From our survey

A St. Louis partner's script for the appointment that matters

Some couples in St. Louis have had the same conversation so many times it has worn a groove. "You should talk to someone." "I am fine." "You are not fine." Then silence, and the dishes, and another month. If you are the partner who keeps starting that conversation, this piece offers a different set of words, aimed at a different target: not convincing your partner of a treatment, but getting them into a productive appointment with their own doctor.

Why aim at the appointment

A poll our publisher funded this summer asked 443 adults across ten Midwest states one blunt question about influence: if you were going to try a treatment like ketamine or esketamine for depression, whose say-so would it take? Seventy-four percent answered with their own doctor. Family and friends, the category a spouse falls into, came in at 18 percent. Media barely moved anyone; ads moved 2 percent, podcasters only 1 percent.

The people polled were a cross-section of the public, not couples, and these are the final validated figures. What it does suggest is that your words may do the most good when they point toward the exam room.

Part 1: The kitchen-table script

Choose a calm moment, not the tail end of a fight. Keep it short. Leave room for a no.

"I am not trying to fix you or push anything. I have watched you carry this for a long time, and I think your doctor should hear how it has really been. Would you be willing to make an appointment just about this?"

If they say the medication is fine:

"Okay. Would it hurt to tell the doctor it is only sort of working? They might have ideas we have not heard of."

If they say they do not have time:

"Let me handle the scheduling. I will find something that works and drive you. You just have to show up."

If they say no:

"I hear you. The offer stands. I love you either way."

What to leave out: specific drug names, articles, and anything that sounds like an ultimatum. Most people have not heard of the newer options. Three in four poll respondents, 73 percent, could not place the name Spravato, so bringing it up cold can sound like you have already decided for them.

Part 2: Building the one-page history

Before the visit, offer to help put together a single sheet:

• Each antidepressant tried, rough dose, how long, and what happened
• Side effects that caused stopping
• Therapy, counseling, or employee assistance sessions
• Sleep, appetite, energy, work, and relationships
• Drinking or other substance use, honestly
• Other conditions and medications

That page is often the difference between a vague visit and a real plan, because it shows the doctor whether standard treatment has been given a fair trial.

Part 3: In the exam room, if you are invited

Let your partner speak first. Your role is to fill in gaps, briefly and specifically.

"Can I add something? Since around [month], I have noticed [specific changes: sleeping until noon on weekends, dropping the gym, not returning calls from family]. It has been steady, not up and down."

If the doctor asks about medication history and your partner is fuzzy:

"We wrote down what we could remember. Here is the list."

Then hand the conversation back:

"We are here to hear what you think makes sense next."

Part 4: Questions worth asking before you leave

Your partner may be too tired to remember these. You can ask on their behalf, or hand them this list:

• "Does the history we brought suggest the depression is treatment-resistant?"
• "What are the next options, and what would you try first?"
• "Should esketamine be on the list, or does something in the history rule it out?"
• "If you refer us to a psychiatrist, can you recommend someone in network?"
• "Will insurance need prior authorization, and who starts that?"
• "If it involves clinic visits, how often, and will a driver be needed?"

For context: Spravato is a nasal form of esketamine, and the FDA approved it for adults whose depression has not improved with standard antidepressants. Doses happen only at certified sites under observation, and patients are barred from driving until the following day. IV ketamine, offered by some local clinics, and at-home ketamine, prescribed through telehealth, are both off-label uses with different levels of oversight. Brain Recovery Centers has a page on how Spravato treatment runs if you want to read before the visit.

A St. Louis note on coverage

Ask the doctor's office to confirm that any referral is in network, especially if you live on one side of the river and your partner's plan is tied to an employer on the other. Coverage dominated the poll's list of what people weigh when picking a provider, cited by 85 percent. Given the choice, just over half of respondents would put up with extra steps to keep care covered, and just under a quarter would pay their own way for less hassle. The small St. Louis TV market group, 31 respondents, was less swayed by coverage: 48 percent called it deciding or a big factor.

Part 5: The ride home

Afterward, resist the urge to debrief immediately. Ask one question:

"How are you feeling about what they said?"

Then listen. If there is a next step, offer to handle one piece of it, whether that is booking the referral, calling the insurer, or blocking your calendar for rides.

You are far from the only household doing this. Nearly three-quarters of poll respondents, 72 percent, said that depression, anxiety, or PTSD that standard medication missed had shown up in their own lives, the life of someone close, or both at once.

Nothing in this script is medical advice, and no treatment is sure to work. The clinician decides what fits.

If your partner has hinted at suicide, even offhandedly, take it seriously tonight. Use 988, by phone or text, to get the Suicide and Crisis Lifeline, whether you need guidance for yourself or want to hand the phone to your partner. Call 911 for any immediate threat.

Methodology

The publisher commissioned the underlying survey and paid for it. Pollfish's consumer panel carried the fieldwork until June 23, 2026, completing n=443 interviews with adults 18 to 64 from Oklahoma, Missouri, Illinois, Iowa, Nebraska, Kansas, Minnesota, Wisconsin, Indiana, and Ohio. There are no spouse-specific results. Apart from the St. Louis TV market figure, every reported number describes all respondents, with validation complete.