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Ed Mylett
So hey guys, listen. We're all trying to get more productive and the question is, how do you find a way to get an edge? I'm a big believer that if you're getting mentoring or you're in an environment that causes growth, a growth based environment, that you're much more likely to grow and you're going to grow faster. And that's why I love Growth Day. Growth Day is an app that my friend Brendan Burchard has created that I'm a big fan of. Write this down growthday.com forward/ed. So if you want to be more productive, by the way, he's asked me, I post videos in there every single Monday that gets your day off to the right start. Got about $5,000, $10,000 worth of courses that are in there that come with the app. Also, some of the top influencers in the world are all posting content in there on a regular basis, like having the avengers of personal development and business in one app. And I'm honored that he asked me to be a part of it as well and contribute on a weekly basis. And I do. So go over there and get signed up. You're going to get a free tuition, free voucher to go to an event with Brendan and myself and a bunch of other influencers as well. So you get a free event out of it also. So go to growthday.com forward/ed. That's growthday.com ed@ Lowe's Pro Save big on the supplies you need to get the job done with the new Milo's Pro Rewards program. Get member only deals every week and access to free standard shipping. Plus members earn points toward exclusive rewards. Join for free today. Lowe's we help you save. Points are awarded on eligible purchases. Programs subject to terms and conditions. Free standard shipping not available in Alaska and Hawaii. Exclusions and more terms apply. Details@lowe's.com Terms subject to change. Don't miss your chance to spring into deals at Lowes. Right now, get a free 60 volt Toro battery when you purchase a select 60 volt Toro electric mower. Plus buy three 19.3 ounce vegetable and herb Bonnie plants for just $10. It's time to give your yard a grow up. Lowe's we help you Save. Valid through 423. Selection varies by location while supplies last. Discount taken at time of purchase. Actual plant size and selection varies by location. Excludes Alaska and Hawaii. This is the Ed Mylett show. All right, welcome back to the show everybody. So I'm so grateful that this woman has written this book because. Because it's a topic I've not heard covered on any podcast before. And it's something I'm not so sure I don't live myself. And I think it's something that could change your life today. I don't open up every show by saying that, but today's going to be one you remember and it's certainly be one you think about. My guest is a Columbia trained psychiatrist. She's the founder of the Manhattan Behavioral Medicine, which is New York's premier clinical research site. But here's why she's here today. I believe that there are high functioning depressed people. And she has a book that was sent my way there. Right when I saw it, I said, I want to talk to her about this because nobody talks about it. It's almost like this quiet epidemic in the world. And so her book is called High functioning. Overcome your hidden depression and reclaim your joy. This should be a good one, especially for me. And you get to listen in. So. Dr. Judith Joseph, welcome to the show. Good to have you.
Dr. Judith Joseph
Thank you for having me, Ed. It's wonderful to be here.
Ed Mylett
Yeah. Well, let's talk about this. What the heck is HFD and what are some of the hidden signs of it? Just so someone listening may know somebody or even themselves be suffering from this and maybe not even realize it.
Dr. Judith Joseph
You know, I love talking about high functioning depression because I don't think people understand the science of happiness. And in order to understand the science of your happiness, you need to understand the science of what makes you sad, what makes you depressed. Right? There's only ever going to be one you one. Ed, in the future of the universe and in the past, there's only going to be ever one. Judith. Ever think about how powerful that is? And when you're listening to this, if you're listening to this at home, there's only one you so understand the science of your happiness. When you use skills. When you read books and you feel as if you know things aren't changing, it's because you don't know what the science of your happiness is. And when you understand that, then you can use the skills properly. So I'll jump in by saying when I first started studying high functioning depression, people were like, well, that's not a thing. You know, clinical depression is a real thing, right? Because it's in the DSM 5, which is the bible of psychiatry. But what I was seeing was that I was using the DSM, you know, after 2020 and seeing patients and interviewing them and they had symptoms of depression, you know, poor sleep, something called anhedonia, which is a lack of pleasure and joy in life, you know, feeling tired, you know, not enjoying situations, you know, maybe sometimes having problems with concentration. But when you get to the bottom of the checklist where you're supposed to not have functioning or you're supposed to be in great distress, they weren't checking those boxes. And when they were going to see doctors, the doctors were saying, well, come back when. When you break down, come back when you're not functioning well. What type of a broken model is that? And I know you know about longevity science, and you see what's happening, this renaissance in physical health where people are preventing disease, they're preventing cancer, they're preventing heart attack, they're preventing things like, you know, osteoporosis with menopause treatments and so forth. But we're not preventing mental health breakdown. In fact, we are waiting for people to lose functioning, to give them the stamp of clinical depression because you lost functioning. And. And then we do something which is a broken model. Since 2020, the rates of anxiety, depression, mental health conditions are just skyrocketing. But we're waiting for them to break down before we do something about it. As a researcher and a therapist and psychiatrist, I think that we need to intervene before they break down so that we can prevent this crisis that we're seeing unfolding.
Ed Mylett
You said you have to know what makes you sad, right? What does make you sad? What are those markers? What are those things? Because we're going to get to this anhedonia thing in a minute. Anything I've read in probably a year, the term stood out. I'd never heard it before I started to Google how to correctly pronounce it, what is it, etc. Etc. We're going to get there in a second, and I think that'll be a real centerpiece and an enlightening piece for so many people. But first of all, you said you got to know what makes you sad. What. What does make you sad?
Dr. Judith Joseph
There's a really cool model in medical school, and I. I just. I wish. I wish everyone had this model. So I wanted to democratize it. It's the biopsychosocial model. So when you look at it, it's a Venn diagram. So I'll use myself as an example. Biologically, I have low thyroid, so that could play into the science of my sadness and happiness. Biologically, I'm currently in perimenopause, right? So I have to think about the way that my Hormones may be fluctuating that impact my mood. But someone else, you know, like you, you're not going to be in perimenopause. You're a man, right? But you may have medical conditions that play into it. Also, we have to think biologically about our past family history. You know, what things that our parents struggle with. Do they have hypertension, they have heart disease? Think about the biological risk factors, right? And then the psychology. Psychologically, what is your past trauma? What is your attachment style? Personally? You know, I came to this country when I was small, we didn't have much. So I have to think about my scarcity trauma at times and then, you know, my resiliency factors, iq, that all plays into the cycle psychology bucket. And then socially, you know, we were just chatting about how I live in New York and you live, you're in Florida right now. But socially, what are our, the things that play, you know, I'm in a city, I'm not in the country, I don't have access to nature, you know. Socially, what is my work life like? Do I have a stressful work environment? What are my relationships like? Because we know relationships are the number one productivity, the number one predictor of longevity. Socially, what are my habits? Am I getting good movement? Am I eating foods that are nutritious? Am I drinking too much alcohol? Right? Do I have too much tech exposure? Those, those are the social factors. Now this is the key, right? We each have a biopsychosocial, but all of our biopsychosocials are unique. And that's why this model is so important for understanding the science of what makes you sad. Because if we have unhealthy or risk factors in each bucket, then that's going to bring us down. But we can also use this model to know what we need to work on so that we can increase our points of joy.
Ed Mylett
See, I think this is so good. I actually wish this was a three hour interview today because if after the term was coined by you, which I'm sure you didn't coin it, but for me it is high functioning depressed, okay? Depression. I actually audibly out loud said I know more people suffering from this than I don't know people who aren't suffering from it. I'm around high functioning people probably like you are. And many of them I think struggle with this anhedonia, which is, as I understand it, I want everyone to lean in now, okay? And really ask yourself this. My understanding of it is basically, and I'll over summarize because I'm not a PhD is that you struggle or do not allow yourself to feel bliss or joy most of the time. If I'm accurate about that, describe it a little bit more and how someone listening may go, hang on a second here. I, I may have a bout of this or an awful lot of it. Why don't you talk about that a little bit?
Dr. Judith Joseph
If you imagine depression as having two sides, or let's say twin sisters, right? You know, they're fraternal because they're not identical in the way they look. We classically think of depression as weepy, not getting out of bed, sad. But this other sister, she is blunted. She's not getting joy out of life. She's with friends and she can't wait to go home. She's intimate with her partner, she can't wait for it to be over. She's eating her food and she's just shoving it in her mouth and not really savoring it. She's doing work, she's productive, but she's not getting purpose out of the work. Anhedonia is the silent twin, the sneaky twin that comes in the middle of the night and robs you of your joy. And that is the symptom that we see. And the interesting thing about people who are human doing instead of human beings is that they cope with pain and stress. Stress by over functioning, right? So when you think of the classic sister who's depressed and not getting out of bed, think of the sister who doesn't have joy, but to cope with this feeling that she can't understand, the anadonia, she's overworking. And then when she's still, she feels restless. When she's not busy, she feels empty. So what does she do? She keeps on going and doing. The problem with that is that if you're not able to process those emotions and to cope with it more adaptively, you're something's going to give. Either you're going to physically break down. You see a lot of people, you know, with autoimmune diseases, you see a lot of people with physical breakdowns, right? And where does, where is it stemming from? The mind body connection so real. If you're over functioning, overdoing, something's going to give. Either your body will break down, your relationships will suffer you, you may negatively cope by drinking too much or being on the screen excessively, you know, or you may dip into low functioning and have, you know, a mental or psychological breakdown eventually. So it's important to identify that people cope with trauma differently. Some stay in and stay in bed. And others deal with pain and psychological stress by over functioning, overdoing.
Ed Mylett
My dad was a alcoholic who got sober, and he was sober for 35 years and. But he wouldn't. I used to think, alcoholic, that's someone on the street. They can't eat, they can't bathe themselves. They had this picture of what a drug addict or alcoholic is. My father was high functioning, like many alcoholics and drug addicts are. And because he was high functioning, it delayed or put off entirely his ability to get help for it. Because he was, he maintained employment. Every once in a while. We had a healthy family interaction. Right. Time to time, things were good. And so when I read this, I'm thinking to myself, oh my gosh, it's so insidious because you are functioning. You aren't in the fetal position on the floor every single day and can't move. You may not be necessarily suicidal or have ideations. You, you just aren't feeling the emotions that you could or should be feeling. And so I'm wondering, does that inevitably mean he sort of went down this road that most of these folks. And by the way, I had assumed the more you become functioning, the more you build up a tolerance almost to being able to function through it. You almost become built to live in depression or a variance of it, or the lack of bliss or joy. So what's the way out? Do you just wait for your crash like an alcoholic or drug addict to hit a bottom? Or is there a way out from here? Hearing this saying, okay, here's some tactics. And so I know the answer because of the book, but why don't you give us your answer to that? If so, I hope so. You're not going to tell us someone has to wait until they have a crash, until they hit bottom, until they lose their job, until they lose their marriage, until they lose all hope. What's their way out from here if they think. You know what I think? I. I think I'm one of these people.
Dr. Judith Joseph
Thank you for sharing your story. Because it's the stories that connect us right to the truth, right? When, when we hear about things, it doesn't really hit our hearts and it doesn't hit home until we have a story tied to it. And I've heard so many stories like what you just said. People send me DMs. They're like, this is me. But my doctor says I have to wait until I'm broken down, until I stop functioning to do something about it, right? This is how we treat conditions These days we wait to listen to ICD coding and then we can get reimbursed and then we can do something which is a broken model. We need to prevent this. And what you said about your dad, think about it like this is contagious, the way that anhedonia spreads. We all have that history of the bad boss who was angry and made you work so hard and all the, and the organization felt it. Well, joy is contagious as well. It happens in families when fathers and mothers are lacking joy. It spreads to the kids. We know the over committed mom has over committed kids in like a gazillion activities. You know, there are ways to derive pleasure in life. And when I think about happiness, happiness is this idea. It's the state that we may never achieve if we wait and delay our happiness. Many of us say, I will be happy when I will be happy when I have the job, I'll be happy when I have the home, the family. And the studies show that when we have that mentality, even when we get those things, we're still unhappy. Joy on the other side is experiences. It's if you're tired, get rest. If you're lonely, connect. If you're hungry, savor your meal. So joy is the experience, happiness is the idea. And there are ways to correct this. I developed a system called the 5vs method. Yeah, the first V is validation. And it sounds so granular, it sounds so obvious. However, those of us who are high functioning, we have a hard time validating, acknowledging, accepting how we truly feel. Think about the dad who just, you know, is feeling anhedonia, is not feeling joy and just continues working. And when you ask how they're doing, they say, I'm fine, I have a roof over my head, my kids are fed, the bills are paid. But you know, there's a lack of joy, there's a lack of happiness, really real happiness in their lives. So accept how you're feeling. And that starts with self validation, saying I'm exhausting, I'm exhausted, I'm burned out, I'm depressed. Acknowledging how you feel. And this is not just, you know, just loosey gloosey. The science shows that if we can identify our emotions, that act in itself is therapeutic. Why human beings don't like uncertainty. Think about 2020. That was a really hard time for us. We didn't know it was going to happen. And human beings don't like the uncertainty of not knowing how they feel. So when they can name the emotion and accept it, that act in itself decreases the Anxiety. And I use the analogy of when you. When you're in a room and the lights turn off and something falls and you hear a loud thud, many of us will start swinging. Some of us would run, some of us try to escape. But when you turn the light on and you see what it is, oh, a book fell, you pick it up and you put it on the shelf. That's the same way we are about emotion. So validate how you feel and accept it, because that act is so important, it's therapeutic in itself. The second V is venting. When you think of venting, it is the act of letting off steam and expressing how you feel. It could be done verbally, but many of us don't like to talk about feelings. So another way that people can express how they feel is through prayer, through crying. You know, like, letting out a good cry actually releases hormones that make us feel better. And even writing. That's why journaling is so important for people, because the idea of getting the words out onto paper, that concrete and manual act, can be therapeutic in itself. The third V is values. Values are things that are priceless, not with price tags. That is very important because we're chasing the clout, we're chasing the accolades, we're chasing the money. But at the end of the day, the things that truly give us meaning and purpose in life are things that on our deathbed, we're going to be like, I wish I had more time in nature. I wish I had more time with my loved ones, doing the things that gave me a sense of purpose. Those are the values that you want to try and tap into every day. And then the fourth vitals. You know, we only have one body and brain. What are the things that we're doing to nourish our one body and brain? I tell my daughter this every day. How many bodies did God give you? She says, one. And I say, what do you have to do with it? Take care of it. So these are the very boring things that your doctor tells you to do. Getting good sleep, getting good movement, eating foods that are healthy and not processed, that actually nourish your brain, decrease inflammation. But also, I have three additional vitals that are in there that your doctor doesn't ask you about. Your relationship with technology, your work life, balance, and your relationships with other people. Because your relationships are the number one predictor of your longevity. And then the fifth V is vision. How do you plan joy so that you celebrate your wins and you don't delay happiness? And I have all these tools and methods in my book to go through vision. Because if you don't have something to look forward in the future, you're going to be stuck in the past.
Ed Mylett
So, hey guys, I want to jump in here for a second and talk about change and growth. And you know, by the way, it's no secret how people get ahead in life or how they grow. And also taking a look at the future, if you want to change your future, you got to change the things you're doing. If you continue to do the same things, you're probably going to produce the same results. But if you get into a new environment where you're learning new things and you're around other people that are growth oriented, you're much more likely to do that yourself. And that's why I love Growth Day. Write this down for a second. Growth Day.com forward/ed my friend Brendan Richard has created the most incredible personal development and business app that I've ever seen in my life. Everything from goal setting software to personal accountability journaling courses. Thousands of dollars worth of courses in there as well. I create content in there on Mondays where I contribute as do a whole bunch of other influencers like the Avengers of influencers and business minds in there. It's the Netflix for high achievers or people that want to be high achievers. So go check it out. My friend Brennan's made it very affordable, very easy to get involved. Go to growthday.sled. that's growthday.com forward sled Listen, all of us are busy and I keep hearing about tonal when it comes to fitness. I'm like, what is tonal? And then they ended up approaching the show. I have so many friends that are working with tonal because let's be honest, we have a million things to worry about every day. Getting in a good workout should not be one of them. Enter Tonal. Tonal will pick the perfect weight, track your progress and suggest what to do based on your muscle readiness. Taking the guesswork out of getting a great workout. Working hard is worth it if you're seeing results. So many people train and get any benefit. Don't grow. Don't lose the weight. Don't get bigger and stronger. That's what tonal is built for. Tonal's at home strength training system uses adaptive weight to learn your movement and then set optimal weight for every move. It's really cool. Right now Tonal is offering our listeners $200 off your tonal purchase with promo code. Ed mylett that's tonal.com and use promo code edmilet for $200 off your purchase. Wow. That's tonal.com promo code edmylet for 200 off so I'm super fired up. We're creating a bunch of content and doing podcasts today. Guess what I had right before I walked in here? I drank my AG1. I do it before every single show. In fact, I actually do it every single day. I even take it on the road with me when I travel. I would not go a day of my life without my AG1s. It's a habit that actually sticks because you feel the difference and what I can tell you most of the benefits. For me, my body feels calm, yet I have high energy. It's been great immune support for me as well and digestions. When it comes to my health, I want something, something I can trust and that's why I choose AG1. It's science backed ingredients, real benefits that I can feel and it makes it really easy and affordable to get into your body as well. AG1 is now offering new subscribers a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of D3K2 and five travel packs in your first box. So make sure you check out drink ag1.com edmilet to get this offer. That's drinkag1.com edmylet to start your new year on a healthier note, let's talk about this plan joy thing and the venting. I'll ask it as a package question. I think you stipulate in the book just because I read it three days ago and it's been on my mind ever since. But I think you stipulate that this I conflate happiness and joy too much. Number one, that was one lesson from the book. But the other one is that I think you stipulate that these are moments in our life. In other words, it's not a constant state of being. And so is that what you mean by sort of planning your joy? Planning moments that you would assume should be bringing you some form of joy? Is that what you mean?
Dr. Judith Joseph
Absolutely right. Happiness is an idea. Joy is the experience. I'll give myself an example. Today I got my daughter to school on time, went on to a major news network, and then now I'm speaking with you. After our interview, I'm going to block off time and really sit and eat my salad without a screen and tell myself, wow, I did a great job today. You know, I'm a working mom. I. I'm helping people and I'm Going to treat myself like a human being and eat and chew and swallow and savor. Right. And not rush through it by being in front of a screen. That is a small act of love, but it sends a deeper message to yourself that you are a human being, not a human doing. And I'm. And that's savoring that point of joy. It's actually science based. So when people come to see me in the therapy office, they're like, Dr. Judith, I just want to be happy. But in research you rarely find the word happy on our psychrometric rating scales where we measure the science of happiness. But we'll find our points of joy. So we'll ask, when you ate, did you enjoy it? Did you have an appetite? When you connected with a loved one, did you really savor that interaction? When you slept, did you feel rested? Right. These are the sensations that, these are the points of joy that make up happiness. So if you can get a point today or get two points tomorrow, or say, you know, I didn't get any points yesterday, but I'm going to make it a, you know, a habit to try and get at least one or two a day that is more attainable than saying, I just want to be happy. Because happiness, that idea may never even happen for us. And I've traveled the world studying this and I've been to some countries where you'd see children living in the most devastating conditions, but yet they're still joyful, they're still playing. Why? Because you don't have to teach a child how to be joyful. It's in our DNA. It's in our DNA to be happy and to be joyful. So accessing the points of joy every day in these small human, regular human things that we can do can make us overall happier.
Ed Mylett
It's so good. I. It may seem simple to actually plan some of your moments of joy, but I will say the absence of doing that, what are the odds it's going to happen if you don't plan for it in today's day and age? Like, if you really think about it, that's sort of, I'm a plan my moments of joy. Well, okay, let's assume you don't. How likely are they to take place now? It's completely left at random. And your normal life patterns, and I'm reading your work, I'm like, okay, let's see here. I do typically when I go out, want to get home sooner than I should. I do rush through every meal as if it's a Race. I do have a hard time even of moments when I know I should be allowing myself to feel joy and bliss. In those moments, I've become built for it. And I know where it comes from. Which is why I want to ask you next. I think a lot of things as children with parents is caught, not taught lot. And I had, I have great parents. My mom's probably listening to this interview right now, right? She's my favorite human being on the planet. Having said that, I think even my mom would say maybe we could have had more joy in our house. Like I, I hear my dad sitting on the couch alone, sober now, right? Alone. It just kind of like, and I'm like, dad, what's going on? Ah, this politician, this thing, you know. And it was just these very few moments of like, I think I caught it. I think, I think I caught my dad's emotional home. I think you may not turn out personality wise like your parents or even the same career, but emotional home like the real home you live in emotionally, that's. That bears evaluating. So how as a parent, let's ask a parent question. How as a parent can we learn to not pass this functioning depression onto our children and pass the right things on to them?
Dr. Judith Joseph
Yeah, and I'm guilty of it as well. My dad, I call him a renaissance man because I'm originally from Trinidad. He played cricket, he had a band, he is a pastor, he was out in the community, he was a theology student. But he was busy, he was always doing. And you gotta savor the moments because your children will mirror you. There's no wonder that I have an md, mba, I run a lab, I'm doing all these things. I often find myself back into that high fat functioning pattern. And my daughter, at one point in my life, I was over scheduling her because I was over scheduled. And one day she said to me, mommy, I am tired. And I was just like, wow, I'm tired too. So it is contagious. It's important, important that what you do, your children mirror you. You know, if you're in front of your screens, your kid's going to be on their screens. If you're busy, they're going to be busy. And it is contagious. But in the way that anhedonia, that busyness is contagious. Joy can be contagious too. And so the simple things in life that you can do. And I go through these checklists in my book about how to slow down, how to save a moment, this, you know, I'll give an example of brushing my daughter's hair. If I'm brushing it and like, she's like, oh, that hurts. Then I'm like, wait, I'm doing this quickly because I was over scheduled. And what I should have done was not over schedule myself. So the next day, what I'm going to do is plan more time so that when I'm brushing her hair, she sees that I'm taking my time so that she honors her body because she's only going to get one body. And when you're. When I apply lotion to myself, these small acts, I try to do it slowly. And I'm. And I'm sending the message to myself that my body is worthy of care. And being gentle and doing these small things sends the inner dialogue to yourself that you can slow down, nothing bad's gonna happen if you're. If you don't rush through these moments. So it doesn't have to be grand, you know, make it a point that, let's say if you have a meeting later today with your colleague. Colleagues, when you're going to meet with them, you're not going to rush in and out. You're actually going to spend time discussing them, checking in on them, having a meaningful interaction with them. If what you value is kindness, then you're going to say, at least for one person today I'm going to hold the door for them. I'm going to just ask the doorman or the person at the cashier how they're doing, going to check in with them, find out what you value in life. If it's nature, you're gonna, you know, if you're driving, you're gonna take your car through, you know, a park or just take a walk in the park if you're in a big city. But do something every day to honor your values and tap into it so you're gonna one validate how you feel. Oh, I'm feeling hungry. All right, I'm gonna make a break. I'm gonna go and get something to eat. Savor it. Take my time. You know, there are little things you can do to be a human being instead of a human doing. And if you slowly do those things, you know, it doesn't have to be grand. You don' v's a day, tap into one or two a day. Then over time, you will be happier. It's all about collecting the points.
Ed Mylett
You know, one of the things for me, I'm loving a conversation. It's a simple thing, and it is. You've used the word probably five times. So Far, it's just slow down. It's literally for most things. For me, my trigger to bliss is just slow down. I talk fast, I eat fast, I drive fast. It's. Everything is a race almost with me, and it's become something I win. Most of the time, no one else at the table is aware we're racing to eat this food. They're trying to enjoy theirs. And I'm in the biggest hurry in the world. I tell you an interesting story, and then I'll ask you a question about one of your techniques. I was just in Hawaii. I had to go over and speak. I'm gonna. I've been. I'm gonna be there twice in the next three weeks. And I get over there and I'm alone on this trip, and I'm like, I. If I can't relax and enjoy myself in Hawaii, find some joy here. There's a real problem. And where I was speaking every, you know, most people in that hotel knew me, so it was difficult to get any quiet time if I went out of my room because I, you know, people there were there to attend an event I was speaking at. I thought, you know what? I'm gonna get a massage. There's a 60 minute and an 80 minute, and I go, I'm gonna do the 80 minute. And even in a massage, I'm like 15 minutes into this massage, I'm like, oh, my gosh, there's 65 more minutes left in this thing. And I'm literally not enjoying the massage because I'm in a race for the massage to end. Right. It's that crazy. And so in my own case, I actually went back three days later when I left. I'm like, I'm get another one. And I'm actually going to slow down and enjoy this. And so one of the things you teach in the book, I think everyone's going to take this right now. Go, I'm going to do it. Is your 5, 4, 3, 2, 1 technique, which is not really correlated to what I'm saying, but I wanted to just make the point of, of pacing and breathing and slowing down. Very rarely is joy and bliss in moments of hurried, they just. Just not going to be present at the same time. So do you agree with that? And then tell them your technique because it's awesome.
Dr. Judith Joseph
Well, the, the busying yourself is a trauma response. And I'm going to say that again because I don't think people correlate the two. Busying is a trauma response. I do this. I've conducted several PTSD studies and there's an assessment called the CAHPS 5. It's validated by the VA hospital, typically used in combat veterans, but now it's been applied to clinical research. One of the symptoms of trauma is avoidance. And when you think of avoidance in the classic PTSD sense, it's avoiding things that trigger you, like people, places or situations. And avoidance in the form of busying is a trauma response. So you're over committing yourself, you're too busy to acknowledge the pain. And I think that needs to hit home. And that's why I applied the 5 4, 321 method to high functioning depression. Because the 54321 method is a trauma method that allows people to ground. When you think of how you're busy, it's a way to avoid feeling that pain. And many people will say, oh, 2020 was a blur, or my childhood was a blur. Well, the reason it's a blur is because your brain was trying to block memories that were painful. And that helps in the short term, but in the long term it doesn't because you continue to avoid. And then the trauma peaks out in different ways. And 5, 4, 321 allows you to stay in the present to ground you so that you're not, not floating outside a situation or floating outside your body, which is called disassociation. And that's that feeling of like, I don't remember what happened or it was a blur, it's because you were disassociating. Right? So if you want to practice. 5, 4, 3, 2, 1. I do this every morning. It takes me like one to two minutes, but you can do it longer. You imagine one thing that you do, so it could be your coffee and you focus on that one thing. And I have my, my coffee mug here. And so you're holding your coffee and, or your tea or whatever it is that you drink or even water. And you want to stay in the moment. So you're going to think about five things you can see. And so it could be describing what the mug looks like, your hands, you know, four things you can feel. And it could be, you know, feeling the temperature or the, or the mug or like, like you know, what you're wearing or the chair that you're in. Three things that you can hear. And so sometimes you can hear the noises, the music or like the environment, the nature, the breeze. Two things you can smell. So you just like smell the aroma or like even what you're wearing, the fragrance you're wearing, or a candle. And then one thing you can taste, so you can taste it and then you know, what does it feel like going down? What does it taste like in terms of the fav, the flavors. But if you're doing that, I'm not thinking about, you know, my dry cleaning. I'm not thinking about the meeting I have in two hours. I'm so present. And I describe that probably under 60 seconds. But if you practice a little bit of that every day and you're staying present in the moment, you're grounding yourself in the situation, then you're going to calm your fight or flight. You're going to notice that you're not as tense, you're not going to be distracted. And that act brings you into a better state so that you can slow down and anyone can do the 5, 4, 3, 2, 1 method with any activity that you want to be present in.
Ed Mylett
That's outstanding. And I'm going to do that. That's like really, really, really good way to become present. It's simple, it's easy to remember. It's something you can do in a again, me always in a big hurry that you can do in a short window of time. That's really, really good. This message is sponsored by Green Light. Hey guys, I talk about Green Light all the time. I talk about Green light, not on camera with my friends who have children. Because you think about it, at least when I was young, nobody taught me about money. Most parents don't teach that stuff. School doesn't teach it, even though they should. So let's be honest, most of us learned about saving and budgeting way later than we should have way later in life. And so that's where Green Light's so awesome. It takes technology takes and helps your kids and your family build financially responsible children. Greenlight's a debit card and money app made for families that lets kids learn how to save, invest their money and they can even be paid for chores and whatnot. And you can track their spending. Parents can send money to their kids and keep an eye on what they're spending. Meanwhile, kids and teens build money confidence. It's just super good. Millions of people are already using Greenlight. Start your risk free trial at Greenlight today. Go to greenlight.comed that's greenlight.comed to get started. Greenlight.comed the Range Rover Sport blends power, poison performance with a design that's distinctly British. Free from unnecessary details. Raw power and agility shine in the Range Rover Sport. To truly make an impact, you need to take the lead. You need to adapt to whatever comes your way. And when you're that driven, you drive an equally determined vehicle, the Range Rover Sport. Like you, it was designed to make an impact. The Range Rover Sport combines a dynamic sporting personality, elegance and agility to deliver a truly distinctive drive. The assertive stance of the Range Rover Sport hints at its equally refined driving performance. Defining true modern luxury, the Range Rover Sport includes the latest innovations in comfort and convenience. Use the cabin air purification system alongside active noise cancellation for all new levels of quality, comfort and control. A force inside and out. Range Rover Sport was created with a choice of powerful engines, including a plug in hybrid with an estimated range of 53 miles. Build your Range Rover Sport at range rover.com US Sport it sounds to me like a lot of high functioning depression is more than likely I'm over summarizing, coming from some type of trauma somewhere. Is that safe to say what I just said, is that safe to say?
Dr. Judith Joseph
It is. You know, I've only, I'm the only person who's done a peer reviewed clinical study that was published in High Function Depression. We still need more data, but I felt like we needed to have something to validate how people felt. You know, if it's not published or if it's not studied, then you're really going based off of like anecdote. So it was important for me to use my lab to do that and I'm proud of that Work, work. And I hope to do many more and I hope other people start doing studies as well. Thank you. Well, you know, people run from things that are painful. And According to the DSM 5, a trauma to meet criteria for PTSD is typically combat or assault or you know, something near death that you either experienced or you witnessed. However, you know, people come in all the time with traumas that are little t traumas like a bankruptcy or a toxic relationship. You know, I'll tell them that According to the DSM 5, you don't meet criteria for this. But I believe you because there are things that are emotionally and psychologically painful that shape how we view ourselves in the world and how we behave in the world. And so I created a more extensive trauma inventory to include things like that that you won't find in the DSM 5 because I truly do believe that these little t traumas shape us. You know, having a parent who was neglectful, having a, a parent who yelled at times who you were worried about, that is, try telling someone that that's not traumatizing. It is painful and it shapes you. So I wanted to acknowledge things like that, you know, having a business and going through bankruptcy, that is painful. That shapes the way that you interact in the world. And I included those experiences, including collective traumas like pandemics and, you know, things that happen to groups of people, generational traumas, because that does shape us. Us. It changes how we view ourselves in the world and how we interact in the world.
Ed Mylett
I want to ask you about one type of trauma next, but I want to say one thing to everybody on trauma. Even in my own work with coaching people over the years, you call it a little T trauma, but you can, you begin to collect them in your life and they can stack. And I'll tell you all, I'm going to give you all a word that maybe you would replace with trauma, which is disappointment. And the longer you live, you do begin to potentially collect disappointments. And this is a form of trauma in your system. So it may not be the same as your dad yelling at you or being physically struck or. But it's, it's trauma. It's a disappointment of the love of your life left disappointment of a promotion. You didn't get the disappointment of, you did get the promotion and it didn't make you feel the way you thought. A bankruptcy, the ending of any type of a relationship. It could even be the expectation of walking in a room and being received a particular way that you think you look great that night and no one notices you, or someone puts you down subtly or it's a crabby boss, you know, or a passive aggressive friend. You collect these disappointments and that begins to become a trauma in your life. And I think it can dull these responses to being able to produce joy in your life. And all of a sudden you're high functioning depressed. So I just want everyone to evaluate this. This isn't a weakness, this isn't some, you know, way, whatever your political spectrum is, you know, oh, safe spaces. That's not what we're talking about here. We're talking about living as a human being. These are real things. And many of you right now listening to us, you are high functioning. Maybe you wouldn't use the word joy, but depression, but you're lacking the joy you deserve and that's high functioning depression. And so what is? Here's a form of trauma that I want to ask you about because it's in the book, but I want them to hear it. What is scarcity trauma?
Dr. Judith Joseph
I'm so glad you brought that up. Scarcity trauma is something that I, I'm a board certified psychiatrist and researcher and I didn't even realize how much it shaped my behaviors and how I saw myself in the world. The interesting thing about trauma that most people don't know is that trauma makes you feel unworthy, it increases self blame. It's actually on that combat veteran checklist I told you about, the CAPS five. So that when you don't know that these are trauma responses, you don't realize your behaviors are shaped from feeling unworthy and internalizing shame and blame and scarcity. Trauma happens when you either come from a position of, of not having resources, money, food, water, shelter, personally or your ancestors didn't have it and they've passed these behaviors onto you. So think about people who, whose ancestors have fled war and they get, you know, they don't realize that these behaviors of not taking risks, not investing in themselves, hoarding their money, hoarding, you know, food that is expired, having, you know, bags under their, they're a sink that they just can't get rid of. They don't realize that the clutter is related to this scarcity trauma of running out of things and being afraid of losing it all again. For me, I experienced it. I came to this country when I was very small from Trinidad and there were times when we didn't have resources, we didn't have food and I ended up being valedictorian. So I approached scarcity in this way which I didn't realize until adulthood and well beyond. You know, my training was that I would hoard my degree. So I would be like, well, an MD isn't enough. I got to get an MBA and you know, one, one residency training is enough. I got to get a fellowship and then, well, I can't just have a lab. I also have to have a private practice and I also have to have all these things. So I was overdoing so that I wouldn't be in a position of needing again, even though it was illogical. And I am a board certified psychiatrist. I didn't even put this together until well into my research. So you can have these behaviors that are rooted in scarcity trauma and you're not even aware that they're related to how your parents are raised or your grandparents are raised or how you have gone through positions of not having enough. And I see this in farmers, right, people who've come from long generations of farmers where farmers don't know when they're going to have their next crop. So they store and they're constantly thinking about saving and you know, the weather can be unpredictable and then you pass the scarcity trauma onto your, your, your children and grandchildren and they don't even realize they're not, they're not taking risks in life and they're having these behaviors out of a fear of scarcity.
Ed Mylett
I love it. I, I think your work is so awesome. I have my two forms of it. I was on welfare as a little boy. No matter how much wealth I've accumulated, I still have a scarcity fear of being broke and not having food or eating, which is insane if you saw how I live and where I live. But it's there. And then also because of my dad's drinking when he was young, he would be gone. And I have this scarcity issue with people leaving me, whether they, I keep people who work for me way too long working for me after they've proven they're not qualified because I don't like letting people go in my life because I have this scarcity trauma from thinking my dad was going, I've kept it with friends who shouldn't be in my life anymore, but I keep them around because I have this scarcity issue. I'm only sharing things about, about myself with everybody today. So maybe when you hear something, you go, that doesn't apply. And then I give you my version, you go, oh, maybe I do have a Scotia this stuff, right? And so I just want you thinking about that. Here's a tough question, but something that you talk about. What if you're listening right now or watching and you go, I don't think it's me, but it is my boyfriend, it is my girlfriend, it is my daughter, it's my dad, it's my significant other. Is there anything you can do if you're in a relationship with, with somebody and you believe you're with somebody who's high functioning, depressed, Is there anything that you can do?
Dr. Judith Joseph
Before I answer that question, I just want to thank you because I think many people look at you and they see on the outside, strong, powerful leader, has it all figured out. But when you share.
Ed Mylett
Thank you.
Dr. Judith Joseph
And you're vulnerable, it is so powerful. Thank you.
Ed Mylett
I accept that. I appreciate you saying that. Thank you. You not always easy, so thank you.
Dr. Judith Joseph
It's not, it's not easy and, but I think people need to hear, especially men. And so you know, when you have someone in your life who's like this, just know that on the inside they're blaming themselves. They may not be conscious and aware of it, but they've internalized self blame. And when you think of a child, they approach problems with magical thinking. Right. If, if I just get good grades, maybe dad will shape up. If, if I just behave, maybe mom will love me more, right? It's magical thinking. Well, when you don't process that, that trauma, that magical thinking goes into adulthood, right? If I just work, work, work, then I'll never have to have suffering again. Which, and you don't even realize you're actually suffering. You know, you're not, you're a human doing. You're, you're not a human being. So when you have someone like this in your life, know that they've internalized blame and shame. So when you approach them, they're not going to want to burden you. They're not going to want to acknowledge that, you know, they have this happening in their lives because on a deep level, they don't want you to feel bad for them. They don't want you to suffer because of them. So you have to be there for them and you have to validate for them. So you have to show them and model for them that, okay, you know, it's okay if you don't do the X, Y, Z, I'm still going to love you. And they're going to be like, oh, yeah, yeah, sure, you know, I don't think that way. But when you're sending that message, their unconscious brain is soaking it up. So they may not get it the first time, they may not get it the second time, but the fact that you're there, you're shaping their attachment style because you're not leaving, you're not saying, I'm out of here when you're not doing. These people believe that their self worth is tied so closely to their role that if their role breaks, they won't be lovable. But you have to remind them that you're going to be there for them no matter what. So sometimes it's sitting with them even when there's nothing going on, sometimes it's meeting their basic needs because know that they're not getting nutrition. So they may need you to, to bring some food and just like help them out, bring them a glass of water, you know, you need to help them to rest by taking the load off sometimes just offering your help, your presence. They need to know that no matter what, you are there. And it, it sounds so simple, but know that they're projecting onto you what you're feeling, right? You feel as if, oh, like they don't need me, they're so strong. No, they're projecting it onto you. So you have to be there for them. Even though they're exuding confidence. They need that connection. They want you to help them. They just don't know how to ask for it. And then you have to mirror for them. You know, you have to share with them, be vulnerable around them. Show them that it's okay to be vulnerable, to let their guard down for them to share. Because if you're just taking their projection on and at safe value, and you're not sharing, you're like, oh, they don't need me, then that's not helping them. You have to model it for them.
Ed Mylett
Okay, we're going to talk about thoughts in a second, you guys, but I want to ask you. You know, a lot of times I'll have guests on. My audience is more than half women and significantly more now. And in the book, sometimes when I'm doing interviews, I. I'm a male. I think I ask questions from my perspective sometimes. And in the book, you talk about. You said you were perimenopause. Like, what about hormonal effects? I basically. And by the way, if it affects men, speak to that as well. If. When their testosterone levels drop, I don't know. But what about women hormonally? And this idea that maybe this can change over time, as their bodies are changing over time?
Dr. Judith Joseph
Well, it goes back to the biopsychosocial model. So biologically, women experience fluctuations in their hormones over time. I started off really in this space because of postpartum depression. I studied postpartum depression in women who had just given birth. Over the past five years, I've even done studies using psychedelics with postpartum. Postpartum depression is a really interesting thing. When you give birth, progesterone drops. And this can change the way that your brain interacts with something called gaba, which is a neurotransmitter, a neurochemical that helps you feel calm. So if you think about a postpartum mom, she's constantly checking her to see if her baby's breathing right. She can't sleep, she's anxious, so it's not just the sadness. And 80% of women will experience blues. 80%. Yet when you open the brochures, you see a happy mom and a happy kid. But 80% of women experience this, so we have to validate that. But it's not just postpartum. There are windows of vulnerability with regards to hormones throughout a woman's life. Think about puberty. When you're going through your period for the first time, there's something called premenstrual dysphoric disorder. So some women experience intense mood issues and anxiety and low self esteem around their period. So there's the, the, the periods, the postpartum, and then the perimenopause. Most doctors don't even get one course in perimenopause. Most doctors haven't even heard of it. They've, they've heard of menopause, which they probably get maybe one or two hours in, in their entire training. But perimenopause lasts up until you actually have menopause, which is a year without your period. But perimenopause and menopause can have mental health symptoms tied to it.
Ed Mylett
Absolutely.
Dr. Judith Joseph
And I've developed something called the ties method. T I, E S T is thinking. So when you, when you're going through perimenopause and menopause, you may be forgetful, you may not be able to multitask, you may have a hard time organizing problems with your memory. And then the I is identity issues because there are changes that happen in your body and brain that makes you question who you are. So you may find that you have more belly fat. You may find that you know, you're not as into intimacy as you used to be. You may notice that your hair is thinning, your skin is changing. All of these things shape how we view ourselves. And so you may feel like, I don't know who I am anymore. And then there are a lot of muscular changes that happen as well. So if you were into Pilates and you were into all these things and you finding that you're more achy, you may feel as if you can't function in the things that you used to do. And then the E is emotions. The E and ties is emotions. People may experience moodiness, irritability, anxiety that they didn't have before, which also shakes your sense of self. The I, right? The identity. And then the S is sleep. This is what I noticed first in terms of my mental health symptoms related to perimenopause was that I couldn't sleep as deep as I used to. And I was like, what's going on? And so if you're not getting good rich sleep, that impacts all. I say, no pun intended, it ties it all together. Because sleep impacts your thinking, it impacts how you feel about yourself, your identity, and it impacts your emotions, your mood and your anxiety. And so when, and you know that that affect labeling, being able to name it. When I speak about ties at these conferences, women are just like, that's what it is. You know, you hear a woman in her late 30s and 40s saying, I'm old, I'm getting tired. It's perimenopause. That's why you can't hang as late as you used to, you know, that's why you can't have more than one glass of wine. So when you know what you're dealing with, then what does that do? Oh, it's not me. You don't internalize the blame and shame and you're actually able to do something about it. You're going to. For the. For the thinking issues. You're not going to multitask. You're going to prioritize. You're not going to try to be everyone's hero. You're going to not be superwoman. You're just going to focus on what's important. And you're also going to organize your life better. You're not going to have clutter. You know, you're going to make sure you look at your schedule the day before so you're not scrambling in the morning. You're going to use something that I call a launch pad in your home where you put your keys, your wallet, your glasses, so you're not, like, looking for things. And these are. These are things called organizational skills therapy, which I actually do with my small clients of adhd. I start to use them for the women who have perimenopause. It makes their life so much easier. And then the eye, the identity issues, you're going to do things for your skin that are different, because your skin, your hair, they're going to have different needs. You may not be able to, you know, run as much as you used to, but your body is changing as you get older, so you're going to have to lift more weight, you're going to have to eat more protein, meet your bodies. You shouldn't be using the diet from your 20s. When you're in your late 30s and early 40s, you have to change things, right? And that way you can still keep doing the things that you love to do. Your identity. You're still you. Things are different in your body, but you are still you. Two things can be true and then the e. The emotions. A lot of people will say, I'm so moody. I don't know. I just snapped on my husband. I snapped on my co workers. What's wrong with me? Well, know that that's the hormonal fluctuations. There's nothing wrong with you. But when you know it, then you can plan better. If you're feeling this way, maybe you won't, you know, make schedule an interaction with someone who triggers you. Maybe you're gonna, you know, keep toxic people at a minimum. And you're going to regulate more. You're going to practice more meditation, more mindfulness so that when you go into stressful situations, you're not going to fly off the handle. And then the sleep is huge. As you get older, your thermoregulation, so your body's inner thermostat changes. That's why women get hot flashes. So you're going to keep your room cool at night. You're not going to have so much caffeine that you can't turn your mind off when you go to bed. You're going to do things like worry journals. It's called worry procrastination. You're going to try and write all your worries at one time in a day so that way you unpack it so when you go to bed at night, they're not racing in your head. And you're going to eat foods that are rich in melatonin, like walnuts, bananas and so forth. Because you need to really honor your sleep. And there are things like cognitive behavioral therapy that are really helpful for sleep that do not require sleep aids because we know that sleep aids, such as, you know, some certain medications are habit forming and they actually don't improve your sleep. So there are behavioral things that you can actually do to help your sleep at night.
Ed Mylett
I'm really glad I asked you now, guys, by the way. You may think that I asked that for the women, but I didn't because you're probably with a woman. You could be of this age or you will be. I have to tell you something. When you were just describing this, I'm thinking of so many of my friends sort of in this space. I think it's pretty well known that I'm like friends with more of the ladies in the space and I'm kind of like the adopted dude. So like on their retreats and stuff, I'm the one dude that gets invited, right? And, and I have to tell you guys, so many friends of mine have gone through this change and don't understand it. Why am I depressed? Why am I angry? Why do I feel more lost? Lost? Why am I sad more often? Why am I not sleeping as well? And it's almost. You almost just literally described every sing. I'd say 95% of my friends that are near that age and it, it has become a very rough one to six, seven year time in their life. Also often this is timed with life changing Maybe the children are leaving the home for some people at time, like in your case your daughter, years younger it sounds like. But they're leaving the home and dynamics change. And so guys, if you're with a woman, by the way, ladies, I'm not a doctor. Just look at your progesterone levels. If you're having a hard time sleeping, it's something, go right there, take a look at those levels, have a conversation with somebody about it. I'm not prescribing any medication, trust me. But I'm so glad that I asked you that because there's all these things that contribute and I just think when I think of high functioning people in my life that are maybe are lacking the joy they once had or want to have. I'm picturing many of my female friends about that time in their life that you're describing. And so God bless you for covering that. This episode is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy. Just drop in some details about yourself and see if you're eligible to save money. When you bundle your home and auto policies, the process only takes minutes and it could mean hundreds more in your pocket. Visit progressive.com after this episode to see if you could save Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states. Okay, one last question. This has been awesome, you guys. You say in the book you can take control of your thoughts, right? Or there's help in doing that. So I think we should finish with that. A, do you really believe that? And B, how does someone begin to take at least greater control of their thoughts if they're struggling with them, Running away from them or just not being the ones that serve them? Just overall thoughts, changing them. Your viewpoint on thoughts.
Dr. Judith Joseph
Well, you know about the progesterone that you said even when you get tested, because perimenopause is like a roller coaster, not this smooth sailing that people think happens right before menopause. Your project, your levels may not reflect what's happening. So that's why it's important to go based on the symptoms and have a doctor who understands that. And there's a 3Pmethod to know if it's mental health versus perimenopause or menopause. P. The first P is are there changes in your period because mental health symptoms don't have the changes in your period. The second is physical changes. If it's not depression, if you're having your hair falling out, your Skin changing. You're going to the bathroom more regularly. So are there physical changes? And the third is your past history. If you have a past history of postpartum or premenstrual dysphoric disorder, you're more likely to have a harder time with perimenopausal mood symptoms. So understand three P's and that's really helpful. Then I'll jump into the thoughts.
Ed Mylett
Thoughts, no. So glad you got it. That's wonderful. Thank you.
Dr. Judith Joseph
Oh, my pleasure. We often try to control our thinking, but we need to spend more time in our feeling as high functioning folks because we tend to ruminate. And there, there's something that I mentioned called worry procrastination. So if you think about it, the elephant in the room is your problem. Try to practice having that elephant in the room while you're doing what you're doing. So if I'm working and I have anxiety, the anxiety is the elephant. Let him work too. He has his laptop. Let him go to work. I'm going to keep working. It's called metacognition. So you're allowing yourself to have that problem in the room, but you're not focusing on it. And the typical model of cognitive behavioral therapy, which is a behavioral therapy, we try to challenge the thought and change the thought and put the thought on trial. But many of us who are very anxious and ruminative people, that will drive us crazy.
Ed Mylett
Yes.
Dr. Judith Joseph
Rather than trying to change the thought, let's try to stay in the present and feel our feels. So the anxiety is there. We're just gonna, you know what, it's. If you, if you imagine that the, that the issue is like a passing train, the train's gonna keep going. You're staying on, on the platform, but you're not gonna get on the train. So it's just, it's there. So you keep doing what you're doing and it's there, but what you're doing is you're retraining your brain to not, not focus on the problem. You're still doing what you're doing in the present and the problem is still there. That's why worry procrastination is a great tool. You pick one place that you want to worry every day at the same time. So don't pick a place like your bedroom because you don't want worries in your bedroom. Don't pick a place of leisure, like your favorite, you know, couch where you, you relax in the afternoon. It could be a corner at your office or a place in your work or even A place in your home where you don't want to associate with leisure. And that's where you're going to do all of your worrying for the day. So, for example, if you're at work, if you're at work and you have a worry pop up, say, okay, I'm going to save that worry for my worry corner. And you'll maybe write it down on your phone and then say, I'll, I'll save it and worry about it in my worry corner. What the research shows is that if you save your worries for that time and place, by the time you get to that worry corner, you realize you're not even worried about it anymore. So you're retraining your brain to not catastrophize, not put so much weight on these worries. And over time, what you'll notice, because I've done this to myself, you'll notice is that when something pops in your mind and worries you, you're like, well, I will literally worry about that later. And then when you get to your worry corner, you realize it was not as catastrophic. So you. It's one of my daughter's favorite movies is Kung Fu Panda. It's kind of like you're training yourself to be this master warrior where like, yeah, the worries are still there, but I'm still present. I'm still focusing on what matters right.
Ed Mylett
Now that is so good right there. It's finding that place. And by the way, the reason you don't want to do it in your bedroom, you're creating triggers and anchors to that space that when you then walk in there later, it triggers the worry. By the way, I'm going to do that. When you were talking, I'm thinking, where am I going to do this? But I'm going to do that. I'm going to pick my space. I also just think awareness of a worry and a thought helps it lose its power and influence over you. You when you just become aware of what you're doing. And I'm going to worry about that later when I get over to my worry corner, my worry place. And by the time you get there, the emotion of the moment's probably left you. Most of the time, perspective kicks in. You've also not created triggers and anchors all over these places you're at regularly that then re trigger worries when you go into those spaces. This has been so good and your work, I hope. I just want to encourage you. I this high functioning depression. This concept is amazing that you're the first person I've ever spoken to about this, and it took 54 years, yet it absolutely is probably an epidemic. It is probably an epidemic in our world. And I love the fact that you don't just diagnose the problem, you provide a bunch of solutions for it as well. I think you're awesome. I think you're wonderful. I think your work matters so much because these are the people that are creating and innovating and moving the needle in families and lives and businesses every day. And they're, they're under treated and under helped because they're quote, unquote functioning. And so you're changing family's lives. You really are. Thank you so much for this today.
Dr. Judith Joseph
Thank you for all that you do. Thank you for using your platform for good and for allowing me to share this message. Because I truly believe that when people are joyful, the world is a better place. People who are joyful make less mistakes. People want to be around them. They view the world differently. They're kinder. And I truly do believe that joy is, is really the key to a lot of the problems, solving a lot of problems in this world. So thank you. Thank you so much. This is.
Ed Mylett
Yeah, kindness. Kindness and beautiful energy is contagious. And you have that, that immediately. You have that. There's a warmth to you. There's an energy that I think everybody's felt today, whether they're listening or watching. And I certainly have. I wish we were doing this in person. But you guys, this was Dr. Judith Joseph, and for a lot of you, it's your first exposure to her, but I have a feeling it won't be your last. The book is called High Functioning. Overcome your hidden depression and reclaim your joy. And I know we just did that for the last hour to some extent, and I think the book can do more of it for you. So God Bless you, everybody. Dr. Joseph, thank you so much. And everybody, max out your life. God bless you. This is the Ed Milan show.
Podcast Summary: The Hidden Epidemic of High-Functioning Depression with Dr. Judith Joseph
Podcast Information:
Introduction
In this enlightening episode of The Ed Mylett Show, host Ed Mylett delves deep into the often-overlooked topic of high-functioning depression (HFD) with esteemed guest Dr. Judith Joseph, a Columbia-trained psychiatrist and founder of Manhattan Behavioral Medicine. Dr. Joseph introduces listeners to her groundbreaking work and her book, High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy. Throughout the conversation, Ed and Dr. Joseph explore the nuances of HFD, its signs, underlying causes, and effective strategies to combat it.
Understanding High-Functioning Depression (HFD)
Dr. Joseph begins by defining high-functioning depression, emphasizing that it differs from typical clinical depression. Unlike traditional depression, individuals with HFD maintain their daily responsibilities and outward appearances while silently struggling with persistent sadness and anhedonia—the inability to feel joy.
Dr. Judith Joseph [03:31]: "When you understand the science of your happiness, you can use the skills properly."
She critiques the current mental health model, which often waits for individuals to hit a breaking point before providing support. Dr. Joseph argues for proactive interventions to prevent the escalation of mental health issues.
Signs and Symptoms of HFD
The conversation transitions to identifying the subtle signs of HFD. Dr. Joseph highlights that while individuals with HFD may not exhibit overt symptoms like those listed in the DSM-5, they still experience significant distress. Key indicators include poor sleep, anhedonia, fatigue, and concentration difficulties.
Dr. Judith Joseph [09:41]: "Anhedonia is the silent twin, the sneaky twin that comes in the middle of the night and robs you of your joy."
Ed resonates with the concept, sharing a personal story about his father’s high-functioning alcoholism, which underscores the insidious nature of HFD. He emphasizes that functioning well externally can mask deep-seated emotional struggles.
Biopsychosocial Model: The Foundation of Understanding HFD
Dr. Joseph introduces the biopsychosocial model—a comprehensive framework encompassing biological, psychological, and social factors that contribute to an individual's mental health.
Dr. Judith Joseph [06:26]: "All of our biopsychosocials are unique. And that's why this model is so important for understanding the science of what makes you sad."
This model helps in identifying specific areas to address, enabling tailored interventions to enhance joy and reduce depressive symptoms.
Personal Stories and Impact of HFD
Ed shares his father's battle with alcoholism and how high-functioning traits often delay seeking help. This personal anecdote serves to highlight the hidden nature of HFD and its prevalence among successful individuals.
Ed Mylett [11:50]: "Alcoholics and drug addicts are high-functioning. Because they were functioning, it delayed or put off entirely his ability to get help for it."
Dr. Joseph connects this to broader societal trends, noting the rise in anxiety and depression rates since 2020 and the need for early intervention to curb this "quiet epidemic."
Coping Mechanisms and Strategies
Dr. Joseph outlines actionable strategies to combat HFD, introducing her 5V's method:
Validation: Acknowledge and accept your emotions without judgment.
Dr. Judith Joseph [15:08]: "Validate how you feel and accept it, because that act is so important, it's therapeutic in itself."
Venting: Express emotions through talking, crying, praying, or journaling.
Values: Reconnect with personal values and what truly brings meaning to life.
Vitals: Focus on physical health—adequate sleep, nutrition, exercise, and managing technology use.
Vision: Plan moments of joy and celebrate small wins to foster ongoing happiness.
Further, Dr. Joseph introduces the "ties method" specifically addressing hormonal changes in women, such as those experienced during perimenopause and menopause, that can exacerbate depressive symptoms.
Dr. Judith Joseph [49:27]: "When you know what you're dealing with, then what does that do? Oh, it's not me. You don't internalize the blame and shame and you're actually able to do something about it."
Impact of Trauma on HFD
A significant portion of the discussion focuses on the role of trauma in developing HFD. Dr. Joseph differentiates between "Big T" traumas (e.g., combat, assault) and "little t" traumas (e.g., disappointments, relationship breakdowns) that accumulate over time, contributing to HFD.
Ed Mylett [41:35]: "Disappointment... is trauma. It's a disappointment of the love of your life left."
She emphasizes that recognizing and addressing these traumas is crucial for mental health, advocating for a more inclusive understanding of what constitutes trauma beyond traditional definitions.
Supporting Loved Ones with HFD
When asked about supporting partners or family members suffering from HFD, Dr. Joseph advises:
Dr. Judith Joseph [45:32]: "You have to be there for them and you have to validate for them."
Managing Thoughts and Emotions
In addressing thought control, Dr. Joseph introduces the "worry procrastination" technique, allowing individuals to acknowledge their worries without letting them dominate their present moment.
Dr. Judith Joseph [62:36]: "Rather than trying to change the thought, let's try to stay in the present and feel our feels."
This method helps in reducing anxiety and fostering a more balanced mental state by compartmentalizing worries to specific times and places.
Conclusion
The episode concludes with Dr. Joseph reiterating the importance of joy in improving individual lives and, by extension, the world. She encourages listeners to adopt the strategies discussed to reclaim their joy and mitigate the impacts of high-functioning depression.
Dr. Judith Joseph [64:16]: "I truly believe that joy is really the key to a lot of the problems, solving a lot of problems in this world."
Ed Mylett expresses profound appreciation for Dr. Joseph's insights, highlighting the transformative potential of recognizing and addressing HFD.
Key Takeaways:
Notable Quotes:
This episode serves as a vital resource for anyone seeking to understand high-functioning depression, offering both scientific insights and practical tools to foster mental well-being and reclaim joy.