My whole life I’ve dealt with the trifecta of depression, anxiety, and OCD. I was always functional, with all 3 disorders clocking in at maybe a 3/10. Depression always felt like more of a chemical thing, it was never situationally based. Anxiety &amp; OCD were usually health related. Hypochondria I guess? 
Anyways, I never knew “episodes” existed, I always just hovered at the same baseline. Then, in 2017, I had a severe panic attack after smoking some potent weed. It really shook me, and it sent me into what I guess would be my first episode. It was my first time experiencing dissociation, and it terrified me. I was in a constant state of panic for months. At the time I had been on Lexapro for YEARS. My GP was ill equipped to deal with this so she recommended a new doc for Meds. Big mistake. New doc decided I should quit taking Lexapro and switch to Zoloft, which perhaps would have worked if she had done it correctly. Instead of cross tapering or weaning off Lexapro, she decided to have me stop taking Lexapro cold turkey, wait a month until it was out of my system, and then start Zoloft. Going cold turkey off Lex was a nightmare of biblical proportions and sent me further into the most intense depression and anxiety I’d ever experienced. 
After a hospital visit, they suggested an outpatient program. I agreed, and there they got me back on the Lexapro. After a few more long months, things evened out. I returned to a manageable baseline, although the depression was a tad higher because I could no longer self medicate with weed (the experience ruined weed for me, would immediately send me into panic mode). But still, things were going well. 
Fast forward to January 2022 and suddenly, out of the blue, I wake up one day super depressed. No appetite. Couldn’t sleep at night. I was so confused… my first episode had a clear and obvious trigger (panic attack/ill advised cold turkey med change). I’d never had something like this happen with no trigger. That’s when I started to dig deeper and found out that “episodes” exist. 
This time I had a doc I trust. Added Remeron which was AWESOME at first, felt better than I had in years! Was sleeping and eating great, for about 10 days, then SPLAT, all that went away, back to square one, and I even developed tinnitus from the Remeron. So I nixed the Remeron and we decided to switch from Lexapro as well, but the RIGHT way this time. I did a seamless cross taper to Effexor. I’m on my 4th week of it, went from 37-75-112-150. My last day on the Lexapro was last Friday, which was the day I did the increase to 150. Things have improved slightly, def not where I wanna be tho. I now know that episodes can last anywhere from days to months (or longer) so I’m trying to be patient. It’s tough tho. Eventually I may have to decide whether to increase Effexor again or augment with something else (an AA perhaps). 
Not sure what I meant to accomplish with this wall of text but if you read it, kudos to you! I guess I just wanted to document this strange journey. Maybe you’ve been through something similar or know someone who has. Maybe you can offer advice (which I’d welcome). Either way, I hope whoever is reading this is doing well, and I wish you all the best of luck in this thing called life!