Podcast Summary: The Rich Roll Podcast – "High Functioning: The Hidden Depression That May Be Stealing Your Joy & The Tools To Get It Back With Dr. Judith Joseph"
Introduction
In this compelling episode of The Rich Roll Podcast, host Rich Roll engages in a deep and insightful conversation with Dr. Judith Joseph, a renowned psychiatrist and professor at NYU Medical School. The episode, released on May 12, 2025, delves into the nuanced subject of high functioning depression (HFD), a condition often overlooked due to its subtle manifestation in individuals who appear to be thriving externally. Together, Roll and Dr. Joseph explore the symptoms, underlying causes, and effective tools to recognize and combat this hidden form of depression.
Understanding High Functioning Depression
Dr. Judith Joseph introduces the concept of high functioning depression, emphasizing that individuals with HFD exhibit typical depressive symptoms without the obvious signs of struggling to maintain daily activities. Unlike traditional depression, where individuals may withdraw and reduce their productivity, those with HFD continue to perform at high levels, often masking their internal struggles.
Notable Quote:
Dr. Judith Joseph [07:23]: "For those with high functioning depression, they have the symptoms of depression, but they're not stopping, they're overdoing. You can still access those moments of joy and tell yourself you're worthy of it. That's where you begin."
Symptoms and Indicators of HFD
A significant focus of the discussion is on identifying the signs of HFD. Dr. Joseph highlights anhedonia—the inability to feel pleasure—as a primary indicator. Other symptoms include persistent restlessness, anxiety, impaired sleep, irritability, and emotional numbness. These individuals often maintain their responsibilities but at the cost of their emotional well-being.
Notable Quote:
Dr. Judith Joseph [17:32]: "When you do sit still, do you feel restless? Is it hard for you to just be alone with yourself? ... It's different than burnout. ... We cannot sit still. When we sit still, we feel empty."
The Role of Trauma in HFD
Dr. Joseph explains that trauma, whether significant or seemingly minor, plays a crucial role in the development of HFD. Unresolved past traumas can lead individuals to adopt coping mechanisms such as overworking and constant busyness to avoid processing their pain. This avoidance prevents them from accessing true joy and fulfillment.
Notable Quote:
Dr. Judith Joseph [26:37]: "As you think of combat veterans with PTSD, they avoid triggers. Similarly, those with high functioning depression are avoiding their pain by working, by pushing it down, pushing it down."
Biopsychosocial Model of HFD
The conversation transitions to the biopsychosocial model, which Dr. Joseph uses to illustrate how biological, psychological, and social factors intertwine to contribute to HFD. Factors such as medical conditions, past traumas, and social stressors like financial instability or lack of support systems are discussed as critical components impacting an individual's mental health.
Notable Quote:
Dr. Judith Joseph [37:40]: "Depression does not discriminate. It doesn't care whether you are rich or you have nothing. ... joy is a mindset. It's a mind shift, you know, if you're willing to."
Impact on Different Demographics
Dr. Joseph emphasizes that HFD is not confined to a specific demographic. It affects high-achieving individuals as well as everyday people facing challenging circumstances. Women, especially women of color, are highlighted as being at higher risk due to societal pressures, multiple roles, and higher incidences of trauma.
Notable Quote:
Dr. Judith Joseph [76:33]: "Women are twice as likely to have depression and anxiety compared to men. ... Black women have high rates of trauma. ... they constantly have to wear a mask of pathological productivity."
Tools and Strategies to Combat HFD: The 5Vs Framework
Central to the episode is Dr. Joseph's introduction of the 5Vs framework, a set of actionable tools designed to help individuals recognize and mitigate the symptoms of HFD:
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Validation: Acknowledge and accept your feelings without judgment.
- Quote: "Validating yourself looks like accepting how you feel and acknowledging it." [81:34]
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Venting: Express negative emotions with intention, seeking resolution rather than just unloading.
- Quote: "Healthy venting is doing so with intention." [85:29]
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Values: Clearly define what is important to you to create a personal compass.
- Quote: "Holding yourself accountable to your values is critical." [Not directly quoted, inferred from context]
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Vitals: Maintain a healthy lifestyle, including adequate sleep, movement, and diet, while managing technological engagements.
- Quote: "Your relationship with technology is a huge one. ... it is literally draining your joy." [91:20]
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Vision: Plan moments of joy and pleasure intentionally to ensure they become part of your daily life.
- Quote: "Planning joy is important because when we can imagine things and look forward to things, we're more hopeful." [100:07]
Addressing Societal and Cultural Factors
The episode also touches on how modern societal norms, such as the pervasive use of technology and the normalization of constant productivity, exacerbate feelings associated with HFD. Dr. Joseph discusses the phenomenon of "Zoom fatigue" and its impact on mental health, emphasizing the need for cultural shifts towards valuing well-being over relentless work.
Notable Quote:
Dr. Judith Joseph [94:26]: "When you limit your phone usage, the amount of joy you experience increases significantly, similar to treatments for depression."
Treatment and Preventative Measures
While acknowledging the role of pharmacological interventions like antidepressants for some individuals, Dr. Joseph advocates for a holistic approach combining therapy, lifestyle adjustments, and the 5Vs framework. She underscores the importance of self-awareness and intentional action in managing and preventing HFD.
Notable Quote:
Dr. Judith Joseph [101:25]: "I'm not against medication for the treatment and relief of symptoms. But it's not the only thing that's important."
Conclusion
The episode concludes with Dr. Joseph sharing personal insights into her journey with high functioning depression, highlighting the continuous effort required to maintain joy and prevent relapse into old patterns. Rich Roll and Dr. Joseph emphasize the importance of self-validation, connecting with others, and intentionally incorporating moments of joy into daily life as essential steps toward overcoming HFD.
Final Notable Quote:
Dr. Judith Joseph [119:09]: "Start small. Start self-validating every day. Take that time and tell yourself you're worthy of it. That's where you begin."
Final Thoughts
This episode of The Rich Roll Podcast serves as a vital resource for anyone grappling with the invisible burdens of high functioning depression. Through the expertise of Dr. Judith Joseph and Rich Roll's empathetic hosting, listeners are equipped with the knowledge and tools necessary to recognize, understand, and address this pervasive yet often hidden form of depression.