Dr. Judith Joseph on the Cost of Holding It All Together (May 2025)

Summary

Podcast Summary
Making Space with Hoda Kotb
Episode: Dr. Judith Joseph on the Cost of Holding It All Together (May 2025)
Release Date: April 8, 2026
Guest: Dr. Judith Joseph, Psychiatrist and Author

---

Episode Overview

This episode features board-certified psychiatrist Dr. Judith Joseph, who opens up about her journey through high academic and professional achievement—and the hidden cost of keeping it all together. Dr. Joseph discusses "high functioning depression" (HFD), how it can go unnoticed in driven individuals, and the path she found back to joy. The conversation is candid, empathetic, and rich with both clinical insights and personal anecdotes, offering concrete steps and hope for anyone who feels “meh,” empty, or stuck in a cycle of relentless productivity.

---

Key Discussion Points and Insights

Dr. Judith Joseph's Early Life and Scarcity Trauma

• Caribbean roots and early community:
  • Dr. Joseph grew up in Trinidad within a supportive, communal environment before immigrating to the U.S. at age four (04:22).
  • “In Trinidad, we'd go to the beach every weekend... you had community. Things were slower, you know… you take your time, you do things right.” (04:33, Dr. Joseph)
• Adjustment to scarcity in America:
  • Her family faced financial hardship upon immigrating—sometimes without food or electricity (05:03).
  • Early stress presented as tension headaches and anxiety about grades and bills (05:22).
• Coping as a child:
  • Coping strategy was to become “pathologically productive” and “high functioning,” using academic and extracurricular overachievement to manage internalized shame and trauma (05:47).

The Drive for Perfection and Its Hidden Toll

• Childhood pressures:
  • Felt a strong obligation to succeed as an immigrant: “You have to do well because you have opportunities that others don’t.” (07:34, Dr. Joseph)
• Trade-off of high achievement:
  • Enjoyment of learning eroded over time; academic pursuits were no longer joyful but driven by fear of failure (09:34).
  • “Over time, if you push down the ability to feel that pain, you also push down the ability to feel the joy.” (08:40, Dr. Joseph)
• Imposter syndrome:
  • Despite acceptance to top schools (Duke, Columbia), struggled with feeling like a fraud (11:55).
  • “I remember looking at that pamphlet and being like, this is a mistake...I’m gonna ride with it.” (11:57, Dr. Joseph)

High Functioning Depression (HFD) and Anhedonia

• Defining HFD:
  • Dr. Joseph describes HFD as experiencing classic depression symptoms (fatigue, poor concentration, guilt, restlessness) but without outwardly visible distress—often masked by continued achievement (00:30).
• Anhedonia explained:
  • “It’s a lack of pleasure and interest in things that you once enjoyed.” (03:54, Dr. Joseph)
  • Subtle symptoms like not enjoying time with loved ones, food, or rest (20:27).
• Personal tipping point:
  • Realized her own anhedonia during the COVID-19 pandemic, while externally she appeared highly successful: “I just felt so muted...Oh my gosh, I think I’m depressed.” (19:59, Dr. Joseph)

The Power of “Points of Joy”

• Joy is cumulative:
  • True happiness isn’t found in future achievements but in “points of joy” throughout the day—small pleasures (22:01).
  • “If you had pain and you got relief, that’s joy…If you’re thirsty and you quench that thirst, you got a point.” (22:01, Dr. Joseph)
• Practical recentering:
  • Encourages listeners to abandon the elusive chase for happiness “out there” and instead seek and savor daily moments (23:54).
• Acknowledge and value small wins:
  • Reframe: If you didn't get a point of joy today, there’s hope you can tomorrow (23:55).

Root Causes: Unprocessed Pain and Trauma

• Origin of over-busyness:
  • Hypothesis: Many high-functioning individuals are coping with unprocessed traumas—what Dr. Joseph calls “scarcity trauma” or “little t traumas” (26:07).
• Shame and internal narratives:
  • Shame statements—core negative beliefs (e.g., “I’m a mistake”)—shape experience and behavior, whether remembered clearly or buried (27:16).
  • “One of the symptoms of trauma is burying memories that are painful.” (27:34, Dr. Joseph)

The 5 V’s Method for Healing

Dr. Joseph outlines a stepwise approach for breaking the cycle of high functioning depression:

1. Validation (29:24):
   • “Acknowledge how you feel… if you can pinpoint what it is, then you feel less anxious.”
2. Venting (30:07):
   • Express feelings safely—verbally (with emotional consent), through journaling, or creative outlets.
3. Values (31:09):
   • Rediscover what is truly meaningful, outside external accolades (e.g., knowledge, curiosity, connection).
   • “My values got muddied with achievements and titles, and I had to find my way back.” (31:35, Dr. Joseph)
4. Vitals (31:49):
   • Care for your body (sleep, nutrition, movement), maintain healthy relationships and set boundaries with technology and work-life balance.
   • “There will only ever be one Hoda, ever in the history of the universe…We have to take care of ourselves.” (32:03, Dr. Joseph)
5. Vision (32:53):
   • Plan enjoyable moments or events, even small ones, to look forward to: “Celebrate your wins…have something to look forward to.” (33:03, Dr. Joseph)

Nature vs. Nurture in Positivity

• Are some people just “born happy”?:
  • Some are genetically predisposed to optimism, but learned habits and environment—especially from caregivers—also play a significant role (33:42).
• Dr. Joseph’s mother as a model:
  • Despite hardships, her mother exemplified generosity, joy, and connection: “She had no reason to be as joyful as she was…[but] she was always optimistic.” (34:05, Dr. Joseph)
• Connection as a cornerstone:
  • “Loneliness is a choice. You can always ask for help.” (Dr. Joseph’s mother quoted, 34:52)

---

Notable Quotes & Memorable Moments

• “If you push down the ability to feel that pain, you also push down the ability to feel the joy.”
  —Dr. Judith Joseph (08:40)
• “You don’t have to teach a three year old how to be joyful.”
  —Dr. Judith Joseph (21:26)
• “My way of coping and dealing with the trauma was not dealing with it and avoiding it by busying myself.”
  —Dr. Judith Joseph (05:47)
• “Imposter syndrome is not even a clinical diagnosis. But... none of us, especially as women, would say it doesn’t exist.”
  —Dr. Judith Joseph (15:03)
• “The happiest moments in my life were times when I felt connected.”
  —Dr. Judith Joseph (37:12)
• “She managed to raise four kids who get along...we had this group text. And I think it’s because she just sees the potential in every person.”
  —Dr. Judith Joseph (35:30)
• “Now, I feel like sharing my pain is my way of processing it. And I’m helping others.”
  —Dr. Judith Joseph (36:16)

---

Timestamps for Key Segments

• Early life & scarcity trauma: 04:22–06:54
• Academic pressure & shame: 07:34–09:34
• Imposter syndrome and feeling “meh”: 11:55–15:03; 19:44–20:24
• Anhedonia explained: 20:27–21:26
• The “points of joy” concept: 22:01–23:55
• Social media and the HFD viral moment: 24:21–25:50
• Explaining the “5 V’s”: 29:21–33:29
• Genetics, role models, and the importance of connection: 33:42–35:30
• Vision and embracing connection: 35:47–37:12

---

Conclusion & Takeaways

Dr. Judith Joseph’s journey and research shine a light on the invisible emotional burdens many overachievers carry. By validating difficult feelings, expressing them safely, reconnecting with personal values, caring for one’s “vitals,” and creating a hopeful vision, it’s possible to heal from high functioning depression and reclaim a richer, more joyful life. Ultimately, consistent small joys and nurturing connections—not relentless achievement—anchor well-being.

---

Recommended for:
Any listener who feels chronically busy but unfulfilled, those curious about high functioning depression, or anyone seeking a compassionate, practical roadmap back to themselves.

Transcript

[A]

Your place works hard just like you do. From last night's dinner to everyday messes, you want a clean that actually delivers. Lysol kills 99.9% of viruses and bacterias on surfaces and now leaves behind a fresh lavender scent you'll actually love. Disinfecting wipes, handles, phones, remotes and everyday surfaces. The All Purpose Cleaner keeps kitchens and bathrooms in check and the Power Toilet Bowl Cleaner disinfects the brush and bowl for two in one disinfection. Strong clean, great smell, no extra effort. Don't just clean Lysol Clean this is

[B]

a vacation with Chase Sapphire Reserve the butler the spa this is the Edit a collection of handpicked luxury hotels and a $500 edit credit chase Sapphire Reserve now even more rewarding. Learn [e-mail] Sapphire Reserve cards issued by JP Morgan, Chase bank and a member FDIC subject to credit approval. From the outside, my guest today had it all. Dr. Judith Joseph was a straight A student turned Duke and Columbia grad. She later went on to become a board certified psychiatrist and researcher, opening up the first female run clinical research institute in New York City. But beneath her success, Dr. Judith felt a void. She was, as she describes, pathologically productive. In an effort to mask feelings of inadequacy, Dr. Judith identified what she refers to as high functioning depression, or hfd. She was experiencing symptoms of depression like fatigue or poor concentration, guilt, restlessness without experiencing significant distress. And when Dr. Judith took out her phone and spoke openly on social media about what she was feeling, her video hit millions of views. People everywhere could relate. Well, since that moment nearly five years ago, Dr. Judith has made it her mission to help other people struggling with hfd. And now she's got a new book out. It's called High Overcome youe Hidden Depression and Reclaim youm Joy. And she's here to talk to me about that today, what she's found and how she's approaching life. This episode is for anyone who feels like they're constantly running on a hamster wheel but never quite fulfilled. Dr. Judith is insightful, introspective, and she's got some great tips on how to reach for points of joy throughout your day. I hope you find this conversation as helpful as I did. I'm Hoda Kotb. Welcome to my podcast, Making Space. First of all, I'm so happy that you're here. And I'm happy that you're here because you are speaking to women in a way that we feel understood and heard. And there's a word that you're using which I like. And it's sort of unhurried is the word. Women are sprinting through life. We are blindly running and then collapsing at the end of the day and waking up and doing it again and again and again. This was you, wasn't it?

[C]

This was me.

[B]

Tell me, I want to hear about the old you. What were you like before you had all these beautiful epiphanies?

[C]

Wow. Well, on the outside, I looked perfect. Really. Perfect husband, perfect kid, perfect home, perfect business, Just the perfect career. But no one knew that on the inside, if I wasn't busy, I felt restless. If I wasn't working, I felt empty. And I was pathologically productive. Perfect term to describe the old times, Dr. Judith. But you know, as a board certified psychiatrist and researcher who studies something called anhedonia, I didn't even know when anhedonia had snuck up on me. I had no idea.

[B]

What is, what is anhedonia?

[C]

It's a lack of pleasure and interest and things that you once enjoyed.

[B]

Oh, that you once enjoyed?

[C]

Yes.

[B]

So you're kind of plodding through life at this point. Okay, I want to get to all of this because I find it so incredibly fascinating because I think most of us don't know what we're doing. We picture our parents, really. And I felt like that's how they lived. It's like you went to work, you came home. No one was chasing joy or anything. They just lived their lives. So bring me back to your upbringing.

[C]

Well, I'm from the Caribbean and, you know, in Trinidad, we'd go to the beach every weekend. It was like a good life. You ate your food slowly. You went and you ate it.

[B]

I like it.

[C]

Okay. You had community. Things were slower, you know, and if anyone's ever been there, they see us. You take your time, you do things right.

[B]

Yeah. So you loved that life. Right. Was it just your family or was your extended family there?

[C]

Oh, no, everyone's family on the block. My mother had four kids back to back. And she had a community. So life was good. And moving to this country for more opportunities, things really quickly changed. We didn't have very much. We were dependent on assistance.

[B]

Sure.

[C]

And we at times didn't have food, light bills cutting off. So it was like night and day.

[B]

How old were you?

[C]

I was about 4 years old. Yeah.

[B]

What memories do you have? Cause those are very grown up problems and sometimes grownups shield us from what's going on. But do you have memories of not having enough?

[C]

I do. You know, there were times when I remember running into my mom's room with like tension headaches, like just worrying, worrying about grades, worrying about bills, worrying about things that most kids don't worry about. Right. It was very difficult. But my way of coping with that scarcity trauma, which is a term that I coined on social, that has resonated around the world. My way of coping and dealing with the trauma was not dealing with it and avoiding it by busying myself.

[B]

So even when you were a little kid.

[C]

Yes.

[B]

So you played, you studied, you just did anything. So you weren't worried?

[C]

I was the one who was studying.

[B]

Oh, you were the studyer.

[C]

I've always been high functioning.

[B]

So what did you. Cause sometimes kids who come from poor backgrounds are embarrassed. Like when friends come over, you're like, oh God, don't come over, you know, afraid. Cause I spoke to like Viola Davis or Shania Twain or Tyler Perry, all who've lived through different things. How did you deal with that kind of stuff as a little kid?

[C]

Well, I was definitely ashamed. And one of the symptoms of trauma is actually shame and blame. Like internalized shame and blame.

[B]

Oh, your own fault.

[C]

Yes. And children have magical thinking. It's really interesting because I treat children, adolescents and adults, they somehow believe that they control the outcome. Right. If I just did better, this would happen. If I wasn't a bad kid, Daddy wouldn't have left or I would have more so. So a trauma response is internalizing that shame, which I did not want to tell anyone about what I was going through and pushing through the pain by focusing on my studies.

[B]

So that's where you shined.

[C]

That's where I shined.

[B]

You were the one when they were like, Judith has it. Judith got it right again. That was you always.

[C]

I was, I was the good girl.

[B]

Gosh. And it's almost like pretending from that young age, like we always try to tell our kids to be who they are. But, you know, I think again, other generations, our parents, my parents, I'll speak for my parents taught us what to think, where to stand, what to wear. I feel like we made almost zero decisions of our own. We just became kind of a reflection of them. And it was like in that shadow that we lived. Did you feel anything like that when you were growing up?

[C]

Absolutely. There's that pressure of you have to do well because you have opportunities that others don't have who are back home. You have to represent.

[D]

Right.

[B]

We came all this way for you. Oh, God, that's a lot.

[C]

Which is not always a bad thing. Right. I think that you Know, it's survival technique. And it helped. You know, initially, it was actually a positive thing because I did love learning.

[B]

Yes.

[C]

But over time, if you don't process that pain, you continue pushing through all of these little traumas that life has a way of throwing at you.

[B]

Yeah. You can't bury them for long.

[C]

You can after a while. There's anhedonia. Right? That light bulb girl. We're gonna get to anhedonia.

[B]

I'm excited. Okay, so you're super smart. Did you have lots of friends? Was it like that or not really,

[C]

you know, when you're focused on your studies. For me, my coping was being perfect. If there was a challenge, I would just go at it. There was a competition in the school where whoever read the most books would have the most snacks. So, you know, I had to do that, and I had to dole them out to my siblings because the four of us needed our snacks. You know, we were getting that at home.

[B]

Wow.

[C]

So it became a of life for me. Just doing, doing, doing. Being the human doing, not the human being. And over time, if you push down the ability to feel that pain, you also push down the ability to feel the joy. And that's where I found myself. Not enjoying learning anymore. Now, learning was just an end to me. And I used to love reading, and that was just cramming out all information just to pass that test.

[B]

You're talking about something. I interviewed Shania Twain. She grew up very poor. I mean, she had, like, bags on her feet and no food in the house. She used to say she wasn't hungry at lunch. Cause she didn't have lunch money. And she said. I said, so how did singing come? And she goes, it didn't come out of inspiration. It came out of desperation.

[C]

Yes.

[B]

I sang because I had to sing. That's why I sang. I loved it when I was younger. But then it became a chore. It sounds similar. It was a chore. Now, learning wasn't the. Wow, I learned something new. It's like, I gotta get it. I gotta get it.

[C]

Yeah. It becomes this fear of failure.

[B]

Yeah.

[C]

Versus this pursuit of knowledge.

[B]

Yes.

[C]

And it is a fine line. When you're pathologically productive, you tip from excitement to anxiety very easily.

[B]

What was your childhood bedroom like?

[C]

Oh, it was one room with four kids and one adult. Very different than in Trinidad, where we had space. We had all.

[B]

So you were cramped in there.

[C]

Yes, yes.

[B]

How did you function as a young kid going through, like, school? That would be. I mean, I shared a room with my sister And I was about to kill her most nights.

[C]

Well, my mother was always on with our schoolwork, and she'd say, olia, study. Don't be dunce like me. Right. That's her way of saying, don't be like me. But my mom was on it. She didn't have us watching tv. She had us, you know, really learning because she saw education as the way out.

[B]

Wow. God, I can only imagine is your mom's with us still.

[C]

She is.

[B]

Gosh, she must be so, like, in awe of what she created. My God. Oh, I'm getting all the feels thinking of her. So you're going to college, and you choose the top because that's who you are. Were you ever just tired?

[C]

All the time. I remember applying to colleges and worrying, like, where am I going to get this tuition from? So at one point, I just started applying for every scholarship out there. There was a scholarship for an Italian American football player. And most people would have been like, oh, that's.

[B]

That's not for me.

[C]

That's definitely not for you. But I was like, you know, I'm going to apply for it, because if somebody doesn't apply for it, that money's on the table. You know what? I got that scholarship.

[B]

Wait.

[C]

What I love was in a lodge at an Italian American association and eating with these men. And they're like, are you Italian? And I'm like, no. They're like, okay, well, good luck to you. The money was there, so if no one claimed it, I was gonna go after it.

[B]

That's hustling, too. That's hustling. So you were looking to see what school. How did you choose and how did you know what school you're. Was it basically what was gonna get the financing or.

[C]

It was about financing, and it was about the destination. I always wanted to be a scientist and a doctor, and I wanted to. That was strong in science. And at the time, Duke was number three in the country. And I thought it was a long shot, but I was gonna go for it, you know?

[B]

Of course you did.

[C]

The worst they can say is no. And I got in.

[B]

What was that day like?

[C]

Well, I could not believe it.

[B]

Yeah.

[C]

I remember looking at that pamphlet and being like, this is a mistake. You know, the imposter syndrome started way back then. But I said, listen, if they made a mistake, that's okay. I'm gonna ride with it.

[B]

What did your mom say when you got in?

[C]

They were speechless.

[B]

Yeah. Couldn't believe it.

[C]

They couldn't believe it. But with an immigrant background, their first Concern is, wow, that's so far from home. Yes.

[B]

That's another adjustment for you. It is. Because from being all kind of squeezed in together to now suddenly leaving the nest and kind of being on your own, how was that adjustment for you?

[C]

It was difficult.

[B]

Yeah.

[C]

I'm not going to sugarcoat it. Adjusting from an urban high school, public high school, where I was number one, to a large university where people had, you know, means that I didn't have. It was a huge adjustment. It was like learning all over again.

[B]

Wow. How did you deal with that piece of it? Because to know that other kids had a lot. And again, we talked about shame earlier. Everyone has their shame statement. I have mine. Every single person listening has theirs. Whatever, you know, whatever it is. How did you deal with that as a young, vulnerable kind of kid in college?

[C]

You know, I think for me, I really isolated. Even the kids who look like me, the underrepresented minorities, they had more money than I did. So it was. I felt limited in my ability to relate to others. And I know now that that is not the case. That was a core belief that I needed to challenge. But again, we internalize blame.

[B]

That's what we do.

[C]

And so I was very, very quiet. I had very few friends in college, but the one friend that I really leaned on, who was my roommate, she was really a lifesaver for me because she came from an affluent background, but she knew what it was like to be an outsider. She's Lebanese and Syrian, and she just. She was like, we're going to get through this together. She's like, you didn't learn this in what? She's like, I'm gonna teach you. Without her, without Zana, I would have probably failed. Wow.

[B]

Wow. All you need is one, and that is one. Isn't that so true? Okay, so you get through college and this imposter syndrome, by the way, just so you know, I've interviewed all of the top people in almost every profession, and I still remember Audra McDonald sitting across from me, and she's a Broadway maven. And she goes, oh, gosh, I have imposter syndrome. I go, how many Tonys is it gonna take before you don't anymore? She had like five or six. She was about to win another. And it's like for all of us, all the Atta girls still somehow aren't making the great Audra McDonald feel seen. And, like, she deserved all of these accolades. She said, it's only now that she's saying to herself, yeah, actually, okay, I do deserve this. That Imposter syndrome is I had it up until probably five years ago. I was like, they're gonna come. My office was right there. They're gonna tap me on the shoulder and go, hey, Hoda, tap, tap. Come on. Now we all, now we figured it out. It's time for you to go. Cause you can't imagine that you're in the position you're in.

[C]

Yes, that happens all the time actually. And the interesting thing is that imposter syndrome is not even a clinical diagnosis.

[B]

No, it isn't.

[C]

But none of us, especially a woman, would say that it didn't exist. Of course. Right? Just like high functioning depression isn't a clinical diagnosis. But we all relate.

[B]

More with Dr. Judith Joseph after the break.

[D]

Looking to upgrade your space with quality pieces that fit your budget. Wayfair makes it easy and it's all on sale from April 25th through the 27th during weigh day, like up to 80% off with free shipping on everything. Find exactly what fits your style and needs from furniture and decor to home improvement and outdoor essentials. Filter by aesthetic from mid century modern to farmhouse and score everything from patio furniture to accent pieces. Plus, you can shop with Wayfair Verified. Their specialists vet everything by hand with a 10 point quality inspection so you know you're getting a piece you can trust.

[B]

It gets even better.

[D]

Installation and assembly services are available for a truly seamless experience. Wayday is the sale to shop the best deals in home. We're talking up to 80% off with fast and free shipping on everything. Head to Wayfair.com April 25th through the 27th to shop Wayday. That's W-A-Y-F-A-I-R.com Wayfair Every style, every home.

[E]

And Doug, there's nowhere I wouldn't go to help someone customize and save on car insurance with Liberty Mutual. Even if it means sitting front row at a comedy show.

[C]

Hey everyone, check out this guy and his bird. What is this, your first date?

[E]

Oh no. We help people customize and save on car insurance with Liberty Mutual. Together we're married. Me to a human, him to a bird.

[B]

Yeah, the bird looks out of your league anyways.

[E]

Only pay for what you [e-mail] Liberty, liberty, liberty, liberty.

[C]

At DSW, we ask the important questions like what shoes are you going to wear? Whether you're prepping for wedding season, festival season, or just planning the ultimate vacay, the right shoes can make or break an rsvp.

[D]

So own the moment.

[C]

You've got big Plans. And we've got just the shoes at the perfect price, of course. Get ready to get ready with Designer Shoe Warehouse. Head to your DSW store or dsw.com today and let us surprise you.

[B]

Okay, so let's talk about this. So now you want to make your life. You have all the education, you did all the things. Okay, you went to Duke and then Columbia.

[C]

Yes. God.

[B]

All right, smarty pants over here. You did all the great things. So now there are more components to a big life. It's a husband, it's a job, it's a kid, it's all the things. How did you define success back then?

[C]

Well, back then, it was about titles, you know, getting into the right schools. But then from happiness research, we know this. If you keep getting the things and moving the goalposts, you're never happy. So I was never happy. Nothing was good enough. I couldn't just go for the medical degree at Columbia. I had to also get the mba, right? I couldn't just do one residency. I had to consider another one. And I ended up switching from anesthesiology to. To psychiatry. You know, it just kept going further. And after a while, if you're not living your life in the present, you're missing out on joy, which is what we should all be striving towards. Not this idea of happy, which is this idea that may never really happen for us. Right?

[B]

So happiness is just this thing that we're always chasing.

[C]

Always chasing.

[B]

But like, happiness is what, like, people think it's at the concert. If I get to the concert on me, you know, it'll be so great. Or the birthday party and all those things that I guess happiness lasts for all of two and a half hours or whatever it is. And then it's back to normal life.

[C]

Yeah. Or for those of us who have scarcity, trauma. Once you're no longer in debt, once the student loans are paid, once you have the house and the savings. But we know it's never enough. We keep having this fear that will run out, that all of a sudden, overnight, things will be taken from us. And it is an irrational fear, but it keeps us busy and moving, and we don't experience the joy.

[B]

It's just exhausting, isn't it? It's exhausting. Okay, so to identify, because again, high functioning means you could do everything. And I was thinking about women listening to this. Cause we do all those things. We take the kids to school, we run to work, we do this, we do that. We're exhausted. We kiss our husband good night. We have a meal, we talk about life, and we go. And there's no highs and there's no real lows. It's just humming.

[C]

Meh.

[B]

Meh. Is that what that is?

[C]

Yes.

[B]

So you had that meh?

[C]

I had that meh. I was sitting at a desk in 2020 giving this talk to this large hospital institution, trying to help them cope through what was happening, the uncertainty in the world.

[B]

Was that Covid or.

[D]

That was Covid.

[B]

Covid, yeah.

[C]

And again on the outside, just got onto this prestigious board and giving this talk degrees in the background. I just looked like I had it all figured out. And halfway through the talk, I. I felt that meh, that blood, that deadness inside. I was like, oh, my gosh, I think I'm depressed. It snuck up on me. And I'm a psychiatrist who researches depression and anhedonia. And I think I have anhedonia. I just felt so muted.

[B]

Now, will you explain now just in detail what anhedonia is?

[C]

It's when you are with your loved one and you're just not into them. You're not enjoying it the way you used to. It's when you're eating your favorite food and you used to be like, mm. But you're like, you know, you're having an intimate moment with your partner and you just want to get it over with. It's the simple joys in life. Like when you take a rest or take a nap and you wake up and you're not refreshed. Those simple joys are just not doing what they did for you.

[B]

So that kind of depression isn't easy to spot. You would just think you're in a, quote, funk. Or, I didn't exercise, so I probably feel yuck. Or I ate terribly. You could blame it on a bunch of different things. How do you know when it is those things you're just hitting a bad patch or when it's really something you should really think about looking into?

[C]

Well, I always ask my patients, like, are you a human being or a human doing? And that kind of hits them and they're like, I'm so busy. I'm so busy. Oh, a human doing.

[B]

Yeah.

[C]

And I just don't enjoy things and I feel meh. And isn't everyone like that?

[B]

That's what people think. Everybody's got that.

[C]

And I tell them, I said, listen, you don't have to teach a three year old how to be joyful. You know, you give a three year old a box and a spoon and they'll add it, right? But Somewhere along the way, we, as adults, important humans, we forget and miss out on the joy in life, the basics. Because we're so fast. You know, we're at our desk and we have a zoom and it's on to the next, and it's on to the next. And after three hours, we realize that our belly hurts because we haven't used the bathroom. You know, and that is a simple point of joy.

[B]

Right.

[C]

In research, when we add up happiness, we're adding up these points. Right. If you had pain and you got relief, that's joy. Right. So you're robbing yourself. Oh, that's good. Right? That's a basic joy. Yeah. If you're thirsty and you quench that thirst. You got a point. Right. It sounds very different than the house in the Hamptons. Right. Or the big job.

[B]

But the simple, simple, simple pleasures. Boy, that's fascinating. I can't believe. What are some other small points? I'm so interested. And by the way, we should point out, you have a whole research lab. You have a completely female run research staff. That was all intentional.

[C]

It wasn't. I wish I could say that. We used to start. We started off with all men, mostly men. And then it shifted to all women. We just hired our first man. Spoiler alert.

[B]

No, I'm sure he's great.

[C]

But yeah, it just, it turned out that way over the pandemic over life. Yeah. A lot of people moved away after 2020.

[B]

So what else? Cause I don't think we think about a beautiful cold glass of water on a hot day where we pause for a second and say, wow, thank you. This is pretty spectacular.

[C]

Well, one of the questions I'm often asked is, how is this different than anxiety? Well, on our research assessments, we ask things like tension and muscle aches. And if you are relieving tension, that's joyful. It's hard to be happy when you're stressed.

[B]

Yes.

[C]

So simple things like getting up from your desk and getting off of the screen and doing something like breathing.

[B]

Yes.

[C]

By relaxing yourself. You got a point there.

[B]

Yes. Oh, that's good. How many points do we need? A lot of points.

[C]

We look at a whole plethora of sensations, and it's a game changer for people who have been sad all their lives or just feel as if they've been a funk and they can't obtain happiness when you shift it and you're like, forget that idea of being happy in the future.

[B]

Forget that.

[C]

Let's see if you can get a point today. So if you didn't get a point. Today there's hope tomorrow you can get one or two points, or the next day, it shifts their mindset, you know, it feels hopeful.

[B]

So when you kind of diagnosed yourself with high functioning depression, which is so interesting, then what? Okay, so now, you know, you have this thing and it's like, ding, ding, ding. Something's gone off in your head. Then what? Like, what do you do with that?

[C]

Well, I, you know, because I'm high functioning AI, I had to do a research study on it. I couldn't just leave it on the table. I thought, how many people are just like me? And first I tested the waters. Because I teach at nyu, I developed this course for physicians who are psychiatrists, basically teaching them how to communicate to the press. So if there's a big, you know, devastation, how do you give a press conference where you're not talking above people and you're talking with them? That's good, you know. And so I tested the waters and I said, let me create a social media reel on this just to see if it hits with anyone. I thought maybe 100 people would respond. It was viewed over 20 million times around the world across platforms.

[B]

Tell us about that reel. Like, what did it reveal? What did the reel show? For those who haven't seen it yet,

[C]

Waking up before your alarm because you've got that anxious energy about the next day. Drinking coffee instead of eating a proper meal because we're so busy and important, we can't even feed our bodies.

[B]

Very busy and important. Okay.

[C]

Or when we do eat, we shove it in our mouths in front of a screen. We don't savor it. We're not like, ooh, I like those, you know, pistachios. We're like, just give me calories so I can do my next thing right. Not using the bathroom until you get home.

[B]

Yes.

[C]

So guilty of that. When I was high functioning af, you know, and instead of spending time with your kids who you miss and you love, you're so distracted, you get kind of irritable when you're playing with them. So what do you do? You doom scroll at bed and you look at their pictures or you look online. Anything but dealing with the actual interaction.

[B]

Boy, so once you knew, you hit the nerve which so many other people were saying. Me too, me too. We need solutions, obviously. And there are. I mean, people take medications for depression. Some people do other things. What was your kind of answer to this?

[C]

Well, I had a theory based on my personal experiences and what I was seeing in my practice. I had A theory that people who are high functioning have unprocessed pain in their past, unprocessed trauma, and they're busying to deal rather than processing it. And so when I wrote this protocol, it looks at things like combat assault, having a bankruptcy or having a divorce or being treated poorly because of your background and so forth. I wanted to capture all of those tiny traumas or little t traumas so that we could see if that correlated to whether or not people.

[B]

When you talk about. If you ask every person how they grew up and you ask them what they. Shame statement is kind of a strong word, but I was next to somebody and we were talking about this very thing, and we went around a room and people were saying what their shame statement was. And the woman next to me said, I'm a mistake. And I was like, she seemed perfectly fine, but her whole life she felt like she was a mistake. She was the one who wasn't supposed to be born, and her parents probably made her feel that way, too. So it can be that.

[C]

Absolutely.

[B]

That thing. You're right. It doesn't have to be horrible abuse or terrible. Whatever. And if you're listening, you have one. We all have one. Unless you've buried it so deep you haven't unearthed it yet, but we all have one, so. Okay, so now you know you've got that thing. So now what do you do with that?

[C]

We all have one, but some of us can't remember it. And one of the symptoms of trauma is burying memories that are painful. So just because you can't think of one doesn't mean you can't find your way back.

[B]

More with Dr. Judith Joseph in just a moment.

[E]

And Doug, there's nowhere I wouldn't go to help someone customize and save on car insurance with Liberty Mutual, even if it means sitting front row at a comedy show.

[C]

Hey, everyone. Check out this guy and his bird. What is this, your first date?

[E]

Oh, no. We help people customize and save on car insurance with Liberty Mutual. Together. We're married. Me to a human, him to a bird.

[B]

Yeah, the bird looks out of your league anyways.

[E]

Only pay for what you [e-mail] Liberty.

[C]

Liberty. Liberty. Liberty. You know that thing where you get an amazing pair of shoes at a really great price and want to tell everyone about it? Yeah, so do we here at Designer Shoe Warehouse. We'll give you something to brag about, like the latest styles from brands you love or the trends everyone's obsessing over or shoes that make you feel like, well, You. So go ahead, show off a little. Find shoes that get you at prices that get your budget. Head to your DSW store or dsw.com today. DSW. Let us surprise you.

[A]

This is a Monday.com ad, the same

[C]

Monday.com designed for every team. The same Monday.com with built in AI for scaling your work from day one. The same Monday.comwith an easy and intuitive setup. Go to Monday.com and try it for free.

[B]

So what is. You have the V's, right?

[C]

I do.

[B]

What's the first one?

[C]

The first V is validation.

[B]

Validation.

[C]

Many of us push down how we feel. We don't accept it or acknowledge it. And it's important to acknowledge how you feel because there's a term called affect labeling in psychology where if you can pinpoint what it is, then you feel less anxious. You know, I use this analogy of you're in a dark room and something makes a loud noise and you just start like lurking around. You can't see it, you get really anxious, but you turn the light on, you see what it is. Just knowing what it is in itself is therapeutic.

[B]

So that's it. Finding your thing, whatever your button is. Okay, so once you've, let's say like this girl who I just saw, she knew that's what her button was. I'm a mistake. So now what's the next V?

[C]

The next V is venting, expressing. Get it out, get it out. Now what are we talking about? It's different than trauma dumping. You know, there are do's and don'ts. You know, you don't want to necessarily talk to someone and dump all of your emotions onto them if they are someone who's like, you know, in a position of power that's below you, right? Because then they're not going to say anything to you. They're afraid of getting fired or to your kids, you know, because in that hierarchy they want to be there for you. And they're not going to say, you know, mommy, I don't want to hear. They're gonna wanna attach so they won't reject you. So you wanna think about that. You wanna pick one or two people who you trust and you wanna ask for emotional consent. You want to say, I have something to say to you and are you ready to hear it? Cause you don't wanna get rejected in that moment as well. But venting doesn't have to be just verbal. I work with a lot of neurodiverse clients and people can write in a journal, you can sing. If you're an Artist. You can draw. You know, there are different ways. Pray, crying.

[B]

Right. All of it. Now we vented it. It's out of our system. Okay, and now what do we do?

[C]

Values are things that are priceless. Not with the price tags. You know, for me, I used to truly value knowledge and curiosity, and then I lost track of that because my values got muddied with the accolades and the achievements and the titles, and I had to find my way back to what I valued. And I remember I walked into Barnes and Noble's, I got Michelle Obama's book Becoming, and I was just like, oh, my gosh, I forgot how I love to just read.

[B]

Yes. Basic.

[C]

Yes.

[B]

Like Simple Pleasures.

[C]

Simple Pleasures.

[B]

So you can get back to your values and find them again. And once you're cleared out a little bit, you've got room. Right, to remember those things.

[C]

Yes.

[B]

Okay, so then what's after values?

[C]

Vitals.

[B]

Okay.

[C]

We only get one body and brain.

[B]

Oh, gosh.

[C]

I tell my daughter this since she was 2. How many bodies did God give you? She goes, one, Mommy. What do you got to do with it? Take care of it. You only get one body and there's only one you. There will only ever be one Hoda ever in the future of the universe, in the history of the universe, only one Judith. We have to take care of ourselves. So I talk about the traditional vitals, like sleep, nutrition, movement, but there are the non traditional ones that are really important, like the relationships you're in, you know, are they toxic? Are they healthy? Because relationships will make or break you in terms of your health. They're so important. The research is showing that.

[B]

Wow.

[C]

And then our relationship with technology, you know, there's all this emerging evidence about children, but now there's emerging evidence about how too much exposure to tech impacts adult mental health and then work life balance, which is a constant struggle for many of us who are high functioning, you know, just trying to leave work at work and enjoying our life outside of work.

[B]

Okay. All right. Is there still one more V?

[C]

Vision.

[B]

Vision. I like this one.

[C]

Okay. This is about planning joy for the future so you don't get stuck in the past and it doesn't have to be big. Like this morning, I got my daughter to school on time.

[B]

That's good. And you made it here, too.

[C]

Yes. And I had my coffee in the living room after and I savored it. And that's my treat. That's my point of joy that I put in the near future to look forward to. But it could be bigger. It could be Something like a birthday or, you know, celebrating with your team after you did a big project rather than going on to the next. Right. How many times do we do that? Celebrate your wins because tomorrow's not promised and have something to look forward to.

[B]

I love that. Do you think some people are just born with positivity or born negative? And is that something that we can work on? If someone feels like, I kind of see a cloudy day when I look out, don't tell me the sun's coming out in an hour.

[C]

Yeah. Some of us are born with these happy dispositions. Right. We are more optimistic. But then others, we are also influenced by those who are attachment figures. You know, I remember when I was young, my mother, she had no reason to be as joyful as she was, but she was always optimistic. And there was always a stranger at our table, you know, someone having dinner, and we didn't have much. And I used to be like, this woman is giving our food away, but she just knew that God would provide. You know, she was just that person. Whereas I was the one worry wart, like, where are we going to get this from? And where are we going to get that? And, you know, when I was going through my divorce, I opened up to her, and she had no idea. She had no idea I was struggling. And she says to me, she says, judith, loneliness is a choice. You can always ask for help. You can always lean on others. And I just, like, it hit me. I'm like, here I am, this fancy researcher and my mom, who has no doctorate degrees, and she's just like, you just need to connect, you know, like, so for someone. Oh, my God, for an hour, for someone who has been so joyful, I found myself at, you know, late in my career learning from her. She's not a happiness researcher, but she is an expert in connection.

[B]

Oh, my God, Your mom sounds extraordinary.

[C]

She is.

[B]

Wow. When do you think she was the proudest of you?

[C]

Wow. I think this book. I think she's very proud of me sharing our family's story because, you know, she was someone who. She managed to raise four kids who get along. We're still really close. You know, we had this group text, and I think it's because she just. She sees the potential in every person. She's so optimistic.

[B]

Man, you're really blessed to have her.

[C]

I am.

[B]

She is, too. Wow. What does this chapter in your life feel like? I mean, I feel like I've gotten to walk through your life with you, and here we sit in this moment where you're clearly on top of the wave. What does it feel like in this moment?

[C]

Well, I grew up in a very spiritual household, so there are times in my life when I knew that my gut was saying, this is not for you. Right. And other times that I ignored that and I just went with, well, this is what everyone else says I should be doing. But this, it just feels right. You know, I just feel like there's so many people who don't have words to describe what they're experiencing. You know, they don't know why they can't access joy. They've forgotten who they are. And, you know, before I was so ashamed of my story, my trauma, you know, I perceived divorce and all these things as failures. And now it's just a different way of thinking. Now I feel like sharing my pain is my way of processing it. And I'm helping others. So it just feels like I'm listening to that voice instead of invalidating it.

[B]

Well, this book by Dr. Judith Joseph High, Overcome youe Hidden Depression and Reclaim youm Joy. It's a beautiful book. It's no wonder Oprah wants you on her show and everybody else. So I'm just so happy to be sitting with you. Before we go, I just wanna ask you this. Cause I always ask this at the end. This podcast is called Making Space. Cause I think it's important that we all kind of be a little unhurried in life. So if you did have a day that was only for you, you could wake up when your body said it's time. And you can go to sleep when it said it was time. And you could fill it with anything, whatever, just anything to fill your tank. How do you think that day would unfold?

[C]

Oh, well, you know, I've learned that my values have shifted. I am all about connection. And the happiest moments in my life were times when I felt connected to my siblings, to my daughter, to my team. I would fill my day with interactions with those people that I love the most. Oh, that is. That's my joy. Yes.

[B]

And get a massage, too.

[C]

Okay. Dr. G, thank you so much. I appreciate it. Thank you so much for having me.

[B]

Oh, that was so beautiful. Hey, guys, thank you so much for listening and for coming on this journey with me. If you like what you heard, and I hope that you do, please give Making Space a five star rating and review on Apple Podcasts. And make sure you tell your friends. Follow us on Apple Podcasts, Spotify, or wherever you're listening right now. Making Space with Hoda Kotb is produced by Allison Berger along with Kate Saunders. Our associate audio engineer is Juliana Mostarilli. Our audio engineers are Katie Lau and Bob Mallory. Original music by John Estes. Bryson Barnes is our head of audio production. Missy Dunlop. Scott Parsons is our executive producer. Libby Least is the executive vice president of Today and Lifestyle.

[E]

And Doug. There's nowhere I wouldn't go to help someone customize and save on car insurance with Liberty Mutual. Even if it moves, means sitting front row at a comedy show.

[C]

Hey, everyone. Check out this guy and his bird. What is this, your first date?

[E]

Oh, no. We help people customize and save on car insurance with Liberty Mutual together. We're married. Me to a human, him to a bird.

[B]

Yeah, the bird looks out of your league anyways.

[E]

Only pay for what you [e-mail] Liberty.

[C]

Liberty. Liberty. Liberty.