Depression and PTSD Treatment: Questions and Answers

Understanding what you are feeling

How do I know if I have depression or am just going through a rough patch?

A rough patch usually has a clear cause and lifts when the situation improves. Depression tends to last two weeks or longer, affects several parts of life at once such as sleep, energy, appetite, and concentration, and does not fully lift even when good things happen. If a low or empty mood, or a loss of interest in things you normally enjoy, has stuck around most days for two weeks or more, it is worth talking to a doctor. Our signs of depression checklist walks through this in detail.

What does treatment-resistant depression mean?

It generally describes depression that has not improved enough after trying at least two different antidepressants, each at an adequate dose for an adequate length of time. It is common, affecting roughly a third of people with major depression, and it does not mean you are out of options. See when antidepressants are not working for what usually comes next.

The specialized treatments

What is TMS therapy and does it hurt?

TMS, or transcranial magnetic stimulation, uses focused magnetic pulses to gently stimulate mood-related areas of the brain. It is FDA-cleared for depression and done in a clinic while you are awake, with no anesthesia and no memory loss. It is not painful for most people. You feel a tapping sensation and hear a clicking sound, and the most common side effect is mild scalp discomfort or a headache that usually eases within the first week. More in our TMS explainer.

What is Spravato and is it the same as ketamine?

Spravato is the brand name for esketamine, an FDA-approved prescription nasal spray for treatment-resistant depression. It is closely related to ketamine but is not the same as the intravenous ketamine offered off-label at some clinics. Spravato is given in a certified clinic under supervision, and you are monitored for about two hours afterward and cannot drive for the rest of that day. Our Spravato guide covers how a visit works.

How long does depression treatment take to work?

Standard antidepressants often need four to eight weeks at an adequate dose to show their full effect, which is why patience matters early on. Talk therapy usually builds over several sessions. Specialized treatments differ: a standard course of TMS runs five days a week for several weeks, while some people respond to esketamine more quickly. Timelines vary from person to person, so it helps to set expectations with your clinician.

Cost, insurance, and coverage

Is depression and PTSD treatment covered by insurance in Missouri?

Many depression and PTSD treatments are covered by insurance in Missouri, including therapy, medication, and, for treatment-resistant depression, TMS and Spravato. Coverage depends on your specific plan and medical history. Missouri also has community mental health providers and nonprofits that serve people on MO HealthNet or with no insurance, so cost should not be the reason you go without help.

Does MO HealthNet cover mental health treatment?

MO HealthNet, Missouri's Medicaid program, covers a range of mental health services. Some specialty clinics that treat depression and PTSD, including Brain Recovery Centers in the greater St. Louis area, accept MO HealthNet. It is always worth confirming current coverage for a specific treatment directly with the clinic and your plan before your first visit.

Getting started near Wentzville

Where should I start if I need mental health help near Wentzville?

For most people the best first step is their primary care doctor, who can treat depression and anxiety, rule out physical causes, and refer you to a specialist. Surveys consistently find that a recommendation from your own doctor is the single biggest push that gets people into treatment. If you have already tried the usual steps without relief, a specialty clinic focused on treatment-resistant depression and PTSD may be the next move. See finding mental health help near Wentzville for a full list of local options.

Can my regular doctor treat depression, or do I need a specialist?

Primary care doctors treat depression and anxiety every day. They can start medication, check for physical causes such as thyroid problems, and refer you onward when needed. You typically only need a specialist if your depression has not responded to standard treatment, if the diagnosis is unclear, or if you are considering treatments like TMS or Spravato that are offered at specialty clinics.

What should I do in a mental health crisis?

If you are thinking about ending your life, planning to hurt yourself, or feel unable to stay safe, treat it as a medical emergency. Call or text 988 for the Suicide and Crisis Lifeline, which is free, confidential, and available 24/7, or go to your nearest emergency room or dial 911. You do not have to wait for an appointment.