THE ED MYLETT SHOW - The Hidden Epidemic of High-Functioning Depression with Dr. Judith Joseph

Episode Date: April 22, 2025

Are You Joyful… or Just Functioning? Most people don’t realize it—but there's a silent struggle happening behind the smiles and the schedules. Today, I sit down with Dr. Judith Joseph, a Columbia-trained psychiatrist and author of High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy. We tackle something that I think is affecting more people than anyone talks about… high functioning depression. It's not in the "DSM"—but it’s very real. And if you’ve ever felt like you’re doing everything “right” but still feel empty inside, you need to hear this. We talked about a condition called anhedonia—this sneaky, silent twin of depression that robs you of joy without making you collapse. It’s the part of depression that doesn’t get seen or treated because you’re still performing, still producing, still achieving. Dr. Judith broke down how traumas, even the little ones, can rewire the way we experience joy. And more importantly, she gave a way out. You don’t have to crash to get help. You don’t have to be broken to deserve healing. This episode isn’t just about naming the problem. It’s about owning your emotional truth, slowing down, and reclaiming the simple human experiences that actually fill you. Whether you’re a high achiever constantly “doing” or someone who feels like joy is always out of reach, this one’s for you. Judith’s “5 V’s” framework gives you real tools you can use every day—like planning your joy, validating your feelings, and choosing presence over performance. And let me tell you what stood out most. Joy is contagious! It spreads. To your kids, your spouse, your team. The more we access joy, the more we model it for those around us. This conversation hit home for me—and I think it will for you too. Key Takeaways: Why anhedonia is the overlooked symptom stealing your joy. The difference between happiness (an idea) and joy (an experience). The “5 V’s” system to help reclaim joy: Validation, Venting, Values, Vitals, Vision. How trauma—big or small—can lead to high functioning depression. Tools to help yourself or someone you love who’s silently struggling. The impact of hormonal changes on mental health, especially for women. A method to ground yourself daily and reduce anxiety: the 5-4-3-2-1 technique. Let’s not wait for the crash to start healing. You deserve joy. You just forgot how to feel it. Max out. 👉 SUBSCRIBE TO ED'S YOUTUBE CHANNEL NOW 👈   → → → CONNECT WITH ED MYLETT ON SOCIAL MEDIA: ← ← ←  ➡️ INSTAGRAM   ➡️FACEBOOK   ➡️ LINKEDIN   ➡️ X   ➡️ WEBSITE      Get my exclusive Monday Motivation training in GrowthDay, the world’s #1 app for advanced mindset and personal development. Visit https://growthday.com/ed. This show is sponsored by GrowthDay.    Learn more about your ad choices. Visit podcastchoices.com/adchoices

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visit connexontario.ca, T's and Z's apply. That's the A, T, and Z supply. This is The Ed Myron Show. All right, welcome back to the show, everybody. So, I'm so grateful that this woman has written this book because it's a topic I've not heard covered on any podcast before, and it's something I'm not so sure I don't live myself and I think it's something that could change your life today. I don't open up every show by saying that but today's gonna be one you remember and it's certainly be one you think about. My guest is a Columbia trained psychiatrist. She's the founder

of the Manhattan Behavioral Medicine which is New York's premier clinical research site but here's why she's here today. I believe that there are high functioning depressed people and she has a book that was sent my way there right when I saw it. I said I want to talk to her about this because nobody talks about it. It's almost like this quiet epidemic in the world and so her book is called High Functioning, Overcome Your Hidden Depression and Reclaim Your Joy. This should be a good one, especially for me and you get to listen in. So Dr. functioning, overcome your hidden depression and reclaim your joy. This should be a good one, especially for me and you get to listen in. So Dr. Judith

Joseph, welcome to the show. Good to have you. Thank you for having me Ed, it's wonderful to be here. Yeah, well let's talk about this. What the heck is HFD and what are some of the hidden signs of it? Just so someone listening may know somebody or even themselves be suffering from this and maybe not even realize it. You know, I love talking about high functioning depression because I don't think people understand the science of happiness. And in order to understand the science of your happiness, you need to understand the

science of what makes you sad, what makes you depressed, right? There's only ever going to be one you, one Ed in the future of the universe and in the past. There's only going to be ever one Judith, ever. Think about how powerful that is. And when you're listening to this, if you're listening to this at home, there's only one you. So understand the science of your happiness. When you use skills, when you read books and you feel as if things aren't changing, it's because you don't know what the science of your happiness is. And when you understand that, then you can use the skills properly. So I'll jump in by saying when I first started studying high-functioning depression,

people were like, well, that's not a thing. Clinical depression is a real thing, right? Because it's in the DSM-5, which is the Bible of psychiatry. But what I was seeing was that I was using the DSM after 2020 and seeing patients and interviewing them, and they had symptoms of depression, poor sleep, something called anhedonia, which is a lack of pleasure and joy in life, feeling tired, not enjoying situations, maybe sometimes having problems with concentration. But when you get to the bottom of the checklist where you're supposed to not have functioning or you're supposed to be in great distress, they weren't checking those boxes. And when they were going to see doctors, the doctor was saying, well, come back when,

when you break down, come back when you're not functioning. Well, what type of a broken model is that? And Ed, I know you know about longevity science and you see what's happening, this Renaissance in physical health where people are preventing disease. They're preventing cancer. They're preventing heart attack. They're preventing things like, you know,

osteoporosis with menopause treatments and so forth. But we're not preventing mental health breakdown. In fact, we are waiting for people to lose functioning, to give them the stamp of clinical depression because you lost functioning. And then we do something which is a broken model. Since 2020, the rates of anxiety, depression, mental health conditions are just skyrocketing. But we're waiting for them to break down before we do something about it. As a researcher and a therapist and psychiatrist, I think that we need to intervene before they break down so that we can prevent this crisis that we're seeing unfolding.

You said you have to know what makes you sad, right? What does make you sad? What are those markers? What are those things? Because we're going to get to this anhedonia thing in a minute because of anything I've read in probably a year, the term stood out, I'd never heard it before, I started to google how to correctly pronounce it, what is it, etc. etc. We're going to get there in a second and I think that'll be a real centerpiece and an enlightening piece for so many people. But first of all, you said you got to know what makes you sad. What does make you sad? There's a really cool model in medical school.

And I wish everyone had this model, so I wanted to democratize it. It's the biopsychosocial model. So when you look at it, it's a Venn diagram. So I'll use myself as an example. Biologically, I have low thyroid. So that could play into the science of my sadness and happiness. Biologically, I'm currently in perimenopause, right? So I have to think about the way that my hormones may be fluctuating that impact my mood.

But someone else, like you, you're not going to be in to be a very monopausal man, right? But you may have medical conditions that play into it. Also, we have to think biologically about our past family history. You know, what things that our parents struggle with, did they have hypertension, did they have heart disease? Think about the biological risk factors, right? And then the psychology, psychologically, what is your past trauma? What is your attachment style? Personally, I came to this country when I was small, we didn't have much, so I have to think about my scarcity trauma at times. And then my resiliency factors, IQ, that all plays into the psychology bucket. And then socially, we were just chatting about how

I live in New York and you're in Florida right now, but socially what are the things that play? I'm in a city, I'm not in the country, I don't have access to nature. Socially, what is my work life like? Do I have a stressful work environment? What are my relationships like? Because we know relationships are the number one predictor of longevity. Socially, what are my habits? Am I getting good movement? Am I eating foods that are nutritious? Am I drinking too much alcohol, right? Do I have too much tech exposure? Those are the social factors.

Now this is the key, right? We each have a biopsychosocial, but all of our biopsychosocials are unique. And that's why this model is so important for understanding the science of what makes you sad, because if we have unhealthy or risk factors in each bucket, then that's going to bring us down. But we can also use this model to know what we need to work on so that we can increase our points of joy. See, I think this is so good. I actually wish this was a three-hour interview today because

if after the term was coined by you, which I'm sure you didn't coin it, but for me it is high functioning depressed, okay, depression. I actually out of Lee out loud said, I know more people suffering from this than I don't know people who aren't suffering from it. I'm around high functioning people, probably like you are, and many of them I think struggle with this anhedonia, which is as I understand it, I want everyone

to lean in now okay, and really ask yourself this. My understanding of it is basically, and I'll over summarize because I'm not a PhD, is that you struggle or do not allow yourself to feel bliss or joy most of the time. If I'm accurate about that, describe it a little bit more and how someone listening may go, hang on a second here, I may have a bout of this or an awful lot of it. Why don't you talk about that a little bit? If you imagine depression as having two sides or let's say twin sisters, right? They're fraternal because they're not identical in the way they look. We classically think of depression as sweepy, not getting out of bed, sad. But this other sister, she is blunted. She's not getting

joy out of life. She's with friends and she can't wait to go home. She's intimate with her partner. She can't wait for it to be over. She's eating her food and she's just shoving it in her mouth and not really savoring it. She's doing work. She's productive, but she's not getting purpose out of the work. Anne Hedonia is the silent twin, the sneaky twin that comes in the middle of the night and robs you of your joy. And that is the symptom that we see. And the interesting thing about people who are human doing instead of human beings is that they cope with pain and stress by over-functioning, right?

So when you think of the classic sister who's depressed and not getting out of bed, think of the sister who doesn't have joy, but to cope with this feeling that she can't understand the anhedonia, she's overworking. And then when she's still, she feels restless. When she's not busy, she feels empty. So what does she do? She keeps on going and doing. The problem with that is that if you're not able to process those emotions and to cope with it more adaptively, something's going to give either you're going to physically break down. You see a lot of people with autoimmune diseases. You see

a lot of people with physical breakdowns, right? And where does it stemming from? The mind-body connection is so real. If you're over-functioning, overdoing, something's going to give either your body will break down, your relationships will suffer, you may negatively cope by drinking too much or being on the screen excessively, or you may dip into low-functioning and have a mental or psychological breakdown eventually. So it's important to identify

that people cope with trauma differently. Some stay in and stay in bed, and others deal with pain and psychological stress by over-functioning, overdoing. My dad was a alcoholic who got sober and he was sober for 35 years. But he wouldn't, I used to think alcoholic, that's someone on the street, they can't eat,

they can't bathe themselves. We have this picture of what a drug addict or alcoholic is. My father was high functioning like many alcoholics and drug addicts are, and because he was high functioning, it delayed or put off entirely his ability to get help for it because he was... He maintained employment. Every once in a while, we had a healthy family interaction, right? If time to time things were good. And so when I read this, I'm thinking to myself,

oh my gosh, it's so insidious because you are functioning. You aren't in the fetal position on the floor every single day and can't move. You may not be necessarily suicidal or have ideations. You just aren't feeling the emotions that you could or should be feeling. And so I'm wondering, does that inevitably mean, you sort of went down this road that most of these folks, and by the way, I'd assume the more you become functioning, the more you build up a tolerance almost to being able to function through it. You almost become built to live in depression or a variance of it or the lack of bliss or joy. So what's

the way out? Do you just wait for your crash like an alcoholic or drug addict to hit a bottom or is there a way out from here hearing this saying okay here's some tactics and so I know the answer because of the book but why don't you give us your answer to that? I hope you're not gonna tell us someone has to wait until they have a crash, until they hit bottom, until they lose their job, until they lose their marriage, until they lose all hope. What's their way out from here if they think, you know what, I think I'm one of these people. Thank you for sharing your story because it's the stories that connect us to the truth.

Right? When we hear about things, it doesn't really hit our hearts and it doesn't hit home until we have a story tied to it. And I've heard so many stories like what you just said. People send me DMs, they're like, this is me, but my doctor says I have to wait until I'm broken down, until I stop functioning to do something about it? This is how we treat conditions these days. We wait to listen to ICD coding and then we can get reimbursed and then we can do something, which is a broken model. We need to prevent this. And what you said about your dad, think about it. This is contagious. The way that anhedonia spreads, we all have that history of the bad boss who was angry and made you work so hard and the organization felt it. Well, joy is contagious as well. It happens in families.

When fathers and mothers are lacking joy, it spreads to the kids. We know the over-committed mom has over-committed kids in like a gazillion activities, you know? There are ways to derive pleasure in life. And when I think about happiness, happiness is this idea. It's the state that we may never achieve if we wait and delay our happiness. Many of us say, I will be happy when. I'll be happy when I have the job. I'll be happy when I have the home, the family. And the studies show that when we have that mentality, even when we get those things, we're still unhappy. Joy on the other side is experiences. It's if you're tired, get rest.

If you're lonely, connect. If you're hungry, savor your meal. So joy is the experience, happiness is the idea. And there are ways to correct this. I developed a system called the five V's method. The first V is validation, and it sounds so granolary, it sounds so obvious. However, those of us who are high functioning, we have a hard time validating, acknowledging, accepting how we truly feel. Think about the dad who just is feeling anhedonia, is not feeling joy and just continues working.

And when you ask how they're doing, they say, I'm fine, I have a roof over my head, my kids are fed, the bills are paid, but you know there's a lack of joy. There's a lack of happiness, really real happiness in their lives. So accept how you're feeling. And that starts with self validation,

saying I'm exhausting, I'm exhausted, I'm burnt out, I'm depressed, acknowledging how you feel. And this is not just loosey-goosey. The science shows that if we can identify our emotions, that act in itself is therapeutic. Why? Human beings don't like uncertainty. Think about 2020. That was a really hard time for us. We didn't know what was going to happen. And human beings don't like the uncertainty of not knowing how they feel. So when they can name the emotion and accept it, that act in itself decreases the anxiety. And I use the analogy of when you're in a room and the lights turn off

and something falls and you hear a loud thud, many of us will start swinging, some of us would run, some of us try to escape, but when you turn the light on and you see what it is, oh, a book fell. You pick it up. You put it on the shelf. That's the same way we are about emotion.

So validate how you feel and accept it, because that act is so important. It's therapeutic in itself. The second thing is venting. When you think of venting, it is the act of letting off steam and expressing how you feel. It could be done verbally, but many of us don't like to talk about feelings. So another way that people can express how they feel is through prayer, through crying, like letting out a good cry actually

releases hormones that make us feel better. And even writing, that's why journaling is so important for people, because the idea of getting the words out onto paper, that concrete and manual act can be therapeutic in itself. The third V is values. Values are things that are priceless, not with price tags. That is very important because we're chasing the clout, we're chasing the accolades, we're chasing the money.

But at the end of the day, the things that truly give us meaning and purpose in life are things that on our deathbed, we're going to be like, I wish I had more time in nature. I wish I had more time with my loved ones. Doing the things that gave me a sense of purpose, those are the values that you want to try and tap into every day. And then the fourth, vitals. You know, we only have one body and brain.

What are the things that we're doing to nourish our one body and brain? I tell my daughter this every day. How many bodies did God give you? She says one. And I say, what do you have to do with it? Take care of it. So these are the very boring things that your doctor tells you to do. Getting good sleep, getting good movement, eating foods that are healthy and not processed that actually nourish your brain, decrease inflammation.

But also I have three additional vitals that are in there that your doctor doesn't ask you about your relationship with technology, your work-life balance, and your relationships with other people because your relationships are the number one predictor of your longevity. And then the fifth fee is vision.

How do you plan joy so that you celebrate your wins and you don't delay happiness? And I have all these tools and methods in my book to go through vision because if you don't have something to look forward in the future, you're gonna be stuck in the past. So, hey guys, I wanna jump in here for a second and talk about change and growth.

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Let's talk about this plan joy thing and the venting. I'll ask it as a package question. I think you stipulate in the book, just because I read it three days ago and it's been on my mind ever since, but I think you stipulate that this, I conflate happiness and joy too much. Number one, that was one lesson from the book.

But the other one is that I think you stipulate that these are moments in our life. In other words, it's not a constant state of being. And so is that what you mean by sort of planning your joy, planning moments that you would assume should be bringing you some form of joy? Is that what you mean? Absolutely right. Happiness is an idea.

Joy is the experience. I'll give myself an example. Today, I got my daughter to school on time, went on to a major news network, and then now I'm speaking with you. After our interview, I'm going to block off time and really sit and eat my salad without a screen and tell myself, wow, I did a great job today. I'm a working mom, I'm helping people, and I'm going to treat myself like a human being and eat and chew and swallow and savor, right? And not rush through it by being in front of a screen. That is a small act of love, but it sends a deeper message to yourself that you are a human being,

not a human doing. And that's sav that point of joy is actually science-based. So when people come to see me in the therapy office, they're like, Dr. Judith, I just wanna be happy. But in research, you rarely find the word happy on our psychometric rating scales where we measure the science of happiness. What we'll find are points of joy. So we'll ask, when you ate, did you enjoy it?

Did you have an appetite? When you connect up with a loved one, did you really savor that interaction? When you slept, did you feel rested? Right? These are the sensations that these are the points of joy that make up happiness. So if you can get a point today or get two points tomorrow or say, you know, I didn't get any points yesterday, but I'm going to make it a habit to try and get at least one or two a day. That is more attainable than saying, but I'm going to make it a, uh, you know, a habit to try and get at least one or two a day. That is more attainable than saying, I just want to be happy because happiness, that idea may never even happen for us.

And I've traveled the world studying this and, and I've, I've been to some countries where you'd see children living in the most devastating conditions, but yet they're still joyful. They're still playing. Why? Cause you don't have to teach a child how to be joyful. It's in our DNA. It's in our DNA to be happy and to be joyful. So accessing the points of joy every day in these small human, regular human things that we can do can make us overall happier.

It's so good. It may seem simple to actually plan some of your moments of joy, but I will say the absence of doing that, what are the odds it's going to happen if you don't plan for it in today's day and age? Like, if you really think about it, that's sort of, I'm gonna plan my moments of joy. Well, okay, let's assume you don't. How likely are they to take place? Now it's completely left at random in your normal life patterns. And I'm reading your work, I'm like, okay, let's see here. I do typically when I go out want to get home sooner than I should. I do rush through every meal as if it's a race. I do have a hard time even of moments when I know I should be allowing myself to feel joy and bliss in those moments. I've become built for it and I know where it comes from,

which is why I want to ask you next. I think a lot of things as children with parents is caught, not taught. And I have great parents. My mom's probably listening to this interview right now, right? She's my favorite human being on the planet. Having said that, I think even my mom would say, maybe we could have had more joy in our house. Like I hear my dad sitting on the couch alone, sober now, right? Alone. It's just kind of like, and I'm like, dad, what's going on? This politician, this thing, you know, and it was just these very few moments of like, I think I caught it. I think I caught my dad's emotional home. I think you may not turn out personality-wise like your parents or even the same career, but emotional home, like the real home you live in emotionally, that bears evaluating.

So how as a parent, let's ask a parent question, how as a parent can we learn to not pass this functioning depression onto our children and pass the right things onto them? Yeah, and I'm guilty of it as well. My dad, I call him a Renaissance man because I'm originally from Trinidad. He played cricket, he had a band, he is a pastor, he was out in the community, he was a theology student, but he was busy. He was always doing, you know, and you got to save for the moments because your children

will mirror you. There's no wonder that I have an MD MBA. I run a lab. I'm doing all these things. I often find myself back into that high functioning pattern. And my daughter, you know, at one point in our, in our, in my life, I was over scheduling her because I was over scheduled. And one day, one day she said to me, mommy, I am tired. And I was just like, wow, like I'm tired too. So it is contagious, you know, it's important that what you do, it, your children marry you, you know, if you're in

front of your screens, your kid's gonna be on their screens. If you're busy, they're going to be busy and it is contagious. But in the way that anhedonia, that busyness is contagious, joy can be contagious too. And so the simple things in life that you can do, and I go through these checklists in my book

about how to slow down, how to save her moments. You know, I'll give an example of brushing my daughter's hair. If I'm brushing it and like, she's like, oh, that hurts. Then I'm like, wait, I'm doing this quickly because I was over scheduled. And what I should have done was not over schedule myself. So the next day, what I'm going to do is plan more time so that when I'm brushing her hair, she sees that I'm taking my time so that she honors her body because she's only going to get one body. And when I apply lotion to myself, these small acts, I try to do it slowly. And I'm sending the message to myself that my body

is worthy of care and being gentle. And doing these small things sends the inner dialogue to yourself that you can slow down. Nothing bad's gonna happen if you don't rush through these moments. So it doesn't have to be grand. Make it a point that, let's say if you have a meeting later today with your colleagues, when you're gonna meet with them, you're not gonna rush in and out.

You're actually gonna spend time discussing them, checking in on them, having a meaningful interaction with them. If what you value is kindness, then you're going to say, at least for one person today, I'm going to hold the door for them. I'm going to just ask the doorman or the person at the cashier how they're doing. Going to check in with them. Find out what you value in life. If it's nature, you're going to, you know, if you're driving, you're going to take your car through, you know,

a park or just take a walk in the park. If you're in a big city, but do something every day to honor your values and tap into it. So you're going to one validate how you feel. Oh, I'm feeling hungry. All right. I'm going to make a break, I'm gonna make a break. I'm gonna go and get something to eat, savor it, take my time. There are little things you can do to be a human being instead of a human doing.

And if you slowly do those things, it doesn't have to be grand, you don't have to do all five V's a day. Tap into one or two a day. Then over time, you will be happier. It's all about collecting the points. You know one of the things for me, I'm loving a conversation, it's a simple thing and it is you've used the word probably five times so far. It's just slow down. It's

literally for most things for me, my trigger to bliss is just slow down. I talk fast, I eat fast, I drive fast. It's everything is a race almost with me and it's become something I win most of the time. No one else at the table is aware we're racing to eat this food. They're trying to enjoy theirs and I'm in the biggest hurry in the world. I tell you an interesting story and then I'll ask you a question about one of your techniques. I was just in Hawaii, had to go over and speak. I'm gonna be there twice in the next three weeks. And I get over there and I'm alone on this trip and I'm like, if I can't relax and enjoy myself in Hawaii, find some joy here. There's a real problem. And where I was speaking, most of the people in that hotel knew me, so it was difficult to get any quiet time if I went out of my room

because people there were there to attend an event I was speaking at. I thought, you know what, I'm going to get a massage. There's a 60 minute and an 80 minute. And I go, I'm going to do the 80 minute. And even in a massage, I'm like 15 minutes into this massage, I'm like, oh my gosh, there's 65 more minutes left in this thing. And I'm literally not enjoying the massage because I'm in a race for the massage to end, right? It's that crazy! And so in my own case, I actually went back three days later when I left, I'm like, I'm gonna get another one and I'm actually gonna slow down and enjoy this. And so one of the things you teach in the book, I think everyone's gonna take this right now, go I'm gonna do it, is your five, four, three, two, one technique, which is not really correlated to what I'm saying,

but I wanted to just make the point of pacing and breathing and slowing down. Very rarely is joy and bliss in moments of hurried. They just, they're just not going to be present at the same time. So do you agree with that? And then tell them your technique because it's awesome. same time. So do you agree with that? And then tell them your technique because it's awesome. Well, the busying yourself is a trauma response. And I'm going to say that again, because I don't think people correlate the two. Busying is a trauma response. I do this. I've conducted several PTSD studies and there's an assessment called the CAPS-5. It's validated by the VA hospital, typically used in combat veterans, but now it's been applied to clinical research. One of the symptoms of trauma is avoidance.

And when you think of avoidance in the classic PTSD sense, it's avoiding things that trigger you like people, places, or situations. And avoidance in the form of busying is a trauma response. So you're over committing yourself. You're too busy to acknowledge the pain. And I think that needs to hit home. And that's why I applied the five four through two one method to high functioning depression,

because the five four through two one method is a trauma method that allows people to ground. When you think of how you're busy, it's a way to avoid feeling that pain. And many people will say, oh, 2020 was a blur or my childhood was a blur. Well, the reason it's a blur is because your brain was trying to block memories that were painful and that helps in the short term. But in the long term, it doesn't because you continue to avoid and then the trauma peaks out in different ways.

And five, four, three, two, one allows you to stay in the present to ground you so that you're not floating outside a situation or floating outside your body, which is called disassociation. And that's that feeling of like, I don't remember what happened or it was a blur. It's because you were disassociating, right?

So if you want to practice five, four, three, two, one, I do this every morning. It takes me like one to two minutes, but you can do it longer. Imagine one thing that you do. So it could be your coffee and you focus on that one thing. And I have my coffee mug here. And so you're holding your coffee or your tea or whatever it is that you drink, even water, and you want to stay in the moment. So you're going to think about five things you can see. And so it could be describing what the mug looks like, your hands, four things you can feel. And it could be feeling the temperature or the mug looks like, your hands, four things you can feel.

And it could be feeling the temperature or the mug or like what you're wearing or the chair that you're in. Three things that you can hear. And so sometimes you can hear the noises, the music or like the environment, the nature, the breeze. Two things you can smell. So you just like smell the aroma or like even what you're wearing, the fragrance you're wearing or candle. And then one thing you can taste. So you can taste it and then, you know, what does it feel like going down? What does it taste like in terms of the flavors? But if you're doing that, I'm not thinking about,

my dry cleaning, I'm not thinking about the meeting I have in two hours, I'm so present. And I described that probably under 60 seconds, but if you practice a little bit of that every day, and you're staying present in the moment, you're grounding yourself in the situation, then you're gonna calm your fight or flight. You're going to notice that you're not as tense. You're not going to be distracted. And that act brings you into a better state so that you can slow down. And

anyone could do the five, four, three, two, one method with any activity that you want to be present in. That's outstanding. And I'm going to do that. That's like really, really, really good way to become present. It's simple, it's easy to remember, it's something you can do in a, again me, always in a big hurry, that you can do in a short window of time. That's really, really good. This message is sponsored by Greenlight. Hey guys, I talk about Greenlight all the time. I talk about Greenlight not on camera with my friends who have children because you think about it, at least when I was young, nobody taught me about money. Most parents don't teach that stuff. School doesn't teach it even though they

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It sounds to me like a lot of high functioning depression is more than likely, I'm over summarizing, coming from some type of trauma somewhere. Is that safe to say what I just said? Is that safe to say? It is, you know, I'm the only person who's done a peer-reviewed clinical study that was published in high-function depression. We still need more data,

but I felt like we needed to have something to validate how people felt. If it's not published or if it's not studied, then you're really going based off of like anecdote. So it was important for me to use my lab to do that. And I'm proud of that work and I hope to do many

more and I hope other people start doing studies as well. Thank you. Well, you know, people run from things that are painful and according to the DSM-5, a trauma to meet criteria for PTSD is typically combat or assault or something near death that you either experienced or you witnessed. However, people come in all the time with traumas that are little t traumas

like a bankruptcy or a toxic relationship. I'll tell them that according to the DSM-5, you don't meet criteria for this, but I believe you because there are things that are emotionally and psychologically painful that shape how we view ourselves in the world and how we behave in the world. And so I created a more extensive trauma inventory to include things like that, that you won't find in the DSM-5

because I truly do believe that these little T traumas shape us. You know, having a parent who was neglectful, having a parent who yelled at times, who you were worried about, try telling someone that that's not traumatizing. It is painful and it shapes you. So I wanted to acknowledge things like that. Having a business and going through bankruptcy, that is painful. That shapes the way that you interact in the world. And I included those experiences, including collective traumas like pandemics and you know, things that happen to groups of people,

generational traumas, because that does shape us. It changes how we view ourselves in the world and how we interact in the world. I want to ask you about one type of trauma next, but I want to say one thing to everybody on trauma, even in my own work with coaching people over the years, you call it a little T trauma, but you begin to collect them in your life and they can stack. And I'll tell you all, I'm going to give you all a word that maybe you would replace with trauma, which is disappointment. And the longer you live, you do begin to potentially collect disappointments. And this is a form of trauma in your system. So it may not be the same as your dad yelling at you or being physically struck or, but it's, it's trauma. It's a disappointment of the love of

your life left. Disappointment of a promotion you didn't get. The disappointment of you did get the promotion and it didn't make you feel the way you thought, a bankruptcy, the ending of any type of a relationship. It could even be the expectation of walking in a room and being received a particular way that you think you look great that night and no one notices you, or someone puts you down subtly, or it's a crabby boss, you know, or a passive aggressive friend. You collect these disappointments and that begins to become a trauma in your life and I think it can dull these responses to being able to produce joy in your life and all of a sudden you're high functioning depressed. So I just want everyone to evaluate this. This isn't a weakness. This isn't some,

you know, way whatever your political spectrum is, you know, oh, safe spaces. That's not what we're talking about here. We're talking about living as a human being. These are real things. And many of you right now listening to us, you are high functioning, maybe you wouldn't use the word joy, but depression, but you're lacking the joy you deserve. And that's high-functioning depression. And so what is, here's a form of trauma that I wanna ask you about, because it's in the book, but I want them to hear it.

What is scarcity trauma? I'm so glad you brought that up. Scarcity trauma is something that I, I'm a board-server psychiatrist and researcher, and I didn't even realize how much it shaped my behaviors and how I saw myself in the world. The interesting thing about trauma that most people don't know

is that trauma makes you feel unworthy. It increases self-blame. It's actually on that combat veteran checklist I told you about, the CAPS-5, so that when you don't know that these are trauma responses, you don't realize your behaviors are shaped from feeling unworthy and internalizing shame and blame.

And scarcity trauma happens when you either come from a position of not having resources, money, food, water, shelter personally, or your ancestors didn't have it and they've passed these behaviors onto you. So think about people whose ancestors have fled war, and they don't realize that these behaviors of not taking risks, not investing in themselves, hoarding their money, hoarding

food that is expired, having bags under their sink that they just can't get rid of. They don't realize that the clutter is related to this scarcity trauma of running out of things and being afraid of losing it all again. For me, I experienced it. I came to this country when I was very small from Trinidad and there were times when we didn't have resources, we didn't have food.

And I ended up being valedictorian. So I approached scarcity in this way, which I didn't realize until adulthood and well beyond, you know, my training was that I would hoard my degree. So I would be like, well, an MD isn't enough. I got to get an MBA and you know, one, one, uh, residency training is enough. I got to get a fellowship and then, well, I can't just have a lab. I also have to have a private practice that I also have to have all these things. So I was overdoing so that I wouldn't be in a position of needing again, even though it

was illogical. And I am a board certified psychiatrist. I didn't even put this together until well into my research. So you can have these behaviors that are rooted in scarcity trauma and you're not even aware that they're related to how your parents are raised or your grandparents are raised or how you have gone through positions of not having enough. And I see this in farmers, right? People who've come from long generations of farmers where farmers don't know when they're going to have their next crop. So they store and they're constantly thinking about saving and you know the weather can be unpredictable.

And then they pass this scarcity trauma onto your Your children and grandchildren and they don't even realize they're not they're not taking risks in life And they're having these behaviors out of a fear of scarcity. I love it. I I think your work is so awesome I have my two forms of it. I was on welfare as a little boy No matter how much wealth I've accumulated I still have a scarcity fear of being broken, not having food or eating, which is insane if you saw how I live and where I live, but it's there. And then also because of my dad's drinking when he was young, he would be gone,

and I have this scarcity issue with people leaving me. Whether they, I keep people who work for me, way too long working for me after they've proven they're not qualified because I don't like letting people go in my life because I have this scarcity trauma from thinking my dad was going. I've kept it with friends who shouldn't be in my life anymore but I keep them around because I have this scarcity issue. I'm only sharing things about myself with everybody today so maybe when you hear something you go, oh that doesn't apply and then I give you my version you go, oh maybe I do have a scotia this stuff, right? And so I just want you thinking about that. Here's a tough question, but something that you talk about. What if you're listening right now or watching and you go, I don't think it's me,

but it is my boyfriend. It is my girlfriend. It is my daughter. It's my dad. It's my significant other. Is there anything you can do if you're in a relationship with somebody and you believe you're with somebody who's high functioning depressed? Is there anything that you can do if you're in a relationship with somebody and you believe you're with somebody who's high functioning depressed? Is there anything that you can do? KS Before I answer that question, I just wanna thank you because I think many people look at you and they see on the outside strong, powerful leader has it all figured out. But when you share and you're vulnerable, it is so powerful. Thank you. I accept that. I appreciate you saying that. Thank you. Not always easy, so

thank you. It's not. It's not easy. But I think people need to hear it, especially men. And so, when you have someone in your life who's like this, just know that on the inside, they're blaming themselves. They may not be conscious and aware of it, but they've internalized self blame. When you think of a child, they approach problems with magical thinking. If I just get good grades,

maybe dad will shape up. If I just behave, maybe mom will love me more. It's the magical thinking. Well, when you don't process that trauma, that magical thinking goes into adulthood, right? If I just work, work, work, then I'll never have to have suffering again, which, and you don't even realize you're actually suffering. You know, you're not, you're a human doing, you're not a human being. So when you have someone like this in your life, know that they've internalized blame and shame. So when you approach them,

they're not going to gonna wanna burden you. They're not gonna wanna acknowledge that they have this happening in their lives because on a deep level, they don't want you to feel bad for them. They don't want you to suffer because of them. So you have to be there for them and you have to validate for them.

So you have to show them and model for them that, okay, it's okay if you don't do the X, Y, Z. I'm still going to love you. And they're going to be like, oh yeah, yeah, sure. You know, I don't think that way. But when you're sending that message, their unconscious brain is soaking it up. So they may not get it the first time. They may not get it the second time. But the fact that you're there, you're shaping their attachment style because you're not leaving. You're not saying I'm out of here when you're not leaving. You're not saying I'm out of here when you're on doing. These people believe that their self-worth is tied

so closely to their role that if their role breaks, they won't be lovable. But you have to remind them that you're going to be there for them no matter what. So sometimes it's sitting with them even when there's nothing going on, sometimes it's meeting their basic needs because know that they're not getting nutrition. So they may need you to bring some food and just help them out, bring them a glass of water. You need to help them to rest by taking the load off. Sometimes just offering your help, your presence. They need to know that no matter what you are there. And it sounds so simple, but know that they're projecting onto you what you're feeling, right?

You feel as if, oh, like, they don't need me there so strong. No, they're projecting it onto you. So you have to be there for them, even though they're exuding confidence. They need that connection. They want you to help them. They just don't know how to ask for it. And then you have to mirror for them. You have to share with them. Be vulnerable help them. They just don't ought to ask for it. And then you have to mirror for them. You know, you have to

share with them, be vulnerable around them, show them that it's okay to be vulnerable to let their guard down for them to share. Because if you're just taking their projection on and at safe value and you're not sharing, you know, oh, they don't need me. Then that's not helping them. You have to model it for

them. Okay, we're gonna talk about thoughts in a second, you guys, but I want to ask you, you know, a lot of times I'll have guests on. My audience is more than half women and significantly more now. And in the book, sometimes when I'm doing interviews, I'm a male. I think I ask questions from my perspective sometimes. And in the book you talk about, you said you're a perimonopause, like what about hormonal effects? Obviously, and by the way, if it affects men, speak to that as well.

If when their testosterone levels drop, I don't know. But what about women hormonally? And this idea that maybe this can change over time as their bodies are changing over time? Well, it goes back to the biopsychosocial model. So biologically, women experience fluctuations in their hormones over time. I started off really in this space because of postpartum depression.

I studied postpartum depression in women who had just given birth over the past five years. I've even done studies using psychedelics with postpartum. Postpartum depression is a really interesting thing. When you give birth, progesterone drops, and this can change the way that your brain interacts with something called GABA, which is a neurotransmitter, a neurochemical that helps you feel calm. So if you think about a postpartum mom, she's constantly checking to see

if her baby's breathing, right? She can't sleep, she's anxious. So it's not just the sadness. And 80% of women will experience blues, 80%. Yet when you open the brochures, you see a happy mom and a happy kid, but 80% of women experience this. So we have to validate that. But it's not just postpartum. There are windows of vulnerability with regards to hormones throughout a woman's life. Think about puberty. When you're going

through your period for the first time, there's something called premenstrual dysphoric disorder. So some women experience intense mood issues and anxiety and low self-esteem around their period. So there's the periods, the postpartum, and then the perimenopause. Most doctors don't even get one course in perimenopause. Most doctors haven't even heard of it. They've heard of menopause, which they probably get maybe one or two hours in their entire training. But perimenopause lasts up until you actually have menopause, which is a year without your period. But perimenopause and menopause can have mental health symptoms tied to it. Absolutely. And I've developed something called the TIEs method, T-I-E-S. T is thinking. So when you're going through a pair of menopause and menopause, you may be forgetful.

You may not be able to multitask. You may have a hard time organizing problems with your memory. And then the I is identity issues because there are changes that happen in your body and brain that makes you question who you are. So you may find that you have more belly fat. You may find that, you know, you're not as into intimacy as you used to be. You may notice that your hair is thinning,

your skin is changing. All of these things shape how we view ourselves. And so you may feel like, I don't know who I am anymore. And then there are a lot of muscular changes that happen as well. So if you were into Pilates and you were into all these things and you finding that you're more achy, you may feel as if you can't function in the things that you used to do. And then the E is emotions. The E in ties is emotions. People may experience moodiness, irritability, anxiety that they didn't have before, which also shakes your sense of self, the I, right, the identity. And then the S is sleep. This is what I noticed first in terms of my mental health symptoms related to paramedic

positives, that I couldn't sleep as deep as I used to. And I was like, what's going on? And so if you're not getting good rich sleep, that impacts all, I say no pun intended, it ties it all together because sleep impacts your thinking. It impacts how you feel about yourself and your identity and it impacts your emotions, your mood and your anxiety. And so when, and you know that affect labeling, being able to name it, when I speak about ties

at these conferences, women are just like, that's what it is, you know? You hear a woman in her late thirties and forties saying, I'm old, I'm getting tired. It's perimenopause. That's why you can't hang as late as you used to, you hear a woman in her late thirties and forties saying, I'm old, I'm getting tired. It's peri-menopause. That's why you can't hang as late as you used to, you know, that's why you can't have more than one glass of wine. So when you know what you're dealing with, then what does that do? Oh, it's not me. You don't internalize the blame and shame and you're actually able to do something about it. You're going to, for the, for the thinking issues,

you're not going to multitask. You're going to prioritize. You're not going to try to be everyone's hero. You're going to not be super woman. You're just going to focus on what's important. And you're also going to organize your life better. You're not going to have clutter. You know, you're going to make sure you look at your schedule the day before so you're not scrambling in the morning.

You're going to use something that I call a launch pad in your home where you put your keys, your wallet, your glasses, so you're not like looking for things. Um, and these are, these are things called organizational skills therapy, which I actually do with my small clients of ADHD. I start to use them for the woman who have perimenopause. It makes their life so much easier. And then the eye, the identity issues, you're going to do things for your skin that are different because your skin, your hair, they're going to have different

needs. You may not be able to, you know, run that are different because your skin, your hair, they're going to have different needs. You may not be able to run as much as you used to, but your body is changing as you get older. So you're going to have to lift more weight. You're going to have to eat more protein, meet your bodies. You shouldn't be using the diet from your 20s when you're in your late 30s and early 40s. You can have to change things, right?

And that way you can still keep doing the things that you love to do. Your identity, you're still you. Things are different in your body, but you are still you two things can be true. And then the E the emotions. A lot of people will say, I'm so moody. I don't know. I just snapped up my husband. I snapped up my coworkers. What's wrong with me?

We'll know that that's the hormonal fluctuations. There's nothing wrong with you, but when you know it, then you can plan better. If you're feeling this way, maybe you won't schedule an interaction with someone who triggers you. Maybe you're going to keep toxic people at a minimum and you're going to regulate more. You're going to practice more meditation, more mindfulness so that when you go into stressful situations, you're not going to fly off the handle. And then the sleep is huge. As you get older, your thermoregulation, so your body's inner thermostat changes. That's why women get hot flashes. So you're going to keep your room cool at night. You're not going to have so much caffeine that you can't turn your mind off when you go to bed. You're going to do things like

worry journals. It's called worry procrastination. You're going to do things like worry journals. It's called worry procrastination. You're going to try and write all your worries at one time in a day. So that way you unpack it so when you go to bed at night, they're not racing in your head. And you're going to eat foods that are rich in melatonin, like walnuts, bananas, and so forth, because you need to really honor your sleep. And there are things like cognitive behavioral therapy that are really helpful for sleep that do not require sleep aids because we know that sleep aids, such as you know, some certain medications are habit forming and they actually don't improve your sleep. So there are behavioral things that you can actually do to help your sleep

at night. I'm really glad I asked you. Now guys, by the way, you may think that I asked that for the women, but I didn't because you're probably with a woman, you could be of this age or you will be. I have to tell you something, when you were just describing this, I'm thinking of so many of my friends. Sort of in this space, I think it's pretty well known that I'm like friends with more of the ladies in the space and I'm kind of like the adopted dude. So like on their retreats and stuff, I'm the one dude that gets invited, right? And I have to tell you guys, so many friends of mine have gone through this change and don't understand it. Why am I depressed? Why am I angry?

Why do I feel more lost? Why am I sad more often? Why am I not sleeping as well? And it's almost, you almost just literally described every single, I'd say 95% of my friends that are near that age and it has become a very rough one to six, seven year time in their life. Also often this is timed with life changing. Maybe the children are leaving the home for some people at time. Like in your case, your daughter's younger, it sounds like, but they're leaving the home and dynamics change and so guys, if you're with a woman, by the way ladies, I'm not a doctor, just look at your progesterone levels if you're having a hard time sleeping. It's something, go right there, take a look at those levels, have a conversation with somebody about it. I'm not prescribing any medication, trust me, but I'm so glad that I asked you that because there's all these things that can contribute and I just think when I think of high

functioning people in my life that are maybe are lacking the joy they once had or want to have, I'm picturing many of my female friends about that time in their life that you're describing. And so God bless you for covering that. Okay, Martin, let's try one. Remember, big. You got it. The Ford It's a Big Deal event is on. How's that? A little bigger. The Ford It's a Big Deal event. Nice. Now the offer?

Lease a 2025 Escape Active all-wheel drive from 198 bi-weekly at 1.99% APR for 36 months with $27.55 down. Wow, that's like $99 a week. Yeah, it's a big deal. The Ford It's a Big Deal event. Visit your Toronto area Ford store or ford.ca today. Okay, one last question. This has been awesome, you guys. You say in the book, you can take control of your thoughts, right? Or there's help in doing that. So I think we should finish with that. A, do you really believe that? And B, how does someone begin to take at least greater control of their thoughts if they're struggling with them running away from them or just not being the ones that

serve them? Just overall thoughts changing them, your viewpoint on thoughts. Well, you know, about the progesterone that you said, even when you get tested because perimenopause is like a roller coaster, not this smooth sailing that people think happens right before menopause, your levels may not reflect what's happening. So that's why it's important to go based on the symptoms and have a doctor who understands that. And there's a three P method to know if it's mental health versus

perimenopause or menopause. P The first P is are there changes in your period because mental health symptoms don't have the changes in your period. The second is physical changes. It's not depression if you're having your hair falling out, your skin changing, you're going to the bathroom more regularly. So are there physical changes? And the third is your past history. If you have a past history of postpartum or premenstrual dysphoric disorder, you're more likely to have a harder time with perimetapolism mood symptoms. So understand three P's and that's really helpful. Then I'll jump into the thoughts. No, I'm so glad you got it. That's wonderful. Thank you. Oh, my pleasure. We often try to control our thinking, but we need to spend more time in

our feeling as high functioning folks, because we tend to ruminate. And there's something that I mentioned called worry procrastination. So if you think about it, the elephant in the room is your problem. Try to practice having that elephant in the room while you're doing what you're doing. So if I'm working and I have anxiety, the anxiety is the elephant, let him work too. He has his laptop, let him go to work, I'm gonna keep working.

It's called metacognition. So you're allowing yourself to have that problem in the room, but you're not focusing on it. And the typical model of cognitive behavioral therapy, which is a behavioral therapy, we try to challenge the thought and change the thought and put the thought on trial. But many of us who are very anxious and ruminative people, that will drive us crazy. Rather than trying to change the thought, let's try to stay in the present and feel our feels. So the anxiety is there, we're just gonna, you know what? It's, if you imagine that the issue is like a passing train,

the train's gonna keep going, you're staying on the platform, but you're not gonna get on the train. So it's just, it's there. So you keep doing what you're doing and it's there. But what you're doing is you're retraining your brain to not focus on the train. So it's just, it's there. So you keep doing what you're doing and it's there. But what you're doing is you're retraining your brain to not focus on the problem. You're still doing what you're doing in the present

and the problem is still there. That's why worry procrastination is a great tool. You pick one place that you want to worry every day at the same time. So don't pick a place like your bedroom because you don't want worries in your bedroom. Don't pick a place of leisure, like your favorite couch where you relax in the afternoon.

It could be a corner in your office or a place in your work or even a place in your home where you don't want to associate with leisure. And that's where you're gonna do all of your worrying for the day. So for example, if you're at work, if you're at work and you have a worry pop up, say, okay, I'm gonna save that worry for my worry corner. And you'll maybe write it down on your phone and then say, I'll save

it and I'll worry about it in my worry corner. What the research shows is that if you save your worries for that time and place, by the time you get to that worry corner, you realize you're not even worried about it anymore. So you're retraining your brain to not catastrophize, not put so much weight on these worries. And over time, what you'll notice, because I've done this to myself, you'll notice is that when something pops in your mind and worries you, you're like, well, I will literally worry about that later. And then when you get to your worry corner, you realize it was not as catastrophic.

So one of my daughter's favorite movies is Kung Fu Panda. It's kind of like you're training yourself to be this master warrior where like, yeah, the worries are still there, but I'm still present. I'm still focusing on what matters right now. That is so good right there is finding that place. And by the way, the reason you don't want to do it in your bedroom, you're, you're creating triggers and anchors to that space that when you then walk in there later, it triggers the worry. By the way, I'm want to do it in your bedroom, you're creating triggers and anchors to that space that when you then walk in there later,

it triggers the worry. By the way, I'm going to do that. When you're talking, I'm thinking, where am I going to do this? But I'm going to do that. I'm going to pick my space. I also just think awareness of a worry and a thought helps it lose its power and influence over you when you just become aware of what you're doing. And I'm going to worry about that later when I get over to my worry corner, my worry place, and by the time you get there, the emotion of the moment's probably left you most of the time. Perspective kicks in. You've also not created triggers and anchors all over these places you're at

regularly that then re-trigger worries when you go into those spaces. This has been so good and your work, I hope, I just want to encourage you. This high functioning depression, this concept is amazing that you're the first person I've ever spoken to about this and it took 54 years, yet it absolutely is probably an epidemic. It is probably an epidemic in our world and I love the fact that you don't just diagnose the problem, you provide a bunch of solutions for it as well. I think you're awesome. I think you're wonderful. I think your work matters so much because these are the people that are creating and innovating and moving the needle in families and lives and businesses

every day and they're they're under treated and under helped because they're quote unquote functioning and so you're changing families lives. You really are. Thank you so much for this today. Thank you for all that you do. Thank you for using your platform for good and for allowing me to share this message because I truly believe that when people are joyful, the world is a better place. People who are joyful make less mistakes. People want to be around them. They view the world differently. They're kinder. And I truly do believe that joy is really the key to a lot of the problems, solving a lot of problems in this world. So thank you, thank you so much. This is a... Yeah, kindness and beautiful energy is contagious and you have that immediately. You have that.

There's a warmth to you. There's an energy that I think everybody's felt today, whether they're listening or watching, and I certainly have. I wish we were doing this in person. But you guys, this was Dr. Judith Joseph, and for a lot of you, it's your first exposure to her, but I have a feeling it won't be your last. The book is called High Functioning, Overcome Your Hidden Depression and Reclaim Your Joy and I know we just did that for the last hour to some extent and I think the book can do more of it for you. So God bless you everybody. Dr. Joseph, thank you so much and everybody max out your life. God bless you. out your life. God bless you.

This is the Ed Mylan Show.