The psychiatric conditions we treat, and how we treat them
Bright Horizons Psychiatry is an adult practice. We work with five conditions, and we go deep on those five rather than a little way into everything.
What we treat and what we refer out
We treat these five conditions in adults
- Depression, including depression that has not responded to previous medication
- Anxiety disorders
- ADHD
- OCD
- Bipolar II disorder and bipolar depression
We refer these elsewhere
- Bipolar I disorder
- Psychosis and schizophrenia spectrum conditions
- Substance use disorders
- Personality disorders
These conditions need a level of care we are not set up to provide, and sending someone to the right place is better medicine than keeping them. We refer to Sheppard Pratt, Johns Hopkins, the Menninger Clinic, the McLean OCD Institute and Rogers Behavioral Health depending on what is needed.
The five conditions
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Depression treatment
Depression
Including depression that has already been through two or more medications without a good result. This is the largest part of what we do.
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Anxiety treatment
Anxiety
Generalized anxiety, panic and the anxiety that sits alongside another condition and never quite gets addressed on its own.
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ADHD treatment
ADHD
Adult ADHD, from evaluation through to finding a medication and dose that holds up over a working week.
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OCD treatment
OCD
Medication management for OCD, and honest guidance on when exposure therapy needs to be part of the plan.
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Bipolar II treatment
Bipolar II and bipolar depression
The depressive side of Bipolar II, which is where most people spend most of their time and where treatment most often goes wrong.
Three ways people arrive here
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This is your first time seeing a psychiatrist
You have a rough idea what is going on and you have not been treated for it before. The first appointment is a long conversation and a diagnosis, and treatment starts from a clean slate.
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You are on medication and it is not working
You have a diagnosis and a prescription and something is still off. Either the medication never worked, or it worked and stopped, or the side effects cost more than the benefit. This is the most common reason people come to us.
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You have tried several medications already
Two, three, five, more. At this point the question is not which antidepressant to try next. It is whether the diagnosis is right, and whether a treatment that works differently from a pill is the better move.
Which treatments we use for which conditions
Five conditions, five treatment approaches. This is how they map.
| Treatment | Depression | Treatment resistant depression | Anxiety | ADHD | OCD | Bipolar II |
|---|---|---|---|---|---|---|
| Medication management | Yes | Yes | Yes | Yes | Yes | Yes |
| BrainsWay Deep TMS | Yes | Yes | Alongside depression | Under review case by case | Yes | Case by case |
| Spravato, esketamine | Yes | Yes | No | No | No | Case by case |
| Intramuscular ketamine | Yes | Yes | Yes | No | No | Case by case |
| Telehealth follow up | Yes | Yes | Yes | Yes | Yes | Yes |
Telehealth is available for follow up appointments once you are an established patient. First appointments are in person.
Common questions
Do you treat children or adolescents?
We are primarily an adult practice. However, TMS can be considered for teens as young as 15 with treatment-resistant depression. Call the office so the team can help determine whether you or your teen is clinically eligible.
Do I need a diagnosis before booking?
No. Making the diagnosis is part of the first appointment.
Can I be treated for more than one of these conditions at once?
Yes, and most of our patients are. Depression with anxiety, and ADHD with anxiety, are the two combinations we see most often. Both get treated in one plan rather than as separate problems.
What if I am not sure which condition I have?
That is a normal reason to book. Working it out is our job, not yours.
What happens if my condition falls outside what you treat?
We will tell you at the first appointment and refer you to a practice that is set up for it. You will not be kept in treatment that is not right for you.
Is the first appointment in person or by video?
In person. Follow up appointments can be by video once you are an established patient.
How long does the first appointment take?
Longer than a standard medical appointment. It has to cover your history, previous treatments and what has and has not worked, and that takes time.