The Mindgardens Apex Clinic for Depression is co-designed with people with lived experience of mood disorders and specialises in the combination of treatments for people with complex depression, including medication, psychotherapy and exercise physiology.  This clinic is piloting new approaches to patients who experience more severe depressive disorders but who do not require hospitalisation – the “missing middle”. Consultations are offered face to face, and have also been available via telehealth during the Covid-19 pandemic. The clinic hosts research based on challenging clinical questions, including investigation of the experience of pain among people who live with major depression.