Welcome to the Therapy for Black Girls Podcast, a weekly conversation about mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves. I'm your host, doctor Joy hard and Bradford, a licensed psychologist in Atlanta, Georgia. For more information or to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you love listening to and learning from the podcast, it is not meant to be a substitute for a relationship with a licensed mental health professional. Hey, y'all, thanks so much for joining me for session four fifty six of the Therapy for Black Girls Podcast. We'll get right into our
conversation after a word from our sponsors. When we think about depression, there's a common image that comes to mind, sleeping all day or not enough, withdrawing from responsibilities, and feeling an overall inability to function. And while that image is accurate, it doesn't tell the whole story of what depression can look like. For many people, especially black women, depression can show up on the complete opposite end of
the spectrum. Instead of withdrawing, we give too much thrusting, ourselves into our jobs, family responsibilities, and over committing to whatever keeps us constantly in motion, and in trying to overcome racial oppression and gender discrimination, we mass that pain under layers of hyperactivity and perfectionism. This is what's referred to as high functioning depression, up getting things done and even excelling while feeling completely disconnected from what makes you
feel grounded. Here to unpack what that really looks like is a guest you may have heard on the show before, doctor Judith Joseph. In her book High Functioning, Overcome your Hidden Depression and Reclaim Your Joy, she explores how depression can hide behind competence and accomplishment, particularly for people who have been conditioned to cling to resilience in their most
challenging moments. If something resonates with you while enjoying our conversation, please share with us on social media using the hashtag TVG in session, or join us over in our patreon To talk more about the episode. You can join us at community dot therapy for Blackgirls dot com. Here's our conversation. Welcome back, doctor.
Judith, thanks for having me. It's good to see you again.
Likewise likewise, so the last time we chatted, we were talking all about how your mental health might be impacted by social media. And a lot has happened for you since we livet So you've released your first book called High Functioning Depression, and I would love to hear from you, doctor Judius, because you are well rid and well versed in so many topics. What made high functioning depression the topic for your first book.
Well, I think a lot of people walk around wearing this mask of pathological productivity. On the outside, they look put together. You'd never know that they were struggling inside, without joy, lacking interest, because frankly, they're not functioning right, They're still functioning showing up their rocks. They're the ones that people turn to for help. They're the friend who
seems like they have it all put together. And in mental health, unfortunately, we wait for people to break down before we start interveading, whereas in other areas of health, we don't wait until people have like stage four cancer. We're like, let's catch the cancer, let's reduce the risk. Right, We're not waiting people have a heart attack. We're saying, let's address the risk of heart disease. In mental health,
we're still waiting for people to break down. And I just kept seeing people in my practice coming in who were struggling with the lack of joy, something called ann hodonia. They didn't know what it was. They'd never heard of it, and I had to educate them that this is something that's in the medical literature. We know of it, but many people don't know what it's called. So there is
a way to reclaim your joy. And when I wrote High Functioning, I was very intentional about the cover of it, where I wanted people to be walking in a bookstore and see, oh, look, high functioning. That's me. Let me open this and be like, hold on, wait a second, I think I'm depressing. The subtitle is about overcoming hidden depression because many of us hide our emotions, especially as black women. We push it down, we put our own
emotions to aside, we take care of others. And this book is about reclaiming joy.
So it's interesting and I appreciate that you're calling out antadonia because it is one of the classic, like Hallwark, depressive symptoms, and you're saying that you found a lot of your patients just didn't even know that it was a thing that they needed to be connected to why do you think that is given that it is one of the things we are typically looking for to diagnose oppression.
Interestingly enough, I went to a very large therapy conference and I went around collecting content and asking different therapists what is antadonia? What is antadonia? A lot of therapists had never heard of ant hoadonia. And I think there's this inherent bias within healthcare where we look for people to break down. We're looking for very obvious signs. We're looking for someone crying, We're looking for someone not getting out of bed. We're not looking for someone who's feeling
nothing or lacking joy, and we overlook it. If you go to your doctor and you're like, I'm not sleeping while my eating habits have changed, but I'm still functioning, They're not going to say, well, are you still enjoying life? They're going to say, are you suicidal? Are you breaking down? You know, like what's happening in terms of your functioning. They're really not looking for whether or not you're enjoying life, that you're actually seeking pleasure or interested in things, because
in our healthcare system, that's not considered a crisis. That's not a problem that healthcare professionals can fix. So we're very reactive in our approaches to mental health versus being proactive and looking for signs of ant hodonia. When you eat your food, does it taste good? When you connect with a loved one? Do you feel seen and heard when you're listening to music? Does it light you up? If we were to ask those type of questions, then
we would uncover ant hodonia. But we're not asking that. We're asking are you suicidal? Are you having thoughts you don't want to live anymore? So, because we're always looking for the crisis, the clear crisis, we're missing the existential crisis. Is life even worth living for you? And I think many healthcare professionals, especially doctors and nurses, they probably struggle with ant hodonia too. When you think about it, they're in fast paids lives. They're taught inherently to take care
of everyone else but themselves. Patient comes first. They work long shifts, they don't even like pee or go for bathroom breaks or eat properly right, So they're already inherently and hedonic. So why would you look for something that you're experiencing that you've normalized. Why would you even look for that in your own patients. You'd be like, well, you're not in crisis, you're not societal'll come back next year,
come back when you break down. And so I think that it's a shift that needs to occur within healthcare, some would say first, in order to really address it in the general population.
And I know you are kind of one of the first doing kind of large scale research on high functioning depression. And I think when I think about like Black women in the way that depression often shows up for us, right like in large point due to our socialization, that like stuff just has to keep going, like you can deal with your mood later, like you just got to keep going. I would be curious to know if Black women don't over index in terms of high functioning depression.
Can you talk a little bit about the work that you've done and what your research is showing in terms of Black women in high functioning depression.
The interesting thing about my study is that it's the first study and high functioning depression in the world. And when I was writing it up and submitting it to IRBs and in the process of ParaView, I remember the people who were reviewing it, were like looking for other papers in the world, and they just kept looking and then they were like, wait, this is the first study in the world, and I was just shocked it is the first one. We do need more research in this area.
But what we found in this first study is that there seems to be a high correlation between caregiving and antedonia, which is not rocket science, right. If you are taking care of other people all the time, and because that's your priority, you're not really prioritizing yourself. You're not going to have interest in things you once enjoyed, You're not going to be feeling joy, and so that was not
a surprising finding. Another finding was that there's a high correlation between HFD and trauma, and that was interesting because our hypothesis is that people who are trying to outrun past pain may be using busying as a coping mechanism. So when you think of the classic trauma responses, usually people want to avoid people, places, and situations that trigger negative emotions. But with high functioning folks, people avoid negative
emotions by just taking on other tasks. So these are the people who will say when I sit still, I feel restless. When I'm not busy. I feel empty why because their go to coping mechanism is too busy to distract. And you know, initially it doesn't look all that bad, right, it looks productive, pathologically productive, because on the outside you're doing all these great things. People are saying you're killing it, but secretly it is actually killing you, right, because over time,
you're going to neglect your basic needs. Over time, your body may break down. You may actually develop a depression where a depressive episode where you stop functioning, or you may start to cope with your pain in ways that are not healthy, like excessive drinking, other excessive behaviors that are not really healthy for you. So something's going to give eventually. And so we found those two correlations as trauma. And when we were interviewing patients, we didn't just do
a survey. We I have a lab in Manhattan. We had the research staff, myself interview people, collect the data. Because what we found is that when you send out surveys tends to not be as accurate as when you're talking to people. And sometimes people don't understand something they ask for clarification. So when we were talking with people, we were surprised to learn that a lot of times people didn't even realize that, like, oh, this painful thing that happened was a trauma and I didn't know how
it shaped me. I just kind of just pushed it down, never talked about it, and just kept going. And so when we did our trauma inventories, we were very intentional about including things that we typically don't see a PTSD diagnosis. So, in order to meet criteria for PTSD, your trauma has to be either life threatening or assault, you know, like something like a combat or a motor vehicle accident or
someone attacking you. But if things like let's say a severe bankruptcy and that left you homeless in the real world, a therapists say, oh, that's traumatizing, but according to textbook standards, that doesn't count as a trauma. So we wanted to include these experiences that are painful that shape the way that you view yourself and the way that you view yourself in the world.
And doctor, did you find that there were any particular like categories of trauma that seem to be more correlated with high functioning depression.
Definitely the big T traumas, so more severe traumas like being physically attacked. The ones that typically meet criteria for PTSD, those tend to be highly correlated. And that makes sense because you know, one of the symptoms of trauma and there are like over thirty symptoms of trauma. People think it's just like hypervigilance or flashbacks or nightmares. There are thirty plus and so one of the symptoms of trauma
is actually like internalizing self blame, shame, and guilt. And we know that this is like the human brain's way of coping with how did something bad happen to me?
Why did something bad happen to me? And many times when bad things happen to us, our brains automatically goes into this like very regressive default mode, like a child would think like, oh, I must have done something bad, there must be something about me, versus a more mature or a higher level of thinking about it would be, oh, bad things happen to good people all the time, Right, I didn't do anything. But our brains do that as a way of kind of controlling the situation because we
don't like uncertainty. So it's like, something bad happens to me because I'm bad, right, And so many times folks don't have their trauma process, will go on this path in life where they people please, where they've been over backwards, where they don't feel worthy of rest because they don't feel worthy internally. And that is a trauma response that many folks don't even connect. They don't even make that
correlation because they haven't fully doubt what their trauma. They're still trying to outrun it.
More from our conversation after the break. So, I wonder if you can talk about if we're talking about some symptoms that aren't necessarily like your classic depressive symptoms and some that are, so what would it look like Is this a diagnosis that people are getting of high functioning depression? Like how would you talk with your therapists or your psychiatrist about Like, Hey, I read this book, but I think that this might be me Like what kinds of
things would you be looking for to figure out? Like, Oh, is this something I'm struggling with.
What's interesting is that years ago, when I first started creating content about high functioning depression, I had a lot of therapists saying, Oh, that's not real. Why are we talking about high functioning depression? We need to be talking about clinical depression. What I said was, listen, there's enough depression to go around for all of us, right, Like,
let's not try to compete with each other. But now I have therapists reaching out to me saying thank you for this book because I have so many clients who are still killing it, who are still crushing it, who are still showing up, but they are struggling with antedonia. They're using work, they're using business as a coping mechanism, and frankly, there's like nothing out there for them. And so now I think a lot of therapists are realizing
that depression has many different faces. That not everyone stays in bed, not everyone's crying, not everyone's shutting down, some people can't sit still, and many times it's misdiagnosed as anxiety. And not to say that the two don't travel together, but anxiety has a lot of physical symptoms. When you look at generalized anxiety disorder, there are a lot of physical physiological symptoms of anxiety like tummy, a tension in your body, heart racing, sweaty palms, feel like you're going
to pass out, and you don't see anadonia there. And so the key thing a lot of these therapists are seeing is something called anadonia, this lack of interest, this lack of pleasure. And it's one thing if your client is busy and productive and enjoying it. But what these therapists are telling me is that they have these clients that look great on the outside. They're doing many things, but they don't enjoy it and they can't slow down. And that is the key, right, because as human beings,
we were built with the DNA for joy. It's literally built into our genetic code. So if you are not experiencing joy, if you've lost your ability to reclaim joy, that is a problem. Right. It's not going to get you admitted to hospital. It's not a medical emergency, but it is an existential crisis and it's something that you are deserving of. So if you're lacking joy, don't ignore it.
So that is what you would really kind of qualify is like the homework of high functioning depression is this antedonia, and like the lack of joy.
The lack of joy, the antedonia and the inability to sit still, right, because that's what makes it different than this anxiety, right, the inner restlessness. What we found in our clinical research study is this inability to sit still because you're outrunning pain. You think you're chasing happiness, but you're trying to outrun something you haven't processed in the past. When people finally click that together, they really want to understand, well, one,
did I actually stop experiencing joy? When did this painful situation occur? Like, I need to figure this out. And this is important because this can actually help you to start to change the way that you cope with pain. Rather than pushing it down, you may start to validate it. And that's why I put the five v's in my book because I want it people to use a simple method, a step by step path towards reclaiming joy, and it starts with validation.
So can you talk more about the five vs?
Five is a number that's been popping up in a lot of my travels. I traveled the world studying mental health issues, and five I think pops up across the globe because most of us have five fingers, right, and so validation is the first fee. When you think about validation, validation is acknowledging how you feel and accepting it no matter what, without judgment. It usually is this analogy of imagine you're in a dark room, pitch black, you can't
see anything, and you hear a loud crash. Well, some of us would start freaking out, some of us start screaming, some would start swinging, some of us would start running. But if you turn the light on and you saw that it was an inanimate object that fell and you're safe, then you're like, oh, certainty has gone away. We feel at ease. So when you acknowledge how you feel and you turn the light on on what's really happening. That's
how many of my clients feel. Sometimes I have men come to my office and they're like, I am so angry. My wife says, I need anger management. We peel back on that emotion, like, are you really angry? What makes you think you're angry? Well, I was yelling, and I said, well that's a behavior, right, yelling could be anger, but it could be something else. Well, I slammed doors. Again, it's a behavior. What did you really feel? And then we take some time and we figured it out and
the person's actually quite worried. They're worried about not providing, they're worried about being a failure. And so that's why it's important to name your emotion and name and acknowledge your experiences, because only then when you turn that light on can you actually figure out the appropriate mechanism. Because the tools for anger, you know this, very different than the tools for worry, and so validation can be self validation.
It could be you acknowledging it and accepting it for yourself. We can validate other people with my tools in the book The Quizzes. I find these rating scales to be very validating because in medicine, if you have like a heart condition or you can go for a test, you can get an EKG. If you have high cholesterol, you can go for blood work. But for mental health we
don't have that as yet. So I need it to have these measures, these ways to validate using actual tools, and so validation could be in the form of a rating scale. If you're wondering, oh do I have Antedonia created these rating skills based on some of the other research tools that I use in my lab for my clinical studies, so that you can say, okay, what level
do I have of anaedonia? And some of my clients will flo out the Anadonia rating scale and they'll be like, oh my gosh, like, I don't enjoy half the things I used to do right, and I would not have known had I not filled out this rating scale. So there are many ways to validate the second V is venting. So in my lab, I'll have people take turns with this big balloon, and we'll take turns dunking it into a big tank of water, and one hundred percent of
time that balloon pops up. Why because you can't out math physics right, It's going to pop up one hundred percent of time. And then we'll take turns deflating this balloon, and what happens. We can easily push this balloon, deflate a balloon at the bottom of the tank. And so I like this analogy because if you don't express your emotions, if you don't get it out right, then you imagine
that at balloon, your emotions will pop up in your health. Right, many of us have these migraines, we have these tummy pains, we don't even know what's going on, body aches. It'll pop up in our relationships, so we snap at our loved ones. It'll pop up out work. So that's why it's important to get in the practice of expressing how you feel and Venting can be done verbally, It could be done in a therapy setting with a therapist. It
could be done with journal writing. Validating. Venting can be done through expressions such as prayer for people who are faith based, so you can vent in many different ways. You got to find a way that's healthy for you. What about the other three? Well, and before I go into the other three venting their dos and don't, right,
you don't want to be trauma dumping on people. I always tell my clients, if you're venting to your kids, I'd rather vent to me because your child isn't going to say, Mommy, I don't want to talk to Your child will listen because they want to feel connected to you. They don't want to be rejected. But they're going to worry about you, right, So think think about who you're venting to. Is it someone in a lower position of power than you? Is this person going to resent you
like an employee? And also be very intentional about it. Are you venting just to get people on your side and you don't really care about the resolution or are you really intentional about Okay, I have a problem, I need to get it solved. I'm going to be unbiased. I'm going to ask people who I trust to give me honest feedback. Right, and before you vent to people if it's not your therapist, because if you pay a therapist,
you can say whatever you want, right. But when you're venting to people in your life, really check in and ask for emotional consent. Ask is this okay? Time? Is this going to trigger you? Right? So, there are dos and don'ts to venting, And what's exciting doctor Joy is that there's recent research on why proper venting Why, Like there's evidence based venting why it's important because if you're venting in that trauma dumping way, you actually feel worse.
They liken it to pouring gas on a fire. So you want to vent with intention, You want to vent with emotional consent. The third bee is well, don't you.
Joseph, I want to dudge you. I want to stay here because there's been lots of conversations around like trauma dubbing online, and I'm really glad you dove into that because in my mind, there is a difference like what I am doing with clients in session, even if they are vincing so to speak, like we are processing, working
through it. What I imagine happening with vincing to like a best friend is just like you might say like, oh, this thing happened to me, and maybe your friend is just saying like, oh my gosh, that's really messed up, and that feels very different to me. So can you talk about like the difference in what like would be venting to a therapist versus venting to a friend. And if you are venting to a friend, should you expect there to be some resolution from the venting.
That's a really great question. Usually with my clients, what I advise is you pick one or two people because and I talk about this in the book, you don't want to be like a sprinkler. You don't want to be like anyone who could listen, this is what happens, This will happen, you know, like because that will unfortunately, that will bite you in the end. People talk, and you can't trust everyone. But when you get into a practice of identifying one or two trusted individuals, you want
to nurture that relationship. And what I mean by nurturing is you want to make sure there's reciprocity. Right, if you're my go to friend, I'm your go to friend right when you need help, I'm there. When I need help, You're there and check in with them. Emotional consent looks like I have something really painful to tell you and I'm really struggling. Is this a good time or can we schedule a call? Right? That's what emotional consent looks like. It doesn't like, let me call this person and start
crying on the phone. Right. And yes, none of us are perfect. We'll have those days, but generally speaking, you want to have that relationship as being sacred. Now, it's different with a therapist. You and I know that when someone has trusted us with their mental health, it's not about us. Right, not to say you treat your therapist poorly, but you know your therapist is there to listen to you and to literally understand your patterns over time, to take notes, to guide you, but not tell you what
to do. Right. That's why we go to school for so many years and then to pull on these We go and we do our research and we come back with these different tools because this is a therapeutic relationship, so it's very different. You don't have to be like, is it okay if I tell this? No, we want you to tell us there's none that. Usually we don't share. There are some cases where we do share if it is appropriate for the treatment, but usually it's not like, okay,
now it's my turn, you know. And if you're in a therapy and your therapist tells you way more than they should be, you may want to think about that, right. So they're very different relationships, but generally I would say pick one or two people, and there's this understanding that this is how you vent. We're not just trying to
like pour gas into a fire. When we get together and when we share something that's happened to us, we're looking for an honest feedback and how to resolve a situation, not just gossiping, not just tearing people down, not just doing this because it feels good in the moment but then feels awful later. There's a real goal to this venting. Goat, thank you for that clarification. So you're reading to the fourth of the values. These are things that bring your
life meaning and purpose. You see the the accolades in the background. I have so many degrees I can't even hang them all. There was a time in my life when that was all that matter. And I'm from a Caribbean background. I came to this country with very little, so it was always like you got to get as many degrees as possible. You're here and other people aren't. You got to take advantage of any and all opportunities.
And there was a time when I did that. And not to say that it's necessarily a bad thing, but over time, if you have to really think about what it is that's happening, are you seeking out things that have price tags or are they truly priceless? And for me, the priceless part of my love hate journey with knowledge and learning, the priceless part was when I was a lot younger, and I just love to learn. I was very curious. I wanted to get my hands on everything
just for the sake of learning. But for premetters out there, when you start that pre med journey, sometimes it can be so intense that you're just about I just don't want to fail. You just want to like get through it, and you stop. Actually, at least for me, it stopped being about the knowledge and the curiosity. It was more about, well, I just can't fail. So then you start to get
numb to the a's and the accolades. And it was during twenty twenty where personally I was at a peak in my career where I had just gotten onto this board at Columbia, this prestigious board, and like it was always on TV and like everyone was like, wow, you're doing so well. And I was experiencing the worst anadonia of my life. And I just thought, well, what's the point of having all the success if there's no joy?
And I had to do a deep dive into what really brought me purpose and meaning, and for me, it was going back to my past and looking at times where I actually felt full and fed, as in like, wow, this is meaningful. And I remember it was when I was helping others and when I was learning for fun. So I started reading again. If I just started one stop reading again. I remember I read Michelle Mama's book Becoming, and I was like, why didn't I read this before?
Like oh, because I was so busy reading research protocols, internal articles. Right, So I just started like reading for fun again and it just like lit me up. And then I thought, well, let me start doing things for others that don't pay me, just out of like the goodness of my heart. Because I grew up in the church volunteering and that used to make me feel joyful. Started doing that again, and slowly my aunt Hadonia went away.
But I think many of us we don't realize that the things that are really priceless, those are things that really matter, because when you're in your last minutes of life, you're not going to be like I wish I had another degree, or I wish I had a house another house. You're going to say like I wish I could spend five minutes doing the things that made life worth living, you know. So that could be your family, it could be your faith, it could be a cause that you
believed in. Usually it's not things with the price tags. So try and tap into those things. And that's what the values are. And there's a lot of evidence on values. There's a lot of research on it, both in the spiritual community and the religious community and in the mental health community.
More from our conversation after the break, well, doctor Judy, I want to stuff you because something you mentioned makes me think about I know you are a mom. I'm a mom. Lots of moms in the community, lots of people with little ones in our lives, and so many of us come from these families where it's the whole idea of like you got to work twice as hard to get half as much.
Success is really driven by like degrees.
And so when you think about, like maybe with your own child, and like any suggestions for people who are raising little ones around, like how to not reinforce this idea that this is what really makes you happy, Like these are the things that really matter.
The thing I love about my daughter, she just turned nine, is that she's very different than me. She is more about like the soft life. She'll be like, so I'll be you know, I'll be like, Okay, we gotta do this, we gotta do this, And she's like, Mom, I'm tired, and you look tired too, And I'm like, you know what, I am tired, thank you.
You know.
So, I really like now to listen to the people in my life. I listen to my daughter, I listen to my lab, like the people at work in my lab. If they're like, listen, we're doing too much, I listen and I slow down. Whereas before it was like, come on, guys, we just have to do more. We just have to but validating others, right, you know, the first V has been very instrumental in my journey. And I used to have this deep fear that if I slow down had
all nothing thinking that meant stopping slow down. Slowing down is not stopping. And what I found personally is that when I slow down and I focus on one or two projects that are really important, I flourish versus trying to do everything, because then none of those projects flourish, they're just like half done. So listening to others has been a tool that I've incorporated in my life. But for my patients who maybe don't have a network of people around to listen to or to get feedback from,
I say, listen to your body. We all have a part of our body that starts to It's like our tell right. Personally, if my nails are not being done, I'm like, okay, I'm too busy, right. But for others it could be if you're back there's a certain part of your back that's aching. It means that you're working too much or you're doing too much. For others, it could be their hair, right, Just listen to your body.
It could be your skin. There's a whole field of psychodermatology where your skin literally will tell you what's happening, you know mentally, So if you don't have someone to guide you, just listen to yourself, self validate and that can help you to point you in the right direction.
So that sounds like modeling really for the little people in our lives is really helpful, right, like getting a chick on our own kind of productivity and then modeling that so that the kids and have a self life.
As you mentioned. Yeh, yes, So my daughter, I'm very intentional about. Okay, we're gonna do things slowly and with compassion, right self compassion. I was raised by a mom who had four kids back to back, like one one year apart. And we have a lot of hair. And my mom she's an Indian Caribbean background, my dad's Afro Caribbean, so she didn't really know how to do the curly hair
and so she would be struggling pulling our hair. Now when I do my daughter's hair, I just have these you know again, I had to go back in my memory lane. I'm very slow with doing your hair. I'm very careful. I don't want her to feel that rush like Tomi. Hair should be pleasurable. It should be like a relaxing, wind down technique, and so I'm very careful about not passing on a lot of those busy type of cultures to her so that she can access joy through many ways in life.
Okay, so I misspoke. Values was number three. Now we are moving on into number four.
Oh. Vitals, yes, vitals, yeah, vitals. When my daughter turned too, I started telling her every night we had this routine, this bathroom routine, how many bodies did God give you? And she'd say one, mommy, And I'd say, what do you have to do with that? Take care of it? And it's something that she knows to this day. Right, you only get one body and brain, and so it's
really up to us to take care of it. So taking care of your vitals looks like, you know, getting good movement, and that doesn't have to be like a workout regimen. It could be, Okay, instead of working through meetings all day, I'm going to get up and I'm going to go for a walk around the block or a walk down the hall to get water, getting any amount of movement. And if you're not into exercising, you
could be dancing to your favorite song every day. But that's really important taking care of vitals looks like eating foods that are not highly processed, and there's a whole field called nutritional psychiatry where you eat foods that are good for your brain that decrease inflammation, and this is actually very helpful in letting your brain release those happy chemicals. Taking care of vitals looks like getting good deep sleep without being on your devices at night, so you get
that rich ram sleep. And also a part of the non traditional vitals that I put in my book have to do with technology.
Now.
I was on your show last year talking about the reset method and about all of the ways that technology can be harmful for our brains. So knowing ways that technology may be impairing your happiness and putting limits on that, and then you know, taking care of vitals. A part of that is making sure you're nurturing your healthy relationships, because there's a whole body of research coming out of Harvard now showing that the quality of your relationships is
a huge predictor of your longevity. So you can help all the kill that you want. If you're partnered with someone toxic, you know you're not going to be healthy, right, So those are all important ways to take care of your body and bring because you only get one. And the final V is vision. How do you plan joy in the future so you don't get stuck in the past. And this is include celebrating your wins, so you know, rather than saying, Okay, I'm supposed to do this, say
I did. Right. It's like a slight shift. But let's say you get your kid to school on time like I do every day. I'm going to sit in my living room and I'm going to have some coffee and just say I did that before rushing off to work. And I've grown to like really look forward to that moment where I get to sit and rest and relax and enjoy the fact that I did this thing.
Are there any myths about high functioning depression that you feel like we have not discussed that you feel like it would be really important to debunk for the community.
Yes. When you think of high functioning depression, you often think of someone who looks depressed, right, so like people think, oh, this is just someone who looks depressed who is actually busy. No, you know, I talk about Chesley christ who was a Miss USA, beautiful, always smiling, bubbly, but ended up dying by suicide. And her mother, April Simpkins, is a good friend of mine and she actually endorsed my book and she said Chesley had anadonia, but no one knew it, right.
I want people to know that you can be beautiful and bubbly and smiling and the life of the party and still struggle with high function and depression. It's not just someone who's like high powered and has a grimace on their face and getting things done. It's the friend that you know makes you laugh. It's the family member that is always there when you need them. It's an entrepreneur who's taking care of all of their employees but
not taking care of themselves. It's that student who's getting straight a's but who's actually struggling.
It may be a little early, given that you are kind of on the cutting edge of a lot of this research, but is there any like genealogy connection, Like are we looking at like, oh, is this something that has like a genetic component that maybe your mommy, your grandma, they're all socialuggle with high functioning depression and you didn't know it.
I didn't do any genetics testing in my study, but I've done studies where genetics were involved, and we're trying to pinpoint whether or not there are different types of depression. I know that I believe it's Stanford that just came out earlier this year with a study looking at the different types of depression based on genetics and imaging, and
that article is interesting. They didn't talk about high functioning depression, probably because there was no other study besides mine, but they did talk about different types of depression, and so I think people are starting to realize that a lot of mental health conditions have different subtypes. There's a recent article I can't remember which university published this, but there
were like different subtypes of autism, right. So a huge part of medicine that is missing is what's called precision medicine, right, or precision psychiatry, trying to figure out what type of subtypes, what phenotypes there are. And in my writeup, when you start the NIH website and you look for my paper, you'll see that we put we're looking at a different phenotype, right, We're trying to see the not so typical face that people associate with depression. We're trying to see if there
are categories that are often overlooked. It's important to do this work because we know that if we wait until people break down, we're too late. Why wait, we should just show people the signs so they can actually start taking the steps to reclaiming their joy before they break down.
Doctor Judith, what does it look like for us to continue these conversations, especially in the community of black women right, like, so that we aren't shaming people for what they're experiencing, whether we are decreasing some of the stigma related to high functioning depression.
Well, I think talking about things openly definitely helps, and sharing stories. I was recently at Essence Fest and I had my book. I had a fireside chat with one of the editors, Minique Flicker, and she actually said during the talk, I think I may have struggled with this. And it's like having those conversations out loud in a room full of people and being able to say that and then have people in the audience shaking their heads
and agreeing. I think that's huge because it like, not long ago, people weren't saying that, they weren't acknowledging it. They were saying, oh, that was someone else. And I think there's still a lot of work to be done. Usually when you go to especially like high powered events or workplaces, people feel more comfortable using terms like burnout and oh I'm burnt out too, Oh yeah, me three. But if you say I'm depressed, people are like, oh, there's not like a so am I or me three?
It's like we should do something about that. Right, So, I do think that the word burnout is actually overused. I think people are actually a lot of people are actually depressed, but they are too afraid to say it, and burnout seems more culturally acceptable. But we have to remember that the term burnout was even in our medical literature until like thirty years ago. Right, It's a relatively new phenomenon. And the difference between burnout and high functioning
depression is that burnout is a workplace condition. I have this brain model here that I often use. So when you think about the brain, the brain in the workplace experiences a lot of symptoms in burnout because the pressures of the workplace are causing the burnout. But when you remove that brain from the workplace and that brain gets rest and is away from the stressors, that burnout gets better. Right, high function depression in the workplace you have all the
same pressures of the workplace. You sell the symptoms, you remove that brain. What happens. They don't get better, They're finding other work to do. They can't sit still, they can't relax. When they're not busy, they're empty. When they're not doing work, they feel restless. So that's a difference. Burnout is caused by the actual environment. High function depression is something internal. There's something inside that's not resolved. So even if you take them out of the environment, they
can't relax. And so I think a lot of education needs to be done about that, and that's why people are taking all these burnout courses and they're still not feeling better. I think a lot of people have individualized pain that they're not acknowledging, and it's being mislabeled.
How would you say the pandemic kind of interacted with high functioning depression. What are your guesses around whether that led to maybe more high functioning depression or what.
Yeah, and I'll bring my brain out again with the pandemic. Like if you think about trauma as an ocean, we got hit with this uncertainty. Okay, then before we could recover, ro'll told oh, actually you can go back, We're safe, okay, but then we're like, oh, sorry, there's another variant. You have to hide again, So another wave. Oh and then there's Black Lives Matter and George Floyd. Here we go. We hit again with another trauma, and then the capital
hit with another trauma. This environmental disasters hit again, wars abroad hit again, seeing people dying in terrible ways. We just don't get. We haven't had a moment to recover. Our brains have just been hit by so much and it doesn't seem like there was a break. This is a consensus that I've seen around everywhere. It's like what's next? And over time, if you get trauma wave after trauma wave, if trauma wave and you're just not able to literally
catch your breath, you start getting numb. You start to see things online and you're like, you don't even feel anything anymore. When you see disasters, it's like, eh, So, anedonia is tied to trauma as well, and that's why it's important for us to have these terms to understand what's happening to our brains so we can protect our brains. Right, if you know that your brain is being traumatized over and over again, by images you're gonna learn. Okay, maybe I need to take a break. I need to turn
off my phone. Not to say that you shouldn't be pluged into what's happening or informed, but you don't have to be informed twenty four seven. You know you're worthy of rest, you're worthy of self care. So what would you do INSTEADY limit your phone use, go out in the world, touch some grass, interact with people. When you hold a loved one's hand, when you hug a loved one, when you kiss a loved one, oxytocin is released. It's the love attachment hormone. You're not getting that when you're
just like texting them. You want to be able to get out in the world and experience points of joy because it's literally healing. And when I say points of joy, I use that term very intentionally because in the research, the way that we measure happiness is by adding up points literally on these rating scales. But in the real world and therapy world, when patients come in, they're like, oh, doctor dud, I just want to be happy. They don't think in terms of points. They're thinking when I ask them,
what is happiness for you? Well, happiness is when I get like this dream partner, or happiness is when I get a big job or pay off my debt. Right, they're thinking about these events, But happiness is just that it's a situation that depends on the externals. So when something happens externally, then you get happy. Right. Joy is very different. Joy happens when you experience these sensations that literally are responsible for making your brain feel experience happiness.
So that's joy looks like when you eat your food, you're tasting it, you're savoring it. It's yummy. Right when you decide to take a nap, you wake up and you feel refreshed. When you are lonely and you reach out to a loved one, you feel seen and heard and connected. When you're stressed, you're able to self soothe. Stress is actually measured in the happiness research. People don't even realize that it's really hard to access joy when
you're very, very stressed. So you know, the joy are all these experiences that we're literally leaving on the tape and sometimes because we're on our phones all the time. Right, So try this, when you're eating your food, put your phone away, put it in like the next room, and literally just eat your food and peace and taste it and savor it. When you're talking to your loved one or playing with your pet, put the phone the other room,
and just be really present. Right. All of these experiences literally release the points of joy that we add up to see if someone's becoming happy, versus people who say, well, when X happens, I will be happy. Because that delayed happiness model doesn't work. Even when you get those things that you're holding your breath for, you're still not happy. So try and experience the points of joy in the every day, because that's how you actually measure whether or not you're becoming happier.
Thank you so much for that, doctor Judith. I know so many people will resonate with everything that you have shared here today. I know lots of conversations will happen. Please let us know where can we stay connected with you and grab our own copy of High Functioning.
Thank you so much for having me. It's so great to see you at all these events. You can follow me at at doctor Judith Joseph, and you can buy my book wherever books are sold, High Functioning Perfect.
Thank you so much, doctor Judith. We'll make sure to include all that in.
Our show notes. Thank you.
I'm so glad Doctor Joseph was able to join us again for today's conversation. To learn more about her and her work, be sure to visit the show notes at Therapy for Blackgirls dot com slash Session four fifty six, and don't forget to text this episode to two of your girls right now and tell them to check it out. Did you know that you could leave us a voicemail
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y'all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care,