Brian Erb

I’m Brian Erb, PMHNP-BC, a board-certified Psychiatric Mental Health Nurse Practitioner in Texas. I help adults who are dealing with depression, anxiety, bipolar disorder, trauma/PTSD, ADHD, sleep problems, and co-occurring substance use. A large part of my work is at Windmill Wellness Ranch in the Texas Hill Country, where I complete psychiatric evaluations, manage medications, and coordinate care that can include TMS and other brain-based treatments when they make sense.

Clients often come to me after feeling overmedicated, undermedicated, or unheard. I take time to get the history right, explain options in plain language, and make changes carefully. I am direct, practical, and nonjudgmental. You do not need a polished story before we start—just a willingness to work on what is getting in the way of feeling stable.

I focus on psychiatric evaluation and medication management, with supportive counseling woven into visits rather than standalone psychotherapy. Care starts with a thorough assessment: symptoms, medical history, substances, sleep, past medication trials, and what has or has not worked. From there we build a plan together.

I use an evidence-based, whole-person approach. Medication is a tool, not the whole treatment. I watch for interactions, side effects, and whether a medicine is actually helping function—not just reducing a score on a form. When it is appropriate, I also consider neuromodulation options such as TMS and coordinate with therapy and recovery supports. Sessions are collaborative. I will be honest about risks and benefits, and nothing is started or changed without your informed agreement.

You should leave with a clearer picture of what is going on, a specific next step, and a plan you understand. First visits are comprehensive evaluations. Follow-ups are typically shorter and focused on how you are sleeping, functioning, and tolerating medication, with adjustments as needed.

You can expect plain-language explanations, realistic timelines, and a provider who tracks details (labs, side effects, prior trials) so you are not starting from scratch every visit. My goal is for you to feel informed, steadier, and more in control of your care—not rushed or talked past.