UCSF offers various therapies and services for qualified adults with certain serious psychiatric conditions, including some forms of depression, bipolar disorder and schizophrenia. Learn more about electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and our treatments for bipolar disorder, obsessive-compulsive disorder (OCD) and tics. All services require a referral from a psychiatrist.

Bipolar disorder treatment

Bipolar disorder, formerly called manic-depressive illness, is a brain condition that causes pronounced shifts in mood, energy and activity levels, and interferes with being able to carry out day-to-day tasks. People with bipolar disorder experience periods of exceptionally intense emotions, changes in sleep patterns and energy expenditure, and other unusual behaviors. During these distinct periods, called "mood episodes," emotions and behaviors differ drastically from those typical for the person.

In addition to medical treatment and medication management, we offer specialized group therapy to some patients. These eight-week sessions are conducted in a classroom-like setting with a focus on topics that help patients better understand and address their own condition, such as:

  • Self-awareness and mood charting
  • Review of medications
  • Sleep management
  • Communication skills
  • Stigma
  • Impact of drugs and alcohol on mood
  • Preventing mood episodes

Participants can benefit from meeting others facing similar challenges and sharing experiences and tips. Graduates gain access to an alumni group that meets monthly. The number of spaces available for new patients is limited.

Electroconvulsive therapy

Electroconvulsive therapy (ECT) is available for people experiencing certain behavioral and emotional disturbances, including some forms of depression, bipolar disorder and schizophrenia. It is most often used to treat severe depression that hasn't responded to medications and psychotherapy.

Evaluation for ECT includes psychiatric and physical assessments as well as consultations with interested patients (and their families, when appropriate). The steps for receiving an ECT evaluation include:

  • Referral by primary psychiatrist.
  • Initial evaluation by a psychiatrist trained in ECT. Please note:
    • We strongly encourage family members to attend.
    • UCSF is a teaching hospital, so psychiatry residents and medical students may be involved in your evaluation and care.
  • Preoperative evaluation by specialists in anesthesia through the UCSF Prepare Program. This will be scheduled by a coordinator following the initial evaluation.
  • Orientation to the ECT procedure area. This will be conducted by the coordinator on the same day as the Prepare Program appointment.

Performed under general anesthesia (patients are completely asleep), the treatment is a series of six to 15 sessions scheduled on Monday, Wednesday and Friday mornings. It's about three hours from the time of arrival until discharge. After each session, the patient must be picked up by a friend or family member.

Obsessive-compulsive disorder (OCD) and tic disorder treatment

Symptoms of obsessive-compulsive disorder (OCD) include uncontrollable, recurring thoughts and repetitive, hard-to-resist behaviors. Tic disorders are marked by repetitive, involuntary and unwanted movements or vocal sounds that cause significant distress and disrupt daily life.

We offer treatments tailored to these conditions, such as exposure and response prevention (ERP) for OCD and comprehensive behavioral intervention therapy for tics (CBIT).

Neuromodulation: transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)

For eligible patients, we offer transcranial magnetic stimulation (TMS), a noninvasive type of neuromodulation approved to treat major depression that hasn't responded to standard treatments. TMS may also benefit patients with other conditions, including obsessive-compulsive disorder and anxiety.

TMS precisely delivers magnetic pulses to parts of the brain that are underactive or overactive in patients with depression or OCD. Treatment sessions, lasting about 45 minutes, are administered five days a week for about six weeks.

For most patients, TMS is a well-tolerated procedure with few side effects. Patients can drive home or return to work immediately after an appointment. The most common side effects are scalp irritation where the magnet is applied and mild headache. TMS doesn't require anesthesia and doesn't impair memory or thinking.

We also offer a type of neuromodulation called deep brain stimulation (DBS) for patients with severe depression or OCD. This therapy requires a minimally invasive surgery in which electrodes are placed in the brain and connected to a battery-powered device that delivers intermittent doses of electricity.