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Accepting New Patients • Major Insurance Accepted • Serving Rockville & Frederick

Psychiatry services for adults in Rockville and Frederick

We work with adults whose depression, anxiety, ADHD, or OCD has not responded the way it should. That often means several medications tried and a lot of appointments that went nowhere. Deep TMS, Spravato, and ketamine sit under the same roof as standard psychiatric care here, so getting to the next step does not mean starting over with a new clinic.

Request an appointment See what we treat
Clinical psychiatric care at Bright Horizons Psychiatry
  • Major insurance accepted
  • No referral needed to book
  • Rockville and Frederick locations
  • Adults 18 and older

How most people end up in our office

  • The medications stopped working

    You have been through two, three, sometimes five antidepressants. Some helped for a while. None of them held. What you want now is a plan that goes beyond the next prescription.

  • You want someone to check the diagnosis

    Years of treatment for one condition, and the treatment never quite fit. A full re-evaluation can change what happens next, particularly when Bipolar II or ADHD was missed early on.

  • You need care your insurance covers

    Advanced psychiatric treatment has a reputation for being cash only. Ours mostly is not. We take Medicare, Maryland Medicaid, and major commercial plans, and our staff handle the prior authorizations.

Six services, one practice

Everything below happens under one practice with one chart. Your psychiatrist and the person running your TMS sessions are looking at the same notes.

Deep TMS treatment at Bright Horizons Psychiatry

Deep TMS

Deep TMS uses magnetic pulses to stimulate the brain regions involved in mood regulation. You sit in a chair wearing a cushioned helmet. The machine clicks, you feel a tapping on your scalp, and after about twenty minutes you get up and go back to your day. There is no anesthesia and no recovery period, which is the main practical difference from ECT.

The standard course runs five days a week for roughly six weeks. That is a real commitment, and it is the reason some people rule TMS out before they understand it. Accelerated protocols exist for exactly that problem. They compress multiple sessions into a single day so the whole course fits into a shorter window.

We use BrainsWay Deep TMS, which reaches deeper cortical structures than the figure-8 coils used in older systems.

  • No sedation, no anesthesia
  • You drive yourself home
  • Covered by most plans we accept

Spravato (esketamine nasal spray)

Spravato is a nasal spray derived from ketamine, approved by the FDA specifically for treatment-resistant depression. It is not something you take home. You self-administer it in our office and stay for a monitoring period afterward, which is a federal requirement rather than a clinic preference.

People choose Spravato over other ketamine options for one reason more than any other. It is the version insurance usually covers. Because it carries an FDA indication for treatment-resistant depression, most of the plans we accept will authorize it once the documentation is in place. Our staff build that documentation, submit it, and handle appeals when the first answer is no.

You will need a ride home on treatment days.

Spravato treatment at Bright Horizons Psychiatry
Intramuscular ketamine treatment at Bright Horizons Psychiatry

Intramuscular ketamine

IM ketamine is given as an injection rather than a nasal spray. It reaches the bloodstream more directly, and the dosing schedule can be adjusted in ways Spravato's fixed protocol does not allow. For some patients that flexibility matters.

The trade-off is coverage. IM ketamine is used off-label for depression, so it is generally cash pay rather than insurance. We will tell you that before you book, not after.

Which of the two makes sense depends on your insurance, your history, and how you responded to anything ketamine-based you have already tried. That is a conversation for your evaluation, not something to decide from a website.

Comparing the three advanced options

Comparison of Deep TMS, Spravato, and IM ketamine
Feature Deep TMS Spravato IM ketamine
How it is given Magnetic pulses, helmet coil Nasal spray you self-administer Injection
Where In office In office In office
Sedation None None, monitored after None, monitored after
Typical insurance coverage Usually covered Usually covered Usually cash pay
Can you drive home Yes No No
Schedule Daily for about six weeks, or accelerated Twice weekly at first, then tapering Varies

Conditions

What we treat

We are a boutique adult practice, which means the list is shorter than a hospital system's and the attention on each case is longer.

  • Treatment-resistant depression
  • Major depressive disorder
  • Bipolar II and bipolar depression
  • Generalized anxiety
  • Panic
  • OCD
  • ADHD in adults
  • PTSD
  • Insomnia connected to a mood disorder

What we do not treat

Being clear about this saves people a wasted appointment.

  • Bipolar I
  • Psychosis and schizophrenia
  • Substance use disorders
  • Personality disorders
  • Anyone under 18

We are outpatient only. No inpatient beds, no partial hospitalization, no intensive outpatient program, and no 24 hour crisis line.

Where we send people instead

If what you need sits outside our scope, we will say so at the evaluation and point you somewhere that fits. Depending on the situation that is usually Sheppard Pratt, Johns Hopkins, the Menninger Clinic, the McLean OCD Institute, or Rogers Behavioral Health.

If you are in immediate danger, call 988 or go to your nearest emergency room. We are not set up for emergencies.

What the first few months look like

  1. Book

    Call or use the online form. You do not need a referral. We will check your insurance before the first visit so there are no surprises.

  2. Full evaluation, in person

    A long first appointment covering your history, every medication you have tried, and what actually happened on each one. This visit has to happen in person.

  3. A plan you agreed to

    We lay out the options that fit, including what each one costs you and what your insurance will and will not authorize. You decide. If TMS or Spravato is on the table, our staff start the prior authorization while you think about it.

  4. Treatment and follow-up

    Whatever you start, we track how it is going and adjust. Once you are established, follow-up visits can be by video from anywhere in Maryland. If you already have a therapist, we coordinate with them rather than duplicating their work.

Does insurance cover TMS and Spravato?

Usually yes, for both, on the plans we accept. This is the question we get more than any other, and the honest answer is that coverage exists but the paperwork is the barrier. Insurers want documentation that you have tried and failed a certain number of medications first. Getting that documented correctly is the difference between an approval and a denial.

We accept Medicare, Maryland Medicaid, and major commercial plans. IM ketamine and some accelerated TMS protocols are the exception and are usually cash pay, because they are used off-label.

Two locations in Maryland

Frederick

7360 Guilford Dr, Suite 100
Frederick, MD 21704

Monday to Friday, 9am to 6pm

(240) 599-1001

Now open, serving Frederick County including Urbana, Mount Airy, and Clarksburg

Get directions

Telehealth follow-up is available to established patients anywhere in Maryland. First appointments happen at one of the two offices.

Questions we get asked

Do I need a referral?

No. Book directly by phone or through the site.

Does insurance cover TMS?

On the plans we accept, usually yes. Insurers require documentation that a certain number of medications were tried first. Our staff assemble that and submit it, and we appeal if the first answer is no.

Does insurance cover Spravato?

Usually, for the same reason. Spravato holds an FDA indication for treatment-resistant depression, which makes authorization more straightforward than it is for off-label ketamine.

What is the difference between Spravato and IM ketamine?

Spravato is a nasal spray with FDA approval for treatment-resistant depression and is usually covered by insurance. IM ketamine is an injection used off-label, which gives more flexibility on dosing but is usually cash pay. Which one fits depends on your insurance and your history.

Does TMS hurt?

Most people describe a tapping sensation on the scalp and some scalp tenderness in the first week that fades. There is no sedation and no recovery time. You drive yourself home.

Can my first appointment be virtual?

No. Initial evaluations happen in person at Rockville or Frederick. Once you are an established patient, follow-ups can be by video anywhere in Maryland.

Do you treat adult ADHD?

Yes. That includes adults who were never assessed as children and adults who suspect an earlier diagnosis was wrong.

Do you see children or teenagers?

No. We treat adults 18 and older only.

Do you take Medicare and Medicaid?

Yes to both, including Maryland Medicaid, along with major commercial plans.

How soon can I be seen?

Availability changes week to week. Call the office and we will tell you what is open.