# Home-based transcranial direct current stimulation (tDCS) for bipolar depression: effects on quality of life and functioning—an open-label study

## TL;DR

A home-based tDCS treatment improved quality of life in people with bipolar depression, but the effects may be linked to reduced depressive symptoms.

## Contribution

This study introduces a supervised home-based tDCS protocol for bipolar depression and evaluates its impact on quality of life.

## Key findings

- Bipolar participants showed significant QoL improvements after 6 weeks of tDCS.
- Improvements in QoL remained elevated at the 5-month follow-up.
- QoL gains were no longer significant after adjusting for depressive symptoms.

## Abstract

Individuals with bipolar disorder often experience reduced quality of life (QoL). Transcranial direct current stimulation (tDCS) is a promising non-invasive treatment for bipolar depression that is portable, safe, and suitable for use at home. We developed a home-based tDCS protocol with real-time remote supervision and examined its effect on QoL in bipolar depression.

In an open‐label design, 44 participants (31 women) with bipolar depression of at least a moderate severity received 21 sessions of home‐based tDCS (2 mA, 30 min, F3 anode/F4 cathode) over 6 weeks, with a follow-up visit conducted 5 months from baseline. QoL was assessed using the quality of life enjoyment and satisfaction questionnaire (Q-LES-Q) at baseline, week 2, end of treatment, and follow-up session. Baseline and post treatment scores were compared with healthy control participants (28 adults; 17 women).

At baseline and at the end of treatment, bipolar participants showed a significantly lower Q-LES-Q score than healthy controls (p < 0.001). Within the bipolar group, there was a significant improvement in total Q-LES-Q scores (p < 0.001) and across multiple domains by week 6 and remained elevated at follow-up. Changes in Q-LES-Q were no longer significant after adjustment for depressive symptoms.

A 6-week course of supervised home-based tDCS was associated with significant QoL improvements in bipolar depression, which appeared to be closely linked to reduction in depressive symptoms. Randomized, sham‐controlled trials are warranted to clarify the specific contribution of tDCS to improve QoL in bipolar depression.

The online version contains supplementary material available at 10.1007/s11136-025-04135-2.