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Frequently Asked Questions About Psychiatric Care in Maryland

Getting the right psychiatric care starts with asking the right questions. Below you’ll find honest, detailed answers to the questions we hear most often from new and prospective patients at Bright Horizons Psychiatry in Rockville, MD.

Whether you’re exploring treatment options for the first time, looking for an alternative after antidepressants haven’t worked, or simply trying to understand what to expect — this page is for you. If you don’t find what you’re looking for, our team is always happy to speak with you directly.

How is a psychiatrist different from a therapist or psychologist?

This is one of the most common questions we get — and it’s an important one. A psychiatrist is a medical doctor (MD or DO) who specializes in mental health. Because they’re physicians, psychiatrists can diagnose mental health conditions, prescribe and manage medications, and offer advanced medical treatments like TMS therapy or esketamine.

A therapist or psychologist, on the other hand, provides talk therapy and counseling but typically cannot prescribe medications. Many patients benefit from working with both — a psychiatrist for medication or treatment management and a therapist for ongoing counseling.

At Bright Horizons Psychiatry, our providers focus on diagnosis, medication management, and advanced treatment options including TMS, esketamine (Spravato), and IM ketamine. We can work alongside your existing therapist or help you find one if needed.

Your first appointment at Bright Horizons Psychiatry is a comprehensive psychiatric evaluation — typically 45 to 60 minutes. This is not a therapy session. Our goal is to understand your full mental health history, current symptoms, any previous treatments you’ve tried, and your personal goals for care.

During your first visit you can expect:
A detailed review of your psychiatric and medical history
Discussion of your current symptoms and how they’re affecting your daily life
A review of any medications you’ve previously tried or are currently taking
An honest conversation about treatment options that may be right for you
A clear next step — whether that’s starting a medication, scheduling a TMS consultation, or exploring esketamine

We encourage you to come with questions. The more we understand about your history and goals, the better we can tailor a treatment plan to you.

Yes, absolutely. We welcome patients who are transferring from another provider. Switching psychiatrists is more common than people think — and there’s no need to feel uncomfortable about it. Whether you’re moving to a new area, unhappy with your current care, looking for access to treatments your current provider doesn’t offer, or simply want a second opinion, we’re here to help.

When you switch to Bright Horizons, we’ll ask for your previous records to get a full picture of your treatment history. This helps us avoid starting from scratch and ensures continuity of care. We never make assumptions — we’ll review everything with you directly and make sure our approach makes sense for your specific situation.

Our practice primarily treats adult patients (18 and older). Some of our advanced treatments, including TMS therapy and esketamine, are currently FDA-approved and clinically indicated for adults. If you have a teenager who needs psychiatric care, we recommend asking your pediatrician for a referral to a child and adolescent psychiatrist in the area.

If you’re unsure whether your situation falls within our scope, please call us — we’re happy to discuss and point you in the right direction if we’re not the best fit.

Treatment-resistant depression (TRD) is a term used when a patient has tried at least two different antidepressant medications at adequate doses and for adequate duration, but hasn’t experienced sufficient improvement in their symptoms. It’s more common than most people realize — research suggests that approximately 30% of people with major depressive disorder don’t respond well to standard antidepressants.

Signs that you may have treatment-resistant depression include:

  • You’ve tried two or more antidepressants and seen little to no improvement
  • Medications worked initially but stopped being effective over time
  • You’ve experienced significant side effects that made it difficult to stay on medication
  • Your depression has been present for months or years despite treatment attempts

If this sounds familiar, you’re not out of options. Bright Horizons Psychiatry specializes in treatment-resistant cases. TMS therapy, esketamine (Spravato), and IM ketamine are all specifically designed for patients who haven’t responded to standard treatments — and all three are available at our Rockville, MD practice.

These are three distinct treatments, each with different mechanisms, protocols, and ideal patient profiles. Here’s a straightforward comparison:

The right treatment depends on your specific diagnosis, history with other treatments, insurance coverage, and personal preferences. During your consultation at Bright Horizons Psychiatry, we’ll review all options with you and recommend the one most likely to work for your situation. Many patients ultimately try more than one treatment over time.

In most cases, yes. TMS therapy is specifically designed to be used alongside antidepressant medications — the two approaches work through different mechanisms and can complement each other. Many patients continue their existing medication regimen throughout their TMS course and some see enhanced results from the combination.

For esketamine (Spravato), the FDA-approved protocol also involves combining it with an oral antidepressant. In fact, esketamine is specifically approved as an add-on treatment rather than a standalone therapy.

For IM ketamine, your provider will review your current medications before beginning treatment. Most medications are compatible, but there are some that may interact — our team will conduct a thorough medication review before your first session.

The short answer: don’t stop any current medications without speaking to your provider first. We’ll guide you on exactly what to do or adjust before and during treatment.

This depends heavily on the type of treatment — here’s an honest breakdown:

Antidepressant medications: Most people need 4-8 weeks at a therapeutic dose before seeing meaningful improvement. Some take longer. It often takes trying more than one medication to find the right fit.

TMS therapy: Most patients begin noticing improvement around weeks 3-4 of their treatment course. The full course is typically 6 weeks (30 sessions). Some patients notice earlier, some later.

Esketamine (Spravato): This is one of the fastest-acting treatments available. Some patients report improvement after their first or second session. The acute treatment phase is 4 weeks with twice-weekly sessions.

IM ketamine: Ketamine is known for its rapid onset. Some patients experience significant relief within 24-48 hours of their first infusion. A standard initial course is 6 infusions over 2-3 weeks.

We always set realistic expectations during your consultation. Mental health treatment is not always linear — there may be adjustments along the way — but our goal is to find what works for you as efficiently as possible.

We accept most major commercial insurance plans as well as Maryland Medicaid and Medicare. Accepted plans include but are not limited to:

  • BlueCross
  • BlueShield
  • Aetna
  • Cigna
  • United Healthcare / UnitedHealthcare
  • Maryland Medicaid (HealthChoice)
  • Medicare
  • Tricare
  • Others (please call to verify)

Coverage varies by treatment type and individual plan. TMS therapy and esketamine (Spravato) are covered by most major plans when medical necessity criteria are met. IM ketamine is typically not covered by insurance and is self-pay.

We verify your insurance benefits before your first appointment so there are no surprises. Call us or visit our insurance eligibility page to check your specific coverage.

Insurance denials are frustrating but common — especially for newer treatments like TMS and esketamine. The good news is that denials are not always final, and our team has experience navigating this process.

Here’s what typically happens when a claim is denied:

  • Prior authorization is required — we submit clinical documentation showing medical necessity on your behalf
  • If denied, we file a formal appeal with supporting clinical evidence
  • If the appeal is denied, you have the right to request an independent external review
  • In some cases, peer-to-peer calls between our provider and the insurance medical director resolve denials quickly

We fight for our patients’ coverage. Our team handles the prior authorization and appeal process — you don’t have to navigate this alone. In the meantime, we can also discuss self-pay options if you need to start treatment before insurance is resolved.

Out-of-pocket costs vary by treatment. Here are general ranges — our team will give you exact pricing during your consultation:

We never want cost to be a barrier to getting care. Speak with our team about payment options and we’ll do our best to find a solution that works for your situation.

We work hard to see new patients as quickly as possible — in many cases within the same week. We understand that when someone decides to seek psychiatric help, waiting weeks or months for an appointment can feel defeating.

Availability varies based on the type of appointment needed:

  • New patient consultations: typically available within 1-2 weeks, often sooner
  • TMS evaluations: usually schedulable within the same week
  • Telehealth appointments: often available within days

Call our office directly for the most current availability. If you’re in a situation that feels urgent, please let our front desk know — we always try to accommodate patients who are in acute distress.

Both options are available at Bright Horizons Psychiatry, and each has advantages depending on your situation.

Choose telehealth if: you have a busy schedule, transportation challenges, prefer the comfort of home, live further from our Rockville office, or need a quick follow-up appointment for an existing prescription.

Choose in-person if: you’re a new patient coming for an initial evaluation, you’re starting TMS therapy or esketamine (these must be done in-office), your symptoms are complex and benefit from a face-to-face assessment, or you simply prefer meeting your provider in person.

Many of our patients do a mix of both — initial evaluation and treatment sessions in-person, with telehealth for ongoing medication management check-ins. We’ll help you figure out the right cadence for your care.

We treat a wide range of psychiatric conditions in adults, with a particular specialty in mood disorders and treatment-resistant cases. Conditions we commonly treat include:

  • Major depressive disorder (MDD)
  • Treatment-resistant depression
  • Anxiety disorders (generalized anxiety, social anxiety, panic disorder)
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • Postpartum depression
  • Seasonal affective disorder (SAD)

If you’re unsure whether your condition falls within our scope, the best approach is to call us. We’ll be upfront about whether we’re the right fit or if another specialist would serve you better.

Yes, when clinically appropriate and medically necessary, our providers can prescribe controlled substances including stimulants for ADHD (such as Adderall or Ritalin) and benzodiazepines for anxiety or acute psychiatric symptoms.

Prescribing controlled substances requires a thorough psychiatric evaluation and ongoing monitoring. We take medication safety seriously and follow all Maryland state prescribing guidelines. For patients transferring from another provider who are already on controlled substances, we’ll review your history carefully before continuing or adjusting any prescriptions.

If you have specific questions about a medication you’re currently taking or hoping to start, please bring that up during your consultation — we’ll always give you a clear, honest answer.