipolar disorder, can one see improvements in that area as well? Some cases have reported that this may in fact be the case. While the process may need to be a bit more nuanced than with depressed patients, practitioners are finding that the results are looking promising.
Can TMS Treat Bipolar Disorder?
The Difference Between Unipolar Depression and Bipolar Disorder
Unipolar depression (or what we collectively refer to as just depression) is where an individual will remain in just one state when triggered. A depressive one. Bipolar disorder is where mania comes into the equation. When the individual is triggered, there is the chance of shifting between either mania or depression. A person must have at least one manic episode in their lifetime in order for a diagnosis. This mania can result in excessive energy, impulsiveness, lack of concentration, and an urge to engage in risky behaviors. In Bipolar I, mania tends to be higher, and in Bipolar II, the depressive state tends to be lower. And with these differentiations out of the way, a more thorough breakdown of bipolar disorder itself is necessary in understanding if TMS may benefit.
Additional Source: Bipolar Disorder – National Institute of Mental Health (NIMH)
A Quick Breakdown of Bipolar Disorder
Bipolar disorder affects about 2.3 million Americans a year. About 4 percent of adults experience it at least once in their lifetimes. It has the highest percentage (83%) of serious impairment than any other mental illness. This is due to the dramatic flux and shifts of day-to-day activities. It can feel impossible to properly juggle relationships, work, and other responsibilities when also dealing with extreme mood swings. A state of mania will take place followed by a crash into depression.
Much like a rollercoaster. This may occur frequently or there may be rare cases involving a traumatic event or sleep disturbance. Furthermore, doctors believe it is due to a chemical imbalance in the brain. Specifically, norepinephrine and serotonin tend to play pivotal roles. For example, when norepinephrine is too high, it may trigger mania, and when it’s too low, it may trigger depression. Because of this, doctors have found medications to be tricky when treating this disorder. Some medications may alleviate depression in the short term but trigger mania in the long term. This is where alternative treatments for bipolar disorder, like TMS, have the potential to play an imperative role.
Since transcranial magnetic stimulation has the ability to “light” up the brain, practitioners have some concerns that it may trigger manic states in people with bipolar disorder. They fear that it may be too stimulating. However, studies have proven the risks are low. That it’s about the same as the risks associated with SSRI’s. A manic state wouldn’t happen overnight and not as long as practitioners monitor the situation closely. In fact, improved cognition in depressed bipolar patients has been discovered. Also, some clinics are finding that because an individual is more likely to switch between the two poles, they may actually start to feel better quicker than a depressed patient who typically only stays in that one state.
A closely measured treatment looks like evaluating daily energy levels, motivation, mood, and sleep by a trained team of professionals. As far as the actual TMS treatment goes, the stimulation may be lowered, the pulses may be adjusted, and the protocol may be more relaxed. These changes are essential in being able to treat bipolar disorder in individuals. Therefore, making sure the center has personalized treatment options is crucial.
Is TMS Effective for Bipolar?
Ultimately, research is showing that transcranial magnetic stimulation is effective in treating the depressed state, but it needs more research when it comes to treating the manic one. The lack of data is due to practitioners being reluctant in trying it out in the first place out of fear of making matters worse. However, the limited studies show that it does in fact hold promise. It is proving to reduce symptoms of mania and has less of an ability to “switch” on a patient than what was initially predicted. Again, finding a clinic that can focus on a personalized treatment is important. Whether that’s a specific frequency, the number of pulses, or targeting a certain area/areas of the brain, it must be unique to the individual. If you or someone you know has bipolar disorder and has yet to find relief from pharmacology or psychotherapy, TMS may be the answer.
TMS Institute of Great Plains Mental Health
Paula Whittle, PMHNP, and Dr. James Sorrell believe that mental health should be considered as a primary driver for one’s overall wellbeing, both physically and mentally. At TMS Institute of GPMH, we want to make sure your connection to the world you live in is addressed – to change the order to … SPIRIT, MIND, and BODY. As a result, we believe when people are treated in this order they feel better, more at peace, and much stronger to face life’s challenges. Transcranial magnetic stimulation (TMS therapy), the most advanced form of depression treatment, offers us the ability to enhance our patient outcomes following our philosophy of a holistic approach to treating mental health conditions.
Contact us today to schedule a consultation.