Magnetic Resonance-Guided Focused Ultrasound Bilateral Capsulotomy for the Treatment of Refractory Bipolar Depression

This study is testing a non-invasive brain treatment called MRI-guided focused ultrasound capsulotomy for people with severe bipolar depression that has not responded to multiple medications. This procedure uses sound waves — guided precisely by MRI — to target specific brain circuits involved in depression, without any surgery or incisions. **You may be eligible if:** - You are between 18 and 65 years old - You have a diagnosis of Bipolar Disorder Type 1 or Type 2 - You are currently in a depressive episode with a significant depression score on a standardized scale - Your bipolar depression has not responded to at least two different medication regimens tried for at least 4 weeks each - You are able to give informed consent and attend study visits **You may NOT be eligible if:** - You do not have treatment-resistant bipolar depression - You have conditions that make focused ultrasound or MRI unsafe - You are under 18 or over 65 - You are unable to give informed consent Talk to your doctor to see if this trial is right for you.