The Hidden Cost of Holding It All Together
Dr. Judith Joseph joins me to talk about high functioning depression, anhedonia, and the science of your joy.
The insidious thing about high functioning depression is that it’s easy to miss, especially in ourselves and the people we love. Those of us who have suffered from it rarely feel immediately debilitated by it. In fact, in the midst of it, we rarely feel anything at all. That’s the problem.
Earlier this year, Dr. Judith Joseph published the first peer-reviewed clinical research on high functioning depression. She’ll tell you that most people who struggle with it are managing just fine. They’re getting things done, checking the boxes, performing the tasks of every day life. But they’ve gone numb. They’ve hit a deep level of burnout such that all joy is inaccessible.
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(A pic from a time a couple years back when I was going through the motions—in this case, Slacking, cleaning the vacuum filter and eating my daughter’s wooden toy “salad”—without feeling much at all.)
This is going to sound particularly familiar to those of us who are high performers and who, like Dr. Joseph herself, were overachievers as children. Grinding was how we established identity. Without self reflection and work, it can become the crutch for when we’re not feeling great. We work harder.
This approach doesn’t help those of us who are depressed. It makes things worse.
In my conversation with Dr. Joseph, we talk about her personal experience, the science of naming what you’re feeling, and a word I hadn’t heard before: anhedonia. It’s the inability to experience pleasure in activities that once brought joy. You know what I’m talking about here. It’s that “meh” feeling so many of us carry around without realizing it has a cause. "Identifying and naming a feeling, in itself, is therapeutic," she told me. Her motto: Understand the science of your happiness.
In her new book, High Functioning, Dr. Joseph offers a “five-V “framework for reclaiming joy. I find it’s useful for understanding how we call can do the work to make sure we’re feeling our lives, not just going through the motions. Her Five V’s include:
✅ Validation – Acknowledge and accept your feelings without judgment.
✅ Venting – Express emotions in a healthy, intentional way to relieve pressure.
✅ Values – Reconnect with what truly matters to you to guide your decisions.
✅ Vitals – Pay attention to physical health, as it directly affects mental well-being.
✅ Vision – Create a hopeful, intentional picture of the life you want to lead.
It’d be too easy to think of this episode narrowly as a conversation about mental health. That’s certainly core to Dr. Joseph’s work. But I invited her into the studio because I think this work tells us something important about the way we want to live and how we move toward it. I hope you find something for yourself in it.
