Elfrieda and Yolandi are sisters suffering from two very different kinds of sadness. Elf, as she's largely known by friends and family, is a world-famous pianist, who seems to have it all – success, wealth, a caring partner and an endlessly supportive family – but has been suicidal virtually all of her adult life. Yolandi, her younger sibling and the narrator of All My Puny Sorrows, has woken up in her 40s, facing a second divorce, bouncing between regrettable sexual encounters with men she doesn't care about and working on a novel that's going nowhere.

Ostensibly, Elfrieda is the big story here – men repeatedly fall in love with her; she's seemingly immune to the effects of ageing; and her talent is so unique and intense that when she plays her piano people feel they "should not be there in the same room with her". Miriam Toews displays a deep understanding of depression, but she also uses Elfrieda's latest suicide attempt to ask arguably more interesting questions about why the more "ordinary" sister's life is not as joyful as it once was, and explore the contrasting effects on both women of a tragic family history.

For a book so centred on death, it's a surprisingly folksy and convivial read, full of emotionally constipated men and pleasantly unvarnished moments of female bonding involving mordantly witty women. "You mean you will pretend to be me?" Elf asks when an agent asks if he can represent her. Toews, fast moving towards the top league of Canadian novelists, has a way of seeing the world that feels like a slightly tilted painting you don't want to straighten up.