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How many depressive episodes have you had in the last year?

From Dr G, Ontario, Canada to Kirsi Hunnakko, Ontario

Portrait of Kirsi Hunnakko

Trigger warning: reference to suicide

Dear Dr. G,

I was diagnosed with depression 25 years ago and it’s been my trusty sidekick ever since. You’d think by now I’d know its subtleties, as intimate as we’ve been. Instead, every day is a pop quiz:

Am I having a depressive episode, or am I responding appropriately to a global pandemic?

Is this a depressive episode, or is this grief bubbling up as I process trauma?

Do I feel like crying because I’m depressed, or because I’m overwhelmed?

Is this depression, or side effects from the meds I’m taking for depression?

Is my exhaustion a symptom of depression, or is it a symptom of my arthritis, or parenthood, or capitalism?

I understand the need for assessment guidelines and quantifications, but depression doesn't fit neatly into clinical boxes.

The DSM-5 says it’s diagnosable depression if symptoms are causing “clinically significant” distress or impairing function. But what if you can function, but sometimes you forget what joy feels like? What if you can handle the day-to-day tasks of your life, but sometimes you don’t want to live it?

What if that’s significant to me?

I don’t know how many depressive episodes I’ve had in the past year. Better questions would be: What can you tell me about how you experience depression? How can I help you? What do you need?

Episodically yours,

Author’s note: I’ve got what I need right now - supportive friends, coworkers and family, a peaceful home, medication that works, a counsellor on stand-by - and I’m safe and well. If you think you might be depressed or you’re having thoughts of suicide, please tell a loved one and seek support. 24/7 crisis support is available at 1-833-456-4566 (Talk Suicide Canada).

You can read more about Kirsi’s journey with depression at her website, Joy to the Girl.

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