
Loading summary
A
You're listening to Self Conscious with Chrissy Teigen, an Audible original podcast. Join me as we explore the cutting edge of health, wellness and personal growth with the world's leading experts and thinkers. From inspiring stories to actionable insights, our conversations aim to help you lead a healthier, happier and more productive life. There's a particular kind of pain that doesn't look like pain at all. It doesn't make you stay in bed all day. It doesn't wreck your ability to perform, to parent, to produce. In fact, it actually might even make you excel. You show up, you smile, you get things done. And no one, not even you, realizes that something is wrong. It's called high functioning depression and it hides behind full calendars, flawless to do lists, and the phrase I'm fine, you're not falling apart, but you're not feeling much of anything either. My guest today, Dr. Judith Joseph, has written a book that finally puts words to all of this. High functioning Unlock your hidden depression and reclaim your joy shines a light on the kind of pain that hides behind perfection, offering a path back to something that actually feels good for a change. Dr. Judith believes that burnout, perfectionism and people pleasing aren't just personality traits. They're signs of pain that we haven't been taught to name. Today we'll learn how to spot that pain, what to do with it, and how to begin the quiet, brave work of coming Back to yourself. Dr. Judith welcome to Self Conscious. I have heard of high functioning depression, but never been diagnosed with it. And I love a diagnosis and I say this all the time, but this is my therapy area. And whenever I'm like laying on the couch and my therapist is sitting here, I'm begging him to tell me what's wrong with me. And it's really frustrating because oftentimes I feel like it'd be so helpful if someone told me that I had something so that I could embrace it more. But I do feel like for the first time I'm talking to somebody that really understands me. So thank you for being here. I feel really connected to your book and this one's gonna be like a real one for me. Cause this I get and this is gonna be very helpful for a lot of people to understand that you can seem like you've got it all going on and you can seem like you have everything and feel like something's wrong with you because you don't feel the joy that you're supposed to feel or the excitement or I'm going on vacation. I should be excited. I Should be this. That I should be able to, you know, assign feelings to things.
B
Well, first, thank you for validating me. Validation is so important. And what you described, not having a term and wanting a term and needing a term is so crucial. And I find that when I was in therapy training, a lot of the old school therapists would say, be a blank slate. Listen, don't talk. Let them figure it out. But for many people, that is so daunting. And I think it's a reason a lot of people give up therapy. And because I've traveled the world looking at mental health across different cultures, I know that in certain countries, you got to tell it like it is. Yeah. Or else people would be like, this lady's looking at me weird and she doesn't talk. And they're out.
A
Yes. Oh, my God. That's exactly where I'm at right now. I've had my therapist for so many years, and, oh, my God, he might be listening to this, but maybe this will be helpful. I don't know, but I feel like he is just a listener, and I'm not hard up for listeners. It's not hard to get me to talk. I understand that if I really never spoke or I seemed. I was keeping things inside me. Why that would be, like, a good tactic. But I'm always like, no, man, I need to hear something. I need to hear the one little quote that's gonna get me through the week and that I often actually find on Instagram randomly or reading books like yours. Ye so many parts where I was like, man, this would have changed my entire year if I could have looked at things from this perspective. So that's what's so beautiful. And I'm so happy you could say that you understood that you weren't supposed to just be this person for someone to talk at, because not all of us need that.
B
And when I was going through my own personal therapy journey, my first therapist was similar to your current therapist. Very blank slate. But I needed that at that time. I needed to do some self discovery. But now with my current therapist, she is so expressive. And I grew up in the church, so sometimes she'll drop a word and I'm like, oh, I needed that today. You know, so at different seasons in our life, we need different types of interventions. And what you describe, like, not knowing what you were dealing with. There's actually a term for that. It's called affect labeling. In therapy, if you know what you're working with, that in itself is therapeutic. So I liken it to let's say you were in a really dark room and you heard a loud crash. And most of us would be like, oh, my gosh, I can't see what it is. They'd start swinging, they start yelling or running. But when you turn the light on and you see it's, oh, it's an inanimate object. I'm safe. That in itself decreases your anxiety. So when we know how we're feeling and we have a name for what we're dealing with, that in itself is therapeutic. And that's why it's so important to use these terms to name high functioning depression.
A
I'm sweating already. I'm like, oh, Lord. So what exactly is high functioning depression, then? What do you label it as?
B
I'll take you back to 2020. I was sitting at my desk and I was giving this talk to this large hospital system, and I was supposed to be the voice of healing and guidance in what was a chaotic time for a lot of healthcare professionals. And I just remember halfway through the talk feeling as if, wait a second, I think I'm depressed. And it just hit me.
A
When was this?
B
This was April of, okay, so, yeah, yeah, during the pandemic. And I was having these symptoms of depression, like, feeling blah meh, which is called anhedonia, a lack of joy and interest in things that once gave you pleasure. I was feeling, like, changes in my sleep. All of the symptoms of depression that you typically see. Low energy, lack of motivation. But the problem is that as a researcher who studies depression, when you go down the checklist, when you're doing a depression score, if you don't meet that box, that last checkbox of you're not functioning, then you don't meet criteria. And I was functioning on the outside. I looked put together. I was what you would call pathologically productive. I was doing a gazillion things, mother to my small child, running a lab, taking care of my team, taking care of patients through a really difficult time, helping hospital systems, being on tv. It just looked like everything was figured out. So I had the same experience that you had, Christy. I was feeling like, what do I have to complain about? I felt guilty. Like, why am I depressed? Almost as if it was my fault. And that led me to initially not want to talk about it. I even hid it from my own therapist. But then I said, I wonder if other people feel like me. I wonder how many people, who are the rock, who are the mothers, who are the parent, who are the caregivers, who are the entrepreneurs, how many people show up Every day. And they are struggling behind this mask of pathological productivity. I need to figure this out. So I started the research. I have a lab where we actually study clinical depression, like the real depression, where you do break down, where you are in crisis. But I thought if there's this queue of people waiting to break down and we're just waiting for that box to be checked, this is a problem in our healthcare system. We're seeing this boom of longevity signs, this renaissance in healthcare where we're saying, don't wait for the cancer to develop. Let's catch the cancer. Let's show people how to figure out the risk factors so they can prevent it. Or with menopause, right now we're saying don't wait for the bones to break for osteoporosis, treat women with these hormones and these therapies. But in mental health, we're still waiting for people to break down. We're still waiting for that box to be checked, and then we do something about it. And I thought that was a broken model. So I did the research and what I found was that there was a high correlation between trauma that's unprocessed and high functioning depression. But our way of dealing with trauma is not by staying in bed and crying. Our way is to busy ourselves and we avoid it. So on the outside, we're rewarded, right? We look like we're doing all these wonderful and no one knows how much we are struggling. Sometimes we don't even know it because we're pushing down all these feelings. The problem is that when you push down the pain, you also push down the joy.
A
Mm. Mm. Oh, my gosh. We were actually talking about this yesterday. Avoidance. And I do everything possible to never have a silent moment. My TVs are always going. We sleep with the TV on when I'm doing work, downstairs on my laptop and on my phone. At the same time, the TV's blaring. I really can't take silence. And I do feel like my therapist knows this about me. So he has a little bit of joy in our silent moments. Cause he knows that I'm thinking about something. But I think I've just gotten really good at tuning out feelings. One weird thing for me is that I cannot assign feelings to anything that I feel. I. What was the. I couldn't pronounce it.
B
Alexithymia.
A
When you just have no joy.
B
Anhedonia.
A
Anhedonia, yes. Or excitement, pleasure, anything. My therapist loves to do the thing where he's like, how does that make you feel? How are you feeling right now? What's the feeling in your body you're feeling right now? My answer 100% of the time is nothing. I'm not mad. I can tell a story where anyone else would be raging that this happened to them or that someone they trusted did this to them. And then all I can say about it is, I feel nothing. I don't ever feel mad at people. I don't. I'm not jealous. So I take it as a win because I don't have those negative feelings for people ever. But I definitely don't have positive ones either. And that's such a bummer. Like, I know that I can look at my kids. Oh, my God, I have so much joy. I literally watch them doing anything. And it makes me so happy when I see John win. It makes me so happy for any of my own business or anything else. I really don't feel much ever. My therapist says that it's like just the greatest way of protecting myself. And it's just hard to come to terms with because I am a really emotional person, and I'm meant to be really emotional. I'm meant to have big feelings. And then one thing that struck me as crazy was that I do ketamine therapy. So I'm always filling out the surveys on it, and you're doing a one through five score for different things. And I started realizing that a lot of my high scores were not because I cry a ton or because I throw rages and fits. You actually receive a lot of high scores by wanting to cry and not being able to, which is exactly what.
B
You were just saying, Anhedonia.
A
And that's really interesting to me because I was always taught growing up that depression is you're crying into a handkerchief all day, or you're just slumped in bed and you're watching TV and eating yourself silly and drowning out your sorrows with alcohol, this, that. But it is so much more complicated.
B
It is. And most people think of depression that way. They think of depression as, you're not doing anything, you're staying in bed, you're crying. I describe it to my patients as depression's like twin sisters. One sister is weepy, not functioning, getting all the attention because she visibly looks as if she's in distress. The other sister is not complaining, not feeling anything, the quiet. So they're the good girl. So a lot of people miss out on anhedonia. In fact, I recently went to a conference with all these therapists, and I went around and asked them, do you know what anhedonia is, and a lot of therapists didn't even know what it was. But it's been in the medical literature for over 100 years. And I want people to understand what it is because again, when you can name it, you feel less shame and blame. You're less like, oh, something's wrong with me, I don't feel happy. You're like, oh my gosh, it's anhedonia. And it could be related to high functioning depression or it could be related to unprocessed trauma or something that happened earlier in my life where I just pushed down all of my emotions so I can't feel joy, including the pain.
A
One thing you talk about too, and it was the first time I heard somebody else say it was the capital T, trauma and lowercase T. I get so frustrated with myself because I think I've only had two capital T's and the rest have been really tiny T's. And my therapist says those tiny T's really add up. So can you go ahead and explain that concept for people? Because I think it's going to be really helpful to a lot of people to hear because it finally really made me understand that there are different levels of trauma. And just because you didn't experience, your house didn't blow up, you weren't like viciously attacked that there are still levels to trauma. Can you talk a little bit about it?
B
Yeah. So I do a lot of post traumatic stress disorder research in my lab and according to the bible of psychiatry, which is the dsm, the Diagnostic Statistical Manual, in order to meet criteria for a trauma that leads to ptsd, it has to be life threatening or like this major assault. So you think of combat veterans and so forth. But the problem is that many people have events or situations in life that happen to them and it shapes the way that they view themselves and the way that they interact with others, the way that they behave in the world. And it's so significant, but it gets dismissed. So if you go to a doctor, and this happens in my lab all the time, where people are interested in PTSD studies, I'll first go through the trauma inventory and they'll have all of these symptoms of trauma. Like they avoid things they don't want to be triggered, they have poor sleep, some of them have nightmares, hyper vigilance. But then I ask them about the trauma.
A
Every time you say something, I'm like.
B
But the problem is that if that trauma doesn't fit nicely into a box, they don't get validated. I have to tell them I'm so sorry, but according to this criteria, you don't meet criteria for having this trauma that's necessary for ptsd. But then off the record, I'll say, I believe you. It's so important to validate people and to believe them because things like being in a partnership with someone who's verbally abusive, we know in neuroscience what that does to your brain, how that puts people in fight or flight, how it shapes people. But that type of trauma doesn't meet criteria for the textbook trauma. So imagine someone coming to you and they've lost everything because they were partnered with someone who was toxic, who was verbally manipulative, who pulled the strings financially for them, left them with nothing, and they are living in fight or flight. And all these symptoms of trauma, they're busying themselves to avoid it because they're constantly restless. When they sit still, they feel empty. When they're not working or busy, they feel restless, right? And then you tell them, well, your trauma doesn't meet criteria. That is so deflating. So I wanted people to feel seen. I wanted this research that I'm doing to really reflect the everyday experiences. Because I think sometimes in research we're so disconnected from the real world. Like in the real world, people approach things like, so differently. I'll give you an example. When they come to my private practice, my patients, they'll say, Dr. Judith, I just want to be happy, right? But in my research practice, when we're measuring happiness in the lab, it's completely different. A private practice patient will say, I want to be happy. And I'll ask, oh, what does that mean? And they'll say, it's when I get the partner, when I get the home, when I get the kids, when I get the job, when I pay off my debt, it's always an idea or an event in the future. So happiness is an idea in the real world.
A
What is it about young trauma to be so connected to this high functioning depression as opposed to just being depressed?
B
The really interesting thing about young or early childhood traumas is that many people cannot even remember their childhoods. And I'm a psychiatrist and I work with children, adolescents, adults and elders. So I see the whole spectrum of development. And a lot of children, they'll do this magical thinking early in childhood. What they do is if something really bad happens, what they'll say to themselves is, if I were a good boy or a good girl, this wouldn't have happened. And then what happens is they create this narrative about themselves where they start to internalize the shame and guilt and blame. So then they develop these tendencies where they end up being people pleasers. So they end up doing everything for others. Sacrificing their own joy, not processing that pain, pushing it down, having this life of anhedonia. And they just think that's normal. They think that's life. And they just walk through not being met, not being supported because they look like they're okay. They have developed their coping mechanisms. The problem with that is that eventually something's going to give. Either they do develop a clinical depression when they stop functioning or their body breaks down. And that's why we have so many conditions that we don't understand in a lot of people, physical conditions. Or they develop unhealthy coping mechanisms like they'll engage in excessive substance use or overusing. What a lot of people do today, which is technology, getting these unhealthy habits that happen because they haven't really processed that pain. So they don't even know what to do. They are empty when they sit still, they are restless when they're not busy. So I want people to understand this because again, there's only one Chrissy ever. There's only gonna be one you in the future of the universe and in the history of the universe, only one you. And those who are listening, there's only one you. So understand the science of your own happiness before you start applying tools to you. You gotta understand yourself.
A
I don't remember a lot of my childhood. I do a really incredible job of blocking out entire years around so I can have that one event that maybe happened in whatever year, but I can block out the two years before and the two years after it. I don't know if you work with like EMDRs or anything like that, but I've tried to unlock some memories so I can at least take them head on and deal with them. But for the most part I'm like just blank. I know that like my mom left us when I was maybe three. It could be 13, 12, 11, I don't know. Cause I don't really talk about it. But I do know that I. And I only know this because my sister told me. I came home from school one day and I just thought we were robbed. I was like, oh my God, everything's missing. And my mom had left us and moved to Thailand and I was living in Washington at the time. So I came home around maybe 12 or 13 or something and she was just gone. Which is so weird because we were so close. And I don't think anyone would expect it because we are close now. We're what you would consider close. She lived with us in this house, and she recently moved back to Thailand, which is like drumming up all other sorts of other feelings again. But I think me being able to block out basically 10 to 22, 21. I basically only remember meeting John, and I was 20 when I met him. And then, like, I kind of have faint memories coming back around, like, 21, 22. But do you think it's possible to tackle those subjects when I can't remember anything, Is it worth even trying to remember, or can I possibly get over it somehow?
B
I think it's absolutely possible to remember those things, but doing so requires trust. And what you're describing, the lack of remembering. There are over 30 symptoms of PTSD, but we only know about from the media and from movies. The one or two that are flashy, right? Like the nightmares, the hypervigilance, the flashback. There were over 30 symptoms. And when I create content, I talk about these. Because in our research, we use something called the Caps 5. It's a gold standard assessment, and it was developed by the VA hospitals for combat veterans. But we use those trauma assessments for all types of trauma. Now, again, if you were to come into my lab and I did a trauma inventory, I would have to tell.
A
You any day, by the way, we can go from here if you want. I'm, like, already crying thinking about it.
B
But it's so important for you to talk about this. You're being brave. But it's so important because a lot of people feel like you. They can't remember their childhoods, and they think there's something wrong with them, and they feel guilty and they don't talk about it because everyone else can talk about their childhoods, right? But this is so important. Someone's gonna wake up and be like, oh, my gosh, something happened to me, right?
A
I don't have pictures. I don't really have. Every once in a while, I'll see an old picture, and that'll prove to me, like, oh, my gosh, like, I. I went to Thailand, I visited her, or. But for the most part, people have to fill in a lot of the blanks for me. And then I've had other traumatic things happen when I was even younger. So thinking about how much I don't remember is so devastating because sometimes I wonder if I even deserve to feel this way or be mad at certain things because I'm like, I might be misremembering my whole childhood. Maybe it was amazing. Maybe I'm putting blame on people when they were wonderful to me or great parents. And it's a tough spot to be in because you can't trust anything. So I never trust any emotions I have. I don't even trust the weather. I literally have to look at John all the time, and I'm like, are you feeling cold? And I'll be like, all that matters is that you feel cold. I don't know how I feel. I don't know if I'm cold. I don't know if I'm sick. I don't know if I don't feel good. I don't know any feelings ever. I don't know how to feel anything. And I think that, like, the life we live, obviously, is really tough because you can never do anything. And it's frustrating for me because I just always, like you said, I wanted to be a good girl. And in my mind, my mom left, so was I not a good girl? So when I think about how I don't feel anything, all I can do is assign how I feel now to something which is, like, I pretend not to care that she's gone or that she ever left. But as they say, the body keeps the score, right? So there's something happening here, and it's frustrating. So what would you say to somebody or anybody else out there that's feeling like they can't feel anything? What's the first step in getting back to that? What's the first step in being able to feel again?
B
Well, if you're listening to this and you're crying, that's great. You know that.
A
And by the way, I never cry anymore. This podcast is never going to believe it, but, like, really get you some tissue.
B
As a therapist, as my pet peeve to sit here crying without a tissue.
A
Box, I have a really hard time crying. And it really frustrates me because I'm on Lexapro, I'm on the Things, and, like, you're not able to cry. So I know that when. That it really means something when I do. So don't worry. This feels good. And it looks terrible, but it feels really good. Sorry, guys.
B
It's a therapy. Do not apologize. You need to get it out. And crying is so therapeutic. When you let go of those tears, your body does amazing things. Like, tear ducts are not in our eyes just to keep our eyes moist so we can see they're there for a reason. That's why babies cry so much. It makes us feel better. And you gotta get that pressure out of your system. And if you're crying while listening to this, know that you're tapping into emotions that are necessary for you to eventually access joy. And.
A
But even, like, my. Like, right now, my gut is just.
B
Still, like, that's okay. Accept it.
A
And I just wanna smile.
B
And, like, that's all right.
A
That's. Cause that's my world that I have to be in. You don't really get to be upset very much.
B
Mm. Yeah. A lot of public figures feel like they can never show how they're truly feeling. And that's why we hear all these, like, stories of people who rel. Like, oh, my gosh, I had no idea they were struggling. Because you're told and rewarded to wear a mask of pathological productivity and smile and joy. But by you showing all of these emotions, just the act of you crying and tapping into that, you're helping so many people. It'll take time for you to feel comfortable with it. And that makes it.
A
That makes me happy. But I'm scared because my mother and I have not talked about any of this. Like, we've never addressed her leaving. I don't know if it's an Asian thing or what, but I just very quickly accepted her back. And we never discussed anything. Anything.
B
It's definitely an immigrant thing. Let me tell you.
A
I talk about that. We're just not gonna speak about it ever.
B
That specific type of trauma is, again, one of those traumas that if you went into any research center, they'd say, I'm so sorry. You don't meet criteria. But in my lab, I'll be like, I see you, but you're so right.
A
There are things that I really prioritize in my life, and one is joy, connection, and family, really. And I don't really make it a point to make those things happen for me. I know that, like, I am meant to be silly and weird and crazy and physical. And I'm also meant to be out in nature. And I'm meant to strike up conversations with people, like, on the street and appreciate being social beings. And I don't do any of that anymore. I don't do anything.
B
Those are your values. That's the third V. All the things you listed. Family, nature. For some people, they can't even remember what their values are anymore. When I ask some of my clients, when was the last time you felt physically, spiritually full and fed? And it's a very kind of, like, guttural, primitive saying. Full and fed sounds like a baby having milk. But it's just that. Have you Ever watched a baby drinking milk? If only we could eat our meals the way babies drink milk. But it's back to the basics. Like, we were built with the DN for joy. We all have dopamine in our brains, but somewhere along the way, things happen to us, and we just can't access it that way anymore. So I think it's important to have these exercises that I lay out to help you find your way back to that. To go back to a time when you felt as if things were lighting you up again. And for some, they can't remember it.
A
So. Yeah, I don't.
B
I don't. Yeah. So doing the exercises. Let's try to go back to a time when you felt physically or spiritually full. If you could think about a time, Christy, like your earliest memory, when you felt spiritually full and fed.
A
I don't.
B
How old were you when your mom left?
A
She left around 12ish. But I think I started erasing things probably closer to 9, 10.
B
So let's go back to maybe 6 or 7.
A
Yeah.
B
That's a first grade, right? Yeah, I guess.
A
And I kind of only know by how Luna is because we're so much alike. So when I see what she's like right now, I can only imagine what I was like. And. And it meant that I was awesome, honestly.
B
Did you have a favorite pair of shoes?
A
She was awesome. And, yeah. I had a dress that I loved so much. My dad went to Tijuana and he had a. He would bring me back off the shoulder a dress from Mexico and describe it for me. I wore it. I just wore it every day for weeks. And I'm only remembering this because we just got back from spring break in Mexico and I bought Luna.
B
It's okay. Take your time.
A
And all the kids like similar outfits. And so now thinking of why I did that without even knowing. But yeah, my dad growing up was great, and he worked a lot out of town for as much as I don't remember when I remember something like that, that's so nothing. It's a big deal. And that's why I'm emotional. Sorry.
B
That's okay. You don't have to apologize. But what I would do with my patients is a similar exercise. If they can't remember, sometimes we bring in something called a transitional object. So it's a picture usually, or a teddy bear or some trinket from childhood.
A
And then you can talk all about it all the time, and then you can go back.
B
So if you were my client, I'd look at that picture of you wearing the off the shoulder dress from Tijuana and go through the emotions if you were to put yourself back in that place. What did that little girl feel when she was wearing that dress? And that little girl probably felt excitement, creativity, joy from the colors. Because that little girl values the arts and fashion and feeling proud when wearing something that makes her feel good about herself. These are all values that many of us forget. And then we wonder how we end up in fields like fashion. Right?
A
I know.
B
Because it was always a part of our values. We just forgot it because our memories got pushed down. But these simple exercises, they're so simple. But when you're working with someone that you trust, it allows you to access that again to get that playful joy. And you're like, oh, my gosh, no wonder I love to do this with my daughter. No wonder this triggered this memory, because that was a point where I really felt full and fed, because I felt like my dad was coming and I had something to look forward to and I could celebrate myself. And it made me feel warm and fuzzy.
A
It frustrates me that my therapist doesn't. I just met you, and you sat down here, and I got to read your book. I got to see myself and understand myself. So I really hope that through this conversation, people can maybe go advocate for themselves and tell their therapist there's a specific thing that would work for them. Because I'm not that person, I don't speak up ever. For the past few months, I've felt very inside my own body and haven't been able to release. So if anyone else out there listening is able to get some release just from listening to you, I think we've done our job here. It's really awesome.
B
That experience of not feeling connected to your body is, again, one of the symptoms of trauma. It's a depersonalization feeling like you're floating above yourself. Sometimes you're there, but you're not there.
A
Oh. I've never, ever felt connected to my body, which is why I could always be so bad to it. I could do drugs. I could lend it out sexually like nothing. Just never felt like it was my own and just had no pride in it. And the same went for my emotions. I just took on whatever other people's emotions were. I had to always walk on eggshells as a kid because I didn't know if someone was gonna overreact or be mad. I never could gauge what mood anybody was ever gonna be in. So I just learned to really adapt to how they were Feeling. And I think that's why now I can't have my own feelings, is cause I'm like, are you good? Are you happy? Then I'm happy too. If you're warm, I'm warm. If you're chilly, I'm chilly. I always saw that as a trait of me being so easygoing, and it was something that I thought was cool about me. And now I'm actually seeing how sad it is.
B
Well, over time, people will take. If you're a giver, they'll take yes. And it's not that they're bad. It's just human nature. We are built to interact with people and to fall into these patterns. And if you keep putting yourself out there and you don't set boundaries, you will eventually be surrounded by takers. That's just the nature of. Of the beast of being a human being, you know? But what you're describing about not feeling connected and valuing your body, it takes us right into the vital section of the 5 Vs. The 4th V is knowing your body and saying to yourself that I am worth it. There's only one me. Think about that. There will only be one you. And the chances of you existing are so small. So you are here for a reason.
A
Okay, so let's go through my trauma inventory. What exactly are you trying to uncover?
B
So the reason that it's important to reflect on childhood trauma, adult trauma, and collective trauma is because sometimes we don't even realize how these events impact us and shape us in terms of how we see ourselves and how we interact with others in the world and with trauma. Usually, people pay a lot of attention to childhood trauma because the thought was that only these early childhood events shape you. But we're learning now that the brain changes throughout your lifetime because of something called neuroplasticity. So it's important to also acknowledge things that happen in your adulthood and that have happened to generations before you, because even, like, intergenerational trauma and collective traumas can shape you. So we're gonna go through this inventory.
A
I'm so ready. I love stuff like this, actually, because it validates.
B
It does. Yes.
A
Very good.
B
And so it's a yes or no. So I'll start with childhood trauma. So in your childhood, did you feel unsafe in your neighborhood growing up?
A
Yes.
B
In your childhood, were you bullied by a pair prior to the age of 18?
A
Yes.
B
In your childhood, have you seen anyone being beaten, stabbed, or shot in real life?
A
No. Or. I don't know if this counts, but as a. I think everyone remembers There were websites that just went online and they were incredibly violent. And. Yeah, I saw beheadings. I saw train accidents. I saw everything. And it's. Yeah. So does that count?
B
It does. That's a vicarious trauma when you see it happen to someone else. Okay. And thank you for pointing that out. In your childhood, did your caretakers fail to make you feel important or special?
A
Yes.
B
Yes. In your childhood, did your family cut the sizes of meals or skip meals because there was not enough money in the food budget for a significant period of time?
A
No.
B
In your childhood, did you live with anyone who was depressed or mentally ill?
A
Yes.
B
In your childhood, did you live with someone who was suicidal?
A
No.
B
In your childhood, did you live with anyone who was a problem drinker or had a problem with alcohol?
A
Yes.
B
In your childhood, did you live with anyone who used illicit drugs or abused prescription medications? Sorry.
A
I was like, I wish I could. No. I wish they took prescription medications. Sorry. That's okay. No, sorry. I'm. The trauma comes from below. Sorry.
B
Okay, well, laughing is a coping mechanism, so don't apologize.
A
I mean, I wish they did.
B
Yeah. In your childhood, did you live with anyone who served time or was sentenced to serve time in prison, jail, or another correctional facility?
A
No.
B
In your childhood, were you ever in foster care?
A
No.
B
In your childhood, did you ever see or hear a parent, a stepparent, or another adult who was helping to raise you being yelled at, screamed at, sworn at, insulted or humiliated it?
A
Yes.
B
In your childhood, did you ever see or hear, in your home, a parent, a step parent, or another adult who was helping raise you being slapped, kicked, punched or beaten up?
A
No.
B
In your childhood, did you ever see or hear a parent, a step parent, or another adult who was helping to raise you being hit or cut with an object, such as a stick or cane, bottle, club, knife or gun?
A
No.
B
In your childhood, did you ever have a parent, a step parent, or any other adult living in the home swear at you, insult you, or put you down?
A
Yes.
B
In your childhood, did you ever have a parent, a stepparent, or another adult living in the home hit you so hard you had marks or you were injured?
A
No.
B
In your childhood, did you ever have an adult or older relative, family friend or stranger who was at least five years older than you touch you in a way that made you feel uncomfortable or was inappropriate in a sexual way? Okay.
A
Yes.
B
I'm sorry to hear that. In your childhood, did you ever have an adult or an older relative, family friend or stranger who was at least five years older than you ever attempt to have or have any type of inappropriate intercourse with you?
A
Sorry, how is that different from the last one?
B
Just touching one is touching and the other one is. Yeah, that.
A
Yes.
B
I'm sorry to hear that.
A
Okay.
B
In your childhood, were your parents ever separated or divorced?
A
Yes.
B
And in your childhood, were you diagnosed with a serious medical condition or life threatening injury?
A
No.
B
In your childhood, did you ever experience significant discrimination because of your sexual identity, gender identity or gender expression?
A
No, not gender. Race is like. No. Okay.
B
Race is important. And, and, and this is, and please just take a time to just collect yourself and have tissue.
A
Sometimes I'm like, who hasn't?
B
Like that response of who hasn't is something that's really common in childhood trauma. It's like, well, this happens to everyone. No, you deserved to have a childhood without pain and without trauma and feeling safe. Every child deserves that.
A
I do feel like it's. I just feel like, you know, you hear so many stories, so you're like one. What's wrong with men? I don't know many girls that could answer no to a lot of those questions. That's sad.
B
Unfortunately, the data shows that it's very common and many of us don't talk about it out of shame and self blame. I'm going to stop there because I just want people to realize that trauma extends beyond childhood adults. When I. When you look at the questionnaire and you go through adulthood traumas, you'll see these same questions get asked in adulthood. Because some people live with others who have severe mental health issues, who indulge in substances, who physically harm them and violate them. This happens throughout adulthood too, and it shapes you. And when people can identify that these things happen to them, that it's not their fault, then they can take the steps necessary to healing because it's not their fault. They should feel safe. Everyone deserves to be safe. Everyone deserves to be respected and loved.
A
I think a big part for me is like one of the moments that sticks out the most from it was literally being told like you seemed like you wanted it, you didn't stop it. So it wasn't just that it happened, but like it was just like beaten into me that I didn't do anything to stop it. Yeah, that doesn't help.
B
There's something called the just world theory. And the hypothesis is that for many of us as human beings, when we hear bad news and bad things happening to people, our automatic thought is, well, they must have done something right. So bad things happen to bad people, good things happen to good people, and it's Our brain's way of saying this is how we can control a bad outcome. If we can say that only bad things happen to bad people, then it's somehow in our control that if we just be good, only good things will happen. That hypothesis is important to acknowledge because bad things happen to good people all the time. But our immediate reaction as humans is to blame, right to victim blame.
A
What were they wearing? What were they doing? Were they drunk? Were they.
B
Yeah, why were they there in the first place? You know? And it's important for people to know that this self blame leads you to not want to seek help, leads you to never talk about it, leads you to push it down, to busy yourself, to hide behind a mask. But the science shows us that we need to talk about trauma. We need to validate the experience that happens to people so that they know that they're worthy of healing. And in the trauma inventory, when people fill it out, they'll see that there are other types of traumas, like the traumas that get passed down from generations. Did your parents not have much? Did your grandma not have much? Did they pass down these behaviors onto you, or you hoard, or you don't take risks? All of those things are important. The collective traumas that we all went through as a society with the pandemic, we don't even have a memorial, we don't even have a holiday to reflect on that. But that is still impacting many of us today. It's important to acknowledge that these bad things can happen to good people and you are worthy of love, healing, and respect.
A
It's hard because even I, the only way I know I was good was that I was so young. So that's what makes it. Or else I wouldn't honestly know. I'm worried that if I were like 15 or 16, I would have looked at the same scenario and been like, you were probably just a big slut and totally open to making someone feel like they could do this and blah, blah, blah. But the one thing I hold on to was that I was little and I, like, never could have imagined it. And I think one thing that sucks for me and for so many people that are probably listening is that experience, which I'll just be honest and say, like, it was my best friend's father. That experience, it's what made me a sexual being. Like, it's what started it. So, like, this happened to me. I went off that same weekend maybe, and was like, what's gonna make me feel less gross about this? And it would probably be hooking up with someone in the vicinity of my own age. So it, like, catapulted this, like, one circumstance, this thing that could have just been, like, maybe like, never forgotten about, never talked about, at least into this whole whirlwind of sexuality that I was not ready for. And I think that's why it's so impactful to me. I almost feel like if it were just this circumstance. I've had a ton of those. I have a ton that I don't think about so much. But I think about this one. Not only because it was like the first time I'd ever known that something down there was for use by other people, but the flood of what happened in direct connection because of it happening, that pisses me the fuck off. That one 10 minutes, whatever, or weekend away fucked up the next. I was gonna say five years, but I could do the math. Subtracting me about to be 40 right now.
B
So, yeah, it's important for you to.
A
Protect me for forever from good men. I can't. Even someone that I love so much can't touch me on my upper inner thigh without me thinking about his.
B
Fine. No, that. Take the time you need.
A
He fucked me. He fucking fucked me to where I can't even accept pleasure or think that I'm worthy of it. He fucked me. And I never really said that. So sorry.
B
No, please.
A
Sorry.
B
There's no need to apologize.
A
No, I'm mad at him for fucking John, for screwing him over. For screwing over any wonderful boyfriends I had. I had a lot. I don't think these people have any idea what they do. And it's just like. I don't know. I'm sorry. It's just. I'm mad at him for screwing someone over. As awesome as John is, as awesome as I could have been, as positive, and like, God, I would have been unstoppable.
B
Well, you have that insight where you're able to say a lot of the behaviors subsequent to that. Me putting myself seemingly in these situations where I'm replaying it. That is very common as a trauma response. But how people view it is they'll say, well, if it was so bad, why did they end up doing this again? Right, Again. There are like 30 plus symptoms of trauma. And one of the things that humans do is they'll put themselves back in the dangerous situation. It's called risk taking behavior in an effort to control the outcome so that this time around, maybe it'll be different. I have control. Right. And it's so validating to me. Yeah, it's validating for anyone listening who's been like, oh, my gosh, that was me. And people blame me. And they said, well, if it was so bad, why did you end up doing this? This is why our human brains put us back in these situations, to try and change the outcome, to give us a control outcome. If I beat this one, if I'm in control, then I'm bigger than it. I got away. You hear people doing things like getting cars and riding fast, driving fast, and using a lot of drugs and risky behaviors, but it's their way of trying to control a dangerous and scary outcome. But knowing it and being able to reflect and say, this is why I did this. I'm not a bad person. Something bad happened to me. And this is what led to. This allows you to feel worthy of love, respect, protection, all the things that you're entitled to that were robbed of you when you were a child.
A
I remember hearing somebody say that, yes, something like that is traumatic, though, but. But a really big part of it also is how people reacted. Maybe if you opened up about it. I personally didn't open up about it. Do you think that. Do you think that it would have been as traumatizing for me at 40 if I had felt like I had a safe place to talk about it at the time?
B
Absolutely. The children that I've worked with who have had similar things happen to them, this is what we know is true. If after an event like this, you're told it's not your fault, that you're removed and you feel safe and you have a routine again where you know what to expect that gives you the best outcome. Yes. And therapy as well. All of those basic things. Feeling safe, knowing it's not your fault, and knowing what to expect and being loved unconditionally and fully accepted, Those are all things that heal you.
A
Okay. It gives me hope for my daughter. Like, I lose it when I have to talk about what she's gonna experience and go through. And hopefully you just wanna be. You have the daughter the same age. You wanna be their. And now for the toolkit. Each episode, our guests distill their expertise into practical and actionable insights. Today, Dr. Judith will lead us through a series of exercises designed to help us release our trauma and access joy.
B
Okay. So, Chrissy, I would be honored if you would help me with my experiments and if you would join me as a visiting professor of the happiness lab. So this is your white coat ceremony. Well, I find it really helpful to demonstrate some of these five Es using visionary things or imagery. Because not everyone learns by listening. Reading. Some people learn by seeing. And it really solidifies the idea of these principles. So I'm gonna walk you through the 5 Vs. The first one we did.
A
Am I gonna cry again? You poor thing. You've just had to look into my crying eyes this whole time.
B
Okay, that's okay, because that's one of the V's is venting. So we'll start with just explaining why it's important to have these five Vs, because we need tools to guide us through change. And when you think of the 5Vs, think about the science of your happiness. There's something called the biopsychosocial model that most of us learn in medical school, but I wanted to make it available to everyone. So, biologically, what are the things in your life that lead to making it hard to access joy that are physical? For example, I have a low thyroid. And so if I don't take care of my thyroid, I'm not gonna be as happy or I'm gonna be very anxious. But other people have different medical issues. Some people have hormonal issues. People have things like asthma and so forth or things that run in their family. So biologically, what are the things that are pulling away from your joy? Psychologically, what are the things that you have in your past, like your past traumas, attachment trauma, physical traumas and so forth, or other conditions like ADHD and so forth? What are the things that get in your way? For me, I come from a history of scarcity, so not having much as a young child led to me wanting to work so hard, and it's never enough. So I have to unpack that and acknowledge that. And then socially, what's happening in your surroundings? Do you have access to nature? Do you have healthy relationships? Are you engaging in healthy habits like getting movement, eating foods that are healthy for you, or are you engaging in things that are toxic or with toxic people? So the biopsychosocial is important for everyone because in the way that we all have our own fingerprint, we all have our own biopsychosocial, and they're all unique. Using the technique in my book to draw out your biopsychosocial, you understand where you can actually add joy back to areas that are losing points of joy.
A
That's amazing. And it's so real for intangible, for people to see. I really like that.
B
And it's validating, which goes to the first V validation. So this is accepting and acknowledging how you feel and what has happened to you. And so people who are listening. Just close your eyes and think of something that's happened to you that you never told anyone and say to yourself.
A
Oh, I don't know, I tell everyone.
B
Or something that you've only told a few people. Okay, just say to yourself in your mind that this happened to me, it was not my fault, and I am worthy of. Of love and joy. Okay, now open your eyes. That was self validation venting. This is one that a lot of people, sometimes they think they're venting healthily, but they're trauma dumping, right? So say out loud one emotion that you had today. Just say it out loud.
A
Annoyance.
B
Okay, there you go. You said it. Now when you say things like this, you can solve that like you did. You can write in a journal, you can pray, you can sing. It's really important that if you choose to vent to someone who is not your therapist, to make sure you ask for emotional consent. So if you want to ask someone, okay, I have something to say to you, but are you in a place to hear it right now? Is it okay? And that's important because if you're just venting, that is really trauma dumping. You're not using empathy and you're not going to get as much out of it. And if you're venting without intention, you may actually be making yourself feel worse. And some of the studies and the research will show that it's like pouring gas onto a fire. So vent with intention. Vent with emotional consent. Sometimes you can salt vent, right, like we just did just now. Values. This is a really fun exercise. So you see right here we have a little experiment. I want you to look at the stones and I want you to describe what the words on the stones are.
A
Serenity, feeling at peace, gratitude, joy, faith, wisdom, family, love, healing.
B
And go ahead and pick up four of those stones that represent things that give you meaning and purpose. So these are things that are priceless. Not with price tags.
A
Oh, yeah. Love, love, family. Either healing or joy. I feel like joy's obvious, so I'm gonna do healing.
B
And I love how I saw some stones that are already here outside. Yeah, and then you're already practicing this. You didn't even know, right?
A
I know my kids wrote those ones.
B
So I love it. And stones are important. I'm gonna pick up gratitude and faith and joy because I run a happiness lab. That's important for me. The reason that I ask my clients to keep these stones and rocks that have these meaningful words on them is that sometimes we get so lost and we get so busy we end up feeling empty and we don't know how to hold onto these things. So these represent things that anchor us and help us to feel full and fed spiritually. Right.
A
So I'm holding three stones. The first one I chose was family. It felt very obvious, love. And then I went back and forth, but I ended up grabbing healing over joy.
B
That's really deep because it's really hard to access joy without healing, you know? And so what I want you to do, I'm going to demonstrate something for you. I'm holding this beaker of water, and I want you to put your stones into the beaker of water and say them out loud as you're putting them in.
A
Healing, love and family.
B
Now you can see them clearly, right? You can see the words.
A
Yeah.
B
So I'm going to show you what happens when we don't tap into the things that give us meaning and purpose and we get distracted by the things that are with price tags versus priceless. I'm dropping this colorful dye into this water. And what you'll notice is that as I stir this, it's really hard to see those words. Right. We're losing sight of family, healing and love. Can't see them anymore. We got distracted. And when we start to tap into the 5Vs and we start to anchor on what's really important, I'm going to pour this other solution in. And over time, what you'll notice as we stir this is that the water starts to clear. And it takes time, but we'll start to see those words again. I'm going to sit this down so they'll let the scientific solution work and we'll go through the other V's as we let that rest.
A
I've seen that I've added that color a lot in life.
B
And as that is simmering, what we'll do is work on the other V's. So the fourth V is vitals. Something I tell my 8 year old every day is, you know, since she was 2, I'd ask her, how many bodies did God give you? And she'll say, one, Mommy. And I'll say, what do you got to do with it? She'll say, I got to take care of it. You know, we only get one body and brain and we sometimes forget that we have to really take care of our vitals. So there's something called V breathing where you can just slowly take a deep breath in through your nose and out through your mouth one more time. In, out through your mouth and then out through your mouth. Adults really like doing that, it really allows you to stay centered, and it calms that fight or flight naturally. There's a reason that we can tell our lungs to hold the breath, but we can't tell our heart to stop beating. So I want you to. To plant your feet on the floor and put your hands on your lap, close your eyes, and take a slow breath in through your nose, but an even slower exhale through your mouth. And we'll do that three times. Let's start with one. In through your nose and out through your mouth. Again. In through your nose, out through your mouth. In through your nose, out through your mouth.
A
Up.
B
And what that you can open your eyes. What that does is it calms you naturally or fight orf flight. So you can access your joy and focus on being present. And let's check on our potion here. Yes. Our solution. Can you see those words?
A
I can.
B
What do they say?
A
Healing, family and love.
B
Yes.
A
Yeah.
B
When you're intentional about giving priority to things that give you meaning and purpose and not getting distracted by those other things that are with price tags. You can anchor yourself on those rocks and feel connected and grounded in purpose. And the last V after vitals is vision, planning, joy, and celebrating your wins. So I want you to. To celebrate your win to. What's one thing that you're gonna acknowledge and celebrate?
A
I have so many questions. I'm like, what exact? Like what? Like a today or today?
B
Okay, what's one thing that you can celebrate? Today.
A
Should be easier.
B
Just one thing from our interaction together. How about that?
A
I got to open up and cry.
B
That is a win. A huge win.
A
Yeah.
B
Huge win. It took you some time, though. Yeah. You gotta practice it. And for those who are listening, I want you to thank yourself because you didn't have to listen. You didn't have to invest in being curious about the signs of your happiness. But you did. You did that today and celebrate that and then share it with someone else. Tell someone else about what you learned today. Spread that joy. Because joy is contagious in the same way that anhedonia is. A lack of joy is contagious. Joy is contagious. So share that with someone today and celebrate your win.
A
Thank you for doing what you're doing.
B
Thank you.
A
You're helping so many people.
B
You are, too. Thank you.
A
Oh, my gosh. Dr. Judith, thank you so much for being here. This is really going to help so many people. I feel so much lighter despite the topics that we tackled. I just feel so much wholeness and joy, and I cannot wait for people to listen to this and read your book because for me this was a completely life changing hour. So thank you so much for being here.
B
Thank you so much for being so brave and so generous with your experiences and sharing so much of yourself. You are such a light and trust me, you have impacted me as well. So the feeling is very mutual.
A
Dr. Judith, I want to thank you so much for joining me on Self Conscious. High functioning by Dr. Judith Joseph is available on Audible. Until then, tune in, turn on and feel better. This is Chrissy Teigen and you've been listening to Self Conscious, an Audible Original podcast. This has been an Audible original produced by Audible and Huntley Productions hosted by Chrissy Teigen Written and directed by Jimmy Jelly Executive Producers Jimmy Jelinek Chrissy Teigen Executive Producer for Audible Stacy Creamer Head of Creative Development at Audible Kate Navin Chief Content Officer Rachel Giazza Copyright 2024 by Audible Originals, LLC Sound Recording Copyright 2024 by Audible Original SA.
Episode: Dr. Judith Joseph: Childhood Trauma and How to Recognize High-Functioning Depression
Host: Chrissy Teigen
Guest: Dr. Judith Joseph
Date: October 16, 2025
This emotionally charged episode of Self-Conscious with Chrissy Teigen delves into the complex realities of high-functioning depression and the persistent impact of childhood and smaller, everyday traumas. Joined by psychiatrist, researcher, and author Dr. Judith Joseph, Chrissy shares her personal experiences in an open, cathartic dialogue that puts words to the invisible pain many experience, but few recognize or name. Through candid conversation, Dr. Judith provides pathways for understanding, validating, and healing from emotional wounds—big and small—with tools to help listeners reclaim their joy.
What is High-Functioning Depression?
Dr. Judith defines it as depression that hides behind “full calendars, flawless to-do lists, and the phrase ‘I’m fine.’” People often look outwardly successful and productive, all while internally feeling numb, lacking motivation, and unable to access joy.
Naming the Pain ("Affect Labeling")
She explains that simply having a term for what you’re experiencing is deeply therapeutic. Naming your feelings or condition can bring a sense of relief.
Dr. Judith introduces her "5 Vs," a practical framework for restoring joy and beginning healing:
The conversation is intimate, emotional, and validating, with both women speaking candidly about pain, numbness, and the messy journey of feeling again after trauma. Dr. Judith brings warmth, deep expertise, and actionable knowledge, creating a space where both Chrissy and listeners can access difficult truths and begin pathways to healing.
Dr. Judith and Chrissy’s dialogue is a moving testament to the silent struggles many endure. By giving language to hidden pain and offering science-backed, practical strategies, the episode serves as both a validation and a road map for those seeking to feel whole again.
Resources:
High-Functioning: Unlock your hidden depression and reclaim your joy by Dr. Judith Joseph (Available on Audible)