Clinical Research Directory

Inclusion Criteria: 1. Subjects will have a diagnosis of Bipolar Disorder Type I or II, current episode depressed as measure by a MADRS ≥ 20. 2. Subjects must be maintained on a stable dose of all psychotropic medications for a period of at least two weeks prior to screening. 3. Subjects must be capable of providing informed consent. 4. Subjects must permanently reside within a 2-hour drive of McLean Hospital. 5. Subjects must be currently seen by a provider (psychiatrist, therapist, PCP) whose practice is within a 2-hour drive of McLean Hospital. Exclusion Criteria: 1. Dangerous or active suicidal ideation, as measured by the C-SSRS (see "Safety Measures" section), and physician evaluation. 2. Subjects meeting DSM-5 criteria for schizophrenia, schizoaffective disorder, or other psychotic disorders, or dementia. 3. Current mania as defined by a score of ≥ 10 on the Young Mania Rating Scale at screening. 4. Subject has an MMSE score ≤ 24. 5. Subject is pregnant or plans on becoming pregnant. 6. Subject has recent history (within 7 days of screening) of ECT or TMS treatment. 7. Subject has recent history of substance abuse (cannot meet DSM-5 criteria for substance abuse, no significant drug abuse within last 3 months, no history of dependence in last year, no drug use within last month, other than marijuana use). 8. Subject has any contraindication for MRI (i.e. Presence of a pacemaker, neurostimulator, or metal in head or neck).