From our survey

Your patients search symptoms, not molecules: a note for referrers

Patients rarely walk in asking for esketamine. They walk in having typed "help with depression" at midnight, read three pages of coping tips, and decided to mention it as the visit for something else wraps up. If you are a primary care physician or anyone else who refers, the words they used in that search are worth knowing, because they are the words they will use with you.

We collected those words through a survey of 443 Midwestern adults, where one blank-box question asked respondents for the phrase they would search when seeking help. The 319 answers form a small but vivid record of how people describe their need before anyone clinical is involved. Figures here describe the whole sample, drawn from the validated data.

The record

These are phrases respondents wrote, unedited:

• "how to help someone with depression"
• "depressed"
• "ptsd treatments"
• "therapist near me"
• "depression medicine alternatives"
• "someone please help me"

The pattern is consistent. Symptoms and requests, not pharmacology. None of the phrases above names a drug, a drug class, or a procedure. Even "depression medicine alternatives," the most treatment-oriented phrase, describes a wish rather than a product.

Why they do not use your vocabulary

The simplest explanation is that most of them have never encountered it. We asked respondents whether they knew Spravato, a nasal form of esketamine that has FDA approval for hard-to-treat depression. Seventy-three percent did not. Another 21 percent knew the name and little else, and only 6 percent understood what it was.

Nobody asks for a therapy whose name they have never seen. For newer options in particular, awareness is not going to arrive through the patient's own searching. It arrives, if it arrives at all, through a clinician.

Where the conversation actually happens

The survey makes the next point clearly. As a starting point for a newer depression treatment, 56 percent of respondents chose primary care, 23 percent went with psychiatry, and 12 percent would begin with their own online search.

On whose recommendation would carry them into such a treatment, 74 percent chose their own doctor, with friends and family a distant second at 18 percent. Advertisements drew 2 percent; podcast hosts, a single percent.

Taken together, these findings describe a handoff. Patients search privately in plain language, then bring that plain language to you and wait for you to supply the clinical options. The search is the admission. The visit is the decision.

What the words can tell you

Each type of phrase hints at something a referrer might want to explore.

• "Depression medicine alternatives" may signal frustration with current medication, concern about side effects, or interest in non-drug options. The same respondents put weight on drug-free care, 64 percent of them, even though just 25 percent knew what TMS was.
• "How to help someone with depression" points to a caregiver. The person with the appointment may not be the person searching, and a family member in the room may carry the real history.
• "Ptsd help" and "ptsd treatments" suggest trauma is part of the picture, which may shape which referral fits.
• "Someone please help me" is not an information request. When a patient's language sounds like this, a safety screen comes before anything else.

The scale of the need

These searches do not come from a niche population. Seventy-two percent of respondents reported depression, anxiety, or PTSD that stayed put through standard medication, in their own lives, among people close to them, or both. Thirty-seven percent said it was them alone; the rest split between someone close, 22 percent, and both, 13 percent.

These respondents came from the general population, not a clinic roster. The implication for a primary care panel is that patients stuck after first-line depression treatment are likely more common than the number who raise it.

Practical implications for referring clinicians

• Ask about searching. A question like "Have you been looking anything up about how you are feeling?" invites patients to share the phrases they are carrying, and often the concerns behind them.
• Translate out loud. When you introduce an option, start with what it is, then name it. "An FDA-approved nasal spray exists for depression that standard medication has not improved. It is called Spravato, and it is given at a certified clinic." That gives the patient words they can repeat and search. A plain-language Spravato page can back up that conversation.
• Separate the look-alikes. Patients who search will encounter IV ketamine clinics and at-home ketamine services. Those are off-label or less supervised models, distinct from the approved product given under observation. A sentence from you can prevent confusion.
• Anticipate coverage questions. Insurance was the provider factor 85 percent of respondents could not leave out of their top two. Referrals that name an in-network clinic are more likely to be completed.
• Use plain-language handouts. Written material that uses the patient's vocabulary, describing symptoms and next steps, will be read more readily than material that leads with a brand name.

The attitudes you will meet

Patients' first reactions to ketamine therapy were more open than hostile. Thirty-four percent answered cautious but open and another 18 percent hopeful or curious; counted together from the raw answers, that is 51 percent. On the other side sat 21 percent who called themselves skeptical and 9 percent who reacted negatively, with 18 percent saying the phrase meant nothing to them yet. Most will want honest information, not a pitch.

Scope

What you have read is market research on how patients search and choose care, not clinical evidence, and it offers no guidance on which patients are candidates for any treatment. That remains a clinical judgment.

If a patient's words suggest suicidal thinking, follow your safety protocol, and make sure they leave with the number for the Suicide and Crisis Lifeline: 988, open to calls and texts at every hour, with veterans able to press 1.

Methodology

The analysis draws on our survey, which Pollfish's consumer panel carried to its June 23, 2026 close. Respondents numbered 443, aged 18 to 64, in Minnesota, Kansas, Missouri, Indiana, Oklahoma, Iowa, Illinois, Ohio, Nebraska, and Wisconsin, 319 of whom answered the open search question. Phrases are quoted verbatim. The data cited is top-line and comes from the panel's validated final export. The publisher both commissioned and paid for the fieldwork.