Accelerated Theta Burst Stimulation for Inpatients With Bipolar Disorder

Inclusion Criteria: * Male or female, between the ages of 18 and 80 years at the time of screening. * Able to read, understand, and provide written, dated informed consent prior to screening. Proficiency in English sufficient to complete questions and follow instructions during fMRI assessments and aiTBS interventions * Stated willingness to adhere to all study procedures, including availability for the duration of the study, and to communicate with study personnel about adverse events and other clinically important information * Primary diagnosis of Bipolar I or II Disorder according to the Diagnosis and Statistical Manual of Mental Disorders, 5th edition (DSM-5) * Currently experiencing a hypomanic or manic episode according to the criteria defined in the Diagnosis and Statistical Manual of Mental Disorders, 5th edition (DSM-5) * YMRS score of ≥12 at screening. * Access to ongoing psychiatric care after completion of the study. * Must be adherent or agreeable to pharmacotherapy per clinical standard of care at screening. * Patients who are in both voluntary and involuntary hold. * In good general health, as evidenced by medical history. * For females of reproductive potential: use of highly effective contraception. Exclusion Criteria: * Currently pregnant or breastfeeding. * Primary psychiatric condition other than Bipolar I or II Disorder requiring treatment other than stable comorbid anxiety disorder. * Diagnosis of Intellectual Disability or Autism Spectrum Disorder * Current moderate or severe substance use disorder or demonstrating signs of acute substance intoxication or withdrawal * Active suicidal ideation (defined as an M-SSI \> 8) * History of significant neurologic disease, including dementia, Parkinson's or Huntington's disease, brain tumor, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma * Contraindication to receiving rTMS (e.g., metal in head, history of seizure, known brain lesion) * Contraindication to MRI (e.g. ferromagnetic metal in their body) * Treatment with another investigational drug or other intervention within the study period * Any other condition deemed by the PI to interfere with the study or increase risk to the participant * Current unmanageable psychosis that the PI believes would interfere with treatment * Any history of psychosurgery * Depth-adjusted aiTBS treatment dose \> 65% maximum stimulator output (MSO). * Any other condition deemed by the PI to interfere with the study or increase risk to the participant.