There are two people in most stories about depression that will not lift. One is living inside it. The other is standing just outside, watching, trying to help, often feeling useless.
Both are affected. Both need something. And they rarely need the same thing. This comparison, written with readers in St. Peters in mind, lays out the two sides next to each other, with our commissioned survey of 443 Midwest adults as the backdrop.
How the survey split the experience
One question asked whether standard medication had fallen short against depression, anxiety, or PTSD, for respondents themselves or for someone close. The answers broke down like this:
- Yes, me: 37 percent
- Yes, someone close to me: 22 percent
- Both: 13 percent
- No: 28 percent
Combined, 72 percent had some direct contact with stalled treatment. Adding the "me" and "both" answers gives 50 percent who had lived it personally. Adding "someone close" and "both" gives more than a third who had watched it happen to a person they love. The 13 percent in the middle have been on both sides.
These numbers are final, taken after Pollfish validated the panel. We report only the overall figures. We do not have separate breakdowns for each group, so the comparison below is about roles and practical needs, not about how each group answered other questions.
What it feels like
Living it: Often numbness more than sadness. Exhaustion. A sense of being defective because the medicine that works for others did not work for you. Difficulty making calls, keeping appointments, or explaining yourself.
Watching it: Helplessness. Frustration that can turn into guilt. Uncertainty about whether to push or back off. Worry that runs in the background of every ordinary day.
The biggest obstacle
Living it: Energy. Depression drains the exact resources you need to find better treatment, like initiative, organization, and hope.
Watching it: Permission. You can see the problem clearly but you cannot make the appointment for an adult who does not want it, and pressing too hard can backfire.
What each side tends not to know
Here, both sides are in the same boat. Most people have never heard of some of the options that exist after standard medication. In our survey, nearly three quarters had never encountered the name Spravato, an esketamine spray carrying FDA approval when depression resists treatment; a scant 6 percent could say what it does. TMS, a drug-free option, was familiar to about a quarter of respondents. For a plain primer, see an easy-to-read Spravato primer.
Neither the patient nor the person watching can raise what they have never heard of. That is one reason it helps to know the landscape before the next doctor visit.
Where each side should start
Living it: With your own doctor. Most of our respondents would begin there too. A majority, 56 percent, named their primary care physician as the first stop. Book a visit specifically about your depression, bring a list of past medications, and ask what comes next.
Watching it: With an offer, not an instruction. "Would it help if I came with you?" works better than "You need to see someone." Offer to handle the logistics that depression makes hard: finding the insurance number, keeping the medication list, driving.
What each side can say to the doctor
Living it: "I have tried these medications for this long, and I am still struggling. Does this count as treatment-resistant depression, and what are my options?"
Watching it (with permission, at the visit): "From the outside, here is what I have noticed over the past few months." Caregivers often see changes in sleep, eating, or withdrawal that the patient does not report.
What each side worries about with newer treatments
We cannot say how each group answered, but top-line figures show the concerns people carry overall. When ketamine therapy for depression or PTSD was first mentioned, a third of respondents were cautious but open, a fifth were skeptical, and only 9 percent were outright negative.
Living it: Common worries include "Will it change who I am?" and "What if this fails too?" Those are fair questions for a clinician.
Watching it: Common worries include safety, supervision, and logistics. It helps to know that esketamine is given under supervision at a certified clinic with monitoring afterward, and that patients need a ride home on treatment days. At-home ketamine sold through some telehealth services is a separate, off-label arrangement with less oversight. Ask the clinician to explain which is which.
The practical load
Living it: The appointments, the side effects, the waiting to see if something works.
Watching it: Often the transportation, the phone calls, the reminders. In St. Peters, where many households juggle commutes along I-70 and Highway 94, that can mean rearranging a workday. Location mattered to our respondents: 43 percent wanted a provider close to home among their top two.
Both: Coverage. With 85 percent ranking insurance in their top two, it is the question to answer early. Call the insurer together, if the patient agrees, and ask whether the treatment is covered and whether prior authorization is needed.
What each side needs from the other
Living it: Patience, practical help, and not being treated as fragile or as a project.
Watching it: Honesty about how things really are, and the chance to help in ways that are actually wanted.
The 13 percent in the middle
Some people have been on both sides. If that is you, you may understand better than anyone why the conversation is hard. You also may be running low on reserves. Taking care of your own treatment is not selfish. It is how you stay able to show up for anyone else.
Whichever side you are on, if the situation turns to talk of suicide, act immediately. Reach the Suicide and Crisis Lifeline by dialing or texting 988. People on either side of the story can use it: the person struggling, or the person who is scared for them.
Methodology
Source: our survey on Pollfish's consumer panel, which 443 people aged 18 to 64 answered before its June 23, 2026 close; they live in Nebraska, Iowa, Kansas, Oklahoma, Missouri, Indiana, Illinois, Wisconsin, Ohio, and Minnesota. Only top-line percentages are cited, all from Pollfish's validated final data. Every number is final. The publisher commissioned this survey and bore its entire cost. This is general information, not medical advice.