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You know that feeling when you're doing.
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It all, but somehow it still doesn't feel like enough. You hit every mark and you're still running on empty. Psychiatrist Dr. Judith Joseph calls it high functioning depression when you look fine, even successful, but inside you feel nothing.
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But here's the thing, that same drive that is moving you forward might also be what's holding you back.
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She calls it pathological productivity and once you see it, you can't unsee it. What I love about this conversation is that Dr. Judith doesn't just name the problem, she gives you the tools to.
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Stop running on empty and to finally.
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Start feeling full again.
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Welcome Dr. Judith Joseph. I am Survey. So excited to have you here on the Aspire podcast.
C
Thank you for having me, Emma. I'm so happy to be here. I love talking about this topic.
A
Honestly, I love that we get to talk about this topic because I read a lot of books and I was so excited to get an early copy of your book. And I think that, you know, it's so interesting because I think in the world that we live in right now, we're always looking for really simple answers to highly complex problems. And what I love about your book is that it's a highly complex problem, but you have managed somehow to boil down this beautiful solution and explain the science of happiness in a way that for me, I literally was like, how do I buy this book for every single person, not just woman, every single person I know. And I don't get that feeling often. And so I'm so happy that you're here today to really take us through what the science of happiness is. But one of the things that I got from you was that you can't have happiness without having sadness. And we all know that that is an emotion. All of us feel it sometimes. And you are an expert on the subject of high functioning depression. And so I really want to be able to dig into that before we get to this amazing system and these tools that you've created for happiness. But to start, I know that a lot of your research is actually rooted in your own personal experience. And so I'd really love to understand just a little bit more about how you came to the research and to really understand more about you as a person.
C
Well, thank you. You know, I love talking about happiness because everyone wants to be happy. And when my patients come to my private practice, the first thing they'll say is, Dr. Judith, I just want to be happy. But when I have patients in my research lab, you won't find the word happy on any of the rating scales for psychiatry. So what you'll find are these things called points of joy. If you're tired, when you rest, do you feel refreshed? When you're hungry, when you eat your meal, do you savor it? When you're lonely and you cuddle with your kid or your pet, are you feeling connected? We add up all those points and that equals happiness.
A
Wow.
C
But in the real world, people are like, I just want to be happy. And then I ask my patients, okay, well, what does happiness mean for you? And they're like, when I get that job, when I get that partner, when I have that house, the kid. But when people get those things, the science shows us they're still not happy. Right. And that can seem so out of reach, that idea of happiness. So I explain to my patients that happiness is an idea, joy is an experience.
A
Oh, yeah.
B
I love that you get a little bit every day.
C
If you didn't get a point today, you can get a point tomorrow. And the motto of my happiness lab is understand the science of your happiness. There is only one Emma. There will only ever be one Emma in the future of the universe and the history. So why do we use tools that make other people happy when we don't even understand the science of our own happiness?
A
And how individual is that? Because when I read your framework, I. There's not a page in the book where I wasn't like, I get that. I understand. I watched this and actually we have to kind of go back a second because I watched this TikTok video of you over and over and over again. And it was actually like digging into the idea of what even is high functioning depression. So will you tell us, like, what does it mean and how does it manifest?
C
So in my lab, I use something called the DSM 5. It's the diagnostic statistical manual for psychiatry.
A
Oh, one second. You might have to say that one slightly slower for me this time in the morning.
C
It's the bible of psychiatry, basically.
A
Okay, I got it.
C
So I pull it out and it's big and you open it and then you're going down the checklist. And what we do when we identify depression is we look at symptoms like, okay, poor concentration, low mood, anhedonia, something that means a lack of pleasure and interest and joy, not being able to feel rested. All these things. But at the very bottom of the checklist is, is it impairing your functioning or is it causing significant distress? And what I found in 2020 and beyond is that I would go down the checklist and most of the people wouldn't check that box. In fact, the people I was treating, they were actually over functioning. So what happens is you go to your doctor, you have all these symptoms of depression, but you don't check the box of lacking functioning. And they say, well, come back when you break down. Yeah, it is a broken model. And I truly believe the majority of Us are over functioning. We're pushing through pain. We have symptoms of depression that are not being addressed because we haven't broken down. And we're seeing this in longevity science. You know this, right? Like we're trying to catch the cancer before it starts. We're trying to catch the heart disease before it causes a heart attack. We're trying to prevent osteoporosis with the HRT and the menopause treatments. But in psychiatry, we're like kind of in the dark ages. We wait for you to break down before we fix you. I'm trying to change that. Let's identify these high functioning individuals who push through their pain, who have these symptoms and let's prevent the breakdown from happening to begin with.
A
But this is the part that makes so much sense for me because when you are, if you are building a business, if you're in a career, if you are pushing yourself, you, you're getting stuff done every single day. You are not sitting in a dark room. You do not relate and put yourself in that kind of situation where you're thinking about, I'm depressed, this is something that's affecting me. But you're actually saying that you can get up every morning, be doing the absolute most and have high functioning depression. That is a reality for so many people.
C
It is. And the thing that gets these high functioning folks like myself on my into my office and sitting in my couch, in the chair is something's off. Like when I'm not busy, I feel restless. When I'm not working, I feel empty. And I just don't enjoy things. And I tell them that is something called anhedonia. It's an old term, anhedonia. Anhedonia. It sounds like an exotic model from like Europe. Right. But it's not. Anhedonia means a lack of pleasure and interest in things that you once enjoyed.
A
Right. So this is like pre burnout. This is not when people say, you know, I've had enough, I've quit in my job, I'm totally burned out, I've got a reset. This comes way before that.
C
Yeah, well, burnout is something that's occupational. Right?
A
Right.
C
So by definition. And burnout was only added to the medical literature only like a couple of years ago, really only recently Is this.
A
Part of the medical literature.
C
Anhedonia?
A
No, anhedonia. And also high functioning depression.
C
High functioning depression is not in the medical literature because you don't check the box of not functioning. You're over functioning. Wow.
A
You literally are breaking new ground with this information. And yet we can all identify with it so simply. That's incredible to me.
C
But the anhedonia thing, that's what people, that's what they come to me with. Like my artists who are like, I'm up there performing and the crowds are going wild, but I feel kind of like dead inside. Right. I don't enjoy it anymore, but I can't stop. I have to keep going. It's the person who's like showing up every day at the office. And they used to love work, they used to love their business, but now it's like, doesn't excite them anymore, but they're doing it anyway, right. It tends to be people who others depend on. The rock, the entrepreneur, the mom, the teacher, the doctor. Right. You can't slow down. And so after a while, you don't identify, you don't tap into depression. You tap into that feeling of meh, blah, blah. And that's a red flag. That's high functioning.
A
And what is the difference between high functioning depression and then just like anxiety?
C
So anxiety and depression are like the flip side of a coin kind of. You know, it's interesting because in my world, we address the treatment of both the same cause they tend to travel together.
A
Right.
C
And also anxiety is more, I think, acceptable. Like if you tell someone like, oh, I have anxiety, they're like, oh, yeah, who doesn't? But if you tell someone that you're depressed, they're like, ooh, okay, well, nobody.
A
Wants that diagnosis, right? That means, like, I've got to get on medication. Like, I'm not going to be able to function as usual. That's why I think that the high functioning definition piece of this is for me, the complete light bulb of it. All. Right? It's like, that's when you can suddenly be like, but wait a minute, I'm doing everything and I'm doing it to the best of my ability. And I get up and I go out and I get all of these things down. But actually there's something not quite like right here. There's something not quite fusing there.
C
Absolutely. That's why depression needs a rebrand. It's not someone in bed crying, weeping. It's someone who gets up, shows up, but doesn't feel excited about life, is not grasping joy. And that's the anhedonia. And it's important to identify it and to have names. Because imagine if you were in this room and someone closed the door and turned off the lights and you heard this loud thud. Some of us would start swinging, other of us would run for the door. But if you turn the light on and you saw, oh, well, that was just a bookshelf that just kind of fell, you're like, whew. That's why it's important to name and identify the feeling. Because human beings don't like uncertainty. We have to have a name for it. And then when you know, oh, it's anhedonia, right? I can do something about this, then there's that therapeutic relief of anxiety. So naming the feeling is an intervention in itself. It's a therapeutic intervention when you can identify what you're struggling with.
A
I mean, and you're a doctor, so you can identify these things, but could you identify them for yourself? Like, how did you even come to starting this type of research?
C
I'm a board certified psychiatrist, award winning. All the things, all the accolades. I didn't even know when I was depressed. I remember it was in 2020 and I was giving this talk to this large healthcare institution and they were coming to me for help because they were freaking out. They didn't know what was gonna happen. And I remember, like talking to them and giving them tools. And then I was like, oh my gosh, I think I'm depressed. Like, I felt numb, I felt overwhelmed. But I couldn't stop on the outside. I had just gotten onto this prestigious board at an Ivy League institution. I was getting all of these, like, praises in the press for, like, helping people. I had a small child at home. My husband at the time was a frontline worker. It looked like I had the perfect life. No one knew that I was struggling behind this mask of pathological productivity. But I couldn't slow down. Pathological.
A
When you say that, pathological productivity, it's like a knife. It's like, yeah, I feel like that is just the one phrase that you say that I think every, like so many people will be able to relate to that. Pathological productivity, that is just like a sign of our times, is it not? Like that is what we're all doing and how we all feel so much of the time.
C
It is. And in my research, I found that it's tied to trauma. So when you do PTSD studies, like for combat veterans, right, you look at things like avoidance of triggers, right? So if someone looks at something and they get triggered, they want to avoid it. But for us pathologically productive people, we avoid processing our pain by busying ourselves with work. And that's why we keep adding on the work and the projects. We know deep down we shouldn't, but we can't because we're running from processing and dealing with our past.
A
Wow. Wow. So you're in this vicious circle. You're doing too much and in order for you to get through that, you just add more things on and you can't stop and you cannot stop. And you actually were your own patient in some way. You like self diagnosed this.
C
You know, I sat there and I was like, if I don't realize that anhedonia snuck up on me. And I study anhedonia and I'm depressed and I didn't know that how many people are just like me? And at first I was ashamed. Like I didn't even tell my therapist.
A
Oh, wow.
C
And one of the symptoms of trauma that's unprocessed is shame. That's why people don't like to talk about the traumas. They blame themselves. The first thought was, how did I not know this? Why didn't I identify it in myself? Right. Shame and blame, and that prevents you from getting help. But over time, I opened up to my therapist and she was like, oh, you know, you can always tell me these things. And we work through it, we process the trauma. And so I thought, I have to make this available to everyone, have to do this study because there are many people who are struggling, who won't get help because doctors are waiting for them to break down. I can't let that happen. And we know from the numbers now that the rising rates of anxiety and depression, we have to prevent these things. We can't wait for them to have to break down. We don't have enough providers.
A
So is high functioning anxiety actually classified as a mental illness at this point?
C
No, it's not. High functioning anxiety and high functioning depression are just not. And the reason is because in mental health you have to break down. You gotta check that box first.
A
Right.
C
It just sounds like you're a businesswoman. Yeah.
B
I mean, it's so crazy.
A
Like, why would. And also why would you go out and check that box for yourself like you never would? Because by the virtue of you being high functioning, you're like, no, I'm going to get up and do something, like do another thing. So you're never going to get to that place where you're like, this is what's happening to me in that clearer term. Right. It's just, that's not. That wouldn't be right for somebody who's high functioning.
C
Yeah. It doesn't feel good for them because they've forgotten who they are. They've tied their identity and their value to their role.
A
Doing More.
B
Yes.
A
To their role, to being successful, to getting more out of the day, to like squeezing one more thing in, to exhausting themselves. And it's so incredibly funny to me because I just, you know, when you say, you know, get back home and haven't been to the bathroom all day, I'm like, that is me. I do that all the time. You know, it's just. It's just incredible. I think that what's so fascinating about your book is that you've really contextualized the idea of what high functioning depression is and how it manifests itself for so many people. But the part that was truly enlightening and so unbelievably exciting for me was this science of happiness and the way that you kind of had the five Bs. And again, I looked at that, I read it, and I was like, well, this is, this is easy. This is not complicated stuff. This makes so much sense. And I really want you to dig into the, into the 5Bs. But is it that simple? Because what you're talking about is a really complex problem that takes years and years to create these patterns and, you know, to live a life like this. So is it that easy to turn off the switch and behave completely differently? Because your book kind of sets us up in a way that's like, check off these five Bs and you'll be fine. And I just wonder, like, is it that simple?
C
It is. And I think it's simple because many of us don't understand ourselves. And when I put the framework in my book, I wanted to democratize this work because a lot of people don't have access to therapists, or they don't have time, or they never do it. Right. They just wouldn't go to.
A
Well, I also think that there's still a lot of stigma. You know, we think that therapy is available to all, but there's still so much stigma, especially in certain communities, of taking the help that you need. And also if you're high functioning, the part where you admit that you even need help.
C
Right.
A
So there is all of that that, you know, maybe you're not quite there yet.
C
Yeah. And many of us don't have time. Right. That's the truth of it.
A
And so try really hard to fit my therapy appointment in as we speak. Yes, that's right. Maybe I don't have time. That is the actual truth of my morning this morning.
C
So when we understand that, okay, there's only one us ever understand the science of your happiness. In medical school, every med student knows this, but most people don't know it, and I wanted to make that available to everyone. So there's a biopsychosocial to every human being. Our biopsychosocials are all unique and different, just like our fingerprints. Biologically, I always use myself as an example. Biologically. What are your medical conditions that may be pulling away from your happiness? For me, I have a low thyroid, so if I don't check that, you know, I could cause anxiety really easily. Also, I'm in perimenopause. I'm in my early 40s, so I have to think about how those hormonal.
A
Fluctuations, we could do a whole episode just on that.
C
Right.
A
I mean, add to all the episodes and there still won't be enough episodes on being perimenopauser.
C
Right?
A
For sure.
C
And then the second is the psycho part, so the psychology. I have a history of scarcity, trauma. So I came to America from the Caribbean when I was very young. We didn't have much. You came from Trinidad. Yes, I did. I love this.
A
My father's Trinidadian, so I immediately. I feel like every time there's something about the Trini connection in the face and the smile in the eyes, and as soon as I look at you, I'm like, that's it.
C
So psychologically, I had this trauma that, honestly, I hadn't processed until very recently. Why couldn't I slow down? Because I never wanted to run out of resources again. I never wanted to have a day when I didn't have food or couldn't pay bills. And when I was very young, I used to stress about those things.
A
Yes.
C
But I'd never processed that. So when I'm collecting accolades and opening my third lab, even though I know I'm gonna be okay, there's always this fear of, we need to hoard the money and the resources. Cause what if something happens, right?
A
Oh, you're speaking my language. Yeah.
B
Yeah.
A
But I think that that's so. And I think it's so important that you have tracked this research in this condition back to some trauma happening. And I think I feel exactly the same. When you come from a place where there is scarcity, scarcity in resources, you're not, you know, you're unsure about the level of care you're gonna receive or if the lights are still gonna be on. That stays with you. It stays with you. And I'm the same to this day. Right. I know that we're not gonna run out of groceries or toilet paper in my house, but, my God, will I stack Them up to such a. It's almost embarrassing, you know, and that comes from somewhere. But if you don't look at that behavior and if you don't process that behavior, I just wonder like, I guess my question is, I guess there are just so many people that don't understand their trauma. They don't get to the place where they can actually even unpack that. And so is that really where you need to start before you can get to the point of, you know, being diagnosed as high functioning and move on to the science of happiness? Have you got to be able to unpack that trauma and figure that part out first? Is that the first step?
C
It is, it is. It really is important. And many people, like you said, they don't even remember it. And did you know that one of the symptoms of trauma is actually forgetting? Your brain pushes it down.
A
Yes, just Dr.
For sure, yes, your.
C
Brain pushes it down so that you can focus on the prize. So you don't even know that these have happened. And so I made sure to put a very comprehensive list in my book so people can unpack these traumas that they can't even remember remember. But that's the first step. And then in the social part of the biopsychosocial, this is your life, this is what's happening every day. So these are your relationships, are they toxic? Are they healthy? This is your work, is it supportive? Is it unsupportive? This is like what you eat, are you eating processed foods, are you drinking alcohol? What's happening socially? Are you getting movement? So when you understand your biopsychosocial, then you understand what's pulling away from your happiness so you know how to restore your joy.
A
Wow, that is unbelievable. And you did all of that in this unbelievable book, High functioning.
B
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A
I live for that moment.
B
But getting there? That's another story. Every year, I swear, the holiday gift list just gets longer than the choices get bigger and my decision paralysis just gets stronger. I'll spend an hour comparing five nearly identical sweaters and then somehow get distracted and start shopping for myself. It's a cycle. And this is exactly why Macy's personal stylists have become my secret weapon for holiday gifting. If you haven't tried them, they're totally free. And yes, they can help you with your holiday outfits. But the real magic is when you realize they're basically expert gift whisperers. They help you find things that feel made for your someone's not just something for everyone. Something for your everyone. I'll give you an example. Last year, I spent weeks trying to find a gift for a friend who cooks like it's a competitive sport. Every time I thought I'd found something, I'd second guess myself.
A
Is this too basic?
B
Is it too niche?
A
Does she already own three of these this year?
B
I would have saved myself so much time because Macy's stylists literally think like gifting co pilots. You just tell them, okay, I'm shopping for the friend who cooks from scratch because it's an act of love. Or the beauty minimalist who still wants a little luxury. Or the effortlessly cool guy who wants somehow, you know, nails everything without even trying. And they pull the perfect ideas, like a Le Creusette round Dutch oven for the home chef, the kind of piece that just becomes part of every shoe soup and roast that comes out of their kitchen. Or the Hermes lipstick set for someone who appreciates luxury but keeps their beauty routine minimal. It's timeless, it's chic and the packaging is iconic. Or the Baba Classic Bidal wax jacket, the effortless, cool outerwear staple he'll reach.
A
For year after year after year.
B
And don't even get me started on the fine jewelry they have right now. There's an assortment from brands like rh, Macy's, Effie, La, Vi.
A
I really want to dig into this five V's. So talk to me a little bit about how we can actually act on the 5 Vs in our own life. But maybe we should just like track through them. Because to me, this was the part where I was like, wow, if you can recognize these symptoms in yourself, then what's next? Because by virtue of being a high functioning person, you want to get to the solutions. And I love that this book is giving you really concrete solutions. And I go back to the simplicity of them because as I read these things, I was like, wow, like, this is easy. This is stuff that I can take on every day. This doesn't feel like something that is another thing on my to do list. So start with me with validation. Because I think women especially, we're constantly thinking about everybody else. There is a tendency to people please. And one of the things that I talk about all the time is that you can't be a people pleaser and a leader. And sometimes I can definitely feel like I'm the person that a lot of people will come to to validate their feelings and what they're going through. And who am I speaking to? And you start like the first V in your science of happiness is validation. So please tell me a little bit more about it.
C
Well, the reason I picked five is because most of us have five fingers. Oh, wow.
A
And you're making it easy for us.
C
Yes. And so when you imagine the 5Vs, think about DNA in our bodies was made to produce dopamine Joy. So it's within our reach. We all have it as humans, we forget how to access it. So you think of tapping into one of those five B's a day. We get so busy, you know, you don't have to. You have children, you don't have to teach a three year old how to be happy. You give them a box and a spoon and they'll be rolling around the floor. But with us, we forget. We forget the basics so we don't.
A
Lose the ability, we just forget to do it because other things are taking priority.
C
Yes, we get too busy. We're chasing the idea of happy and we're missing out on the experience of joy. And the five Es allows us to tap back into that so we can reclaim our joy. And the validation is the first step because we push down our pain all day long. We invalidate ourselves. Like, I was recently at this convention, and there was a room full of 300 women, and I asked them, how many of you all have gone through a full day and you did not pee? And it was just, like, an audible laugh.
A
This is my number one all the time. I don't want to think about the state of, like, my internal organs. After I decided that it was like, that is me 1,000%.
C
Yes. But we invalidate ourselves. We feel the pain, we feel the discomfort, but we're like, okay, just one more meeting. One more meeting.
A
Why? Why would we do that?
C
Because we've gotten accustomed to pushing down and silencing our voices, our experiences. We're pushing through pain all the time. But. But when we ignore that pain, we're missing out on a point of joy. And here's why. It's really difficult to be joyful when you're having discomfort. And also, you're on the zoom meeting, and your body's saying, hey, hey, we gotta empty this.
A
And you're just ignoring it.
C
You're just going right through it. So go take a break. What's the worst thing that's gonna happen if you go and relieve yourself? Right. It sounds so basic. That's why I said it's simple. But we forget we're chasing other things, like spa days, but it's as simple as tapping into joy and validating ourself. So validation is accepting and acknowledging how you feel. The second V is venting. And venting is important. It's a physics term, but it's also a psychology term. Because when you think of a balloon. And I often do this experiment in my lab where I show people a balloon and I try to push it under a tank of water. And what happens when you push it down? It pops right back up. If you don't slowly deflate this balloon and express your emotions during the day, they're gonna pop up where you don't want them to. You're gonna snap at your kid. You're gonna snap at your team. It'll pop up in ways like crying when, like, someone does something like not hold the door for you. Right?
A
Right.
C
So you have to express your emotions slowly, but do it gradually.
A
Is that part important? What if you're explosive in? How is that something completely different? Because I wonder about how you can express that in a way that is healthy. Right. Very important. When you talk about venting, it's like, it has to be. And a measured way, I'm sure.
C
Absolutely. There's research that shows that asking for.
A
A friend, obviously, who may be prone to some, you know, validating herself outbursts, but I guess like, with a high functioning person, you can get to that point where you know, you haven't done that and so you're just at this tipping point and it comes out in the wrong way. So give me the healthy ways to do it, please.
C
Yes. If you're just like lashing out, that's trauma dumping. That's not venting. Right. So you want to first ask someone, you know, ask for emotional consent. Is it okay if I talk to you about this? Is it? You know, are you willing to hear something right now? Because I need someone to talk to. And then make sure you're doing it with intention. Don't just trauma dump. Make sure you're getting feedback from the other person. Right. And you don't want to be like a sprinkler and tell everyone you want to pick your one or two people to carefully talk to.
A
Yes. Well, I'm sure that that is the case with so many. I mean, again, especially women. And thinking from my own point of view, I know that there's just a handful of people that I feel comfortable like, truly, honestly, 100% with like nothing, you know, no holes barred, venting to. So I guess you have those people and are you saying that you need to be, you know, you need to go to them and say, is it okay that I am using you in this way, Like I am about to vent? Or is that just like a regular conversation with one of your best friends?
C
No, I think you should check in and say, is it okay if we talk about this?
A
Because you think it sets you up for a different type of conversation.
C
And the research shows that when you do it that way, people are more willing to have empathy for you.
A
Interesting.
C
You're gonna get better feedback. You're actually going to feel better. But when you don't do that the right way, the research shows that venting in that way, in the wrong way can lead. It's like pouring gasoline on a fire. You actually feel worse after.
A
And so if you go home to your husband, again, asking for another friend, and you just are pouring out everything that's happened in your day and this like thing that happened with this person at work and all the things that are on the top of your mind, that doesn't count as venting.
C
Yeah, that's not the healthy venting. That's the Unhealthy venting. So you wanna check in and you wanna be reciprocal, you wanna be that person to be there for that person as well, right?
A
100%.
C
That's why it's important to have these conversations. And not everyone feels comfortable with venting verbally. Some people feel more comfortable with crying, and that's okay, you're expressing emotions. Others like to pray. Some of the artists that I work with love to sing or dance. Some people express it through their fashion. You have to find a way that's authentic. And I would say think about who you're venting to. If you're a verbal venter, it's okay to vent to your therapist and not check in because you're paying them. But don't vent to your kids, you know, because your kids will worry about you and people who are under you in terms of power dynamic. Your employees, like, they're not gonna say no, they're gonna listen. Cause they don't wanna get fired.
A
Totally. Yeah, totally. But that's a really interesting part of this. And I think the venting piece for me was a real unlock because I do feel, and I would imagine if you're a high functioning person, you will often be that person that people vent to, that they choose to. And I'm not always ready for that. I'm not always in the place where I can take that. So what happens if, you know, turn the shoes on the other foot and you're the person that people are coming to venting all the time, like, is it okay to say no?
C
Absolutely. What you want to say to them is, I want to be here for you, but right now I can't because I'm working on something. It doesn't mean that I don't care for you. I just want to be able to show up for you and I want to do you justice. Right. So maybe consider talking to someone else for now. Or write it down. Because you can vent by writing in a journal and say, here's what works for me. You know, write it down, write yourself a letter. And then when I'm ready, I'll let you know.
A
So we've spoken a bit about validation, We've spoken about venting. The next one I love so much because it's about values. I feel that from a very young age I felt very clear about my values. So much of that comes from my heritage, it comes from where I come from. And I've always understood kind of intrinsically who I am and what matters the most to me. But I think it's one of the things that people find very hard to pinpoint, like, what are my values? What do I care about?
B
And I think it's part of the culture now.
A
We get. We're bombarded with information, right? From social to the news to just, you know, the fact that you could be on social media. You have a lot of people following you, you have a lot of opinions, you have comments coming in.
B
But the interesting thing about that is.
A
That we have access to more information and more opinions than ever before. And yet such a lack of individualism and our own opinion. And so when it comes to identifying what our values actually are, there's kind of like this herd mentality. Right. It's like, well, maybe I think this and maybe I think that. So how do people get down to their true values? How do you even identify? Like, what matters to me the most?
C
Ask yourself, are my values things that are priceless or do they have price tags? Oh, and many.
A
Oh, that's a good. That is a good one.
C
My dad is a pastor, so I.
A
Okay, so I felt like you were taking me to church there. I was like, I was about. Yes, yes, yes, yes. Okay. Your dad is a pastor. It shows. I'm just going to tell you right now, I'm feeling that pastor daughter energy. Yeah, that's amazing, actually. So you grew up in the church.
C
I did.
A
You did, yes.
C
I grew up in the church and helping people all the time. Even if we didn't have much, we always helped others. And it's really why I wanted to become a doctor, is to help people.
A
Yeah. And it's part of your value system.
C
It is. But I lost sight of that. As someone who has been in all these prestigious institutions, I started getting like, the imposter syndrome. Like, I don't belong. My peers are richer than me. What if they find out that I don't have classy like them? You know, like, so I just tried to gain the accolades. Why get just a medical degree? Why don't I get an MD MBA while I'm at Columbia, Right? Like, who does that? And like, collecting the labs, all the accolades. I lost sight of why I went into medicine in the first place. Right. I valued helping people, but I was so busy becoming accomplished that I lost sight of it. And that's why I ended up with anhedonia. I also used to love to read. I used to read for days and I got stuck reading medical journals and organic chemistry. And then when I read Michelle Obama's book Becoming, I was like, oh, my gosh. I enjoyed this so much. I started reading again.
B
Same.
A
I think it's so interesting that you said that particular book, because I think up until that point point for me, and again, I'm a furious reader. I love reading is where so much of my joy comes from. But I started to get into this thing of only reading books that made sense for my business or books that made sense for my work, or books that made sense for my professional growth. And it was that book that I was like, why haven't I read something like, like this for such a long time? I mean, trust it to be Michelle Obama. You are all about to be becoming like, let's go. You know, it's so interesting. It was the same book for years. Yeah. So probably same moment in time.
C
I loved it so much. I listened to it too. Like, read it and then listened to it. But, you know, I think for reading that book, like, really hit the core of me because sometimes I felt like, what am I doing wrong? I'm a mental health professional. I have all these things. Why am I still so unhappy? When I read her book, she felt at times as if she, you know, everything around her looked great. Why am I still feeling this way? So I didn't feel alone. And in trauma research, we learned that when we realize other people have our experiences, we blame ourselves less. We see it less as, what did I do wrong? Versus, oh, this happens to many of us. And that's why it's important to talk about these things. So if you've forgotten your values and you've forgotten who you are, one of the ways that I help my clients to walk back in time is to think back to a time in your life when you felt full and fed. And it sounds so primitive and basic, but full and fed naturally. Like, spiritually feeling as if, like, you're tapped into purpose. And one of the cases in my book, I talk about someone who never processed their parents, childhood, divorce. And shortly before the divorce, they used to go camping as a family. But this person is now an adult living in a city, has no access to nature, and they forgot that they valued nature. So slowly but surely, we tested the waters, had that person buy a plant, look at pictures of nature, go to Central park, and they started realizing that they could enjoy this value again. Wow. And they found themselves back to where it all started. So there are other exercises in my book that I help people to tap into values. There are high level values. There are surface level values. You want to hold onto things that give you meaning and purpose. Priceless. Not price Tags.
A
I love this. And I think it might be almost like the most important of the 5 Vs. If I could give any of them, you know, the top. The top gold star. I think understanding the validation piece is easy for me when it comes to, you know, this. I really, I really struggle. And I think a lot of people will struggle because for you to say, you know, go back to a time when I feel fed, go back to a time when I feel, I think that's really difficult for people. And if you work a job, you know, like a regular job where you don't love what you do, but you go into work because that's what you do, that pays the bills, do you think that your values have to be tied to what you do, or are they about going back into your past? Like, I just feel like some people have such a struggle to get there to say, what are my values? And do they need to be profound and deep, or can they be kind of a bit more surface? I just feel like that's the part that, like, drilling down into your values will be such an important part of this for people. But it's almost like the hardest one to get to.
C
Yes. And two things can be true. You can have, you know, you need to pay the bills, you still need to have a job, but you can have two type of values. But prioritize the ones that keep you full and fed. For example, think of the single mom who has to provide for her family. She still has to go to work and she still has to value monetary things, right?
A
No doubt.
C
But the things that she prioritizes and puts effort into are the things like her kids. Right? So when you come home and your kid's on the screen, it's tempting for you to be on the screen too. And then you're not talking to each other. One simple way to tap into your value is sit with your child. Oh, what are you looking at there? Oh, oh, who's that? Just. That's connection. It doesn't cost money, it doesn't take away from your day job, but it requires you to be intentional. And it sounds so small, but those tiny points add up. And overall, you're teaching your family and the culture that you value each other.
A
Yes. That makes so much sense to me.
B
I love the way you talk about it.
A
In this system of points, do you go along in your day and be like, I've got a point here and a point here and a point, do you do that?
C
I actually do.
A
Do you have like zero point days?
C
Oh, I absolutely, absolutely.
A
Oh, good.
C
Okay, good. But the good thing is that if I get zero points one day, I'll say I can at least get a point tomorrow.
A
You do. You do that?
C
I literally do that. And I just recently did my daughter's homework with her, and we were there studying how currency came into play and about how back in the day, you trade a cow for, like, a jacket, and people realize, wait, a cow is worth more than a jacket, right? So they had to come up with money. They would use shells and rocks, and eventually we got to currency. The reason that we tend to get distracted by the price tags is because human brains quantify. We need numbers. That's survival for us. So it's back from being a primitive human. And that's why we have these gurus that people follow because they're enlightened. They're able to see things that are abstract, the things that bring you meaning and purpose, not quantifiable things, but that's important. And so we have to retrain ourselves to tap into things that are abstract, like meaning and purpose, because we get distracted by things that we can count, right? Because we're in survival mode 1000%.
A
And that is why I think this values piece is so difficult. Because it's so easy to say, I've got the. You know, it's like, I've got the.
B
House, I've got the car.
A
I valued those things. Those are things that I wanted from my childhood. But they're not your values, right? And these two things are just so, so different. Like they really are. But how do you get away? Like, what if your value system is a bit skewed? Because I feel like so many of us have a value system that, like, deep, deep down, if we can get there, we understand what our values are. But on the surface, it's like, well, you know, we're valuing different things right now or at this point in our life, or our value system's just a bit off kilter.
C
There are different things you can do. The one thing that I start with is, look around you. Who are you spending your time with? Because that shapes your values. That's why values change over time. You said that when you were growing up, you had this community, and they valued excellence and connectivity. But then over time, sometimes you're surrounded by people who only value the money, right? The clout, the beauty, the superficial things. And that can skew your value system. So you may have to tap into people who don't do that or split your time. And that's how you can get back into it. Other people, I like to go through history, and I ask them, who's a historical figure that if you could have dinner with right now, who would it be? For me, I. Absolutely. I mean, I was obsessed with Harriet Tubman, of course. I know it sounds bizarre.
A
No, it's nothing bizarre about it at all.
C
I've watched the movie where Cicely Tyson played her woman called Moses. I can't even count.
A
It's a great movie.
C
But she just seems so brave, like she didn't care. She was like, I'm gonna go into, like, this dangerous south and claim my people, and I'm gonna do it over and over again. I just found her so courageous.
A
So what does that tell you about your values?
C
I value courage, bravery, people who stand up for justice, you know, and so that taught me that I had to start tapping into advocacy. So I joined advocacy groups. I worked closely with Congress, a congresswoman who focuses on Caribbean mental health. And we did a special on it, and that. That made me feel full and fed. But we lose track of it because I was chasing the clout and the accolades.
B
Wow, that's so interesting.
A
You know, if you were to ask me the same question, I mean, I'd have a laundry list. But my mind, I'm going to be honest, the first person that popped into my mind was Martin Luther King. And if I were to track that back to what you're saying and think about this values piece, it makes so much sense because this is somebody that stood up for their beliefs no matter what. There was somebody that was there for everyone, right? For a generation of people, but also, like, painted this picture of what it would be to be different, for things to be better. And I look at my own life, and I'm like, I can really understand and put that together of why that's the person that flashes into my mind. So I think that's actually a really good. A really good exercise. I love what you say about nature as well, because I wonder if on this values piece that it can be, you know. Cause you spoke in the. In the beginning of our conversation about how individual we all are. But are there some values that are just the same for everyone? Cause it seems to me something like nature, for example, is just one that would make sense for so many people. I always talk about, I start my day in meditation, and I will often, because I live in la, go out into the garden, and I'll put my feet in the grass. And that is, like, for me, it's about rootedness and connection. And grounding. And if I'm by the ocean, which I often am, I have this constant visualization as I stand in front of the ocean and as it's coming, you know, into me as the ocean does, I imagine that, like, everything that I want and everything that I'm asking for, it's all coming my way. And it's something that I have done for years now, and that is all about a connection to nature. So is that one that pretty much could work for anybody?
C
Yes. And the reason that nature does that for us, it's because it gives us a sense of awe. We look at it and we're like, this is incredibly beautiful. And the fact that I'm here, I mean, the chances of a human being coming into existence are so small. So it reminds you that you're here for a reason and how the things. Right, the things that you worry about.
A
So minuscule.
C
Yes.
A
When you look at the ocean, I mean, we were just talking about this yesterday, but it's like when you stand opposite the ocean within problem, it really gets small real quick. You know, it's like, okay, let me contextualize this. But I think it's interesting to think that there could be common values that if you have a hard time finding exactly what it is, there are things that you might be able to go to that just make sense for all of us, because as you say, they're so awe inspiring.
C
They are.
A
That makes total sense. All right. We're really chopping through these values, and I love them because for me, tangible is like everything that I look for in life. What's the four? What's the four? Fee?
C
The fourth V is vitals. Now, your doctor will tell you the annoying vitals. Like, make sure you're sleeping because it clears your brain of toxins. Make sure that you're eating foods that are nutritious and feeding your brain and not highly processed. Make sure that you're getting movement because that helps your heart health and also releases endorphins. But I added three non traditional vital signs in there that your doctor will never ask. Like, when was the last time your doctor asked you if you were in a toxic relationship? Like, never. They don't have time for that.
A
Never.
C
They have 15 minutes to get you.
A
Please. Now, please, please don't tell me. If you're in a toxic relationship, move out.
C
But when you look at the research at Harvard, the number one predictor of longevity is the quality of your relationships. Oh, yes.
A
All the studies say so, right? Yes, 100%.
C
So if people are around you and they're toxic, they're literally draining your life force. So think hard about who you have.
A
In your life and is that everywhere in your life? Do you think about that in the context of who do I live with and who do I spend the most time with? Or is that your colleagues and your, you know, wider friend circle?
C
It's the whole thing, it's the meaningful relationship. So if you're in a close knit office and you see people, I mean, you spend most of your time at work.
A
Yeah.
C
And if you're with a toxic boss or a toxic coworker, that can really drain on you. You're not thinking about, you know, home. When you're home, you're still, your mind is still at work. And it's the same for friendships, it's the same for family members. Some of us have really toxic family members, you know, Think about how you can't cut them off in the Caribbean. You can't cut people off. You know, you can't do that. That's family.
B
Your mom's your mom, your family's your family.
A
They don't go anywhere. There's not even such a thing as a little family distance, thank you very much.
B
No way.
C
So. But you can.
A
What do you do with them?
C
What do you do with your Caribbean family? Please tell me you can limit them.
A
You can have your boundaries. Okay, I knew you were gonna say that. I don't know if there's a Caribbean phrase that's understood for boundaries, but that's a different, that's a whole different episode, I guess.
C
And then, you know, the other non traditional vitals, our relationship with technology. Think about when you're on zoom calls or virtual calls, you're looking at yourself. Human brains were not made to look at ourself while talking to others. Right. So it distracts us, it makes us self conscious, it taxes our brain, it's draining. And we weren't made to be on screens all day long.
A
No, we were not limited. But that's not the only part of technology that's like draining and unhealthy. So. And listen, you're a big social media person. I've seen you, you go viral there. You're out here on the TikTok and Instagram. So what's the balance of that like for you? Because you still, it's not like you're not partaking, you're just picking and choosing.
C
And I have a method called the reset method. Like you have to realize how it's impacting you realization. Are you spending too Much time on the meetings? Is it taking away from your real life, your personal relationships? Is it making you depressed or anxious because you're comparing yourself? Is it making you mentally exhausted so realize how it's impacting you? The next E is educate yourself. We have all this data now on how it impacts children, but we also have emerging data on how being on screens literally is like depression for some adults. There was a recent study published on that. So educate yourself about that. The S is strategy. What is your plan? Are you going to limit it to one time of the day, A certain time of the day? Are you only going to follow certain accounts that feed you spiritually and unfollow the ones that make you feel bad? Have a strategy and a plan for it. You're going to limit it in the home, right? Everyone is off the screens during dinner, things like that. The next E is expectation. What do you hope to get from this? Are you hoping to feel better, more connected, more productive? Have a clear expectation and then the T is, you know, thoughtfulness. Reflect on what you did. Did you get what you needed out of it? Do you have to be more flexible or more rigid?
A
Is this your system?
C
Yes.
A
Oh, it's fantastic. I think this makes so much sense to me because again, it's like when you work how I work, there is no way that you're saying, okay, no technology, right? It's just not going to happen. So it's just about finding I'm one of these people. Like I never reach for my phone first thing in the morning because I think it robs me of the morning, robs me of the person that's sitting next to me and having a cup of coffee and a conversation for the 15 or 20 minutes that we might have. But I think that finding those limitations and those boundaries are really, really important.
B
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A
So we're talking about vitals and I do really want to make sure, because you spoke about like the obvious vitals, the things that your doctor would talk to you about. And then we've got these other three, so talk me through those. And the last, tell me the last.
C
One is the work life balance, which just does not exist for many of us. So we have to be intentional about leaving work work at work. Really intentional.
A
Ah, do you do that? Like, but honestly, because you've got so much going on, like you're not seeing your patients during the day and then clocking off. When are you doing your social media? When are you doing your extracurricular? How are you here? So what, what is the reality of that? Because I think I'm pretty disciplined. I leave my office every single day at five. There is no meeting after four for me. If you want to talk to me at 5:05, you better be walking to the elevator with me. Having said that, I will go home and I'll have dinner with the kids and I'll do bedtime and bath time and put those babies down and then I'll go back to work because, like, how am I gonna get everything in so how do you draw those boundaries? Or are. If they're your boundaries, are they enough?
C
Personally, what I do is I ask my team for help. You know, I asked one of my lab managers, I said, you're in charge with getting us out the door by 5pm and you ask my team. That lab is a lot.
A
Me too.
C
It's possible. It is.
B
It's possible.
C
It is. Because when you tell yourself the work will always be there, like, no matter how much you read that chart, no matter how much you click that box, there'll still be more boxes, there's more charts that shift happens. And you know what? That's not gonna be something I wanna do when I'm on my deathbed. I'm not gonna be like, I wish I got five more charts done. No, I wish I had time with my daughter.
A
A million percent, A million percent. These are the only things that matters. And I really like to think it's not my own philosophy, but I watched this incredible video that went viral, I don't know, four or five years ago, and it was Jesse Itzler. And he talks about this concept of time V moments. You know, it's like you might have 20 years left with your parents, but if you only see them twice a year, then actually you're only gonna see them 40 times. And what are you doing with those 40 individual moments? And I think when you start to contextualize life like that, and it goes back to this idea of like, you know, checking in with the things that matter and knowing your vitals like these. Those are the things that become really important. But take me back, because I think feel like we just skipped over the real vitals. Because the first thing. Well, when you see somebody that you can immediately say, this person is. Is clinically depressed, right? The first thing that we go to is they're not taking care of themselves. And so I really want to just sit in those things that would be like the stuff that you would probably talk to your doctor about. Because we. Again, if you are in a high powered job, if you are somebody that's high functioning, it's really easy to also forget about those things. And so how do you, as the person you are doing all the things that you do, and now writing this incredible book, how do you keep. Keep tabs on those basic vitals, on the things that are just making you get up and making your health optimal every day? Do you have tips and tricks to keep ahead of that?
C
Well, for sleep, it's really important. And people who are high functioning doom Scroll. And the studies show that we do it because it's our way of controlling bad outcomes. It's equivalent to doom scrolling is a.
B
Way of controlling bad outcomes.
A
Please explain that to me.
C
How? One of the symptoms of trauma is trying to put yourself into a traumatizing situation to control the outcome. That's why people, when they have trauma, they'll engage in risky behaviors like drinking too much, speeding, having really reckless relationships and so forth. When we doom scroll, we're exposing our brains to all this bad news with this underlying wish that we can somehow change the outcome. Right? If I just learn about it, then somehow it's gonna change it. It doesn't make sense, but we do it right. And it also stems from anxiety. So at night, please don't keep your phone on after nine. Like don't expose your eyes to that. Also eat foods that are rich in melatonin, like walnuts, bananas. Those things actually nourish your brain so you get rich deep sleep. If you're someone who's in perimenopause, keep the room cool, make sure that you're not having too much caffeine during the day. These are all parts of getting good sleep.
A
And good sleep is critical, isn't it?
C
So critical?
A
I mean for me it's like the sleep piece. It's. You cannot between somewhere between sleep and nutrition or just eating. Like these are the two things that are non negotiables for me. I cannot function on too few hours of sleep. There's just no, there's no way. And it's part. Almost the way that I think about sleep is that it's almost part of my how I plan my schedule. Because if I look at my schedule for the week and I can say that I got off a plane last night at 12 and I come here at 6 and then I'm you know, leaving the office to go out somewhere. I'm like alarm bells go off in my head on a Sunday night when I'm looking at my schedule for the week ahead. If I have a schedule that I think is unsustainable because there's going to be a lack of sleep. And I just feel like getting ahead of it and knowing and saying this is my priority. This is a non negotiable for me because I won't be able to do what I need to do this week if I don't get seven hours every night.
C
Yeah, and you make poor decisions when your brain isn't rested. You are impulsive, you eat unhealthy foods.
A
It's A slippery slope.
C
Yes, yes. Sleep is important and food is important. I mean, it's okay to have a cheeseburger like I did last night?
A
Absolutely.
C
It is, once in a while. But I mostly stick to salmon, leafy greens, berries, nuts.
A
You're eating food that fuels you and fuels your brain.
C
Yes. And there's a field called nutritional psychiatry where scientists look at diets that can actually help to support someone who's depressed or who's anxious, and foods that help you think clearer and to have better memories. So food really is medicine. I know it sounds cliche, but it's so important.
A
No, there's nothing cliche about it because again, I think for women it can.
B
Be such a slippery slope.
A
Right. It's like you're feeling a bit down in the dumps, you're feeling a little overtired, so you have that extra coffee, you have the extra snack, and then it goes down and down and down and down. And all of a sudden you're, you know, eating a cheeseburger not once in a while for a treat, but, you know, three nights a week, and that ends up making you feel worse. And so, you know, you're just on this, like, horrible, vicious cycle. And so getting the nutrition again, it's so much about planning, because if you can plan these things and think about them ahead of time, I feel like they go well. And it's when you neglect those things that you know you're in trouble.
C
And, yeah, they're within your control. You can't control everything, but you can control.
A
They're within your control. Yeah, they really are.
C
And then the other boring, traditional vital is movement. I was recently at a conference and I told them that when I would go to Trinidad and play in Carnival, we would do this like, you know, Wynan and the bilateral stool.
A
Yes. I'm so excited for this. I feel like there's like a Trinidad trip coming up for us during Carnival. This is going to be so good. Could we count this as research? If it's part of, you know, actually the movement is going to make us feel better. It's going to like, work on our high functioning selves. Like.
C
Yes, we're actually writing a protocol for this in our research. And our research.
A
Are you reading?
C
Yes. About bilateral beats and movement. Because when I give these talks to Caribbean associations, a lot of times people don't want to come by my booth because they're like, oh, that's mental health. But I say mental health is ours. When we do our wine in, you know, like, that's Bilateral stimulation. We're activating the right and left brain, so it's healing.
A
Wow.
C
So get movement in the way. That's authentic for you. If you don't like to work out, dance, whine all the way down to ground because you're getting movement, and that's actually healing.
A
God, that's incredible. Incredible. All right, so the fifth and final V is vision. Vision is so important to me. So you talk about this idea of planning for joy, right? Being able to see the success in your future. And so I really want you to talk to me about that, because I feel like it's such a huge part of my personality.
C
When you plan points of joy, it keeps you moving forward instead of getting stuck in the past. And it doesn't have to be a big grand plan in the future. You should plan those too. But you can also plan points of joy in the day, right? The near future. When I get my daughter to school on time. Every day, I sit in my living room and I brew. I'm kind of like a coffee snob, so I brew this, like, St. Martin coffee that I got that's like, rum flavored. There's no rum in it, but it tastes like.
A
It's like, good morning.
C
I know, right?
The alcohol has evaporated. Trust me. But it's so yummy. And I sit there and I'm like, mm, this is good. Like, I deserve this moment because I got this child to school on time. She didn't show up with her hair looking like, who shot John? You know, like. And I'm gonna have this break before I go to my office, and this is for me, and I look forward to that every day. And, you know, I think if you plan points of joy for yourself, for your family, for your team, it gives us all a mission. It's like a mini mission. And human beings need that. We need something to work towards. It's the experience on that journey rather than the destination that really counts.
A
Is it like. It's a moment of mindfulness when you think about it like that? Is that how you can think about the daily parts of, like, the daily joy that you get? Is it a moment where you just.
C
Like, everything slows down, you slow down, but you tap into what's actually giving you joy in terms of your sensation. So if you think about it, when you're drinking your coffee and you're tasting the flavors, you're stimulating the sense of taste, you're stimulating the sense of smell, you feel the warm cup in your hand, you're tapping on it. You hear, you know, the vibrations on the cup. You're really engaged and present and squeezing as many points of joy out of that experience as possible because you're present and you're not distracted. And you're doing this one thing with intention. And when you plan joy, it doesn't have to be like, oh, I'm gonna think about my coffee this way every day. But even like when you're finishing a project, how many of us, we finish a project, a deadline, and then onto the next versus like, wow, I just finished that project. Like, it was big. Let me just take a pause and let me like, you know, go have lunch outside for once. Not sit at my desk and shove the food in front of my screen. It's these small things that send your brain a message that you're worthy, that you deserve this, that you don't have to continue, you know, this track of you're a human doing instead of a human being. It sends a message to your deeper self that you deserve to slow down.
A
As you say these things. I'm really struck by the fact that we're talking about such small things, like literally, like stopping to enjoy your coffee and stopping to appreciate the moment or an achievement when you've finished a project. What have we lost? Like, why are we having a conversation about something that should be so innate? Because I feel like, you know, did 20 years ago, was everyone just sitting there enjoying their coffee. And we're not so much now.
C
We get so busy. In my practice, I treated children, adolescents and adults and elders. And it's so interesting because when I look at the elders and the really small children, they're very similar, right? They love to sit and like really eat that when they eat, they're like, you know, but like the adolescents and the adults, they're just like, you know, like, they just. We get so busy and distracted by things we think will make us happy. Right, that idea.
A
Yes.
C
That we miss out on the actual experiences of joy.
A
We're in a giant midlife crisis. It's crazy that you say that. I just had my mother in law staying with me and she would. I'm a big foodie, so I love to cook. And she would sit and eat the meals and she'd be like, m. You know, she's 78. And I'd be like, why are you everything until, you know, like four meals in. I'm like, she's just having a del. You know, she's in California enjoying the ingredients. Just let her live. You know, And I'm like, yeah, Until I can get on to the next. But it's kind of sad that we have to stop and remind ourselves to like, just live and breathe and enjoy life and appreciate the moment. So this is a retraining for so many of us because perhaps a lot of what we need to be happy and to stop experiencing our lives of one task after the other after the other, it's all there. Nothing that you're talking about is like, I don't need to go and buy anything now. I don't need to go and stock up on any, you know, like, anything. It's all. And this is gonna sound so trite, but it's all completely within me and it's all within our control.
C
Yes, it is in our DNA.
A
It's in our DNA.
C
We tap into it every day and reclaim our joy. It's in our hands. We just don't even know it. We get too busy.
A
So when you work with a patient when, like, how long does it typically take for this reframing to actually set in? Like, is it. Because I'm looking at these things and I read it and I thought, this is all quite easy, but do you suggest that we choose one of the five Bs to work on first or are we just trying to attack the lot? Because as a high functioning person, I'd like to just get on with it.
C
Yeah. I recommend doing one or two at a time because the research shows us that we shouldn't be multitasking. Tap into one or two. Start with validation, but if you're not there yet, tap into the vitals and try to get at least one or two points a day. Gamify it a bit, you know, and see if you can switch it up the next day. But don't do all at once. Don't be high functioning. Right. Like, slow down.
A
Don't be high functioning about the base. Which is immediately what I want to do.
C
I'm like, I'm going to get 100 points today.
A
That's not the point. You're like, get two or three points. Take care of your sleep and slow it down. And stop to smell the roses. And do that and see if you can master that for a week. And then you would move on to something else.
C
Yes. And look, pay attention around you. People will tell you, did you do something different with your hair? There's something about you. What is it? And you're like, I slowed down and I started. I'm no longer human doing. I'm a human being. They'll want a piece of what you have too, because anhedonia is contagious, you know, but so is joy. And we've all been in situations where we were working under someone who was like, depleted of joy and spread. The whole organization was like. But we've also, hopefully some of us have been in situations where the leader was joyful and everyone's like, ah, totally, it's contagious. I'm not happy all the time, but able to access that joy. It's contagious. So look around you as you do it. Your family's gonna be more joyful, your friends are gonna be more joyful. They're gonna want what you have.
B
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A
Which by the way I use every.
B
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A
I wonder, you know, of course, I employ an enormous amount of people. We're sitting in my studio within my office right now. Can you apply this to an entire company? Like, just because I know so much of the work that you do is, you know, working with, you know, individuals. But can you go into a company and look at the health of the organization in that same kind of way? Because again, where, you know, if you have high functioning depression, a lot of that is a symptom of your professional environment. So is it something that you can actually think about as an enormous, like a group of people? Because I love that idea of something being contagious, but also that you could work on it together.
C
Yes. I've given talks like this to major institutions. I recently gave a talk last year at the White House, the executive office of the President and taught some of their key people how to access joy on the job. You know, many of them love their work. They're like wow. To be here, we do awesome. But the two things can be true. A job can be wonderful and prestigious and an honor, but it can also be hard. Right? It could also, like, cause stress. So I had to teach people how to do that, this at the office. And it was fun because I, I like to use like a desk, mock and, and like, say, you know, this is how you can practice your values. You know, keep a picture of a notable figure in my office. I have Barack and Michelle, little statues from the Smithsonian. But like, you know, wear designers that make you feel proud, validate yourself. So for some people, I encourage having mirrors that you look at yourself. You're like, for me, I'm like, sometimes I'm like, I look tired. Like, oh, I am tired.
A
Yes, I am tired. Yeah, I am just tired.
C
Venting. Talk to a coworker. You can practice all of these at work. The vision part. Plan joy for the corporation. If you all do something and it's a big project, don't just say, okay, what's the next deliverable? Celebrate it. Get a lunch. In our lab. We have little lunch parties, little lab parties to celebrate small wins. You can do the same.
A
Yeah, I think it's so important, and it's so. Because we all work in these silos and we're in front of screens and often there are people that like, enormous amount of people in my office that work with headphones on. We built this giant kitchen to say, this is a moment where you get to take a break and sit together. There are no screens in there. There's nothing that denotes work. It's like, there's a bunch of snacks, there's a bunch of food, there's a bunch of drinks. And everybody should take this moment because I remember coming up like, one of the joys of work was like, like, who you met. You know, I met my husband through work. And so I'm not necessarily saying that's what we all need to do here. Don't anybody get me wrong. But this idea of like, taking a break to come together and when we work in these environments that are so, you know, results orientated and with this, you know, fixation on growth and moving forward, of which all of the organizations I have any part of really are, you have to encourage the behavior to take a moment to, like, connect with one another. And I actually think it has this unbelievable impact on the organization as a whole. Before we completely move off of the 5Vs, I really want to talk about what happens when high functioning depression is like, undiagnosed because I'm sure there's like such a flip side and I really want to encourage people to focus, like, read your book first and foremost, because it is so incredibly fascinating and so empowering with these tools that you're giving us. But what happens if you just ignore this stuff? What happens if you think, you know what, I'm fine, I've been working like this for years and I'm just gonna keep on going?
C
Well, what happens is you run the risk of possibly dipping into low functioning depression. Right. Which is clinical depression.
A
Right.
C
Or your body suffers and you see people going to the emergency room with like, chest pain, panic attacks, and it's actually, you know, mental stress.
B
Yes.
C
Or you could develop unhealthy soothing mechanisms like drinking too much alcohol, you know, substance use, or, you know, overusing other things to soothe how you feel, like shopping too much, being online too much. All of those things are considered, you know, what happens when you don't get the treatment and support you need. So we're trying to prevent those things. And it's also important to honor the mind body connection. So many of us, we carry a lot of stress in our shoulders, like we have grinding in our teeth. I did a social media video where I talked about all the physical signs and people are like, oh my gosh, I have that. I never knew that's what that was. Yeah. So like, honor the mind body connection. And that's why I talk about in my book, ways to like, relax your shoulders. You can tense them, you can relax them. We are given this ability to hold our breaths. We can't tell our, our heart to stop beating. We can't tell our liver to stop processing. We can't tell our brain to stop thinking, but we can tell our bodies to hold our breath. And that's for a reason. Yes, it's survival mode reason. Because if we were thrown into an ocean, we need to hold our breath to breathe and not drown. Or if there were an explosion or gases, we want to maintain our oxygen level. But also our bodies have that ability to help us to relax with our breath work. When we use deep breathing and, and diaphragmatic breathing, we can actually calm our fight or flight and then think clearer. So, like, access those things again. They're free. They're not rocket science, but they're so easy for us to do.
A
Why is it that, and this I find such a disturbing statistic, but why is it that women are twice as likely to suffer from depression and anxiety than men?
C
It is disturbing, but it's not surprising, right it's shocking, but not a surprise.
A
It's absolutely not a surprise because I feel like I grew up and, you know, with so many women around me that were diagnosed with clinical depression who were medicated for long periods of their life back in those days, you know, everybody was given Prozac, and everyone in, certainly in my own family were on these, like, kind of very long stints of being on this medication.
B
And.
A
And, you know, it was life altering. It was life altering for them. It was life altering for the people that were around them. And if I think about my own immediate friend group at one point or another, you know, people are medicated and they have no choice because they don't see any other reason for themselves. That's only on one side of my friendship group. It's only with the women. And it isn't surprising at all. But there's such a sadness that comes with even thinking about that. And is it changing?
C
Well, no, the numbers are still there. Women are twice as likely to have depression and anxiety. And, you know, if it were just up to medication, we'd all be on Prozac and everyone would be happy. There'd be no sadness. But it's not just medication. That's why it's important to understand the science of your happiness. Think biopsychosocial.
A
I am going to think biopsychosocial. Like, literally, this is gonna be my new thing, biopsychosocial. I'm literally gonna write it down. It's going on the bathroom mirror.
C
So biologically, women have more vulnerable periods in their life.
A
No doubt. Childbirth. Like, we're going through it.
C
Your literal period.
A
Oh, yeah, that one. Every single month. Like, I'm done having kids. Can I stop having a period now? Like, why are they. Why do they still come every month? It's like, we're done, please.
C
And those hormonal fluctuations makes us more vulnerable. So our periods, you know, can come with something called pmdd. Premenstrual dysphoric disorder, postpartum depression, perimenopause menopause. So the hormonal fluctuations in themselves make us more vulnerable. And then we make up 80% of those with autoimmune conditions. So think about that. And then psychologically, you know, women, we have trauma. There's a lot of sexual trauma in girls, a lot of trauma of not being treated right and being disrespected in the workplace. And then we have to think about our attachment styles and our attachment figures. Many of us have very unhealthy attachment figures. And then socially, you Know, things that are happening around us, we have to work twice as hard and we get paid less. I mean, that alone. Wouldn't you be depressed?
A
You're depressing me now. Like, literally, when you list out all of that between, you know, the hormones, just that list of things that women have that men don't have. Then we talk about pay parody and then we talk about, like, it, it to me is it. It becomes maddening. Like the, the even that I asked the question that we're like, you know, it's like women are twice as likely to suffer. Like, of course women are twice as likely to suffer from depression and anxiety. That is a laundry list of things that we are going through that men quite simply are not and not in the same way.
C
And it's important to list it because it's validating, because many of us feel like, okay, we're not doing enough. I must be doing something wrong. Well, you're taking care of your parents, your kid, your job, yourself. Like, it is not your fault. This is something that's happening to many women and that decreases the shame and self blame. Right. Because it's not you, it's the situation.
A
I mean, multiply. I mean, that's just unbelievable.
I don't think I've ever quite heard somebody list out everything like that. I don't think I've ever really contextualized that. And I don't think I've ever really thought about the women that I grew up with and that I'm close to knowing. You know, I could make lists in my head right now of the sexual trauma of things that they have gone through, of the traumatic instances of, you know, have just like going through like menopause for five years and not really even understanding what it was and being told you're imagining things and to go away and then, you know, having children and, you know, postnatal depression not being recognized, like, and on and on and on and on and a million different things.
C
Yeah, I call it a trauma wave. It's like one thing hits you, but you don't. You can't even catch your breath. And another one, another one. It's like. And it can seem daunting, but. But if you reframe it and you're like, okay, I understand the science of what's making me unhappy now. I know how to add to these areas to make me happier.
A
And that's why we all need to read this book. That's why every woman that knows me is about to get a copy of this book. Because I said it in the beginning. I love this high functioning. Overcome your hidden depression and reclaim your joy. This book is so much more than that. It's so clear. You've really explained a problem that I think so many people have. So clearly. You've done it in such a beautiful way and then you've given us the tools. And that's the best part of all of this. You actually just told us. Here are some things that are really simple for you to grasp, to get ahold of, and to do. And you don't need to do them all at once. You can take the pieces of these five Vs and start getting ahead of the whole thing before it gets really out of control.
C
Yes. Give yourself the gift of being curious about yourself. Understand the science of your happiness. There's only ever gonna be one you. So, like, take care of yourself. Understand the science of what's making you unhappy, and then you'll know how to be happier.
A
I mean, honestly, it's a revelation. Thank you for explaining the science of our happiness. I'm so excited we had this conversation. Before I let you go. There are a couple of questions that we like to ask, ask every single guest on the Aspire podcast. So now we're going to do some rapid fire questions. The first question is, what is the first thing you do when you wake up?
C
The first thing I do when I wake up is I snuggle my daughter's cheek. She still smells good, you know, like she does. Oh, my gosh.
A
Mine don't smell so good. I love that your daughter's like, my kids are going to kill me. But they don't.
C
But it's important because when you snuggle and you touch, you're releasing oxytocin, which is the love and attachment hormone. So it's really. It's a point of joy.
A
It's a point of joy first thing in the morning. Yes, Tick, you've done it. You got one point straight away.
Whatever. Even if she loses them, you're still going to do that snuggle. So it doesn't matter. What is the last thing you do before you go to bed?
C
The last thing I do is I actually pray. Like I grew up praying. And in my household, with our siblings, we would say this thing to each other and you're not gonna understand that. Sorry everything I did to you. But it's. I'm sorry for everything wrong I've ever done to you. So it was a way of, like, a clean slate. Cause it was four of us, so we fought all the time.
A
Oh, I know the four. I'm one of four. That is a. That's dangerous territory we're going into right there. But you would do that every night? All the siblings.
C
The siblings. And if we.
A
Wow.
C
I didn't say. And it was our way of like this, like clearing the day. So for me, it's like I pray and it's not a long prayer. It's like, thank you, God, for another day, you know, very short. But it reminds me that I'm so small in the grand scheme of things. I'm not a religious person, but I'm spiritual and I didn't have to have today, but I had a day.
A
Every day. You had it. I pray every night too, so I love that one. What are you currently aspiring for in your business life?
C
Well, right now we're doing FDA regulated studies with psychedelics like psilocybin. And it is so fascinating to me.
A
Fascinating.
C
So many untapped. And I used to be afraid to do these studies, but I'm being my Harriet Tubman of science.
A
Damn right you are. You and your band of married women, you are going there. That is incredible. And what are you aspiring for in your personal life?
C
Well, personally, I just want joy. Every day I want to squeeze joy out of it. Like the people in my life. That's what makes me happy. Like the connection. And I have a wonderful partner, my beautiful daughter and my siblings, like we have a group chat. We chat every.
A
Oh, the single group.
B
The sibling group chats are really real.
A
I mean, we won't even go there.
B
Tell me.
A
I keep saying, you know, I'm such a huge reader and I feel like your book is gonna change so many people's lives. Just the understanding that it gives you. But what is a book that's changed your life?
C
Oh, becoming Michelle Obama.
A
Wasn't that a great book?
C
Oh, my gosh. And then her. Her voice.
B
Yes.
A
Well, her voice is just like. I mean all of her is just so you know, Michelle. Michelle is everything we need.
C
Michelle.
A
Yes, definitely. What is something you valued when you were starting out your career that you don't know?
C
Oh, I value slowing down. I used to be all about like getting this study. My favorite thing to say now is no. I'm like, no, no, no.
A
And no explanation is my favorite. Like just know. Yes, yes, I love that.
What is something that you value now.
C
That you didn't then I didn't value enough. How much I've done. Like, it was always like, what can I do next? I gotta do more. I have to get another degree. I have to. Now I just, like, I sit back and I look at everything and I'm like, dang, girl, you did the thing. Yes.
A
Yeah. I can tell you I read your intro. So it's absolutely. You've done it. You're good. You can relax. You're really, really good. You're someone to aspire to.
C
Slowing down is not lazy.
A
I used to feel like I'm not lazy.
C
No, girl, no.
A
You're just soaking it in. Reframe, immediate reframe. It's all slowing down. You're just, like, watching it happen. You're like, yes, thank you. I did that. I love that. Thank you so much. This has been an incredible conversation and. And I'm so grateful that you've written the book and that you would come here and speak to us.
C
Thank you for having me. I could talk to you for days, anytime. It's such a pleasure and an honor.
A
Thank you, my dear.
B
If you're loving this podcast, be sure to click Follow on your favorite listening platform. While you're there, give us a review.
A
And a five star rating and share.
B
An episode you loved with a friend who'll be so grateful. Aspire with Emma Griffith. Emma Greed is presented by Audacy. I'm your host, Emma Greed. Our executive producers are Corrine Gilliatt Fisher, Derrick Brown and me. Our executive producers from Audacy are Maddy Sprung Keyser, Leah Reese Dennis, Asha Salouja and Jenna Weiss Berman. Stephen Key is our senior producer. Sound design and engineering by Bill Schultz. Angela Peluso is our booker. Original music by Charles Black. Video production by Evan Cox, Kirk Courtney, Andrew Steele, Carlos Delgado and Arnie Agassi. Social media by Olivia Homan. Special thanks to Brittany Smith, Sydney Ford, My teams at the lead company and wme. Maura Curran, Josephina Francis, Hillary Schuff, Eric Donnelly, Kate Hutchinson, Rose, Tim Meekol, Sean Cherry and Lauren Vieira. If you have questions for me, you could DM me at Aspire with Emma Greed. Greed is spelled G R E D E. That's Aspire. A S P I R E with Emma Greed. Or you can submit a question to me on my website. Emagreed me.
A
Some of the best lessons don't come from a classroom. They come from experience. On the Power of Advice, a new podcast series from Capital Group. You'll hear from CEOs, investors and founders about how they built careers, took risks and reinvented themselves. If you're starting your own journey, this is the kind of advice you won't want to miss. Available wherever you get your podcasts published by Capital Client Group Inc.
Aspire with Emma Grede
Guest: Dr. Judith Joseph
Release Date: December 9, 2025
In this illuminating episode of Aspire with Emma Grede, Emma sits down with award-winning psychiatrist Dr. Judith Joseph to unpack the phenomenon of “high functioning depression.” Despite outward success and productivity, many individuals secretly struggle with emptiness, lack of joy, and a relentless drive that can ultimately undermine well-being—a state Dr. Joseph terms "pathological productivity." Drawing from her new book and personal experience, Dr. Joseph breaks down the science of happiness, introduces her pragmatic “5 Vs” framework, and provides actionable tools for reclaiming authentic joy.
“We have symptoms of depression that are not being addressed, because we haven’t broken down. … In psychiatry, we’re kind of in the dark ages. We wait for you to break down before we fix you. I’m trying to change that.” (07:24)
"We avoid processing our pain by busying ourselves with work. ... We keep adding on the work and the projects. We know deep down we shouldn't, but we can't because we're running from processing and dealing with our past." (13:53)
"Happiness is an idea. Joy is an experience." (05:51)
"There is only one Emma. … Why do we use tools that make other people happy when we don't even understand the science of our own happiness?" (05:54)
Dr. Joseph introduces the "5 Vs"—a simple, memorable framework to build daily joy and combat high functioning depression.
[Main segment starts at 27:15]
"Validation is accepting and acknowledging how you feel...When we ignore that pain, we're missing out on a point of joy." (28:32)
"If you're just lashing out, that's trauma dumping. That's not venting." (30:36)
"Ask for emotional consent: Is it okay if I talk to you about this?" (31:03)
"Sometimes I felt like, what am I doing wrong? … When I read [Michelle Obama’s] book, she felt at times … everything around her looked great. Why am I still feeling this way? So I didn't feel alone." (37:07)
"The number one predictor of longevity is the quality of your relationships." (47:32)
“When you plan points of joy, it keeps you moving forward instead of getting stuck in the past… It’s the experience on that journey rather than the destination that really counts.” (65:10)
"Did you know that one of the symptoms of trauma is actually forgetting? Your brain pushes it down so that you can focus on the prize." (21:31)
"This is something that's happening to many women and that decreases the shame and self blame. … Because it's not you, it's the situation." (84:16)
This episode is characterized by compassion, candor, and accessible science. Dr. Joseph and Emma Grede approach mental health not as a clinical afterthought but as the foundation for ambitious, successful lives. The "5 Vs" are presented not as one-size-fits-all, but as a flexible toolkit; listeners are encouraged to experiment, slow down, and find their own path to joy, reframing productivity and emotional health for the modern age.
Dr. Joseph’s message:
“Give yourself the gift of being curious about yourself. … There’s only ever gonna be one you. So, like, take care of yourself. Understand the science of what’s making you unhappy, and then you’ll know how to be happier.” (86:32)
Recommendation:
This conversation is a must-listen for anyone navigating high achiever culture, perfectionism, or burnout—and especially relevant for women leaders keen to reconcile drive with authentic happiness. Dr. Joseph’s book "High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy" comes highly endorsed as both a diagnostic guide and daily toolkit.