Pharmacological and nonpharmacological treatment effects on functional outcomes in major depressive disorder

Depression impairs functioning across a wide range of domains (e.g., home, family, social, work, and school) for individuals worldwide. This chapter highlights the many pharmacological, nonpharmacological, and neuromodulatory treatment options that can improve functioning. It is clear that there is no one treatment that works for all depressed individuals. Evidence to determine the best treatment approaches to resolve functional impairments is still lacking, and functional impairments frequently remain a significant concern for those with depression, even when depressive symptomatology resolves. Some evidence suggests that improving functioning earlier in the course treatment has greater long-term effects and shows better overall improvement in both depressive symptomatology and functioning. To advance the field, we must remain vigilant about measuring functioning as part of the evaluation of treatment efficacy, work to identify ways to match individuals to the right treatment option for them, and ensure that functional impairments are addressed early on in treatment.