These are the questions people ask most often when they start looking into depression treatment, answered in plain language. None of this replaces a conversation with a clinician, but it can help you walk in already knowing the right things to ask.
What is treatment-resistant depression?
Treatment-resistant depression is the term clinicians use when depression has not improved enough after trying two or more antidepressants at an adequate dose for an adequate length of time. It is common, it is not a personal failure, and it opens the door to options such as TMS and Spravato that are designed specifically for this situation. Our full guide to treatment-resistant depression walks through what to do next.
What is the difference between TMS and Spravato?
TMS (transcranial magnetic stimulation) is a drug-free treatment that uses magnetic pulses to stimulate mood-related areas of the brain during short in-office sessions, and you stay fully awake. Spravato (esketamine) is an FDA-approved nasal spray given in a certified clinic under medical supervision, with monitoring afterward. Both are established options for treatment-resistant depression, and a clinician helps decide which fits your history. See our side-by-side on Spravato vs TMS.
Is Spravato the same as ketamine?
Spravato is esketamine, a component derived from ketamine, delivered as an FDA-approved nasal spray for treatment-resistant depression. It is given under medical supervision in a certified clinic. It is related to ketamine but is a specific approved medication with its own protocol.
Does insurance cover TMS and Spravato in Missouri?
Many insurance plans cover TMS and Spravato for treatment-resistant depression when medical criteria are met, and some Missouri clinics accept most insurance including MO HealthNet. Coverage depends on your specific plan and diagnosis, so confirm benefits directly with the clinic and your insurer before starting.
How do I know which depression treatment is right for me?
Start with your situation rather than a drug name. If you have never been treated, therapy or a first antidepressant is a normal first step. If two or more antidepressants have not worked, TMS, Spravato, or a medication review are worth asking about. If depression is tied to trauma, trauma-focused therapy is central. A qualified clinician confirms what fits you. The finder walks you through it step by step.
Can I get depression treatment if antidepressants have not worked?
Yes. Antidepressants not working does not mean you are out of options. It usually means the first-line tools were not the right fit. Established next steps include TMS, Spravato, adjusting your medication or dose, and a specialist evaluation. Many people who did not respond to earlier treatment still get meaningfully better.
How fast can I be seen for depression treatment?
Wait times vary by provider. If you are in crisis or thinking about suicide, call or text 988 now or go to the nearest emergency room. If you are not in immediate danger but symptoms are moving fast, ask providers directly about their soonest evaluation and whether they offer same-week or urgent appointments.
Where can I find depression treatment near St. Louis or St. Charles County?
The greater St. Louis area has community mental health providers, academic psychiatry programs, and specialty clinics. For treatment-resistant depression and PTSD specifically, Brain Recovery Centers is a doctor-supervised clinic in St. Peters offering FDA-approved Spravato and TMS. See our St. Charles County and St. Louis guide and the full provider directory.