Three in four: a St. Louis caregiver's read on meds that missed

If you have spent the last year watching someone you love try one antidepressant, then another, and still not come back to themselves, you probably feel like the only person on your block doing it. You are not. You may not even be the only one in your family.

One question in our survey of 443 Midwesterners, drawn from ten states including Missouri and Illinois, raised the question of depression, anxiety, or PTSD outlasting standard medication for themselves or for someone they are close to. Seventy-two percent answered yes. That is roughly three people out of every four, drawn from the general population rather than a clinic waiting room.

This data story is for caregivers in the St. Louis area. It looks at what that number tells you, where it stops, and what you can do with it. Each number comes from the full ten-state sample and reflects the panel after Pollfish signed off on its final validation.

How the 72 percent breaks down

The yes answers came in three forms:

• It was me: 37 percent
• It was someone close to me: 22 percent
• Both me and someone close to me: 13 percent
• Neither: 28 percent

Adding the "someone close" and "both" groups together, over a third of the people we surveyed have watched a person they care about go through depression or a related condition that standard medication did not resolve. That is the caregiver's slice of this data. And the 13 percent who said "both" are a reminder that caregivers are sometimes carrying their own struggle at the same time.

What the number does not say

It is worth being careful here. The question asked about personal experience, not about a diagnosis. It did not ask how many medications were tried, at what doses, or for how long. So this is not a measure of clinically defined treatment-resistant depression. It is a measure of how many people have lived with, or next to, depression that standard care did not fix.

That is still a striking thing to learn. A condition often described as a special case turns out, in this sample, to be something most households recognize.

Who else is in the room

The survey also asked respondents who they were. More than a quarter, 29 percent, were parents or other relatives of a veteran or a first responder, and another 6 percent were the spouse or partner of one. Most respondents, 58 percent, fell into none of those categories. In a region with large veteran and first responder communities, caregiving often comes with its own history.

Why this matters for a St. Louis family

Knowing you are in a large company does two things.

First, it can take the edge off the isolation. Depression that does not respond to the first or second medication is not a sign that your loved one is doing something wrong, or that you are. It is a common experience.

Second, it suggests that options designed for this situation deserve a real look. Newer treatments exist for depression that standard medication has left behind, among them esketamine, a nasal spray with FDA approval that is given under supervision at certified clinics. Most people have never heard of it: 73 percent of respondents did not recognize the brand name Spravato. Should that include you, this caregiver-friendly Spravato explainer covers the basics. That gap between how common the need is and how unfamiliar the options are is exactly where a caregiver can help.

What most people would do next

The survey offers a clear picture of where people turn. For a newer depression treatment, 56 percent would start at their primary care doctor's office and 23 percent at a psychiatrist's. When the question turned to whose advice would actually tip them into trying it, their own doctor carried 74 percent of the vote. Friends and family followed at 18 percent.

So your role is not to be the expert. It is to help your loved one get to the person whose advice they will act on, prepared.

Practical steps for St. Louis caregivers

• Write the medication history. List each antidepressant or mood medication, roughly for about how long, and how it went. This is the single most useful thing a doctor can have when considering options for depression that has not improved.
• Book a visit that is only about this. A mood concern tacked onto the end of a physical rarely gets enough time. Ask for a dedicated appointment.
• Check which side of the river your coverage lives on. The region spans Missouri and Illinois. MO HealthNet and Illinois Medicaid have different plans and networks, and commercial and Medicare plans vary too. When choosing a provider, 85 percent of respondents placed coverage in their top two.
• Plan for rides. If a clinician recommends esketamine, your loved one cannot drive after a session, so line up a driver for each one, and early treatment usually involves frequent visits.
• Look after yourself. If you would have answered "both," your own care matters too, and it is not selfish to say so. Consider an appointment for yourself.

When you are worried about safety

Depression that lingers can become dangerous. If your loved one speaks of not wanting to be around, or you see them giving things away or saying goodbyes, act that day. Anywhere in the St. Louis region, the Suicide and Crisis Lifeline will also coach you on helping someone else. Reach it at 988 by phone or text, and veterans can press 1. If the danger is immediate, dial 911.

A careful note

This article reports survey findings about experiences and preferences. It is not medical advice, nor a claim that a particular treatment will work. Whether esketamine or another option suits your loved one depends on a clinician who knows their history.

Methodology

Pollfish's consumer panel hosted our questionnaire, and 443 people aged 18 to 64 had filled it out by the June 23, 2026 cutoff, from Missouri, Illinois, Oklahoma, Indiana, Kansas, Iowa, Wisconsin, Ohio, Nebraska, and Minnesota. No St. Louis-only results are cited here; percentages are ten-state top-line figures from the panel's validated final data. The experience question asked about personal or close experience, not diagnosis. Our publisher ordered and paid for the survey.