Clinical and Functional Impairment in Treatment Resistant Depression

In this episode, Dr Anita Clayton and Dr Linda Trihn discuss the impact of TRD on patient’s life.

Dr. Trinh highlighted that impact on quality of life is highly subjective, varying considerably across individuals, but that functional ability — such as going to work, attending school, or engaging in family activities — is often how patients themselves measure progress. With a lifetime prevalence of approximately 20%, depression affects a broad population, though roughly half will experience only a single episode while the other half face chronic, recurring illness — meaning the burden is far from uniform.

Panelists emphasized the importance of understanding what matters most to each individual patient, whether that relates to energy levels, sedation, cognitive function, or specific life activities. Dr. Trinh introduced "joy" as a meaningful quality measure that goes deeper than simple happiness, reflecting a more holistic sense of well-being. Using motivational interviewing to uncover each patient's personal goals was recommended as a valuable tool for guiding individualized, patient-centered depression care.

In the next episode, “Goals of Treatment of Treatment Resistant Depression,” panelists discuss how remission — defined beyond symptom scores to encompass true wellness and quality of life — should be the ultimate goal of TRD treatment, with patient preferences and side effect tolerability playing a central role in achieving it.