Depression treatment for adults in Rockville and Frederick
Evidence-based depression care for adults across Montgomery County — medication management, FDA-cleared Deep TMS, and Spravato for treatment-resistant depression, delivered by clinicians who take depression seriously.
- Psychiatric evaluation for depression
- Careful medication management
- Deep TMS and Spravato on site
- Follow-ups available by telehealth
Symptoms
Depression is one of the most treatable conditions in psychiatry. It often shows up as low mood, exhaustion, and lost interest — not just “feeling sad.”
-
Mood and energy
- Low mood that lasts most of the day, most days
- Loss of interest in work, hobbies, or people you used to enjoy
- Fatigue that sleep does not fix
- Feeling slowed down — or restless and unable to sit still
-
Thinking and sleep
- Trouble concentrating, deciding, or remembering
- Harsh self-criticism or hopelessness about the future
- Sleep that is too little, too much, or broken
- Appetite or weight changes without trying
-
When medication is not enough
- Two or more antidepressants tried without lasting relief
- Partial improvement that stalls before you feel like yourself
- Side effects that cost more than the benefit
- Depression that returns every time a medication is stopped
What the process looks like
Depression treatment is not a straight line. We take the time to get the diagnosis right, then adjust as your response, side effects, and life demands change.
-
Initial consultation
Book online or by phone. Intake paperwork is sent ahead of time so your first appointment is clinical work, not forms.
-
Comprehensive evaluation
A 60 to 90 minute in-person appointment at Rockville or Frederick covering your history, symptoms, previous treatments, and goals.
-
Clear options, clear plan
We walk through medication options, Deep TMS, Spravato, therapy referrals, timelines, and trade-offs. You are a participant in the decision, not a passenger.
-
Follow-up and adjustment
Most patients are seen every two to four weeks early on, then less often as stability settles. Established patients can do many follow-ups by telehealth in Maryland.
Treatment options
Effective depression care is not one-size-fits-all. We match the plan to your symptoms, medical history, and what has already been tried — with medication, Deep TMS, and Spravato under the same roof.
-
Medication management
SSRIs, SNRIs, atypical antidepressants, and augmentation strategies chosen for your presentation — started carefully, monitored closely, and adjusted until the benefit is real.
-
Deep TMS
FDA-cleared BrainsWay Deep TMS for major depression that has not responded to medication. Sessions are about 20 minutes. Available on site in Rockville.
-
Spravato (esketamine)
FDA-approved nasal spray for treatment-resistant depression, given in office under supervision. Covered by most of the insurance plans we accept.
-
IM ketamine
Intramuscular ketamine when a different route or faster schedule than Spravato is the better fit. Usually cash pay rather than insurance.
Conditions that commonly occur with depression
Depression rarely shows up alone in adults. We look for what else is in the picture so treatment does not miss half the problem.
-
Anxiety
Anxious depression is common. Treating only one half often leaves the other half running the show.
-
ADHD
Years of underperformance and self-blame can look like depression. Sometimes both are present and both need attention.
-
OCD
Living inside OCD often breeds depression. Getting both diagnoses right changes the medication plan.
-
Sleep problems
Insomnia and hypersomnia both amplify depression — and they often need their own attention in the plan.
What makes depression care different here
We would rather give you the full picture than a sales pitch — benefits, limitations, and a plan that fits how you actually live.
-
Same psychiatrist every visit
A boutique practice, not a high-volume clinic. Appointments are long enough to talk through what is actually happening.
-
Built for treatment resistance
Depression that has failed multiple medications is the largest part of what we do — Deep TMS and Spravato sit under the same roof as everyday prescribing.
-
Conservative prescribing
We start with the smallest effective dose and the fewest medications needed. Changes are deliberate, not reactive.
-
Therapy coordination
We do not offer therapy in-house. We coordinate closely with Montgomery County specialists whose practice is built around depression and CBT.
What untreated depression often pulls in
Leaving depression untreated does not only leave low mood in place. It often narrows life and invites other conditions into the mix.
- Work, school, and relationships that slowly fall behind what you know you can do
- Anxiety and irritability that grow out of exhaustion and hopelessness
- Sleep disruption that keeps mood and energy worse the next day
- Physical symptoms — pain, gut issues, fatigue — that send you through medical workups with no clear answer
- Years spent cycling through partial medication responses without a durable plan
- Waiting when depression is one of the most treatable conditions in psychiatry
Insurance and depression visits
Psychiatric evaluation and medication management for depression are billed as standard outpatient psychiatry under the plans we accept, including Medicare, Maryland Medicaid, and major commercial carriers. Your responsibility is whatever your plan sets for a specialist visit.
Deep TMS and Spravato are usually covered for treatment-resistant depression once prior authorization is in place. We verify benefits before the first appointment so there are no surprises.
Depression questions we get asked
Does Bright Horizons treat depression?
Yes. We provide psychiatric evaluation, medication management, Deep TMS, Spravato, and IM ketamine for adults with depression, including treatment-resistant depression.
Does insurance cover depression treatment?
Medication management and psychiatric evaluation are generally covered by most insurance plans. Deep TMS and Spravato are usually covered for treatment-resistant depression after prior authorization. We verify coverage before beginning treatment.
What is treatment-resistant depression?
Depression that has not responded adequately to two or more antidepressant trials at adequate doses and durations. Options include medication reevaluation, augmentation, Deep TMS, Spravato, and IM ketamine.
Does TMS help with depression?
Yes. Deep TMS is FDA-cleared for major depressive disorder in adults whose depression has not improved on antidepressant medication. In large real-world studies, roughly half of patients respond and about a third reach remission.
What is the difference between Spravato and IM ketamine?
Spravato is an FDA-approved nasal spray for treatment-resistant depression and is usually covered by insurance. IM ketamine is an injection used off-label, which allows more dosing flexibility but is usually cash pay.
Does Bright Horizons offer therapy for depression?
Not in-house. We coordinate with trusted therapists in the Montgomery County area and work closely alongside them.
How quickly can I be seen?
We typically schedule new patient evaluations within one to two weeks, with faster access for urgent presentations.
Can my first depression appointment be virtual?
No. Initial evaluations happen in person at Rockville or Frederick. Once you are an established patient, many follow-ups can be by video anywhere in Maryland.
Do you treat bipolar depression?
We treat Bipolar II and bipolar depression. We do not treat Bipolar I.
Is my information kept confidential?
Yes. Your psychiatric records are protected under HIPAA. We share information only with your consent or when the law requires it, such as situations involving imminent safety risk.