DFW · Treatment-Resistant Depression
Best Psychiatry Practices for Treatment-Resistant Depression in DFW (2026)
Disclosure: Willow & Stone publishes this guide and lists its own practice first. The other practices are independent, and we have no affiliation with them. Their details come from their own websites as of September 2026. Please confirm credentials, fees and availability with each practice directly.
← All guides · By the Willow & Stone team · Updated September 2026
Key Takeaways
- Treatment-resistant depression usually means depression that has not improved after at least two antidepressants taken at an adequate dose for an adequate length of time.
- DFW options fall into three groups: a careful medication and history review, procedure-based care (TMS, esketamine, ketamine, ECT), and academic research programs.
- Spravato (esketamine) is FDA-approved for adults with treatment-resistant depression and is only given in certified settings under a restricted safety program.
- Willow & Stone is listed first because we publish this guide. It sees patients at its Arlington office and by telehealth, focuses on medication review, pharmacogenomic testing and lab work, and does not offer TMS, esketamine or ketamine.
- No treatment on this list, ours included, comes with a promised result. Ask every practice how it decides what to try next and how it measures whether it is working.
If you have already worked through two or more antidepressants and still do not feel like yourself, the next question is less "which pill?" and more "who is going to look at the whole picture with me?" Dallas-Fort Worth has an unusual range of answers: an academic medical center with a dedicated depression research center, private clinics that offer TMS and esketamine, and telehealth practices that start by re-examining the medication history, labs and genetics. This guide describes six of them, what each one offers, and who each is set up to serve.
How we put this list together
Willow & Stone wrote this guide and placed its own practice first. That is a self-ranking, not an independent review, and you should read it that way. The other five practices have no connection to us.
We built the list in September 2026 from each practice's own website. We included a practice only if its site loaded, it described depression care that goes beyond a first-line prescription, and it named a location in Dallas-Fort Worth or stated that it serves Texas patients. We did not use reviews, star ratings or outcome claims, and we have not repeated any practice's response-rate figures, because those numbers cannot be compared across clinics.
The order after the first entry reflects breadth of treatment options described on each site, not a judgment about quality. The criteria below are ones you can check yourself on each practice's website or with a phone call.
- The practice's own site describes care for depression that has not responded to standard treatment.
- Clinician credentials are stated (MD, DO, PA-C or nurse practitioner), so you know who is prescribing.
- The treatment options offered are listed plainly: medication management, pharmacogenomic testing, TMS, esketamine, ketamine, ECT or research trials.
- The site says where care happens (office address, telehealth, or both) and how to start (self-referral or provider referral).
- Insurance or payment information is stated, or the practice says how to verify it.
At a glance
| Practice | Where / format | Best for |
|---|---|---|
| 1. Willow & Stone Integrative Mental Health | Arlington office + telehealth statewide (also NM, FL, AK, AZ, CO) | Adults who have tried several antidepressants and want a slower, data-informed medication review, in Arlington or by telehealth, before (or alongside) procedure-based options. |
| 2. UT Southwestern Medical Center: Center for Depression Research and Clinical Care | Dallas (Empire Central) and Richardson/Plano | People with complex or long-standing depression who want an academic evaluation, access to ECT, or information about research studies. |
| 3. Dallas Psychiatry and TMS Center | Dallas (Mockingbird Lane) + telehealth | Teens (13+) and adults in Dallas who want medication care and TMS or esketamine under one roof. |
| 4. Michael Shiekh MD | Dallas (North Central Expressway) + telehealth | Adults who want one board-certified psychiatrist to manage medication, TMS and esketamine together. |
| 5. Aware Behavioral Health | Dallas (LBJ Freeway) and Irving | Adults in Dallas or the Irving/Las Colinas side who want a clearly explained esketamine schedule. |
| 6. MindWell Urgent Care | Dallas (W. Mockingbird Lane) + telepsychiatry | People who want quick access to an evaluation and a practice that offers several interventional options in one place. |
1. Willow & Stone Integrative Mental Health
Arlington office + telehealth statewide (also NM, FL, AK, AZ, CO) · Dr. Stacey Forbes, DNP, APRN, PMHNP-BC
Willow & Stone is an integrative psychiatry practice with an office in Arlington and telehealth across six states, led by Dr. Stacey Forbes, a board-certified psychiatric-mental health nurse practitioner with nearly two decades of clinical experience, much of it at the Dallas VA Medical Center across inpatient, outpatient and psychiatric emergency settings. For depression that has not responded to treatment, the practice starts with a 90-minute integrative psychiatric evaluation that goes back over every medication you have tried: the dose, how long you took it, what side effects you had and why it was stopped. A surprising number of "failed" trials turn out to have been too short, too low or stopped for side effects that might have been managed differently.
From there, the plan may include pharmacogenomic (GeneSight) testing, which looks at genes that affect how your body processes many psychiatric medications, and functional lab work for thyroid function, nutrient status, inflammation and hormones. Those results inform prescribing; they do not dictate it. The practice's stated approach is to prescribe at the minimal effective dose and to treat medication as one part of a broader plan.
Willow & Stone does not offer TMS, esketamine, ketamine or ECT. If one of those becomes the right next step, you would need a clinic like several on this list, and a clear written history from a medication review can make that conversation faster.
- Complimentary discovery call, then a 90-minute integrative psychiatric evaluation
- Medication management follow-ups (25 to 50 minutes) with the same clinician every visit
- Pharmacogenomic (GeneSight) testing by cheek-swab kit, reviewed over video
- Functional and advanced lab consultation (50 minutes)
- Insurance for Texas patients (Aetna, Blue Cross Blue Shield, United Healthcare, UMR, Cigna); direct-pay with a monthly superbill elsewhere
Best for: Adults who have tried several antidepressants and want a slower, data-informed medication review, in Arlington or by telehealth, before (or alongside) procedure-based options.
Worth knowing: No TMS, esketamine or ketamine; in-person visits are only in Arlington. Coverage depends on your plan, so confirm benefits with the office before the first visit.
2. UT Southwestern Medical Center: Center for Depression Research and Clinical Care
Dallas (Empire Central) and Richardson/Plano · Academic psychiatry faculty; CDRC directed by Madhukar Trivedi, M.D.
UT Southwestern is the academic medical center in Dallas, and its Center for Depression Research and Clinical Care (CDRC), directed by Madhukar Trivedi, M.D., was established in 2015 to advance the treatment and prevention of depression. UT Southwestern's depression page lists electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), intravenous ketamine given under close supervision, and esketamine among its treatments, along with clinical trials that have studied nasal ketamine, esketamine, isoflurane and low-frequency magnetic stimulation.
Care is delivered through UT Southwestern's Behavioral Health clinic at 3030 Waterview Parkway in Richardson/Plano and its Multispecialty Psychiatry Clinic at Empire Plaza, 1430 Empire Central Drive in Dallas. The depression page asks patients seeking a consultation to have their current mental health provider send a referral, so this is usually a second step rather than a first appointment.
For people interested in research, the CDRC runs studies on difficult-to-treat depression, and its site links to a study-participation portal. Research participation has its own eligibility rules and is separate from routine clinical care.
- ECT, TMS, IV ketamine and esketamine listed on the depression page
- Clinical trials through the CDRC
- Two psychiatry clinic locations in the Dallas area
Best for: People with complex or long-standing depression who want an academic evaluation, access to ECT, or information about research studies.
Worth knowing: The depression page asks for a referral from your current mental health provider. In-person clinics; check insurance and wait times directly.
Visit UT Southwestern Medical Center: Center for Depression Research and Clinical Care →
3. Dallas Psychiatry and TMS Center
Dallas (Mockingbird Lane) + telehealth · Brian C. Forsythe, DO (board certified); two PA-Cs
Dallas Psychiatry and TMS Center was founded in 2003 by Dr. Brian C. Forsythe, whom the practice's team page describes as a board-certified Doctor of Osteopathy who trained in psychiatry at UT Southwestern. The team page also lists two certified physician assistants and a TMS coordinator. The office is at 5307 East Mockingbird Lane, near Mockingbird Station.
The practice lists medication management, psychotherapy, TMS and Spravato (esketamine), and it offers telehealth visits for patients who prefer to be seen from home. Its site states that it treats patients aged 13 and older and that it serves Texas residents. It also says it tailors treatment using each patient's DNA, which suggests genetic information is part of its medication planning; ask how testing is ordered and billed.
Because it combines office-based procedures with routine medication follow-up, this is a practice where you could move from medication management to TMS or esketamine without changing clinics.
- Medication management and psychotherapy
- TMS
- Spravato (esketamine)
- Telehealth visits for Texas residents
Best for: Teens (13+) and adults in Dallas who want medication care and TMS or esketamine under one roof.
Worth knowing: TMS and esketamine sessions happen in the Mockingbird office. The home page does not list insurance plans; ask the office.
4. Michael Shiekh MD
Dallas (North Central Expressway) + telehealth · Michael A. Shiekh, MD (board-certified psychiatrist)
Michael A. Shiekh, MD, PA is a board-certified psychiatrist whose practice describes itself as interventional psychiatry. The office is on North Central Expressway in Dallas, and the site lists TMS for depression and anxiety, Spravato, medication management and telehealth.
The practice's Spravato page explains that esketamine is a nasal spray derived from ketamine, that it is given in the office under medical supervision, and that patients are monitored for two hours after each treatment. It describes Spravato as a treatment for adults with treatment-resistant depression, which matches the FDA-approved indication. The site says the practice is credentialed with Blue Cross Blue Shield of Texas and Tricare and that the office can discuss other coverage and payment options.
A smaller, physician-led practice may suit people who want the same doctor overseeing both their medication and any procedure.
- Spravato (esketamine) with in-office monitoring
- TMS
- Medication management
- Telehealth
Best for: Adults who want one board-certified psychiatrist to manage medication, TMS and esketamine together.
Worth knowing: Credentialed plans named on the site are BCBS of Texas and Tricare; others need a call. Spravato and TMS are in-office only.
5. Aware Behavioral Health
Dallas (LBJ Freeway) and Irving · Physician-led; Spravato page names Dr. Sehdev
Aware Behavioral Health has offices at 5720 LBJ Freeway in Dallas and 2300 Valley View Lane in Irving. Its Spravato page lays out the schedule in plain terms: an induction phase of two treatments a week for the first four weeks, then a maintenance phase of one treatment every one to two weeks. Patients give themselves the nasal spray under medical supervision, stay for at least two hours of observation afterward, and need someone else to drive them home.
That level of detail is useful because esketamine is a real time commitment, especially in the first month. Aware also lists TMS, medication management, and care for depression, anxiety, ADHD, PTSD and insomnia, plus QB testing for ADHD. The site says insurance is accepted but does not list specific plans on that page.
The Spravato page names Dr. Sehdev but does not state the clinician's degree, so confirm who will supervise your treatment when you call.
- Spravato (esketamine): twice weekly for 4 weeks, then every 1 to 2 weeks
- TMS
- Medication management
- QB testing for ADHD
Best for: Adults in Dallas or the Irving/Las Colinas side who want a clearly explained esketamine schedule.
Worth knowing: Plan for twice-weekly office visits and a driver for the first month. Clinician credentials are not listed on the Spravato page.
6. MindWell Urgent Care
Dallas (W. Mockingbird Lane) + telepsychiatry · Board-certified psychiatric providers (individuals not named on these pages)
MindWell Urgent Care is a Dallas mental health practice at 1250 West Mockingbird Lane that pairs prompt scheduling with interventional options. Its site offers in-person visits at the Dallas office and telepsychiatry for patients in Texas, Oklahoma, New Jersey, Florida and Kansas, with weekday hours from 8 a.m. to 6 p.m.
Its ketamine page describes intranasal ketamine given under a provider's supervision in the Dallas office, over a number of sessions spread across several weeks, for patients with moderate to severe or treatment-resistant conditions. The same site lists Spravato, TMS, GeneSight testing, medication management and ADHD testing. Note that ketamine (as opposed to Spravato, which is esketamine) is not FDA-approved for depression, so ask how the practice decides who is a candidate and what monitoring it uses.
MindWell says it is in-network with most major insurance plans and that ketamine treatment is covered by most major payers; verify your own plan before starting.
- Intranasal ketamine in the Dallas office
- Spravato (esketamine)
- TMS
- GeneSight testing
- Telepsychiatry in five states
Best for: People who want quick access to an evaluation and a practice that offers several interventional options in one place.
Worth knowing: Individual clinicians are not named on the pages we used. Ketamine for depression is off-label; ask about candidacy, monitoring and coverage.
How to choose the right next step
Start with an honest look at your medication history. If you are not sure whether your earlier trials were long enough or at a full dose, a detailed review may be the most useful next appointment. That is where a practice like Willow & Stone, or any careful medication manager, fits. If your trials clearly were adequate and you have been unwell for a long time, it is reasonable to ask about brain stimulation such as TMS or ECT, which NIMH says is usually used after other treatments have been tried, or about esketamine, which the FDA has approved for adults with treatment-resistant depression.
Think about logistics as much as treatment. TMS usually means frequent office visits over several weeks, and esketamine means staying in the clinic for monitoring and arranging a ride home. An academic center may have longer waits and require a referral. Telehealth removes the drive but cannot deliver a procedure.
Finally, ask each practice the same questions: Who will prescribe or supervise my care, and what are their credentials? How will we measure whether this is working? What happens if it does not? What will it cost, and does my plan cover it? A good practice will answer all four without hesitation.
Common Questions
What counts as treatment-resistant depression?
It is usually defined as depression that has not improved enough after at least two different antidepressants taken at an adequate dose for an adequate length of time. Our article on causes of treatment-resistant depression covers why that happens.
Is Spravato the same as ketamine?
No. Spravato is esketamine, a nasal spray that the FDA has approved for adults with treatment-resistant depression, available only in certified settings with monitoring after each dose. Ketamine given by IV or other routes for depression is used off-label.
Does Willow & Stone offer TMS or esketamine?
No. Willow & Stone sees patients in Arlington and by telehealth, and it offers medication review and management, pharmacogenomic testing and lab work. For TMS, esketamine or ketamine you would need an in-person clinic.
Can genetic testing fix treatment-resistant depression?
No test fixes depression. Pharmacogenomic testing can show how your body is likely to process some medications, which can help a clinician choose or dose them. It cannot say which medication will work for you. See TRD and genetic testing.
Do I need a referral?
It depends on the practice. UT Southwestern's depression page asks for a referral from your current mental health provider. Most private practices, including Willow & Stone, let you book directly through a consultation request.
Sources
- NIMH: Depression
- NIMH: Brain Stimulation Therapies
- FDA: SPRAVATO (esketamine) prescribing information, 2025 label
- MedlinePlus: Pharmacogenetic Tests
- American Psychiatric Association: What Is Depression?
- UT Southwestern: Depression care
- UT Southwestern: Center for Depression Research and Clinical Care
- Dallas Psychiatry and TMS Center: Our Team
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