When a parent in St. Peters starts worrying that a grown child's depression is not lifting, the instinct is to find the answer and deliver it. Research the options, pick the best one, make the case. It is a loving instinct. It is also, according to what people told us in a recent survey, not the thing most likely to work. What moves people is a recommendation from their own doctor. This explainer covers why, and how that recommendation actually comes about.
The survey result in brief
The survey behind this piece, paid for by our publisher and closed in June, reached 443 adults spread over ten Midwest states. One item asked which person's advice would tip them toward trying ketamine or esketamine for their depression. The doctor won by a landslide: 74 percent named their own physician. Relatives and friends drew 18 percent. Veterans or first responders followed online drew 4 percent. Ads drew just 2 percent, podcast hosts a mere 1 percent.
These are final, validated figures for the full sample, which was the general public rather than parents specifically. The St. Louis TV market's small group of 31 respondents put the doctor at 68 percent.
So the most influential person in your child's treatment decision is probably their doctor, and you are in the second spot, which is a meaningful place to be.
What "a doctor's recommendation" actually involves
A doctor's recommendation is rarely a single sentence. It is a process.
Step one: the history. The doctor reviews which antidepressants have been tried, at what doses, for how long, and with what result. Treatment-resistant depression is generally defined by that history, typically after at least two adequate trials of standard medication that did not bring enough relief.
Step two: ruling other things out. Thyroid problems, sleep disorders, substance use, other medications, and certain medical conditions can all drive or worsen depression. A good doctor checks.
Step three: the referral. Many primary care doctors do not provide newer treatments themselves. They refer to a psychiatrist, who does a more detailed evaluation. The survey's first-stop question mirrors this path almost exactly: primary care drew 56 percent, and psychiatry or another mental health specialist drew 23 percent.
Step four: the specialist's judgment. The psychiatrist decides whether a particular treatment is appropriate, explains the risks, and discusses alternatives. That is the recommendation that matters.
Step five: coverage. If the treatment requires insurer approval, the office files a prior authorization request backed by that history.
Where esketamine fits
Esketamine reaches patients under the name Spravato, and this nasal spray is FDA-approved for grown patients who have not improved enough on standard antidepressants. It is given only at a certified healthcare site, patients remain under monitoring after every dose, and driving waits until the following day. The approval does not extend to anyone younger than 18.
It is also not the same as IV ketamine, which is used off-label for depression, or at-home ketamine sold through telehealth, which is off-label and gets far less supervision. A doctor can explain which, if any, makes sense. Brain Recovery Centers has a patient-facing page on Spravato that covers the basics.
Most people have not heard of it. Close to three-quarters of respondents, 73 percent, drew a complete blank on the name Spravato. A mere 6 percent could describe it. If your adult child has never heard the name, that is normal, and it is one more reason the explanation should come from a clinician.
Why the doctor carries more weight than family
The survey did not ask why, so treat this as interpretation. A doctor combines medical knowledge, responsibility, and distance. They are not emotionally invested in the way a parent is. They can say "this might help, and here are the risks" without it sounding like "please do this for me."
That does not make a parent's role small. Family came second, 18 percent, more than all the media sources in our survey put together. The difference is in what kind of influence works. Parents appear to be most effective at opening the door, while doctors are most effective at walking someone through it.
What a St. Peters parent can do
- Encourage the appointment. Suggest that your child tell their doctor plainly that their current treatment is not enough. Many people downplay symptoms in the exam room.
- Help assemble the history. Offer to help write down medications, doses, dates, and side effects. It is the single most useful document they can bring.
- Handle logistics if asked. Scheduling, rides, and, if a treatment like Spravato is prescribed, the drive home after each visit. With I-70 commutes, plan rides ahead.
- Respect privacy. An adult child's medical information is theirs. If they want you involved, the doctor's office can give them a form authorizing staff to speak with you.
- Check the insurance. If your child is on your plan, phone the insurer's member line to learn whether esketamine is covered and what paperwork prior authorization needs.
Coverage is not a side issue. For 85 percent of respondents, coverage ranked among their two leading provider factors, and 65 percent said it would settle or heavily sway their decision about trying a treatment.
What not to do
- Do not push a specific drug before a clinician has weighed in.
- Do not rely on ads, podcasts, or social media posts to make the case. Hardly anyone in our survey said those would move them.
- Do not treat a clinician's "not right for you" as a failure. It is information, and it usually comes with an alternative.
The bottom line
A doctor's recommendation is not a magic phrase. It is the end of a process of history-taking, evaluation, and judgment. Your job is to help your child get into that process with good information and support. The doctor's job is to tell them the truth.
Consider this explainer background reading rather than medical advice; no treatment works for every patient.
If you ever fear your child might hurt themselves, act now rather than hoping it passes. Dial or text 988 at any hour; the Suicide and Crisis Lifeline supports parents too, and a counselor can help you sort out your next step. Call 911 when the danger is immediate.
Methodology
This research was commissioned by the publisher and financed by it too. Pollfish gathered responses from its consumer panel, with the final ones arriving June 23, 2026, for a sample of n=443 people ages 18 to 64 from Kansas, Missouri, Nebraska, Iowa, Oklahoma, Illinois, Minnesota, Ohio, Wisconsin, and Indiana. Everything cited is final and validated.