The Hidden Epidemic of High-Functioning Depression with Dr. Judith Joseph

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Apr 22, 2025

Dr. Judith Joseph, a Columbia-trained psychiatrist and author of 'High Functioning,' dives deep into the often-overlooked issue of high-functioning depression. She discusses the concept of anhedonia, where individuals perform well but feel empty inside. Dr. Joseph introduces her '5 V’s' framework for fostering joy, highlighting the significance of validating feelings and planning for joyful experiences. The conversation also addresses how traumas can affect one's perception of joy, and the importance of acknowledging these hidden struggles for a fulfilling life.

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INSIGHT

Biopsychosocial Model of Sadness

The biopsychosocial model explains sadness through unique biological, psychological, and social factors in each person.
Understanding these layers helps identify what increases sadness and where to focus for joy restoration.

INSIGHT

Anhedonia: Silent Twin of Depression

Anhedonia is the silent twin of depression, robbing joy without losing function.
High-functioning people cope by overdoing, which can lead to physical and emotional breakdowns.

ANECDOTE

Ed Mylett Shares Father's Story

Ed Mylett shared his father's high-functioning alcoholism that delayed seeking help.
Functioning conceals pain, making it easier to ignore the need for healing until crisis.

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Are You Joyful… or Just Functioning?

Most people don’t realize it—but there's a silent struggle happening behind the smiles and the schedules. Today, I sit down with Dr. Judith Joseph, a Columbia-trained psychiatrist and author of High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy. We tackle something that I think is affecting more people than anyone talks about… high functioning depression. It's not in the "DSM"—but it’s very real. And if you’ve ever felt like you’re doing everything “right” but still feel empty inside, you need to hear this.

We talked about a condition called anhedonia—this sneaky, silent twin of depression that robs you of joy without making you collapse. It’s the part of depression that doesn’t get seen or treated because you’re still performing, still producing, still achieving. Dr. Judith broke down how traumas, even the little ones, can rewire the way we experience joy. And more importantly, she gave a way out. You don’t have to crash to get help. You don’t have to be broken to deserve healing.

This episode isn’t just about naming the problem. It’s about owning your emotional truth, slowing down, and reclaiming the simple human experiences that actually fill you. Whether you’re a high achiever constantly “doing” or someone who feels like joy is always out of reach, this one’s for you. Judith’s “5 V’s” framework gives you real tools you can use every day—like planning your joy, validating your feelings, and choosing presence over performance.

And let me tell you what stood out most. Joy is contagious! It spreads. To your kids, your spouse, your team. The more we access joy, the more we model it for those around us. This conversation hit home for me—and I think it will for you too.

Key Takeaways:

Why anhedonia is the overlooked symptom stealing your joy.
The difference between happiness (an idea) and joy (an experience).
The “5 V’s” system to help reclaim joy: Validation, Venting, Values, Vitals, Vision.
How trauma—big or small—can lead to high functioning depression.
Tools to help yourself or someone you love who’s silently struggling.
The impact of hormonal changes on mental health, especially for women.
A method to ground yourself daily and reduce anxiety: the 5-4-3-2-1 technique.

Let’s not wait for the crash to start healing. You deserve joy. You just forgot how to feel it.

Max out.

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