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St. Louis Metro Edition A Health Review for the Gateway Region Evergreen Guides · Reviewed 2026
The

Gateway Health Review

Considered reporting on mental health care across St. Louis and St. Charles County.

The Cover Story · Treatment-Resistant Depression

When the medication was supposed to be the answer, and it was not.

Depression · The Long Read
Sunrise over the Missouri River.
Sunrise over the Missouri River. Photo: Dane Shuman, USFWS.

When antidepressants stop working, the next step is a conversation, not a dead end

For a meaningful share of people, the first, second, or even third medication does not lift the fog. What treatment-resistant depression really means, the serious options that exist for readers across the Gateway region, and why you do not have to wait until you have run out of options to ask what else is possible.

Wildflowers in silhouette on a hillside as first light breaks across a soft dawn sky.
The Long View   Depression that has not lifted is worth taking seriously early. You do not have to wait until you have tried everything before asking what modern care can offer. Photograph: jenny downing, CC BY 2.0
From the Desks
Treatment · Esketamine

Spravato, explained without the hype

One of the first genuinely new mechanisms for depression in a generation. What a Spravato appointment actually involves, and what it is not.

PTSD & Anxiety

The anxiety that will not switch off

Post-traumatic stress and chronic anxiety rarely travel alone. How they overlap with depression, and where Gateway-region readers can turn.

Insurance / Cost

Paying for care, including MO HealthNet

Cost is the quiet reason many people never start. What insurance and Medicaid can do, and the questions that keep you from overpaying.

In Their Words

Published accounts of what modern depression care can look like, from major medical centers, a leading research foundation, and the treatment's own patient library. These are other outlets' stories, not patients of any clinic we feature, and outcomes differ from person to person.

About these links: Each opens a story published by the outlet named. The Gateway Health Review does not host these accounts and did not produce them. They are shared to illustrate what these treatments can do for some people, not as a promise of any particular result, and they are not patients of Brain Recovery Centers.