Dr. Judith Joseph: How to Recognize High Functioning Depression Signs and Find Treatment | TUH #177

As human beings, we are built with the DNA for joy, but many of us have forgotten how to access it, and we confuse happiness with joy.

I think there's a pandemic of people just accepting, okay, they're walking around at a 5 out of 10. They've chalked it up to aging or a consequence of their environment. Whatever way they have to justify that, they're just kind of just okay.

We have something called anhedonia, and it literally means a lack of joy and pleasure. Pleasure and things that once lit you up.

That's a very dangerous place to be because we have a tendency to delay our gratification and say, well, I'm going to be happy as soon as I will be happy.

When I pay off my loans, I find the perfect partner or when I get that big job. The science shows us even when we get those things, we're still not happy. Happiness is the idea. Joy, on the other hand, is the experience. The motto of my lab is understand the science of your happiness.

People like yourself talk about the impact of nutrition and nutrients on our mood and our emotional state.

You're missing out on other points of joy by neglecting your nutrition. And when you're stressed, you make poor choices, and one of those poor choices is what you put into your body.

How do people start to shift the mindset of, I want to begin to slowly put myself first.

If you don't acknowledge what you're feeling, you are going to.

Hey, guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecker, where we go down the road of everything anti aging, biohacking, longevity, and everything in between. And today's guest is a really, really special guest. You're going to get a lot out of this podcast. It's a category that we don't talk about a lot on the Ultimate Human, but it deserves a lot more attention. And it's all about mental health, mental health and resilience and some of the hidden dangers of just being okay. So I want you to welcome to the podcast, Dr. Jude Joseph. Thank you so much.

I'm so excited to be here.

Yeah, me too. You know, it's. There's a couple themes that. That. That are common to everybody that comes with my podcast. And it's all. We always meet in the kitchen, and we start running the podcast there before we come in here. So. And you and I did the same thing. I'm like, we. We should go in the other room and start this podcast. But it was a fascinating discussion, and you've You've had an amazing journey and I feel like you're in such an incredibly needed niche market of mental health. I wonder if you might just for my audience that doesn't know who you are, tell us a little bit about yourself and, and, and tell me about the book and your, and your research in high functioning depression.

Well, you know, probably the people listening, your audience right now, they were just like me. Pathologically productive, wearing a mask.

Pathologically productive. I like that. Doesn't sound like a bad thing, right?

It doesn't, right. It sounds great. We get rewarded for being productive. Behind that mask of pathological productivity, there's emptiness, there's a struggle. You know, when we sit still, we feel restless. When we're not working, we feel empty. And we have something called anhedonia.

I heard you use that term three times today in the kitchen. And I was like, I consider myself pretty up to speed on these medical terms and I've never heard that. Anhedonia?

Yes, it's a very old medical term that honestly, I went to a recent therapy conference and I asked a bunch of therapists, what is anhedonia? Many of them had never even heard of it. But it's a term that's all throughout the literature, in research, and it literally means a lack of joy and pleasure in things that once lit you up. So I mean, it really means meh or bleh.

Meh or bleh. No, we talked about this. I said, I think there's a pandemic of people just accepting. Okay, right. Accepting mediocrity. I mean mediocrity in their, in their socioeconomic life. I mean mediocrity in their state of their mood, their emotional state. They're walking around at a 5 out of 10. And for whatever reason they've chalked it up to aging or a consequence of their environment or a consequence of, you know, their job or their career, their spouse's kids or lack of sleep or what have you. And I think that's a very dangerous place to be because if you were clinically or severely depressed, let's say generally, it would cause you to seek some help. If you were really tormented by something, you generally will reach out when you're just, eh, just okay. You're on the vacation of a lifetime with people you love the most and a place you've always wanted to go, and you're just kind of, you can't get out of first gear, you can't feel your environment, can't connect with it, and you just don't Feel that joy. Is that what this anhedonia is?

It is. You know, and the way that you're describing it, I hear this a lot. People say to me, well, that's just being a mom or that's just being a dad and a provider, or that's just being a human. Right.

Or that's just being 50 or 60 or 70 or, you know, 40. You know, it's, it's whatever way they have to justify the fact that they're just kind of just okay. And I feel like God put us on this earth to thrive. We're supposed to have it all. I want passion, elation, I want joy, arousal, libido. I want all the, I want all those upper tier emotions, you know, on, on the regular. And I think, you know, we, we have a tendency to delay our gratification and say, well, I'm going to be happy as soon as. Or, you know, when I get this job or when I, you know, get the next relationship or whatever it is, you know, I'm sort of delaying and justifying the reason I feel that way now. And we had a very interesting conversation. I thought it was very poignant because now that you brought my attention to it, you were exactly spot on. You know, I just got done a heavy travel in the Middle east and you asked me because I went to Egypt and Bahrain and some of these other countries, especially Egypt. And you said, did you see poverty? And I said, yeah, I saw extreme poverty. And you said, did you notice that there was also a lot of joy? And, you know, now that you mention it, there was like barefoot, dirty kids playing in the street that seemed really, really happy and didn't seem to even realize the environment that they were in. They were just happy with whatever was going on.

Yeah. That's because joy is our birthright as human beings. We are built with the DNA for joy, but many of us have forgotten how to access it. And we confuse happiness with joy. We say, like we were talking about earlier, I will be happy when I pay off my loans, or I'll be happy when I find the perfect partner or when I get that big job. But the science shows us that even when we get those things, we're still not happy.

Right.

We still keep pushing the goalpost further. Joy, on the other hand, is not an idea. Happiness is the idea. Joy is the experience. It is the. When you're hungry and you eat your food like that delicious food in your kitchen right now.

Yeah, yeah. Which we're gonna have as soon as the podcast is over, we're gonna really.

We're gonna dive into it.

She was like, I don't wanna eat. It's gonna make me sleepy. I'm like, my food won't make you sleepy.

So when we're eating our food, we're savoring it. We're like, you know, when we're tired and we take a rest and we wake up refreshed, that's a point of joy. When we're lonely and we reach out to a loved one and we feel seen and just. We feel nurtured and accepted, that's a point of joy. So there are these human experiences that in my lab, we actually add up those points and we're like, oh, that's how we can tell that you're becoming happier. We rarely say happy in our research, but when patients come into the private practice, they're like, Dr. Judith, I just want to be happy, and I have to reframe it. We're going to leave happy. We're not going to use that term. We're going to access points of joy daily. And that's important because some people will never be happy. They'll never reach that goalpost. But we all have the DNA to access joy. But we're leaving our points on the table every day.

When you say we have the DNA to access joy, I mean, this is really something for somebody that's listening to this, that's like, it's easy for you to say, or, you know, you're not in my life, you don't know what I have going on. And they've accepted that mediocrity is at a donia. Is that the right word? Yes, at a donia. And the fact that you're even identifying it as a thing, I think is very important because I think so many people just have the potential to access joy in their life that maybe they don't know how to do it, which hopefully we're going to talk about some ways that they can. But it's. I see it at all levels, you know, and I have been blessed enough to know some. Some very prominent people socioeconomically or, you know, politically or career wise. But you see it in those. That sector as well. So we're not accessing joy because of our socioeconomic status. We're not accessing joy because of who we're married to or where we live. You know, that seems to not be a component of having joy in your life. So I would love to talk more about your research and for people that are listening, you know, first of all, how do they Identify it. And then secondly, what can they, what can they do about it? Are there, are there exercises they can do to reframe the way that they're, they're thinking or even the way that they're experiencing the world? Because I, I do find a lot of people that go and seek like self help, motivational seminars. They're reading the right books, they're going to the right events, they're trying to surround themselves in the right circles. And even they start things like trying to practice gratitude in the morning or prayer or meditation doesn't seem to pull them out of that, that zone that they're in. And I think in some ways makes it worse because they're like, sheesh, man. I went, you know, I went to the Tony Robbins event. I was really excited when I got there. I got home, I read the book, I did the workbook. You know, every morning I'm thanking God and I, I know that I'm capable of feeling more.

Yeah, I hear this all the time. And the motto of my lab is understand the science of your happiness. There will only ever be one. You ever, like, think about that? In the history of the universe and in the future, the chances of us existing are just. It's a miracle.

Oh, it is.

So you are here for a reason. And when you are using these skills, these tools, these books, without understanding the science of your happiness, then you're going to be lost, you're going to be deflated when it doesn't work. And when I speak to large rooms of people, I will literally ask them to use this tool for my book called the biopsychosocial.

Biosychosocial. By the way, we're gonna link the book in the show notes below.

Yeah, it's a powerful tool, but it is not democratized. When we're medical students, we learn about it, we write about it, about our patients. And I thought, why are we keeping this to ourselves? Everyone should have this. So I liken it to a fingerprint. We all have a fingerprint, but every fingerprint is unique.

Right.

Everyone has a biopsychosocial, but they're all unique. So when you're not thinking about the science of your happiness, then how are you going to be happy here?

Right.

How can you add back your points of joy when you're not even sure where you're losing your joy?

Yeah. What's amazing is you're kind of saying happiness is a process because I think a lot of people say it's a choice. And I, and I think that people that are not happy, would choose to be happy. But it's not like I can just say, okay, I chose happiness today and all of a sudden I'm happy or I'm joyful. But so what is this process that people can go through to start unlocking some of these joyous events in their life and sort of progress towards that state in the now? Hi, guys. Gary here. I want to take a few minutes of your time to invite you to my ultimate human VIP community. This is a private community with front row seats to my most advanced health protocols, exclusive monthly Q and A calls, a private podcast where you can ask my guests and me your most pressing questions and my own personal wellness blueprints and everything you need to optimize your health. You'll connect with like minded folks in this community. You'll get firsthand access to cutting edge insights and enjoy special discounts on products that I trust the most. And here's the best part. Membership is just 97 bucks a month, a fraction of the cost my private clients pay for this same deep dive guidance. If you're ready to supercharge your wellness and skip the guesswork, I'd love for you to join us. Head to theultimatehuman.com VIP that's theultimatehuman.com VIP right now to become one of my ultimate human voices VIPs. This is your fast pass to better health, so don't miss it. Now let's get back to the ultimate human podcast.

Well, let's look at the biopsychosocial. I use myself as an example.

Okay.

Biologically, what am I at risk for? So I have a low thyroid. And for those who have a low thyroid as well, I can fix that.

We'll talk about that after the podcast competency of mine.

But if you have these hormonal issues, you know, and right now I'm in perimenopause, so that's another risk factor for being, you know, losing points of joy. But your medical issue is going to be different than mine. So understand biologically what puts you at risk for losing your points of joy. And then know your family history too, because that's important. And then psychologically, what is in your past. So for my past traumas, I came from Trinidad to this country with very little. So I have something called scarcity trauma and I make a ton of videos about this. Really, it's when you come from very little and you're constantly in fight or flight because you worry that you're gonna run out, even though logically you're like, you know, you have money in the bank, you can't slow down.

Yeah.

Because you're constantly afraid that you're gonna run out. For others, there could be a personal trauma that has to do with something violent. But understand how that impacts your points of joy. And for some of us, psychologically, we have attachment styles that are unhealthy. And so we're partnering with people that are unhealthy and not positive for us. So we're losing points. And then socially, that's what's happening around you. Where are you living? How much alcohol are you consuming? What are the types of foods you're eating? Are they processed? Are they causing inflammation? What are the relationships in your life? Because socially, we know from longevity science that that's a top predictor of your health outcomes.

No doubt.

So you know, and what are the habits? Are you smoking? When you understand the biopsychosocial, you know where you're losing points, you know where to add the points back. So I always ask people to start there because like a fingerprint, there's only one biopsychosocial that's made for you. So understand it, do yourself that.

So in terms of, like, when you talk about the biology, like, you know, you have low thyroid, are you suggesting people actually go get some data on their bodies? Like go get, go get some blood work done. Yes, go get some testing done and find out first of all, if everything's in balance. I mean, if you're a woman in your estrogen dominant, or you're a male and you have virtually no testosterone, or, you know, your cycle is off, if you're a female, I'm menstruating female. There's a very difficult time, I would think, balancing your mental health. Because I find it really funny that modern medicine has a tendency to think of this completely separate from this forgetting that little connection here and that we can be sick here and be fine here, or we can be sick here and be fine here. And I don't think that that's true.

It's not true. And hormones travel throughout the body. And even if you do a blood test for, let's say hormone, for perimenopause or menopause, even that point in time may not reflect what's happening. So you want to work with someone who understands that you can't just take one test. You may have to look at all these clinical symptoms and then put it all together.

Right.

But acknowledge that, you know, those hormones don't just stay in that pelvic area, they travel in the bloodstream, they impact every cell in your body. So that's why many of us, again, can't access joy. We don't even understand what's getting in the way of our joy. So this model is extremely powerful.

In your book, do you talk about what labs they should pull? I mean. Oh, you do? Okay, great. So for a woman, because I know you've done a lot in women's empowerment, you came from a women's empowerment event today, right? She had a picture of her and Tyler Perry with her book. And so you're on the move like I am. I love it. And so she was at a women's empowerment event today. And we talk about it a lot on my podcast. That 82% of all autoimmune disease affects women. And it actually has nothing to do with sex. It's not because it's like certain, certain diseases will be in certain populations because of their hair, sickle cell anemia and African Americans, for example. That's a, that's a real disposition based on your heritage. But autoimmune, because you're female is not because you're female. And it's, you know, a lot of functional medicine, doctors postulate that it's because women have a tendency to. They call it caregiver syndrome, you know, to put the needs of others before the needs themselves and almost feel guilty about caring for themselves. So if, if someone's listening to this right now, they want to go on this journey, and obviously I recommend they get your book and we'll link in the show notes. But they, they go and they just get a basic panel. What kind of blood work are you suggesting they look at?

Well, because I'm a psychiatrist, I'm always thinking, what are the areas we can address first? Rather than piling on a medication, let's understand where you're deficient. And in my research, with high functioning depression, people are busy. They're so busy they don't meet their basic needs. So what are they doing? They're eating a lot of processed foods, greasy foods, foods without nutrients, convenient. It's on the fly. And there's a correlation between trauma and hfd. So they feel like there's a core belief of being unworthy. So on a surface level, they're like, they're not thinking, oh, I'm unworthy, so I'm gonna eat this bag of chips. But on a deeper level, they don't love themselves the way they should. So they're eating foods because, look, I just need to fuel myself to take care of others. Many of them lack vitamins, so you have to be tired, sluggish.

My wheelhouse, Love it.

Yes. They're not meeting their basic needs. So I do full vitamin panels and I often see low vitamin D, low B. You know, people are not getting good sleep. They're not, they're just, they're just not getting the nutrition to support their brain.

Yeah.

And then they wonder why they have anhedonia. Well, anhedonia isn't just one avenue. There are many avenues to getting joy in our brains, and nutrition is a really important one of those.

So you start with this blood panel. Imagine you're looking at hormones, vitamin D3. You're, you're looking at nutrient deficiencies, which I am a huge fan. I'm so glad that you said that, because I don't profess to be a mental health expert by, by any means, but I can tell you in the hundreds of thousands of clients that have come through our clinic system, very often you can pull somebody out of their state of mediocrity. A mediocrity, meaning their mental and emotional mediocrity, just by putting the right raw materials into the body. I mean, if at the end of the day, we make our own neurotransmitters, we manufacture them in the body, and the neurotransmitters are creating mood and they're creating emotion. And so if your factory that's manufacturing those raw materials, neurotransmitters, is broken or it doesn't have the nutrients it needs to do its job. Now all of a sudden, you find yourself going down the mental health bandwagon, you know, down, down the mental health road. And truly, nothing wrong with you, you're just nutrient deficient.

I mean, not only is your factory broken, it's on fire because it's inflamed. Many of the foods that we're eating and the chemicals we're eating, it's just causing so much inflammation in our bodies, and it's hard for our brains to be happy when they're inflamed. And not to say that there's anything wrong with medication, but we're missing points, Right. Two things can be true. You may need the support of a medication, but, but you're missing out on other points of joy by neglecting your nutrition, your basic needs.

Yeah. You know, I think high functioning depression is a new term for a lot of people. I find it very descriptive because there are a lot of people that are very high functioning, meaning they're very intelligent, they're very successful in their careers. And they're good people. They're good husbands or wives, they're good fathers or mothers. So myopically looking at them from the outside in, there's nothing wrong, you know, And. And yet they're in this state of patedonia. So can you just describe to us what. What is high functioning depression?

Well, all of the people you described just now, they likely feel more comfortable saying, I'm burnt out, Right?

Yeah.

Burnout is so much more accepted. If someone says they're burnt out, it's.

Almost like a cool thing because it means that you're busting your ass to build your business. And we get that right out at home.

When you go in a room and you say, I'm burnt out, you'll get a very different response than if you walked in a room and you said, I'm depressed. People can be like, well, about that. I'll talk to you later.

Yeah, exactly. When you're like, I'm burned out, they're like, yeah, me too.

Right?

Misery loves company. Everybody's burned out.

You say you're depressed, they're like, wow, okay, well. But the reason is because burnout is so accepted. And when you think about burnout, it is a relatively new term. It wasn't in our bible of Psychiatry, the DSM 5, the Diagnostic Statistical Manual, until very recently. But no one would say that before it was put into that bible psychiatry, that it didn't exist. We all knew it existed. The difference is that burnout is an occupational hazard. So the job is causing the symptoms. The job is causing you to be uninspired, have irritability, low energy, doesn't bring you any joy. And it's also like, causing a lot of stress. Right. It's hard to be joyful when you're stressed.

Yeah.

But when you remove.