The High-Functioning Trap: When Success Still Isn't Enough

Podcast: The Dan Buettner Podcast
Guest: Dr. Judith Joseph (Board Certified Psychiatrist, Founder of the Manhattan Mind Health and Wellness Center)
Host: Dan Buettner
Date: February 12, 2026

Episode Overview

In this episode, Dan Buettner speaks with Dr. Judith Joseph, a leading psychiatrist and researcher, about a silent epidemic of "high functioning depression" among high achievers. Together, they explore why many outwardly successful people feel empty or joyless, the biological and social drivers behind this state, and actionable strategies to reclaim genuine joy and happiness in daily life. The discussion also bridges connections to longevity—Dan’s area of expertise—emphasizing how joy and happiness are not just luxuries but central to living longer and more fulfilling lives.

Key Discussion Points

Dr. Joseph's Background & Personal Experience

• [03:51] Dr. Joseph describes her upbringing with Caribbean parents and the pressure to achieve traditional success. She originally wanted to be a writer, but expectations led her to medicine.
  • "There's this expectation that you delay happiness. And for me, it was really having all of the things on the outside that check the boxes and I should be happy, and I wasn't." – Dr. Judith Joseph ([04:23])
• [07:10] Her first realization of experiencing high functioning depression herself hit during the pandemic while giving a talk—though outwardly successful (awards, recognition), she felt "empty" and "meh" inside.

Defining High Functioning Depression

• [05:51, 08:40] High functioning depression is not formally recognized in standard psychiatric manuals. It’s characterized by meeting the criteria for depression (low mood, anhedonia—lack of joy, sleep or appetite changes, guilt), but without obvious external impairment or distress. These individuals often "over-function."
  • "I call anhedonia the joy thief. It robs you of your joy, kind of like in the middle of the night, right? Sneaks up on you." – Dr. Judith Joseph ([07:35])
• [09:29] Main symptom is elevated "anhedonia"—people can check the boxes of success yet feel inner emptiness.

Why Is High Functioning Depression on the Rise?

• [10:30] Dr. Joseph points to environmental and social factors:
  • Technology keeps us constantly connected to information and work; it’s hard to “switch off.”
  • Diet: More processed and less nutritious food impacts brain health.
  • Collective, unprocessed traumas like the COVID-19 pandemic leave people in chronic stress.
  • Reduced genuine social connection and movement.
  • "If you haven't processed that trauma, and if you're constantly in this fight or flight, things haven't really healed." – Dr. Judith Joseph ([12:24])
• [13:08] Research shows that being in the top 10% for happiness/subjective well-being adds around six years to life expectancy.

Biological Factors & The “Diet of Joy”

• [14:14] Gut health is vital; most precursors to mood hormones (serotonin, oxytocin) are in the gut, and require fiber—90% of Americans don’t get enough.
• [15:47] Diet recommendations for happiness:
  • Leafy greens, berries, fatty fish, beans, fiber-rich foods—essential nutrients for brain health, reflecting Mediterranean and global traditional diets.
  • “If you're not getting foods that are rich in vitamins and you're deficient, you can have unhappiness. It's not just serotonin.” – Dr. Judith Joseph ([14:38])

Signs and Symptoms

• [16:44] Dr. Joseph’s "Seven Signs of High Functioning Depression" include:

  • Persistent lack of joy despite achievement (anhedonia).
  • Lack of energy/motivation, chronic guilt, reluctance to ask for help.
  • Exhaustion unrelieved by sleep (“yucky sleep”).
  • Disconnection from internal experiences of joy.

• Happiness is often externally defined ("when X happens, I'll be happy"); real sustainable happiness comes from intentional, everyday, internal moments of joy.

Measuring and Reclaiming Joy

• [22:38] Happiness can be measured as “life satisfaction” (big-picture evaluation) vs. “positive affect” (day-to-day joy).

• [24:45] Accessing joy is difficult when under chronic stress. Dr. Joseph recommends the "biopsychosocial model" to map where you’re losing joy:

  • Biology: Physical health, chronic illness, medication.
  • Psychological: Past trauma, attachment, thought patterns.
  • Social: Work-life balance, relationships, social habits.

• [32:33] "Everyone should have access to their biopsychosocial. … If you strategically think about it, you can add back your joy in different angles versus it being linear." – Dr. Judith Joseph

Practical Advice & The Five Vs

Starting point for listeners:

• Understand where you are losing joy (biopsychosocial inventory/self-assessment).

The Five Vs For Mental Wellness ([39:17])

1. Validation:
   • Acknowledge and accept feelings without judgment.
   • "If you don't acknowledge your emotions and process your pain, it's really hard to access joy too. You just feel like numb and empty." – Dr. Judith Joseph ([40:08])
2. Venting:
   • Express emotions in a healthy way (talking with someone reciprocal, journaling, prayer, artistic expression).
   • "If you're not venting and expressing your emotions, it can pop up in your relationships, in your health, in ways you can't control." – Dr. Judith Joseph ([42:58])
3. Values:
   • Reconnect with what truly matters to you. Often lost in the pursuit of external success.
   • Listing out and revisiting core values can boost a sense of purpose and happiness.
4. Vitals:
   • Take care of body/brain—sleep, movement, nutrition, tech boundaries.
   • Non-traditional vitals: Limit phone/screen time for mental reset (studies show happiness scores can rise as much as with antidepressants).
   • "They were getting more time outside... actually savoring their food. Points of joy." – Dr. Judith Joseph ([47:19])
5. Vision:
   • Plan for joy in the future and celebrate small wins—not just grand achievements.
   • Savoring moments connects achievement to lasting joy.

When (and If) Medication Is Appropriate

• [31:00] Medication is only recommended for those meeting full criteria for clinical depression. High functioning depression is best approached with non-pharmacological interventions unless coexisting clinical depression is diagnosed.

How to Start if You Suspect High Functioning Depression

• [38:27] 1. Map out where you're losing joy (biopsychosocial model).
• [39:17] 2. Begin to apply the Five Vs: validation, venting, values, vitals, vision.
• Seek professional help if suspected clinical depression or safety issues.

Notable Quotes & Memorable Moments

• “I call anhedonia the joy thief. It robs you of your joy, kind of like in the middle of the night, right? Sneaks up on you.” — Dr. Judith Joseph ([07:35])

• “If you're not getting foods that are rich in vitamins and you're deficient, you can have unhappiness. ... Your brain, the neurons aren't connecting enough, you know, and so thinking about what you put into your body is not just something just to feel healthy. It's actually important for feeling happier too.” — Dr. Judith Joseph ([14:38])

• “If you're doing what you love, you're working hard, you're productive, and you're feeling joy, that's great… but a lot of us, we do so much. ... We're not accessing joy.” — Dr. Judith Joseph ([16:54])

• “There’s only one you… we're not understanding our own happiness. We're not understanding where we're actually losing our own joy.” — Dr. Judith Joseph ([33:06])

• "If it was as easy as a pill, we'd all be on a pill. There'd be no depression." — Dr. Judith Joseph ([34:35])

• "Don't just, well, yeah, I know my value. Well, what are they? ... Get it down on a piece of paper, an empty screen, and better imprinted on your daily life." — Dan Buettner ([44:53])

Important Timestamps

• 03:33–04:23: Dr. Joseph’s upbringing and the roots of high functioning depression
• 07:10–08:19: Her personal “aha” moment and initial research focus
• 10:30–13:29: Environmental causes and importance of joy for longevity
• 15:47–16:44: The “diet of joy” and the role of nutrition
• 16:44–19:38: Seven Signs of High Functioning Depression
• 22:38–24:35: Measuring happiness: satisfaction vs. daily experience
• 24:45–32:59: The Biopsychosocial Model; mapping and reclaiming joy
• 27:16–28:36: Trauma—big T and little t—and its impact on joy
• 38:27–39:17: First steps for listeners feeling depressed
• 39:17–48:43: The Five Vs: Validation, Venting, Values, Vitals, Vision
• 47:19–48:18: Technology’s impact on happiness; planning for future joy

Key Takeaways for Listeners

• High functioning depression is increasingly common among high achievers—external success does not guarantee inner joy.
• Genuine, sustainable happiness comes from repeated, intentional, internal moments—micro-joys—not from ticking off major life goals.
• Nutrition, sleep, movement, meaningful social connection, and boundaries with technology are vital for both happiness and longevity.
• The "biopsychosocial model" is a powerful, practical tool to self-diagnose and strategize personal paths to joy.
• Try Dr. Judith Joseph’s Five Vs: Validate feelings, Vent emotions, align with Values, mind your Vitals, and create Vision for future happiness.
• There’s no one-size-fits-all solution; reclaiming joy is an ongoing, individualized process, not a quick fix.
• Seek professional help if symptoms are severe, persistent, or include thoughts of self-harm.

Connect with Dr. Judith Joseph

• Website & Socials: DrJudithJoseph.com | @DrJudithJoseph

"Thank you for pointing out the fact that many of us are high functioning, but not getting all the joy we should out of life." – Dan Buettner ([49:22])

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