How to Spot and Solve Hidden Depression, with Dr Judith Joseph

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2:32They taste great. So if you care about staying strong, energized, and ready for whatever comes your way, think about them. My friends at Timeline are giving you a high-performance listener, 20 % off. Just go to timeline.com slash highperformance. That's timeline.com slash highperformance. And think about your longevity. Welcome to the Essential Habits of High Performance, where we explore the mindsets and daily practices that help us lead better lives. Today, we're fortunate to be joined by Dr. Judith Joseph, a brand new guest for Essential Habits. Judith's a clinical psychiatrist and a researcher, a best-selling author who works with some of the highest performers in the world.

3:14And what she noticed is a problem that too many of us ignore. You can look like you're thriving, but you can still be struggling. On the outside, you're busy, successful, achieving. Yet on the inside, you're flat, joyless and exhausted. Judith calls this high-functioning depression. Now you may be wondering, why does this matter? It's because we often miss the signs until it's too late. We wait for people to collapse before we offer help. Judith says that's a broken model. and she's developed a framework of five habits to stop that happening. Hey, I'm Damien Hughes and for the last 25 years I've served as an advisor to leaders in sport and business who are looking to shape, create and sustain high performance cultures.

4:01What I love most of all though is learning the habits from our brilliant guests and asking, how can we apply this in our own lives? so our guest today is dr judith joseph and she's on a mission to help people recognize the signs of high functioning depression and to stop seeing exhaustion as a badge of honor psychiatrists call this anhedonia anhedonia literally means a lack of joy a lack of pleasure a lack of interest in things it's a word that's been in the medical literature since the 1800s. But a lot of people who experience anhedonia, they have no idea what it is. They may say things like, oh, I feel meh, I feel bleh, or I just don't feel anything.

4:47And they don't even know that it's a sign of depression possibly. So when you think about depression, it's almost like that iceberg analogy. When you see an iceberg, you only see what's above the surface, but what's below the surface is so much bigger, but we only pay attention to what we can see. And with depression, what we see, you know, are things like sadness or crying or not getting out of bed. But what about those who don't express sadness, who do get out of bed, who are the rocks? You know, they're that mother who can't break down because they have small children take care of. They're that entrepreneur whose team depends on them.

5:25So they know something's off, but they just, they can't slow down. You know, there are these types of people out there who don't even know that there's a term for what they're dealing with. Now that really stuck with me when I first read Judith's book, because if I'm honest, I've had those moments myself, that sense of being flat, even when everything looks good on paper. And what makes this so tricky is society doesn't see it. We look for tears, breakdowns and drama. But as Judith says, many of us just keep going, keep performing and that's why so many don't get the help they need but that word anhedonia is just so powerful because if you don't know what it is you can't name it and if you can't name it well you can't change it judith makes a point that high performers often push through they overwork and busy themselves instead of addressing how they feel what's particularly striking is how often high achievers arrive in judith's office already carrying a sense of guilt they tell her i've got everything I want so why can't I be happy?

6:28From the outside their life looks perfect, the successful career, the recognition, maybe even financial security. But inside they feel flat and joyless. And this is part of the problem because achievement masks the struggle. Productivity becomes the armour. People assume they're thriving when really they're running on empty. Judith has a lovely name for this Pathological Productivity You're constantly busy So you look like you're okay On the underside of this mask There's this anhedonia This lack of joy And it's one thing to be productive And to be joyful There's nothing wrong with that You know, if you're like doing well And you're enjoying what you're doing You're deriving meaning and pleasure And you're productive That's not the same thing But if you're pathologically productive and on the outside you're doing great things but no one knows you're struggling and you're you have no idea what how to address this anhedonia because you never even heard of the word i think that's like a light bulb for these people because they often say i don't know what's wrong with me again there's that internalized shame blame like there must be something wrong with me because i can't even enjoy the things you know i should be happy now that's where her framework of the five v's comes in it gives us a structure to something that otherwise feels overwhelming It can help you check in, notice what's really going on and slowly rebuild joy in your life.

7:55So let's walk through them one by one. The first V is validation. For Judith, this is a starting point, turning the light on instead of pushing the feelings down. Many of us who are high functioning, we get into this pattern of coping by busying ourselves. So we are human doings, not human being. and we cope by staying busy as a form of distraction. And many of us are not aware that we're doing this. This is just how we've developed our coping strategies all along. So slowing down just doesn't even feel accessible to us. And so validation can be really important. Validation is almost like, say you're in this dark place and you can't see anything and you hear this loud crash.

8:46some of us would start swinging some of us would start screaming some would start running but if you turn that light on and you saw oh like there's actually nothing to be afraid of something fell and made a big noise we're able to calm down that uncertainty has been resolved we know what it is we know what we're dealing with so we can take the right action validation is like turning the light on on our emotions on our experiences facing them rather than pushing them down i love that phrase turning the light on. Because in my own research, when people feel stuck, often the fear is bigger than the reality.

9:20Slowing down feels terrifying. You worry, if I stop I'm going to break, I might never start again. But Judith's point is so important. The fear grows the longer that you avoid it. Small acts of validation, even noticing that you're tired and just granting yourself a break chips away at that fear. Many of us wear exhaustion as proof that we're useful when actually it's just masking deeper problems. Validation breaks that cycle. It tells us slowing down doesn't mean you're weak, just means that you're being honest. The second V from Dr. Judith's work is venting. I have a lab in midtown Manhattan where we do research but I also have these demonstrations based on the science of your happiness because I think that it's sometimes very helpful to use imagery.

10:10And so with venting, I bring people into the lab and I'll give them this big red balloon and everyone would take a turn dunking this red balloon into a tank of water. And a hundred percent of the time that balloon pops up. Why? You can't out-math the physics. The numbers don't lie. But then we all take turns deflating this balloon and we push this deflated balloon easily into this tank of water to the bottom without any resistance. This is a nice imagery. It's an exercise to demonstrate how when we slowly release some of our emotions over time, it lets pressure out of the system. If you don't start to express how you feel, what happens is that just like that distended balloon, those emotions will pop up in your health.

10:59It'll pop up in your relationships. It'll pop up in your interactions with your family, your friends, your coworkers. in ways that you cannot control. But if you get into a practice of slowly releasing the pressure from that system, from that balloon, right, that internal balloon, you're not going to have that experience of your emotions popping up recklessly. You'll have more internal regulation. And so venting is important because you can vent in different ways that feel authentic to you to release some of that angst from your body, from your brain. People can vent verbally. And, you know, verbal venting is, you have to be careful.

11:39It's not the same as trauma dumping. You don't want to just go tell everyone your business because people will use it against you. And also, you don't want to go venting to people who are in lesser positions of power. You know, venting to your children is not always appropriate because they're going to worry about you. You know, they're not going to say, I don't want to hear it. They want to bond with you. They want to attach, but then they're going to go and worry. So venting to people in lesser positions of power is not always appropriate. And also like your employees, they're not going to say no to the boss, right?

12:09They'll smile to your face, but then they'll go home and they'll trauma dump onto their family, you know? So pick one or two people that you feel are appropriate and have a reciprocal relationship. You know, like pick someone who you know is going to give you honest feedback, who's not just going to be on your side because that's not how you want to vent. That balloon image is such a clear reminder of what happens when we suppress our emotions. What I found really valuable here is how Judith frames venting as a skill. It's almost like an art form. It's not just unloading on the nervous person.

12:41She talks about venting with intention, aiming to move towards a resolution, or at least having a bit of greater clarity around it, not just repeating the problem over and over. And she stresses reciprocity. The best person to vent to is someone who can listen, but also be honest with you, not just nod along. And then there's emotional consent. Before you offload, it's important that you ask, is this a good time? That's really important, because if the other person doesn't have the capacity in that particular moment, you risk feeling dismissed or rejected, which only then makes things worse. And remember this, venting doesn't have to be verbal.

13:21For some, it's journaling. For others, it might be prayer or even just letting yourself cry. The important point is to release pressure in a way that feels authentic and safe for you. Done right, venting regulates our emotions. Done poorly, it can actually make you feel worse. But now let's talk about Judith's third V, values.

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16:24Values are things that are priceless and not with price tags. And the reason I say that is because we often think, people think, oh, I value my work. Well, what is it that you truly value? And when you dig a little deeper, especially those with high functioning depression, it's really, oh, it's not the work, it's the material stuff, or it's the accolades. But at the end of the day, when you have five minutes left on this earth, you're not going to be like, I wish I had that promotion. No, you're going to say, I wish I had like five minutes, you know, doing something that I love doing or being with someone that I really valued and loved and doing something that brought me meaning and purpose.

17:02So once someone recognizes the importance of values, the next question is, how do you actually uncover them? Especially if life has been so busy or difficult that you've lost sight of what really matters to you. Many people, believe it or not, don't even remember what they valued. And so the role of a therapist is to be this archaeologist with the patient. You're trying to dust off the past and trying to dig to figure out what it is that they truly valued, right? For many, something terrible happened or something significant happened and they just don't even remember. And people are not aware that forgetting the past is a way that our brain copes with painful experiences.

17:42It just buries it so that we don't have to think about it. But sometimes it buries the good with the bad. So we have to dig together to figure out what is it that you truly value? And I write about a particular patient in the past who was very successful on the outside and just could not remember what truly brought them meaning. And when we dig through the past, we look through old pictures that they brought in. We found that this person used to spend a lot of time in nature. but now they were actually in the big city and they were very important but they had very little access to nature and then we figured out that well before when they used to spend a lot of time in nature that was before their parents got divorced and as a family they used to go on hikes they used to go camping but they just stopped doing that because as a unit they just weren't doing that anymore and this person and I started working together to slowly step back into nature very difficult to do in Manhattan But, you know, the first steps were getting plants in their office, then taking a walk through Central Park, then planning a trip, you know, to go hiking and then actually taking that trip.

18:52And slowly they started to feel so joyful. You know, they forgot that this was this important part of their past because they lost sight of the values. and they were, the superficial values, the money and the accolades was actually pulling them away from the thing that actually gave them that purposeful, meaningful value. So they had to figure out how to, you know, tap back into that. Many high achievers chase what looks good on paper, degrees, promotions, status. Judith's point is that those aren't real values. When you reconnect with what truly matters, then you can start making choices that give meaning rather than drain you.

19:31So far Judith has shown us how validation, venting and reconnecting with values can help tackle high functioning depression But she also makes the point that none of that works if we ignore the basics We only get one body and one brain and how we treat them matters Now of course the obvious things count, sleep, nutrition and movement But Judith expands the list of vitals beyond the medical checklist She looks at the non-traditional factors that drain or restore us Our relationship with technology, for example, the quality of our connections with others, and even how we manage our boundaries with work.

20:08It's such a critical reminder that the science shows these modern pressures, constant screens, endless notifications, those blurred lines between home and work, are they directly rob us of the points of joy that we all need to stay healthy and well. Harvard has this huge longevity study center looking at how solid, healthy relationships is actually one of the keys to longevity. And we don't think about that, that the relationships that we have, you know, when you hold your child's hand, when you hug your loved one, you're actually changing your biochemistry by doing this. So imagine what's happening when you're around people who are toxic, who are making you feel bad about yourself.

20:51You know, that's impacting you too. to really think about the relationships that you're in. What I found particularly fascinating in Judith's approach is how she broadens the idea of what vitals mean. Yeah, it's the basics that we all know, like sleep and food and movement. But she's also adding the realities of modern life, the way that technology eats away at our attention, how too much screen time leaves us drained and how poor boundaries at work mean we never properly switch off. For high performers especially, it's this last one that's huge. if you're always on you can never give your brain the chance to recover and without recovery well you can't sustain performance which brings us neatly to the next v vision because it's not only about protecting yourself in the present it's also about deliberately planning joy into your future so we keep moving forward and how do we celebrate our wins and this one you know i think people often think they have to do something grand but celebrating your win and planning joy can be something very, very small.

21:52Like for example, this morning, after I dropped my daughter off to school, I made sure to have a, there's this Caribbean coffee that I love to drink. And I sit in my living room and it's this brand called Tortuga, but it's like rum flavored. It's not alcoholic, but it's rum flavored. It's so smooth. It's not acidic. And I just have this ritual where I sit in my living room and I drink that coffee after I drop her off. And some people will say, oh you're supposed to drop your kid to school that's what you're supposed to do but I just because you're supposed to do things doesn't mean you shouldn't enjoy them and celebrate them because sometimes it's hard you know as a working parent so I sit and that's my protected joy and everybody knows that that's my time and I religiously and ritualistically look forward to that time every day during the weekdays but that's how I protect my joy and I plan joy in the future and it really does work.

22:44I love that. Protecting joy. For Judith, joy isn't an accidental thing. It's a deliberate thing that she builds into her day, even in five minute chunks. And when you start practicing it, then you start collecting what she calls points of joy. The daily evidence that you're happier and more present. And the reason I use the term points of joy is that in the research, when we're determining if someone's getting happier, we're literally adding up these points. So we'll ask a patient, when you ate your food, was it yummy? Were you looking forward to it? That's a point. When you were tired and you took a nap and you woke up and you felt refreshed, did you feel refreshed?

23:26Well, that's a point. When you were lonely and you reached out to a loved one and you felt seen and heard and connected, that's a point. We're adding up all these basic human pleasures and we're saying, okay, if you're able to access those points, That's how we know you're becoming happier. And so these tiny points that we're leaving on the table matter. These moments of joy matter. So don't leave them on the table. Take that bathroom break, have that sip of water, eat that food and savor it. Connect with your loved one. You know, when your dog comes in, like look at the dog and don't look at your phone.

23:58Get as many of these points of joy as possible because that's how we determine if you're becoming happier. So when you change that culture of Anadonia to a culture of joy, don't worry that your work is not going to be as productive, that you're not going to make as much money. The opposite happens. We know that happier workforces are more productive. They tend to stay longer. There's more retention. They have better physical health. So you're saving money there. These are all things that it shows you that it's so worth it to invest in joy. And, you know, I'm from the medical field and I used to be an anesthesiologist.

24:39And one of the things that always hit me the most was the fact that surgeons, they make mistakes when they're unhappy. And that's life or death, you know. So you make better decisions when you're happy. So invest in that joy. Don't be afraid of slowing down because you think that it's going to result in a lack of productivity. The data shows that it's the opposite. that when you invest in that joy and that culture of joy, your organization will thrive.

25:09So here's the challenge for you this week. Take five minutes each day for a mindful check-in. Use Judith's 5-4-3-2-1 method. Notice five things you see, four things you feel, three that you hear, two you smell, and one that you taste. And then write down one point of joy that you experienced. Keep a tally throughout the week. At the end, ask yourself, do you feel more present, more joyful? And if so, what does that tell you about how you're living right now? So that's Dr Judith Joseph's essential habit. What I've really enjoyed about her five V's, remember, validation, venting, values, vitals and vision, is just how practical they are.

25:55These aren't abstract ideas. instead the small daily actions which any of us can build into our lives. If you take one thing from this episode it's to stop leaving joy on the table, name what you're feeling, share it safely, reconnect with what really matters to you, protect your energy and then plan moments of joy into your day. I'd love to know how you get on with this week's challenge. Try the mindful self-checking and track your points of joy. then let us know on Instagram or through the High Performance app. What's the difference it's made for you? I'm Damien Hughes and thank you for listening.

26:34I look forward to seeing you on the next episode of Essential Habits of High Performance.

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