Picture someone on a third antidepressant that has not worked, privately deciding they must be broken in a way pills cannot reach. They tell no one, not even the doctor, because it seems nothing is left to try.
That belief, and a handful like it, keeps people stuck. This myth-check takes on the usual suspects with help from our own survey of 443 Midwest adults. It is written for readers in O'Fallon, but the myths travel everywhere.
Myth: "Almost everyone gets better on the first or second antidepressant."
What the data suggests: Plenty of people do not. In our survey, 72 percent said standard medication had not tamed depression, anxiety, or PTSD, either personally or through someone they love. Half the sample, 50 percent once you combine two answer choices, described their own experience with it.
Those are final figures, and the question captured people's own sense of what happened rather than a formal diagnosis. But they make one thing hard to argue with: medication falling short is a common story, not a strange exception.
Myth: "If the meds did not work, it is because I did not try hard enough."
Reality: Response to antidepressants varies for biological reasons that have nothing to do with effort. Some people need a different medication class. Some have other conditions making treatment harder. Some simply do not respond well to the most common approaches. Clinicians use the term treatment-resistant depression, usually after two adequate medication trials, precisely because this happens often enough to need a name.
Blaming yourself is a symptom of depression, not a fair reading of the evidence.
Myth: "When the pills fail, the only choice left is more pills."
Reality: Medication adjustments are one path, but not the only one. Depending on the person, a clinician might consider structured psychotherapy, transcranial magnetic stimulation (TMS), esketamine nasal spray, or other specialized care.
The trouble is that few people have heard of these. Barely a quarter of our respondents knew what TMS was. For esketamine, sold as Spravato, the picture was even starker: seven in ten had never heard the name at all, and only 6 percent could describe it. When people do not know an option exists, they assume the menu is shorter than it is. A plain-English Spravato guide can fill in that gap.
Myth: "Esketamine and the ketamine people take at home are basically the same."
Reality: They are different in ways that matter. Esketamine, under the Spravato name, holds FDA approval for adults with depression that resists treatment; it is taken under direct supervision in a certified clinic, with monitoring afterward, and patients cannot drive home that day.
Ketamine for depression, including at-home programs sold through telehealth, is off-label. Plain ketamine has no FDA approval for depression, and taking it at home means far less supervision. Those are two separate decisions, and a clinician should help you with either one.
Myth: "People around here would never consider something like ketamine therapy."
What the data suggests: Most people are not closed off. On first hearing of ketamine therapy for depression or PTSD, about a third of respondents, the biggest group, said cautious but open. Another 18 percent were hopeful or curious. Only 9 percent reacted negatively.
Caution is not the same as rejection. It usually means "I want to know more, and I want to hear it from someone I trust."
Myth: "You find these treatments by searching online."
What the data suggests: People overwhelmingly start with a person, not a search bar. A majority, 56 percent, would phone their primary doctor before anyone else, while 12 percent would open a search engine. For three quarters, nothing would persuade them like a recommendation from their own doctor.
In O'Fallon, where many families have long-standing relationships with primary care practices, that is good news. The conversation can start with someone who already knows you.
Myth: "If insurance says no once, that is the end."
Reality: Initial denials are common with specialized treatments and are frequently reversible with more documentation, a peer-to-peer review between your doctor and the insurer, or a formal appeal. Keeping a record of each medication, its dose, and its dates, makes that process easier.
Coverage clearly matters to people here. Eighty-five percent of our respondents made insurance a top-two priority for choosing a provider, and just over half would tolerate extra hoops to keep a treatment covered.
Myth: "Talking about it will make things worse for my family."
Reality: Silence tends to be heavier. Remember that more than a third of respondents in our survey, across two answer choices, had watched someone close to them struggle with depression that medication did not fix. The people in your life may already suspect what you are carrying, and many have carried something similar.
Putting it to use
- Two or more antidepressants without enough relief? Tell your doctor exactly that.
- Ask whether your history counts as treatment-resistant depression, and what options that opens.
- Bring a written list of medications, doses, durations, and side effects.
- Ask about coverage and referral options before you commit to anything.
Whether any particular treatment suits you is for a clinician to decide. What this myth-check can do is clear away the false beliefs that keep people from asking.
If you or someone you love is thinking about suicide, reach out now. Every hour of every day, dialing or texting 988 brings you to a trained listener at the Suicide and Crisis Lifeline. It is not reserved for certain emergencies, and veterans can press 1.
Methodology
Top-line results here come from our Pollfish consumer panel survey, whose 443 respondents, 18 to 64, live in Indiana, Wisconsin, Nebraska, Missouri, Oklahoma, Minnesota, Ohio, Kansas, Illinois, and Iowa. Fieldwork ended June 23, 2026. Results come from the validated final data, and no subgroup figures are reported. The publisher commissioned the study and paid its costs directly. This is not medical advice.