Here is the number that stopped us: 72 percent.
That is the share of adults in our survey who reported depression, anxiety, or PTSD that the standard medicines left unresolved, in themselves or in someone close. Not people recruited from a clinic waiting room. Not a support group. Ordinary adults, answering on their phones, across ten Midwest states that include Missouri and Illinois, the two states that meet at the Mississippi here in St. Louis.
We expected the figure to be meaningful. We did not expect it to describe most of the sample.
Where the data comes from
We paid for a survey on Pollfish's consumer panel; by the time it closed in June 2026, 443 adults aged 18 to 64 had finished it, from Illinois, Ohio, Iowa, Minnesota, Missouri, Indiana, Oklahoma, Kansas, Wisconsin, and Nebraska. Its purpose was to understand how people look for and settle on depression care. Every number is top-line and final.
Breaking the 72 percent apart
The question allowed four answers, and the split tells a story of its own:
- It happened to me: 37 percent
- Someone close to me, not me: 22 percent
- Me and someone close: 13 percent
- None of the above: 28 percent
Put the first and third lines together and 50 percent of respondents described their own personal experience with a mental health condition that did not respond to standard treatment. That is half of the whole sample speaking in the first person.
Combine the second and third lines instead and more than a third had watched it unfold in someone they care about. Roughly one respondent in three has sat with a friend, partner, parent, or child while the prescriptions failed to do enough.
Only 28 percent of the room was untouched.
What "did not help" really covers
We should be careful about what this figure is and is not. It is self-reported. People were not diagnosed by us, and some who said standard meds did not help may have stopped early, had side effects, or never found the right dose. This is a picture of lived experience, not a clinical count of treatment-resistant depression.
Still, the lived experience is what drives behavior. Someone who believes the pills did not work is someone who is either looking for a next step or has quietly stopped looking. Both groups matter.
The next finding explains the silence
If nearly three quarters of people have met this problem, you might expect the next step to be widely known. It is not. Esketamine, sold as Spravato, is FDA-approved specifically for adults with treatment-resistant depression, Yet the name had never reached 73 percent of our respondents. Only 6 percent could describe what it was. A plain explanation of Spravato is a starting point for anyone who wants to know more.
That gap is the heart of this story. The need is common. Awareness of at least one approved option is rare. Those two facts sitting side by side suggest many people around St. Louis may be living with stalled treatment without knowing there are further paths a clinician could discuss.
What people type when they are stuck
We asked respondents to write the words they would type into a search bar when help was the goal. 319 people answered. They did not type drug names. They typed things like "help with ptsd" and "depression medicine alternatives," and, from one person, simply "depressed."
One answer sat with us longer than the others: "someone please help me."
That is what the 72 percent looks like from the inside. Not a query for a product. A plea.
Where people would turn
The survey also asked who respondents would go to first. Primary care won a majority, 56 percent. Psychiatry drew 23 percent and an online search 12 percent; another 5 percent confessed to having no clue where to start.
As for what would really tip them toward something new, their own doctor won 74 percent, a figure that sits close to the prevalence number itself. Friends and family ran a distant second, at 18 percent. Ads managed 2 percent.
The takeaway for anyone in St. Louis who recognizes themselves in these numbers is simple. The most trusted door is the one you probably already have a key to.
Open, with conditions
People were not hostile to newer treatments. Most respondents met ketamine therapy for depression or PTSD, on first mention, with guarded interest: 34 percent picked cautious but open, with another 18 percent hopeful or curious. Only 9 percent were outright negative.
But they had conditions. Of respondents choosing a provider, 85 percent listed insurance coverage as a top-two concern, and 59 percent called FDA approval deciding or big. People want care that is covered, legitimate, and close by. Those are reasonable demands.
What this means if you are one of the 72 percent
- You are not an outlier. Stalled treatment was the majority experience in this survey.
- Not responding to one or two medications does not mean nothing else exists. Clinicians have several further options, and which ones suit you is their judgment to make with you.
- Bring your history. A list of medications, doses, and how long you took each helps a clinician see the pattern.
- Ask directly: "What comes next if these have not worked?"
Esketamine is one of those next options for some adults. It happens under supervision at a certified clinic, not at home, and it is not right for everyone. At-home ketamine sold online is a separate and less regulated arrangement. Your clinician can explain the difference and whether either belongs in the conversation.
If this weight has become thoughts of ending your life, please do not carry it alone tonight. From St. Louis or anywhere else, 988 by call or text reaches the Suicide and Crisis Lifeline, where a trained person answers day or night and veterans can press 1.
Methodology
Source: our Pollfish consumer panel survey, with fieldwork ending June 23, 2026, and 443 finished interviews. Everyone was 18 to 64 and lived in Wisconsin, Kansas, Missouri, Nebraska, Illinois, Oklahoma, Iowa, Ohio, Indiana, or Minnesota. We cite top-line percentages, and every result comes from Pollfish's validated final export. This research was commissioned and fully paid for by the publisher. This is market research, not clinical evidence or medical advice.