When your partner finally says, "Okay, maybe I should look into something else," the next question lands on you almost immediately: look where? In O'Fallon, Missouri, as in most places, there are three realistic starting points for depression that standard medication has not fixed. The family doctor. A psychiatrist. Or the search bar on a phone. They lead to different places, at different speeds, with different risks.
This comparison lays them side by side for spouses and partners. Its numbers trace to 443 adults in ten Midwest states who answered a publisher-funded poll in June. Couples were not singled out, so every percentage speaks for the whole general-public sample, and all of them are final, validated numbers.
What people said they would do first
Asked where they would turn first if they wanted a newer treatment like ketamine or esketamine, respondents split this way: primary care drew a clear majority at 56 percent. A psychiatrist or other mental health professional drew 23 percent. Searching online on their own drew 12 percent. The small remainder scattered: 5 percent confessed they would be stuck at square one, and a mere 1 percent would start by quizzing a friend. O'Fallon sits in the St. Louis TV market, whose 31 respondents make a small group; 61 percent of them would begin in primary care.
A related question explains why the doctor routes dominate. As for whose recommendation would tip them into such a treatment, their own doctor was the answer given by 74 percent of respondents. Family and friends, the group a partner belongs to, were named by 18 percent. Ads were picked by 2 percent.
Route 1: The primary care doctor
How it works. Your partner books a visit focused on mood. The doctor reviews medication history, checks for medical contributors like thyroid problems or sleep disorders, adjusts treatment, and refers to psychiatry when newer options are worth considering.
Speed. Moderate. A primary care visit is often easier to book than a new psychiatrist, but a referral adds a second wait.
Trust. Highest. This is the doctor most people named as their deciding voice.
Risk of a wrong turn. Low. The doctor sees the whole medical picture.
Where a partner helps. Building the written medication history, booking, driving, and, if invited, adding observations in the exam room.
Best for: most people, especially anyone who has not had a checkup in a while or who has other health conditions.
One more advantage is easy to overlook. Primary care is where the rest of your partner's health lives: blood pressure readings, lab work, the medication list from every other specialist. A treatment decision made with all of that in view is simply safer than one made from a single intake form somewhere else.
Route 2: Straight to a psychiatrist
How it works. Your partner books directly with a psychiatrist or psychiatric nurse practitioner, either through insurance or a referral they already have.
Speed. Varies. New-patient psychiatry appointments can take a while to land. Some plans require a primary care referral first, so check before calling.
Trust. High. A specialist can evaluate for treatment-resistant depression and discuss options like esketamine directly.
Risk of a wrong turn. Low, provided the psychiatrist is in network and has current records.
Where a partner helps. Calling the insurer for an in-network list, handling scheduling, and gathering records from past prescribers.
Best for: people who already have a psychiatrist or who have clearly tried multiple antidepressants without enough relief.
Route 3: The search bar
How it works. Your partner, or you, searches for help and contacts whatever comes up.
Speed. Fastest to a phone number. Sometimes slowest to appropriate care.
Trust. Lowest, according to the poll. Online voices, even veterans and first responders people follow, persuaded only 4 percent.
Risk of a wrong turn. Highest. The poll asked what people would type, and 319 wrote answers like "best ways to handle depression," "help with ptsd," and "therapist near me." Searches like these return a mix of very different things: Spravato, the FDA-approved esketamine nasal spray given only at certified sites; IV ketamine clinics, whose depression use is off-label; and telehealth outfits sending ketamine home, also off-label and minimally supervised. From a results page, those can look interchangeable. They are not. Brain Recovery Centers keeps a straightforward description of Spravato care for comparison.
Where a partner helps. Asking hard questions of any provider found online: Which drug? Approved for what? Who is present during treatment? Do you take our insurance?
Best for: finding a therapist, a support group, or a primary care doctor. Less suited to picking a treatment.
Side by side
- Most trusted: primary care, then psychiatrist, then online.
- Fastest to an appointment: often primary care, depending on the practice.
- Most direct path to an evaluation for newer treatments: psychiatrist.
- Highest chance of confusing Spravato with off-label ketamine: the search bar.
- Best use of a partner's energy: logistics and history, on any route.
Coverage, whichever route you choose
Nothing mattered more to respondents than coverage, which 85 percent ranked as one of their two leading provider criteria. Many O'Fallon households carry employer plans, and a share rely on MO HealthNet or Medicare. Before any appointment, confirm the provider is in network. For esketamine, ask whether prior authorization is required. Just over half of poll respondents said they would put up with those extra steps to keep care covered.
A note on the ride home
If a psychiatrist eventually prescribes Spravato, your partner will need someone to drive after every session, because driving is off limits until the next day. Early treatment usually means more frequent visits. That logistics role is one place a partner's help is not just welcome but required.
This side-by-side is meant to orient you, not to serve as medical advice. Treatments help some people and not others, and fit is a clinician's call.
If your partner is talking about suicide, or something makes you afraid for them, skip the routes above and act now. Ring or text 988 whenever you need to; a Suicide and Crisis Lifeline counselor can support you both. When danger is immediate, dial 911.
Methodology
The publisher commissioned and funded this survey. Pollfish recruited respondents through its consumer panel and ended fielding June 23, 2026, having heard from n=443 adults, ages 18 through 64, in Missouri, Iowa, Wisconsin, Kansas, Oklahoma, Nebraska, Minnesota, Ohio, Indiana, and Illinois. The survey did not isolate spouses or partners, and every figure cited is final following Pollfish's validation.