Often the hardest step is not treatment at all but the first phone call. For a lot of St. Louis couples, the partner living with depression is too drained to navigate insurance menus and appointment queues, and the partner watching is not sure where to point them. This guide is a practical map for spouses and partners in the St. Louis area: how to find the right doctor, how to prepare, and how to handle the logistics that tend to derail good intentions.
Why "the right doctor" is the goal
A poll our publisher commissioned in June asked 443 adults across ten Midwest states which voice could talk them into trying ketamine or esketamine for depression. The answer was not close. Their own doctor's word topped the list for 74 percent. The circle of family and friends came next at 18 percent, and advertising sat near the floor at 2 percent.
The general public, not spouses specifically, supplied these final, validated figures. Respondents in the St. Louis TV market, only 31 people and so a small group, gave the doctor 68 percent. Still, the direction is useful for any partner: your effort goes furthest when it gets your partner into a room with a clinician they trust.
Step 1: Start with the doctor they already have
If your partner has a primary care doctor, that is usually the best first stop. That is where 56 percent of survey respondents said they would begin. A primary doctor can screen for depression, rule out medical causes, adjust medication, and refer to psychiatry.
If they have not seen a doctor in years, the first task is finding one who takes their plan and is accepting new patients. Large health systems across the metro have online scheduling. Your insurer's member services line can also produce a list.
Step 2: Sort out insurance before you pick a clinic
The St. Louis region spans two states, and plans do not always treat both sides of the river the same way.
- Employer plans: check whether in-network status covers both Missouri and Illinois providers. Many do, some do not.
- MO HealthNet: Missouri's Medicaid program runs mostly through managed care plans, each with its own network. The plan's member line can list in-network psychiatrists.
- Illinois Medicaid: a separate program for Metro East residents, with its own managed care plans and networks.
- Medicare: ask whether the clinic you are considering bills Medicare for the specific service.
Coverage was the survey's number one concern by a mile. Insurance made the short list of provider must-haves for 85 percent of respondents, and nearly two-thirds, 65 percent, described it as the tiebreaker or something close to it.
Step 3: Build the history together
The most useful thing your partner can bring is a written record. Offer to help create it:
- Every antidepressant tried, approximate dose, dates, and results
- Side effects that led to stopping
- Therapy or counseling, and for how long
- Sleep, appetite, energy, and changes at work
- Alcohol or other substance use
- Other health conditions and current medications
That history decides whether the depression counts as treatment-resistant.
Step 4: Understand what a referral might lead to
If a doctor thinks a newer treatment is worth considering, your partner will likely be referred to a psychiatrist for evaluation. Nearly a quarter of poll respondents, 23 percent, would skip ahead to a psychiatrist or similar professional anyway.
Know the landscape so nothing surprises you:
- Spravato (esketamine): nasal spray with FDA approval for adults whose depression standard antidepressants could not lift. Every dose is given on site at a certified location, followed by observation.
- IV ketamine: offered by some area clinics, off-label for depression, and usually paid out of pocket.
- At-home ketamine: prescribed through telehealth, off-label, and much less supervised.
If your partner has never heard of any of these, that is typical. In the survey, 73 percent had no familiarity with the Spravato name. Brain Recovery Centers offers a readable guide to Spravato for couples starting from scratch.
Step 5: Plan transportation and time off
This is where spouses become essential. If Spravato is prescribed, your partner is not allowed to drive after a dose until a night's sleep has passed. Early treatment usually involves more frequent visits. A few practical points:
- Ask the clinic whether a rideshare is acceptable or whether they want a companion to pick the patient up.
- Traffic on I-64 and I-270 can swing commute times, so build in a cushion.
- If you work, the federal Family and Medical Leave Act may allow eligible employees unpaid, job-protected leave to care for a spouse with a serious health condition. Your HR office can tell you whether you qualify.
Distance matters to people. After insurance, close to home was the most selected priority in the survey, named by 43 percent.
Step 6: Decide together how involved you will be
Your partner has a right to see their doctor privately. Ask whether they want you in the exam room. If they do, they can tell the office, and sign a release if staff should be free to talk with you about their care. Should they prefer to go alone, you can still help by driving, waiting, and listening afterward.
The poll suggests your encouragement matters. Family and friends were the second most persuasive voice. Used well, that influence is what gets someone to the doctor who can help them decide.
Step 7: Take care of yourself as well
Caring for a partner with depression is heavy. Plenty of people carry it: 72 percent of respondents said stubborn depression, anxiety, or PTSD had touched them personally, someone close, or both. Support groups for family members meet across the St. Louis area and online, and a counselor of your own is not a luxury.
This guide offers practical help, not medical advice. Responses to any treatment vary, and a clinician decides what fits your partner.
If your partner ever seems close to acting on thoughts of suicide, get help without delay. Text or call 988 at any hour; a Suicide and Crisis Lifeline counselor can coach you through the moment itself. If harm is imminent, 911 is the call.
Methodology
Research costs were the publisher's, as was the decision to commission the survey, which Pollfish ran on its consumer panel. Fieldwork wrapped June 23, 2026, after 443 respondents, all 18 to 64, had replied from Illinois, Missouri, Ohio, Indiana, Oklahoma, Kansas, Nebraska, Iowa, Minnesota, and Wisconsin. Couples were not surveyed as a group. The numbers are final, validated by Pollfish.