Once a person you love has spent months in depression that medication never touched, advice arrives from every direction. Some of it is good. Some of it quietly sends families down the wrong road before they have taken the first step.
We held six common beliefs about where depression care begins up against our summer poll. It surveyed 443 Midwest adults in ten states, Missouri and Illinois among them, so O'Fallon families on either side of the river sit inside its footprint. Every figure is final.
Myth one: "If they really wanted help, they would look it up themselves."
What the data shows: Most people do not start with a search engine. For a first step toward ketamine or esketamine treatment, a mere 12 percent of respondents chose an online search. Over four times that share, 56 percent, named a primary care visit, and 23 percent would start with a psychiatrist.
So a loved one who has not researched anything is not necessarily unmotivated. They may simply be doing what most people do, which is waiting to ask someone they trust. The practical move is to help them get in front of that person.
Myth two: "A family doctor cannot do anything about serious depression."
What the data shows: People disagree, strongly. On the question of who could persuade them, the family physician won with 74 percent. Nothing else came close.
And there are good reasons for that trust. The family doctor is able to screen for depression, look over past medications, check for physical causes that mimic or worsen it, adjust medication, and refer to psychiatry. They can also document a medication history, which insurers commonly require before approving treatments for depression that has resisted standard care. That documentation often starts in primary care.
Myth three: "You need to know what treatment to ask for before you go."
What the data shows: Hardly anyone does. Almost three quarters of the O'Fallon-area and Midwest adults we polled, 73 percent, were strangers to the name Spravato, the esketamine spray approved when depression shrugs off other treatment. Only 6 percent could say what it does.
Where our poll let people write their own search words, they typed phrases such as "ptsd help" and "depressed," not drug names. That is a perfectly good way to walk into an appointment too. "The medication is not working and we want to know what else exists" is a complete question.
Myth four: "Family members do not really influence these decisions."
What the data shows: They do, just not first. In our survey, a close friend or relative ranked as the runner-up influence, picked by 18 percent. That is nine times the share who said an ad would move them.
Your encouragement matters. Where it tends to work best is in getting someone to the appointment and helping them tell the story accurately once there, rather than trying to substitute for the clinician's recommendation.
Myth five: "Serious depression needs a psychiatrist before anyone will take it seriously."
What the data shows: Most people do not wait for a specialist to begin. A psychiatrist was where 23 percent of respondents would begin, less than half the share who would start with a primary doctor. That ordering makes practical sense. New psychiatry appointments around St. Charles County and St. Louis can take time to get, and some specialists expect a referral before they will book a first visit.
A primary care visit is not a detour; it is often how specialty care gets booked, with the medication history attached. And if a psychiatrist has an opening sooner, take it. Either door leads to the same hallway.
Myth six: "Going to the doctor means signing up for ketamine."
What the data shows: People want options, and the first appointment is where options are laid out, not where anyone is committed to a single one. Our respondents were not uniformly eager. About a third, 34 percent, felt cautious yet open toward ketamine therapy, while 21 percent leaned skeptical and 9 percent were opposed.
A good visit might end with a medication change, a therapy referral, a psychiatry referral, a conversation about TMS, which is a drug-free option, or a discussion of esketamine. Plenty of people care about avoiding more drugs; 64 percent of our respondents put weight on a drug-free choice. Nobody should feel they are signing up for something by showing up.
The thread running through all six
Each one makes the first step feel harder than it is. The survey suggests the first step is actually quite ordinary: a visit with the doctor most people already trust. For caregivers in O'Fallon, that might be an office just off Highway K or Interstate 70, or a telehealth visit through the practice. It rarely requires expertise you do not have.
Three things you can do this week
- Ask your loved one whether they would be willing to see their primary doctor specifically about the depression.
- Offer to make the call, find the insurance card, or drive.
- Help them write down every medication they have tried, and what happened.
Important limits
This is survey research, not clinical evidence, and not advice for any individual. Spravato, the esketamine brand, is the FDA-approved option for adults whose depression has outlasted other care, and a certified clinic must supervise each dose; Brain Recovery Centers explains how Spravato care works for families weighing it. Ketamine that an internet prescriber mails to your door is a separate, looser practice, and the two should not be confused. A clinician decides what is appropriate.
If your loved one is saying they want to die, or you fear for their safety tonight, contact 988 now by call or text. Counselors at the Suicide and Crisis Lifeline work every hour and will coach you as a relative, too.
Methodology
Pollfish put survey 395586438 in front of consumer-panel members until June 23, 2026. We ended up with 443 completed questionnaires, each from someone 18 to 64 in Illinois, Missouri, Iowa, Ohio, Minnesota, Kansas, Indiana, Wisconsin, Nebraska and Oklahoma. Some questions allowed several choices. These whole-sample totals are the validated, final count. Money for the study, and the request for it, came from the publisher.