This study explores the efficacy of accelerated intermittent theta burst stimulation (aiTBS), a form of transcranial magnetic stimulation (TMS), in treating bipolar depression. Bipolar disorder is a mental health condition characterized by alternating episodes of mania and depression, with depressive episodes being more prolonged. A limited number of FDA-approved treatments for bipolar depression leads to overlabeling of treatment resistance and necessitates the research into alternative interventions. This double-blind, randomized clinical trial involved 24 participants with treatment-resistant bipolar depression, divided equally into active aiTBS and sham groups. The aiTBS treatment targeted the left dorsolateral prefrontal cortex (L-DLPFC) based on individualized resting-state fMRI and EMG recordings. Participants underwent five days of treatment, receiving 10 sessions daily. Results indicated that aiTBS significantly reduced depressive symptoms, including suicidality, insomnia, rumination, and negative affect, with no significant increase in anxiety levels. However, aiTBS did not significantly impact anhedonia, a common symptom of bipolar depression. Alongside strengths such as significant results and a lack of severe adverse effects, this study's limitations include its small sample size, highlighting the need for further research to confirm these findings. This study concludes that aiTBS shows promise as a multidimensional treatment option for bipolar depression, offering potential relief for patients who do not respond to existing therapies.