What qualifies as treatment-resistant depression?

A. Treatment-resistant depression is generally defined as major depressive disorder that has not adequately responded to at least two antidepressant trials, each at an adequate dose for an adequate duration, usually 6 to 8 weeks. About 1 in 3 people diagnosed with depression meets this definition. Insurance coverage for TMS and Spravato normally requires this documented history, which is one reason we review your full medication record during evaluation.

A. Yes. BrainsWay Deep TMS is FDA-cleared for OCD, using a different coil and stimulation target than the depression protocol. Dr. Roth has specialized OCD training and previously served as the Medical Director of OCD Programming at Mindful Health Solutions in the San Francisco Bay Area. TMS for OCD works best along Exposure and Response Prevention therapy, and we coordinate with ERP-trained therapists in the Louisville area.

How do I know if my child has ADHD or something else?

A. Attention problems can stem from ADHD, anxiety, depression, sleep disorders, learning differences or trauma, and the symptoms overlap heavily. That is why a proper diagnostic evaluation matters more than a checklist. Dr. Roth is triple-board certified in pediatrics, child & adolescent psychiatry and adult psychiatry, which lets him assess a child's development, medical history, school performance, and family context together rather than treating a symptom in isolation.

Can TMS or Spravato treat postpartum depression?

A. TMS can be used for postpartum depression in appropriate cases, and there is also Zurzuvae, an oral medication specifically approved for postpartum depression. Kim Woods, our psychiatric nurse practitioner, holds specialty certification in Perinatal Mental Health (PMH-C) through Postpartum Support International and focuses her practice on evidence-based psychiatric care during pregnancy and postpartum. If you are breastfeeding or pregnant, that changes the options, and it is one of the first things we discuss.

Is PMDD just bad PMS?

A. No. Premenstrual Dysphoric Disorder is a distinct diagnosis in the DSM-5 involving severe mood disruption, irritability, and depressive symptoms during the luteal phase that resolve with menstruation and recur each cycle. Unlike PMS, PMDD symptoms are severe enough to significantly disrupt work, relationships, and daily functioning. It is treatable, and it is frequently dismissed or misdiagnosed for years

Does insurance cover accelerated TMS the same way it covers standard TMS?

Accelerated TMS is typically not covered by insurance at this time, as most insurers only reimburse the standard once-daily protocol. The all-inclusive cost is $7,500, which includes your evaluation, 38 sessions during treatment weeks, all follow-up visits, and free touch-up sessions within 6 months if needed. FSA dollars are accepted, and CareCredit financing may be available for eligible patients. We understand this is a significant investment, and your written cost estimate comes before anything is scheduled. Many patients find the shorter time commitment worth the cost.

What happens if my insurance denies TMS coverage?

A denial isn’t always final. Many denials are appealable with additional documentation, and our team can walk you through next steps, including self-pay and financing options if the appeal doesn’t succeed.

Is a consultation itself covered by insurance?

Your initial evaluation with Dr. Roth is typically billed the same way any psychiatric evaluation would be under your plan. Our care coordinator will confirm this specific to your coverage before you come in.

Conditions We Treat | Louisville, KY

Many of our patients arrive after years of trying multiple medications and multiple providers with varying degrees of success. What they find at Bluegrass Advanced Mental Health is a different kind of practice - one built around the most effective and advanced solutions.

We treat the conditions using a full spectrum of approaches: TMS therapy, Spravato, comprehensive medication management, and integrated psychiatric care across the lifespan, including children & adolescents. Every plan is personalized. Every protocol is adjusted as you respond. Every patient is seen as a whole person, not just a diagnosis.

Depression is more than persistent sadness. It is the weight that makes ordinary tasks feel impossible, the silence that replaces things you used to enjoy, and the exhaustion that sleep doesn’t fix. For millions of Americans, depression is also treatment-resistant — meaning antidepressants and therapy alone have not brought adequate relief.

Treatment-resistant depression (TRD) is defined as major depressive disorder that has not responded to at least two adequate trials of antidepressant medication. It affects an estimated 1 in 3 of people diagnosed with depression and is one of the primary conditions Bluegrass Advanced Mental Health was built to treat.

OCD is one of the most misunderstood and underdiagnosed conditions in psychiatry.

It is not about being neat or organized. It is intrusive, unwanted thoughts — obsessions — that generate intense anxiety, followed by compulsive behaviors or mental rituals performed to neutralize that distress.

For many people with OCD, it is exhausting, isolating, and deeply disruptive to daily life.

OCD affects approximately 1 in 40 adults and 1 in 50 children in the United States. Many go years without a correct diagnosis. Source: International OCD Foundation

At Bluegrass Advanced Mental Health, Dr. Roth brings specialized training in OCD treatment — including experience as Medical Director of OCD Programming at Mindful Health Solutions in the San Francisco Bay Area.

Anxiety is the most common mental health condition in the United States — and one of the most undertreated. There is a difference between everyday worry and an anxiety disorder that disrupts sleep, strains relationships, limits career potential, and makes leaving the house feel like a negotiation.

Generalized Anxiety Disorder (GAD) is characterized by persistent, difficult-to-control worry across multiple areas of life. Panic Disorder involves recurrent, unexpected panic attacks and the ongoing dread of their return. Social Anxiety Disorder creates intense fear of social or performance situations, often leading to avoidance that narrows daily life.

All three are treatable - and at Bluegrass Advanced Mental Health, all three are treated with the same precision and personalization we bring to every condition.

ADHD is not a childhood condition that people outgrow. It is a neurodevelopmental disorder that affects attention regulation, impulse control, and executive function across the lifespan - from the child who cannot sit through class to the adult who cannot finish projects, maintain focus at work, or quiet a constantly racing mind.

Many adults with ADHD were never diagnosed as children. Others were diagnosed but never received care that actually fit how their brain works.

At Bluegrass Advanced Mental Health, Dr. Roth brings board certification in Pediatrics, Child & Adolescent, and Adult Psychiatry, making him uniquely qualified to treat ADHD across all age groups with a developmental lens that most psychiatrists cannot offer.

Premenstrual Dysphoric Disorder (PMDD) and postpartum depression are serious, biologically driven mood conditions that are frequently dismissed, minimized, or misdiagnosed. They are not a matter of willpower or adjustment.

They are medical conditions with effective treatments — and they deserve the same level of clinical attention as any other psychiatric diagnosis.

PMDD involves severe mood disruption, irritability, and depression in the luteal phase of the menstrual cycle - symptoms that resolve with menstruation but return each cycle with a predictable impact on work, relationships, and quality of life.

Postpartum depression affects approximately 1 in 8 new mothers and can emerge at any time in the first year after birth. Left untreated, both conditions can significantly worsen over time.

What qualifies as treatment-resistant depression?
A. Treatment-resistant depression is generally defined as major depressive disorder that has not adequately responded to at least two antidepressant trials, each at an adequate dose for an adequate duration, usually 6 to 8 weeks. About 1 in 3 people diagnosed with depression meets this definition. Insurance coverage for TMS and Spravato normally requires this documented history, which is one reason we review your full medication record during evaluation.
Can TMS treat OCD?
A. Yes. BrainsWay Deep TMS is FDA-cleared for OCD, using a different coil and stimulation target than the depression protocol. Dr. Roth has specialized OCD training and previously served as the Medical Director of OCD Programming at Mindful Health Solutions in the San Francisco Bay Area. TMS for OCD works best along Exposure and Response Prevention therapy, and we coordinate with ERP-trained therapists in the Louisville area.
How do I know if my child has ADHD or something else?
A. Attention problems can stem from ADHD, anxiety, depression, sleep disorders, learning differences or trauma, and the symptoms overlap heavily. That is why a proper diagnostic evaluation matters more than a checklist. Dr. Roth is triple-board certified in pediatrics, child & adolescent psychiatry and adult psychiatry, which lets him assess a child's development, medical history, school performance, and family context together rather than treating a symptom in isolation.
Can TMS or Spravato treat postpartum depression?
A. TMS can be used for postpartum depression in appropriate cases, and there is also Zurzuvae, an oral medication specifically approved for postpartum depression. Kim Woods, our psychiatric nurse practitioner, holds specialty certification in Perinatal Mental Health (PMH-C) through Postpartum Support International and focuses her practice on evidence-based psychiatric care during pregnancy and postpartum. If you are breastfeeding or pregnant, that changes the options, and it is one of the first things we discuss.
Is PMDD just bad PMS?
A. No. Premenstrual Dysphoric Disorder is a distinct diagnosis in the DSM-5 involving severe mood disruption, irritability, and depressive symptoms during the luteal phase that resolve with menstruation and recur each cycle. Unlike PMS, PMDD symptoms are severe enough to significantly disrupt work, relationships, and daily functioning. It is treatable, and it is frequently dismissed or misdiagnosed for years

Mental Health Care in Louisville, KY

Comprehensive Care for the Full Spectrum of Mental Health Conditions