In Missouri, we like to say "show me." It is a good instinct to bring into a doctor's office when someone you love is struggling with depression that has not responded to treatment. You want to know what is real, what is proven, and what is just talk. For many people, one of the clearest answers to "show me" is whether a treatment is FDA-approved.
This script is for spouses and partners who go along to appointments, or who help prepare for them, and want to ask about FDA status without derailing the visit or speaking over the person who is actually the patient.
You are not being difficult by asking
FDA status weighs on most people, judging by the survey we commissioned of 443 Midwest adults, Missourians included. For 59 percent, approval would be big or even decisive when they weigh a new depression treatment. Missouri's 55 respondents were more divided, at 51 percent. A mere 14 percent told us approval would make no difference. These are final, validated findings.
So if you want to ask, you are asking what most people want to know.
Before the appointment
Talk with your partner first. Settle three things:
- Your role. "Do you want me in the room? Should I ask questions, or just take notes?"
- The goal. "What do you want to walk out knowing?"
- The history. Write down every antidepressant tried, the dose, and roughly how long. Doctors need it, and insurers usually ask for it before approving newer treatments.
Also agree on a signal. A tap on the arm or a glance can mean "go ahead and ask" or "let me handle this."
Opening the topic
Let your partner lead if they can. If they want your help, try something that puts them at the center:
"We've been talking about what comes next, since the medications haven't been enough. Can we ask about some of the newer options?"
Then pause and let the doctor respond.
The FDA questions
Once a specific treatment is on the table, these questions do most of the work:
- "Is that FDA-approved for the kind of depression they have?"
- "Is it approved as a medication, or cleared as a device?"
- "If it's off-label, what's the reasoning for using it here?"
- "What did the approval require, in terms of how and where it's given?"
It helps to know the landscape before you go. Esketamine, the medicine in the Spravato nasal spray, carries an FDA approval for depression that earlier medicines did not clear; patients take the spray at a certified clinic and are observed for two hours or more. TMS, a magnet-based treatment with no drug involved, is an FDA-cleared device for people whose depression has outlasted antidepressants. Infusions of IV ketamine for depression count as off-label, since ketamine's approval is as an anesthetic. Ketamine products sold for home use are not FDA-approved for depression. Brain Recovery Centers has a Spravato overview for families if you want to read ahead.
If PTSD is part of the picture
Many Missouri families live with both depression and trauma. If your partner's struggle includes PTSD, ask specifically:
"Is this approved for depression only, or for PTSD too?"
Esketamine's approval is for depression, not PTSD. Treatment for PTSD is its own conversation, and a good doctor will separate the two.
Practical questions that belong to you
As the partner, you may be the one who handles transportation and scheduling. These are fair to ask:
- "How often would visits be, and for how long?"
- "Can they drive home afterward?" (For esketamine, no; they wait until tomorrow, after sleeping.)
- "Where is the nearest certified clinic?"
- "Who handles the insurance approval?"
That third question matters a lot outside the metro areas. In much of rural Missouri, the nearest certified clinic may be a long drive, and esketamine usually starts with two visits a week. Our survey had 43 percent listing a nearby location among their top two needs in a provider. Ask before you plan around a clinic that is hours away.
If you're not sure about coverage
Missouri families carry every kind of coverage. Respondents ticked each kind of coverage they hold: 39 percent chose commercial insurance, 37 percent Medicaid, a near tie, and 23 percent Medicare. FDA approval usually gives each of these a defined path to coverage for approved uses, often with prior authorization, but the rules differ. After the appointment, ring the member line on the back of your partner's card and ask what is required.
If the doctor says no
Ask why, calmly:
"Can you help us understand what makes it a poor fit? Is there something else you'd suggest?"
The goal is a next step, not a particular treatment.
What not to do
- Don't answer for your partner when the doctor asks how they are feeling, unless they ask you to.
- Don't push for a specific treatment. Our survey put the doctor at 74 percent as the voice most likely to get someone to try something new; a friend or relative drew 18 percent. Your role is to help the right question get asked.
- Don't treat approval as a promise. It means the evidence was reviewed for a specific use. It does not mean it will work for your partner.
After the visit
On the drive home, ask your partner one thing: "How are you feeling about what we heard?" Then listen more than you talk. Write down any names, referrals, or next steps while they are fresh.
This script is general information and not medical advice. Your partner and their clinician are the ones to decide on any treatment.
If your partner talks about ending their life, or you fear they might, reach out right away. From Kirksville to the Bootheel, 988 by call or text will reach the Suicide and Crisis Lifeline, a free and confidential line that never closes.
Methodology
Pollfish fielded the survey, closing its consumer panel run on June 23, 2026. Everyone who completed it, 443 adults ages 18 to 64, lives in Kansas, Missouri, Minnesota, Illinois, Oklahoma, Iowa, Wisconsin, Indiana, Ohio, and Nebraska. Coverage type was select-all, so those figures overlap. Pollfish completed panel validation, so the results are final; only the Missouri figure is a subgroup. Our publisher commissioned and funded the survey.