Major depressive disorder (MDD) is a prevalent psychiatric disorder which often leads to a poor quality of life (QoL) and functional impairment. The lifetime prevalence of MDD ranges from 2% to 21%, with higher prevalence in European countries.¹ According to the World Health Organisation (WHO), depression is the second leading cause of disability globally and is projected to be the first leading by 2030.² Notably, a portion of patients with depression shows an inadequate response to multiple antidepressant treatments which can be complicated by psychotic or other somatic symptoms, and associated with significant psychiatric comorbidity or psychosocial factors.³ Prof. Mak Ki Yan, Specialist in Psychiatry and Honorary Professor of The University of Hong Kong, coined this condition as complex MDD. In a recent lecture, Prof. Mak discussed the unmet needs in complex MDD and shared his clinical experience in managing this type of disorder.