Reclaim Your Joy With Judith Joseph, MD, MBA

In 2020, psychiatrist and researcher Judith Joseph, MD, MBA, was in excessive demand. Her medical apply overflowed with sufferers because the COVID-19 pandemic took its emotional toll, and the media sought her perspective on psychological well-being so typically that she needed to decline appearances. Her lab buzzed with analysis to satisfy deadlines, and he or she was invited to hitch an elite group of ladies in medication at Columbia College.

Slightly than using excessive on her success, nonetheless, Joseph staggered below the load of it. Overwhelmed and ­exhausted — but dissatisfied and stressed — she teetered between fatigue and a relentless drive to maintain busy.

Joseph observed an identical phenomenon amongst a lot of her remedy sufferers: The go-getters, excessive achievers, and super-reliable varieties in her apply had been at greatest feeling “meh” about their accomplishments. And so they sometimes felt responsible about not ­doing sufficient.

Was this despair? Like her, ­Joseph’s sufferers didn’t examine all of the diagnostic containers for medical despair. They may nonetheless get away from bed within the morning. They may get by means of the day with out changing into overwhelmed with disappointment. However there was a definite absence of pleasure of their lives.

Joseph recognized this phenomenon as high-functioning despair. She had seen HFD talked about colloquially on blogs and web sites, however it wasn’t an official prognosis in response to the Diagnostic and Statistical Handbook of Psychological Problems.

Nonetheless, she knew it was actual.

“We put on this masks of pathological productiveness: On the surface, issues look excellent, however on the within, we’re missing pleasure,” Joseph explains. “Ultimately we both slip right into a low-functioning despair, or we begin coping in methods that aren’t wholesome.”

“We put on this masks of pathological productiveness: On the surface, issues look excellent, however on the within, we’re missing pleasure. Ultimately we both slip right into a low-functioning despair, or we begin coping in methods that aren’t wholesome.”

Joseph may discover no medical or psychiatric analysis on the well being dangers of HFD or find out how to deal with it. So she started doing analysis herself, conducting a first-of-its-kind peer-reviewed research.

Joseph found that individuals fighting HFD nearly at all times have a historical past of trauma. These traumas may need been lifeshattering occasions, or they is perhaps lasting wounds inflicted over time by, say, an excessively vital guardian.

This yr, she revealed her findings and wrote about them in her guide Excessive Functioning: Overcome Your Hidden Despair and Reclaim Your Pleasure, and he or she dramatized HFD in brief skits that she shares on social media. We sat down together with her to study HFD and find out how to transfer by means of it.

Q&A With Judith Joseph, MD

Expertise Life | The time period “high-functioning despair” looks like a paradox. How can somebody be depressed and excessive functioning?

Judith Joseph | Despair can have a number of faces. It’s not simply the ­one who’s crying, who’s not getting away from bed, who’s not exhibiting up.

Despair can seem like the one that is exhibiting up, who’s the rock, who’s caring for everybody however themselves. This particular person doubtless struggles with anhedonia, which is a scarcity of curiosity, pleasure, and pleasure. Anhedonia is a trademark of high-functioning despair.

EL | Are you able to speak in regards to the position of trauma in HFD?

JJ | Once you consider classical trauma, [you think of] individuals [who] wish to keep away from locations, conditions, or different individuals who set off them. Of us with HFD attempt to keep away from ache by busying themselves. When they’re nonetheless, they really feel empty and stressed. We discovered that these individuals are making an attempt to deal with ache that’s not processed.

From the trauma and posttraumatic stress dysfunction analysis, we all know that numerous traumatized individuals internalize disgrace: If one thing occurred to them, they suppose that they have to be a nasty particular person. For some individuals, this results in overwork, or they bend over backward for others. Lots of people with HFD are too busy caring for different individuals to consider their very own pleasure.

EL | In your guide, you determine 5 Vs on the trail out of HFD. Are you able to clarify the primary V — validation?

JJ | Validation is about acknowledging the ache you’ve skilled — which is difficult for those who had been raised to consider others and never your self. Lots of people really feel uncomfortable validating their very own emotions and expertise. You might push down your feelings as a coping mechanism.

There’s a grounding approach often called 5-4-3-2-1. You consider 5 issues you’ll be able to see. Then you definitely consider 4 issues you’ll be able to contact, three issues you’ll be able to hear, two issues you’ll be able to odor, and one factor you’ll be able to style. Over time, this trains your mind to be current and to take heed to your physique and experiences. (For extra embodiment practices, see “10 Practices to Get Out Of Your Head and Into the Current.”)

EL | The second V is venting. How can we vent in a wholesome means reasonably than simply complain?

JJ | There’s a big physique of information exhibiting that for those who simply trauma dump and inform everyone your feelings, you don’t really feel higher. You are feeling worse.

As an alternative, consider one or two individuals you belief — and with whom your relationship is reciprocal. Ask for emotional consent and whether or not it’s an excellent time to speak. Slightly than gossiping or airing your soiled laundry, ask for sincere suggestions, even it’s not what you wish to hear.

EL | How do you concentrate on the third V — values?

JJ | Values carry that means and goal to your life — and lots of people don’t know what their values are anymore. After I work with my shoppers, it’s like we’re archaeologists making an attempt to determine when was the final time they really felt joyful. That factors to their values.

Many people are taught about superficial values, issues with worth tags. Personally, I used to chase the accolades and levels — all worth tags!

Through the pandemic, I began to marvel: What do I worth? I recalled my previous — when my dad, a minister, would have us go on stage to carry out at church. I believed I’d by no means carry out once more. Lo and behold, I began doing social media. I had forgotten my worth of entertaining and uplifting individuals whereas concurrently informing them about themes and rules that will in the end enhance their lives. All of us have values and pleasure. They’re someplace in our previous — we simply should take the time to dig them up.

EL | Your fourth V is vitals. What do you imply by that?

JJ | Vitals help your physique and mind — issues like motion, sleep, and vitamin. However in addition they embrace your relationship with expertise: In the event you spend an excessive amount of time in your screens, you’re altering the best way your mind derives pleasure.

Two different nontraditional vitals are your relationships with different individuals (for those who’re partnered with a poisonous particular person, you’re not going to be joyful) and your ­relationship with work. Many people with HFD have a tough time leaving work at work.

EL | How do you outline the ultimate V — imaginative and prescient?

JJ | To me, imaginative and prescient is about planning for pleasure in your life so you’ll be able to maintain transferring ahead as a substitute of getting caught previously. In our happiness analysis, we ask issues like “Once you eat your meals, is it scrumptious? Once you take a nap, do you’re feeling refreshed? When you’re lonely and attain out to somebody, do you’re feeling linked?” All of those are factors of pleasure.

Happiness is an thought, however pleasure is an expertise. I would like individuals to decelerate. Take the time to grasp the place you’re dropping your pleasure and find out how to replenish it. Pleasure is constructed into your DNA. It’s your birthright as a human being. Know that you just deserve it.

This text initially appeared as “Reclaiming Pleasure” within the November/December 2025 problem of Expertise Life. Photographer: Jeff Lipsky/foureleven.company; Hair: Celly Mendez; Make-up: Miranda Richards/Celestine Company and Zarielle Washington, Wardrobe styling: Mindy Saad/Celestine Company