Overworking? You may be DEPRESSED! | Dr. Judith Joseph

Women are twice as likely to have depression, twice as likely to have anxiety compared to men.

You're still pushing yourself. You're like, okay, like maybe this is not a big deal, but you're in a lot of pain.

That guilt is a symptom of depression. People don't realize guilt is a symptom of depression and trauma.

We break down. We feel totally lost.

It's over-busying, over-productiveness, and this is how people express their pain. They're not in the bed crying and not working. They're in the bed working.

I thought my life was over. I was like, this is it.

Find a way to make their way back to joy again so they don't experience Anhedonia, which most people don't even know exists.

How does that help with peak brain performance?

A stressed brain does not make good decisions.

What makes us really happy? What is the formula?

I say that we all have happiness in our hands, right? The 5 Vs.

The first is—

Welcome back, Kwik Brains. Today we have a very special episode. We're switching things up a little bit. Our CEO, Alexis Bank, who many of you are familiar with, she was a keynote speaker at our Limitless Learners Summit. She's also the voice in our Limitless Expanded Audible audiobook, where we talked at the end of each chapter, kind of like a podcast episode. Many of you enjoyed that. We got such great feedback. And she will be leading today's interview with the incredible Dr. Judith Joseph. Going forward, Alexis will be joining us from time to time as co-host, sharing her personal perspectives on topics that have deeply resonated with her. And offering her own unique insights. Alexis, the floor is yours.

You wake up in the morning, manage your family life, thrive at work, and at least on the outside, it appears like you're doing just fine. But on the inside, something doesn't feel right. You're carrying the weight of depression without anyone noticing. Does that sound familiar? That's the experience that led today's guest, Dr. Judith Joseph, to uncover a little-known form of depression, high-functioning depression, where individuals manage to appear normal but are battling deep emotional struggles. I'm no stranger to the sneaky but detrimental effects of high-functioning depression, as I've gone through it personally about 3 years ago. And this is an important conversation, especially for busy people who are always on the go. But there is hope and there is a process that can help you overcome this numbing state to get you back into your high vibrating state, because we all deserve to have joy in our lives while we're achieving our goals. And Dr. Judith has a deep level of insight into how we can do that. She is a board-certified psychiatrist with a wealth of expertise in child, adolescent and adult psychiatry. She also serves as the chair of the Women in Medicine Initiative at Columbia University, and she's the principal investigator for several groundbreaking clinical research studies in mental health. In her lab, Dr. Judith is leading the first-ever research study on high-functioning depression. She also has developed the TICE method to address mental health challenges during menopause, and she's an advocate for menopause research. And Dr. Judith's book, High Functioning Depression, which I have right here, has been eye-opening for me, and I have no doubt it will be powerful for you as well. Hi, Dr. Judith. Thank you so much for being with us today. I know you're very busy and you took your time out of the day to have this conversation, so thank you and welcome.

Oh, it's my pleasure. I love talking about happiness.

Happiness. And also the very important topic that we will cover. So your book, which I absolutely love, with a lot of notes, it was really an eye-opener. And I get to have this conversation now with my team. And also I was having conversation with my mentor and just everyone who I talked to, because we're all at some level high functioning. We're like, oh my God, you know, that's really interesting and insightful topic. And even my mentor went on and just— he watched a bunch of your videos and he's like, oh my God, I need to know her work. So it's transformational and it's very important. So your book is called High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy. When people look at this, like, what exactly is high-functioning depression? And how is that different from other typical depression that you see?

Well, I wanted people to walk by the bookstands and look at it and say, oh, high-functioning? That's me. Like, I'm high-functioning. And then be like, wait a second, it says something about depression and reclaiming your joy. Like, am I depressed? And I think that that is very symbolic of the experience that I had. as a psychiatrist and a researcher in 2020 when I was giving a talk to a massive healthcare system. And they were facing a lot of uncertainty with the pandemic and they were freaking out. And I was called in to be the calming voice, the voice of coping and so forth. And halfway through the talk, I was like, oh my gosh, I think I'm depressed, right? So the COVID of the book is very representative of the experience of people who are high functioning. We put on a mask of productivity. We don't show our struggles. We're the rock. We're the parent. We're the entrepreneur. We're the leader. We're doing everything. We're the caregiver, but we're actually struggling and no one knows it because we wear this mask of productivity. So it is a hidden depression. And the reason I call it a hidden depression is because in the traditional medical system, clinical depression means that you have these symptoms of depression, but you break down. You have impairment in your functioning. You have significant distress, right? To meet criteria for these specific mood disorders, you have to meet those 2 things. But I was seeing people who had all these symptoms. They experienced something called Anhedonia, which is a lack of interest and pleasure in things that once used to light you up. You know, they're exhausted. They can't focus as well. They're not sleeping as well. They feel guilty, you know, when they don't deliver and show up for others. They have these symptoms of depression, but they're functioning. In fact, they're not just functioning. Some of them are over-functioning like I was, right? And I just thought, well, if I'm experiencing this, how many people are experiencing this? And so I did the first study in high-functioning depression to be ever published in a peer-reviewed article in a journal. And I wrote a book based on what I was seeing. And I truly believe that people will feel seen, that they'll find a way to make their way back to joy again so they don't experience anhedonia, which most people don't even know exists. They don't even know that's a medical term. I'm trying to bring that back into the Everyday language. And I hope they not only feel seen and heard, but that they build on the tools that I provide so that they can reclaim their joy again.

Anhedonia. I also never heard of that until I read your book. It's an interesting concept. So you mentioned this high-functioning depression. They're very productive. So I'm curious, like, how is stress playing part of that? Or because normally Under typical depression, stress hinders performance. So how is this showing up for high-functioning depressed people? Like, is it different the way it shows up on the brain?

Yes. And, you know, I started off saying, like, I love to talk about happiness. And so people are always shocked, like, wait, isn't this book about depression?

What are you talking about?

There can't be light without darkness. There can't be happiness without sadness, right? And so I want people to understand the science of their happiness. The science of your happiness is different than the science of my happiness, right? So someone who has clinical depression may express their depression like the traditional meme, right? Like can't get out of bed, crying, pessimistic. But other people experience symptoms of depression and they express it completely differently. They may, rather than acknowledge their symptoms, they become busy. They are restless when they sit still. They are empty when they have nothing to do. So what do they do? They work, work, work. And in my research, what I found was that many of these people, if not all of them, have unprocessed trauma. So there are negative things that happened that they are trying to busy themselves to distract from. And many people, when they think about trauma, they think of PTSD, like flashbacks, nightmares, hypervigilance. You're avoiding things. Well, you don't just avoid things. You avoid emotions. You avoid memories. And so when you have unprocessed trauma, your way of avoiding processing the trauma is busying yourself. So that project that was supposed to be a month ends up being you committing to a second or third project that ends up being a year. Right? That vacation that you were supposed to take gets delayed until next year, or you don't take the vacation time at all. You know, or, you know, you leave work, but you can't turn it off. You can't turn off the work. You find yourself restless, so you end up checking your emails while you're watching your favorite show. It's over-busying, over-productiveness. And this is how people express their pain who have high-functioning depression. So they're not in the bed. You know, they may— they're not in the bed crying and not working. They're in the bed working. They're in the bed doom scrolling, right? Instead of spending time with your kid when you come home from work, you know, you're too burnt out and distracted and you have too much blah, anhedonia, to spend time with your kids. So what do you do? You feel guilty because you didn't spend time with them. And instead, you're in bed looking at pictures of them. I can't tell you how many working moms tell me that, right? So it's like they never win. And that guilt is a symptom of depression. People don't realize guilt is a symptom of depression and trauma. So I want people to understand the science of your happiness because you're the only you who will ever exist. And when you're trying tools that work for others and they're not working for you, it's because you don't understand your own science. And only when you understand your science can you then start to fully utilize the tools that every person has in their DNA for joy. We're all born with the DNA, the genetics to create joy. We all have dopamine in our brains, right? But we just forget about it. We forget how to access it. And so my tools, they represent your hand because most of us have 5 fingers, right? The 5 Vs to thriving, because joy is literally within our hands. We just don't know how to access it. And so understand the science of your happiness and then access your joy using the 5 Vs, and then you can find your way back to who you are. You just forgot who you are.

Very interesting point you made there. Before we get into 5 Vs, I do want to mention what you just talked about, because what I love about your approach, it's very similar to, like you said, understanding your happiness science. And what we find is that we're all wired differently. We're similar, but not exactly. And our life experiences and also what emotions we chose to associate with those experiences, whether we did it consciously or unconsciously, it's all there. And it's Very different. And what, how people, even like the way people define the meaning of success or happiness is very different. And in our, you know, in our company, we're, you know, we talk about the brain types and how do people learn best. It's all different, but we never talk about this, you know, what makes us really happy? What is that formula? So I like that, how you make it very personalized and inviting people to find your happiness and choose your path. Like what really makes you happy and how do you react to hardships? Because we all react very differently. And I think that's a very key important point that, you know, I wanted to bring forth. And also, speaking of that, is there some sort of a checklist or some kind of like self-diagnosis somebody can do? Because knowing that we all have this sort of different path of finding happiness or dealing with stressful situations. Where can somebody start to see that, okay, am I experiencing this right now? Is this temporary or something that I just kind of like fell into? Is there like a place where we can self-check?

Yes. And I love what you said, you know, the duality of it. 2 things can be true. We are all humans and we are all so unique and different, right? So we have to understand what makes us different and we can access tools that work for all of us, but we access it differently, right? Just in the way that DNA, you know, genetics is the same. Human beings are human beings, but some of us have access to parts of our genes that others don't, right?

Mm-hmm.

And with mental health, it's really challenging sometimes because, you know, with— if you have diabetes, you can do a blood glucose test, right? And you can check your hemoglobin A1C, which tells you where you are in your diabetes journey. You know, if you have high cholesterol, there's a number. You can take a blood test and look at your LDLs, your HDLs, your lipids, your triglycerides. And the same goes, you know, for most medical conditions, right? So with depression, there's not that satisfaction, right? You know, people will tell you, oh, you could scan a brain, but correlation is not necessarily causation, right? So you may see patterns, but it's not the same for everyone. A brain that's a postpartum brain may express depression but have a very different look on an imaging scan than a man's brain who's experiencing major depressive disorder. That's why you can't just scan brains and say you have something, right? The science isn't there yet. But with mental health conditions in my lab, the way that we measure whether or not someone's getting better, staying the same, or getting worse are psychometric rating scales. So it's a fancy way of saying that we use these standardized rating scales to ask patients about their symptoms, and we calculate the points of joy. And the interesting thing, and this is why I love what I do, is that in the lab, we use points to tally up depression, right? On, on our rating scales, you very rarely see the word happy. But when a patient comes to a therapist, The first thing they say is, I just want to be happy. So I thought, where's the disconnect between what regular people think and what researchers think? So how can I make that explanation available to everyone? Because it's my purpose to democratize mental health. When we add up these points, what we're adding up are all the components of what happiness is. So happiness is not just one feeling. We always think it's just like a smile. But When you're truly happy, you're feeling these feelings, right? Happiness is when you're lonely, feeling connected to someone, when you're hungry, savoring and feeling like the meal really satisfied you, when you're tired, resting, when you want to feel inspired, engaging in art or creativity. That's what happiness is, right? It's all these little points of joy. It's not just one destination. There are many ways to get there and many pathways to get there. So I really wanted people to have a tool to understand where they were on the span of happiness. So I created the Anhedonia Rating Scale based on other modified rating scales that have been used in the past. But a lot of the ones that were used in the past are pretty archaic. Like, some of them are British. So it's like, did you enjoy a cup of tea today? Like, we don't really drink tea here. So I wanted to use things that were relevant to our culture today. And I modified the scale. And, you know, when I first brought the scale out, I talked about it on a very, very popular program. And I got inundated. I got like almost like 10,000 people filling it out from that one program. And it was like it crashed my website. So I knew people really wanted to understand, like, what is this? Why do I feel meh? Why do I feel blah? They just didn't have the words for it. And it's really powerful to use these names and these titles for these words, these conditions, and these symptoms because it's not just to label someone. I have followers saying, you just want to label somebody. No, it's actually science. When you can name the emotion, it creates less confusion for you. And human beings don't like the unknown. They don't like uncertainty. We all, you know, we didn't have a good time during 2020 when we didn't know what was happening. So naming the feeling, saying I have anhedonia or I'm experiencing anhedonia, is so powerful. It validates us that there's nothing wrong with us, that we're experiencing something that's real, that it's something to pay attention to. And it decreases our uncertainty. We're not like, why do I just feel like this? I don't even know what the name of this is. We now know what it is. And when we know what something is, then we can do something about it that is actually evidence-based. And so when people take this anhedonia rating scale that's available on my website, They know which areas of life they're getting joy from and which areas there's a deficiency. I call it like, you know, not vitamin A deficiency, but A deficiency, like deficiency A for anhedonia, right? Because— or J deficiency because it's joy deficiency. So what are the areas in life that you're losing joy and how can you get points of joy in a day? And this is very powerful. And it's powerful because when someone is trying to be happy, they may be like, I can never feel happy. I can never get there. But when you reframe it and you're like, let me see if I can get several points of joy in a day versus let me be happy, it changes things for you. You're like, well, I'm going to— I got 2 points today. Let me— I'm going to try to get 3 tomorrow. You don't feel like you failed because there's always ways to get points of joy. And I told you how patients come to practice and they're like, I just want to be happy. I often ask people, what does happiness mean to you? And they're stumped, right? There are 2 questions. What do you want? And what is happiness for you? They tend to get stumped or they say, well, happiness is, you know, like when you finally get the partner, when you finally get the job, when you finally get the house, it's always these things. But what you realize is that when you're on your deathbed, you're not going to want more things. You're not going to be like, I really wish I had those like, you know, silver Louboutins, right? You're going to be like, I wish I had 5 more minutes with my loved ones. I wish I, you know, saw that place in nature that made me really feel warm and fuzzy inside one more time. You know, I wish I could do things that brought meaning and purpose. That's, that's what you wish for. So, you know, it's a real reframe. Like, rather than happiness is the destination, it's how do I get these points of joy every day? And it's very powerful. Like, I see patients not feeling hopeless. They don't feel like There's, they're never going to attain what they came for. They, they feel hopeful.

That's the most important part. And what I love about this is that you're almost gamifying this whole, you know, getting the joy and happiness points throughout the day. And it doesn't have to be a lot, even if it's a, like a 1 point that you get that day, you can still consider it a win. And we get this question too, because we talk about the flow state where you get, you know, you feel like you have this invincible power and people always like, well, can I Can I access flow state all the time? Like, it's not—

that's not how things work.

There, you know, there are ups and downs, ebb and flow throughout the days and, you know, pretty much our life. And nothing is constant, right? Like, there's this wave and flow that comes through in and out. Um, so we often misunderstand, even with happiness, that we have to be happy all the time. But that's not true. And it's this, um, the system. And I like how you talked about it's almost like a brain mapping. So you're brain mapping your current process and system of how you're getting these points. I think that's really, really fun to really sit down and think about those things because we don't think about it that way.

We don't. And fun fact, when I was a resident, a child psychiatry resident, because I treat children and adults at NYU, I I wanted to find more joy while I was there. So I asked the program director if I could start a series where I interviewed the people, the experts who came in for grand rounds. And my first interview was, and I hope I do not butcher the name, Mihaly Csikszentmihalyi, who invented flow theory, right? He's passed since then, but we did a little video. It's still actually on YouTube to this day, and I'm mortified because I was a terrible interviewer, but I've grown since then. But he said something interesting. You know, he said a lot of people and a lot of children in parts of the world that are devastated, you'll still find them happy. You'll still find them smiling and giggling because we are programmed for joy, right? So we all have it built in. And even people in the worst conditions in the world, in the war zone, you know, in terrible humane conditions can still find joy. And so, I think that there's this misconception that you can't struggle, like if you're struggling, you can't be happy, you know? Yes, it makes it more difficult, but there's always a point. You can always hit a point. So, I've totally changed the way that I see things too. Like, you know, yesterday I worked really hard and I didn't make a lot of points for joy. So, today I said, I'm going to find points of joy today. I'm going to make it a mission to get more points than yesterday. And then that frees me up because I don't feel so guilty. I'm not like, oh, here I am, this expert in high-functioning depression. I was a workaholic yesterday. Literally didn't even give myself a chance to eat properly and pee. But then today, I'm giving myself more grace. I'm like, I'm going to use the bathroom more. I gave a talk at a women's conference. And I asked the high-powered women, how many of you have worked straight through And you had to pee, but you just held it in and you still worked? And there was not one hand that wasn't raised. The same for eating. I gave a talk at a health conference, healthcare workers, and they laughed. I was like, so, you know, how many of you guys had a lunch break this week? And they just busted out laughing. It just— We are humans doing instead of like a human being, right? So I ask, are you a human doing or a human being? And that's my mantra. I ask myself at the end of each day, was I a human doing or a human being today? I'm going to do more in terms of points of joy for the next day. And it keeps me accountable. And I love that I put these tools in my book because there aren't that many mental health providers out there. In some parts of the country, there's only 1 psychiatrist for every 30,000 people. And if everyone had this information— not that I'm providing treatment, but just this information, then they could start really understanding the science of their happiness and practicing things that can make them have more points of joy every day. And unlike— there's this wave of longevity science. There's this wave of these doctors who are writing these books who are trying to prevent healthcare outcomes. But where's this wave for mental health? You know, I'm waiting for it to come. So I was like, let me be the wave, right? Instead of treating mental health conditions, we need to prevent them. Instead of waiting for someone to break down and develop clinical depression because they have all the symptoms of depression and now they finally check that box of not functioning or distress, why are we waiting for them to get in distress to help them? That's like counterintuitive. It's illogical, right? Because in the mental health and healthcare field, we're taught to be healers. Right? We're not taught to be preventers. That doesn't sound sexy.

We want to heal.

But let's take our egos out of it. Why don't we provide people with the tools to prevent conditions so that they don't need us as much, right?

Mm-hmm.

That they need us for the people who have loss functioning, yes. But there's a whole bunch of people out there with these symptoms who haven't lost functioning. They're over-functioning. Let's prevent a crisis from happening. Let's prevent them from finally breaking down. Mentally and developing low-functioning depression. Let's prevent them from having a physical breakdown because the mind-body connection is real, right? Ending up in the in the ER for like chest pain and cardiac issues. Let's prevent them from self-medicating because they can't express their emotions or cope, you know, adaptively. So they're self-medicating, or they're on their phones all day long, or they're shopping, or they're coping in other unhealthy ways. Let's prevent this. So that we can do something about this looming mental health epidemic that we see it, we feel it, we know it, the numbers are going up. And so for all those numbers where they have broken down, think about all the people waiting in queue to break down. Let's prevent that from happening.

It's really fascinating because yeah, you have to— it's like by the time we break down, we feel totally lost. And then it impacts all areas of the health too. And that's what stopped me eventually because I was going down on this path about 3 years ago. I mean, it started a little more than 3 years ago because it creeps up on you and you don't even know that you're on this path. And after a few years, and it really hit me 3 years ago when it impacted my entire GI tract. And even then you're still pushing yourself. You're like, okay, like maybe this is not a big deal. And then, but you're in a lot of pain and eventually led to like allergic reactions and Eventually led to brain fog, really severe brain fog. I couldn't think about, like, I couldn't remember anything. And in the work that we do, that was like, I thought my life was over. I was like, this is it. Like, this is like, my life was over. And that's what really stopped me on the track. And if you don't pay attention to things, your body's giving you warning signs throughout the entire, like for years, and you don't listen. And it just stops you eventually. It's like, no. Stop here. Like, you're not going any further. And it's sad that we have to come to that place to really start paying attention and acknowledging that, okay, something is not right. Like, I need to do something about this. And, you know, when becoming like, you know, high functioning— because I've been high functioning for a while, um, and what you say about like skipping lunch break and not going to the bathroom for a long time, I'm very much guilty of that. But now I do Something very similar. I didn't think of it as earning joy points, but throughout every day, there's time where I really give myself the time to completely decompress and disconnect from everything that's going on. So, because that's my time of like non-negotiables that I have implemented that allows me to kind of push through in the bursts of time that I designate. But before, I didn't have any of those things. So you're just, going and going and going without checking in with yourself to get those joy points, you know, later in the day or like today for you, you know, you can get your joy point. So I find that really, really fascinating. And you talk about, um, because I know you've been traveling all around the world, you know, doing this research in many different countries and the cultural aspect that you also brought up in your book. I found it really interesting. And during your research traveling through, I think like 30 different countries you went to, have you found any common like signs or patterns that you see that may contribute to people who would be more likely to have the high-functioning depression?

Yes. You know, when I was, uh, when I was in training at Columbia, I got this grant. It's from the government. I don't know if they still do this, but I was able to study cultural psychiatry. My first stop was was actually China, and you know how I said two things can be true: we're all so different, but also we're also humans, right? So we're so the same. But what I found was that understanding your bio psychosocial. really helps people to break their bodies down and their minds down and their just cultures down into a simple model. And you mentioned that when you were going through your high-functioning period, your body was saying stop and stop, please. And it just stopped on you. And when your body says no, it doesn't matter how many times your brain says yes, your body will, will win that battle, right?

Yeah.

So the biopsychosocial model is something that all medical students learn. You know, and we write about it in our little write-ups, and then it goes in the file. But I just thought, what if we democratize this and we just started having patients do this? And so I started doing this. And what I have is I have people write out their biopsychosocial. So imagine 3 bubbles that overlap like a Venn diagram. So biologically, this is what you're at risk for, right? So like, if you have a family history of medical conditions, or if you have medical condition, So I'll use myself as an example. I have a thyroid condition. So that could contribute to me feeling anxious or depressed at times. But also biologically, what medications you take, how do they interact with your whole biome? And then psychologically, what's your past trauma? Personally, I have a past of scarcity trauma. I came to this country from Trinidad when I was young. We had very little. There were times when we were living on— donations, didn't have money to pay bills. So that scarcity was there. And I also had my own personal traumas. And also, you know, within psychology, it's what's your attachment style? Are you anxious? Are you secure attachment? Are you avoidant? What are your resiliency factors, your IQ, and so forth? And then in the social bubble is what's going on around you. Like, it's the nature part, right? So like, what's your job like? What are your relationships like? Do you have a toxic lover? Do you have a toxic boss? Are you caring for your elderly parents? Do you have a lot of kids to take care of? Socially, do you move? Do you eat healthy? Do you smoke? Do you engage in habits like excessive drinking, right? And you see that these overlap a bit, right? Because the social aspect overlaps with your biology, right? Because if you're drinking a lot, that's going to creep into your biology, but it's also going to creep into your psychology. So, they overlap. But understanding what makes you unique, right? So, socially, I'm a I'm a busy entrepreneur. I have a small child at home. You know, there's a lot going on there. And so understanding each component allows you to see where you need to focus more. So for example, if someone biologically had an autoimmune condition, right, but they also had past trauma, and then their job was relatively stable because they were a full-time student, but it was stressful, right? I would want to focus on the things that are actually distressing this person the most, right? So if let's say they had an— the autoimmune condition was out of control, I would say, well, let's focus our efforts there because that's the primary factor that's impeding your happiness right now, right? But let's say the autoimmune condition was well controlled and psychologically their trauma wasn't, right? And socially everything was pretty stable. Well, I'd say, well, it's hard for you to derive happiness because you're constantly in fight or flight. You know, but let's say that the biological and the psychological were stable and then the social was erratic, right? They were in a toxic relationship with a partner. Well, it doesn't matter how much kale you eat, that toxic partner's got to go, right? So it helps you to understand what's stressing the system, right? You are the system. You are the science. What's stressing the science right now? And how could we support you in ways that make sense?

Mm-hmm.

And so with the 5 Vs, tools that I use, you can pull from those tools to address what's stressing you the most. But, you know, across cultures, what I found is this remarkable pattern of interacting with people. It's called masochism. So it's not like the sexual masochism that you see in like these stores, or you read about, and there's nothing wrong with that. No, no judgment there. But what the masochism I'm talking about is the part that many people don't know was removed from the Bible of psychiatry, the DSM-5, the Diagnostic Statistical Manual of Psychiatry. It's not in there, but it used to be in there for version 3. But it was decided to take it out because masochism, which is bending over backwards for people, making others happy at your own expense, being kind of like a martyr, it was thought that it was being overused to victim blame. So when women were being, you know, the victims of domestic violence, they brought it on themselves because one of the One of the traits in masochistic personality disorders is that you incite this towards you. So it was thought to be politically incorrect. And I agree with that, you know, but there are masochistic traits that I believe we kind of threw the baby out with the bathwater. So things that now people call people pleasing, things like, you know, if you are burnt out, taking on more work because you want to please others or, you know, sacrificing your own happiness for others. saying yes all the time. I found that a lot of people with high-functioning depression find themselves in these dynamics. And I talk about how there are different types of masochism that exist. There's cultural masochism, there's, you know, capitalism, there's relationship masochism. But once you recognize it, then you can do something about it. And, you know, I myself have these very toxic people-pleasing ways that I have to remind myself that these will impede my happiness, right? That this is getting in the way of the science of my own happiness. And I give people tools on how to address this in meaningful ways so that they can make radical changes in their lives.

When I was reading your book and you laid out these components, I'm like, oh, I have all of those things. I'm like, no wonder why I fell into this and this And I think culturally came from, and I wanted to bring up this culture piece because that did impact the expectation that I thought people had of me because it was very, you know, I grew up in Korea. I also moved here when I was 11 years old and it was a very difficult time. We came here with almost nothing. So the cultural aspect of how they showed up for me and being the caretaker. I ended up doing the same thing just throughout my life. And as long as everything else was taken care of, that was okay because that's what I associated, you know, my self-worth or value by just constantly giving and giving and giving. And it had to take me down to that path of just completely like losing everything in terms of health and had to rebuild myself back up from that. place that really got me to realize, okay, I need to change the system. Whatever that happened, like that led me here, it cannot continue. But I noticed that as I was going back to just doing the rewiring work, I noticed that it's been long-seated for a long, long time. And that was my programming. So that was really, it was an eye-opener. And that's why I wanted to bring that. Um, ask you about it. Um, but also speaking of, you know, cultural aspects, have you noticed any universal habits for happiness? And how does it show up for brain performance across different cultures? Because you mentioned briefly about the kids in the third world country, like what are some of the habits people have for the happiness component?

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Yeah, you know, that part with the cultural stuff and girls in particular, I found that just about everywhere. You know, girls are just taught to be caretakers, to not brag, to be submissive. And there's a reason for that, right? Like, In our brains, as you know, people with XX, we have different chemistry. Like when we see someone in pain, we have more empathy. Our brains light up differently compared to others who don't have our biochemistry. And so that's why we're caring. That's why we're mothers. That's why we're nurturers, right? Because that extra empathy helps us. to take care of small children. That's why we evolved that way. But knowing that helps me, you know, because when I'm feeling bad for, like, standing up for myself or for setting boundaries, what I say to myself is, oh, my brain is set up this way to take care of my small child. But that guy over there, he's not my child. So I'm not going to feel sorry for him. And it helps me, you know? So I think understanding—

I love that.

—the science of your happiness allows you to be like, wait a second, that's my brain being nurturing. But that doesn't apply here. I need to set limits and protect myself so that I could take care of myself for my small child who deserves my empathy. Right. But that guy, he doesn't deserve it. Right. It really helps you. But, you know, in terms of the universal things, you know, I say that we all have happiness in our hands. Right. The 5 V's. It's within our reach. And the first is validation. When you accept how you feel, no matter if it's good or bad, In our culture, we tend to only show what's good on socials. We only say, hi, I'm great. I'm fine. You? We rarely say, actually, I'm really tired and exhausted and I'm not doing that great, because you'd bring down the room, right? But I think it's important to name all emotions, both perceived positive and perceived negative, right? When you name emotions, there's less self-blame there. It's like, I'm feeling something that's real. I deserve to have all these feelings, right? Things happen to me in the day, right? There's less blame and shame so that you don't have to hide it. You're not hiding behind a mask because there's nothing to be ashamed of, right? So validate your emotions. Vent them. And venting can be very different ways. One of my most recent venting strategies has been crying. Like, I used to be someone who didn't cry that much. But now it's like, I'm upset. I cry. And I'm like, oh, I feel better. But there's biochemistry behind that. When you cry, you release hormones. You release stress. So that's why we were evolved this way. If you think about it, tears don't have any real function aside from lubricating your eye. But actual tears that pour down, they don't really have a function other than to make you feel better. So I cry more. And I used to cry and say, I'm so sorry. But now I'm like, I'm just really sad right now. And there's no shame in it. But venting can also be talking to someone. It could be writing. It could be singing. I sometimes work with artists and they just— I say, sing your feelings, right? So if they're happy, there's like, ah. And if they're sad, it's like, you know, or like you're acting it out. There are different ways to express. Some people do cook. They cook. They wear their feelings. And so, you know, there's no right or wrong way. You have to find, again, what's the science of your happiness. And the 3 You know, in terms of, you know, like, when I talk about actually venting, when you express it, there's no right or wrong way, but there are ways to do it that are better than others, right? So like, telling someone about your feelings versus trauma dumping, right? Talking to a peer versus unloading on your kid, right? Because your kid will listen, but they're going to worry about you, right? So like, you want to be mindful of that hierarchy. And then the values. What are the things that bring you meaning in life? What are the things that are priceless versus with price tags, right? And so, these tend to be like your family, your faith, causes you believe in. I once had a client who they really valued being in a team, but they were working solo. So, It doesn't matter how much money you make if you're unhappy. So, shifting the focus from materialistic to things that really give your life purpose and meaning. And then vitals. We only get one body. I tell my daughter every day, how many bodies did God give you? You don't have to be religious, but for her, I say, how many bodies did God give you? And she goes, one. And I say, well, what do you got to do with it? Take care of it. And since she could talk, I've been telling her this. She knows to take care of herself. So when you brush your hair, do it gently. There's no rushing and pulling. There's only one you. And so how do we honor our body? Because it's our job to take care of our own bodies. So that's eating things that feed your brain and nourish you, getting movement in, getting connection in, not being on screens all the time and having a good work-life balance, getting good sleep. And then the 5th thing is vision. How do you keep yourself moving forward instead of being stuck in the past? And one thing we don't do as high-functioning people is we don't celebrate our wins. We're always on to the next. You know, we're like, when I finally get this thing, I'll be happy. When I finally get this— but no, we're not happy. We keep on piling things on. We don't celebrate our wins. And the data shows that. The science shows that when you have that mentality, when you get those things, you just want more. So how do you celebrate wins in the today? And that's the points of joy. I'm going to get points of joy today. I'm going to celebrate things today. So when I get my daughter to school on time, I sit in my living room and I have coffee slowly and I drink it and I say, did a good job today because her school is so strict. And I got her on time. We didn't have to wait in the naughty line for the late parents, right? So celebrate the wins, you know, the small and the big ones. You know, I used to be very ashamed of when I got awards telling anyone, and now I'm like, I got this award. I worked hard for it. You know, why do I feel as if I don't deserve it, right? Let's challenge that masochism. Celebrate your wins. You know, there's only one you. When are you going to celebrate it? You know, it's your, it's your job to take care of you. And so I think with the 5 Ds, they're universal. Children can use it, adults can use it. And that's how you start to get more and more points of joy every day.

That's so important. And I had the same thing before and I'm still working through it. I'm not quite there yet in terms of celebration, just acknowledging how far you've come. Um, I think for the longest time, a lot of my friends who I grew up with, like, they had no idea who, like, what I was doing because I never talked about it.

I'm just kind of like hidden in the background.

And, you know, I am getting a bit more courage to just at least acknowledge, because I've been doing this exercise a lot these days, just looking back. I'm like, wow, you know, I've come a long way, like from moving here with nothing, just, you know, finding my way through one by one. It's like, no, you did a good job. You know, like you just have to pause for a moment and celebrate and also taking the time. For yourself. I'm notorious for not taking any vacation time, and my team knows that. And she's like, oh yeah, don't leave it to Alexa. She'll never— she'll even forget that it's holiday. But there's like a running joke that's going on. So I'm like, okay, that's probably something that I should be like, something I can't— I shouldn't be proud of, you know, that I need to pay attention and at least, you know, take more time intentionally. So that's, um, that's great. I think I love this 5. the framework. I think it covers— it's a powerful tool. And I think that that's what makes this book— it's not just about discovering and finding, learning more about this hidden depression, but I really see this as like a personal growth transformation book, and it's really powerful. So I wanted to ask also, how does, you know, working through this trauma, past trauma, And finding or redefining purpose, how does that help with peak brain performance?

It absolutely helps. A stressed brain does not make good decisions. A stressed brain is more irritable. A stressed brain snaps at the loved ones and then makes you feel guilty after you snap, right? The thing that I found is that there are these risk factors, anhedonia, A lack of joy, right? Trauma and people pleasing. And all of these things stress the brain. An unhappy brain, a joyless brain isn't as pleasant to be around, right? People are more likely to be around happier people than they are around, you know, people who are not full of joy. People who lack joy, they make less. They actually score lower on tests. You know, like, again, we were designed to be joyful humans for a reason, right? So, you know, it's really important to prioritize joy. It is important to make sure you're getting your points every day. It makes you happier, healthier, get less sick, and want— and people want to be around you. It just makes every day worth living. And the one thing we don't have We don't have tomorrow promised. We all have that in common. So let's try to get our points of joy today.

I agree. And it's really important. I feel like, you know, we, we all deserve it and it should, even though it's not a constant all-day thing, just looking for those little moments to be joyful of, that's really important. And you laid out such great framework for running through, you know, just anyone. you know, who are high functioning, or even, you know, just anyone, even whether you're high functioning or not, just having checkpoints to look for, having a list and bringing attention to specific areas. I think it's super powerful. So this is— yeah, it's been great. So yeah, I wanted to mention about the— now that I have this knowledge, You know, I, when I was talking to my mentor, he, I asked him, oh, how are you doing? He's like, oh, I had a really productive day. And I asked him, no, how are you really doing? Because from our last conversation, um, you mentioned that that's a good way for us to lean into that conversation more with our other high-functioning friends. And oftentimes, you know, because we're so high-functioning that we forget. To check in with ourselves so we can do each other a favor and just pause and just ask that additional question. That's been helpful for me. So I've been trying to like poke at everybody like, no, how are you really doing? I mean, what you're really going through, like you've been really productive. It's kind of suspicious.

Yeah, because many of us don't want to burden others. We feel guilty if we say how we feel. And it's not a burden. So when you say, how are you really doing? You're showing the other person that you can be honest. I really wanna know what's behind that mask. And that can be such a relief to people because they think that if they tell you how they're really feeling, that they're creating stress for you, that, that they're a burden, but it's not the case at all. So challenge that inner guilt. Tell people how you're really feeling and the people who are really there for you, they'll show up for you. They'll be there to hear it. They're not gonna run away.

Or some people just, yeah. And the ones who run away are not your real friends.

They're just not ready.

As we wrap up, we always ask this question in all the episodes because we love learning. We love lifelong learners. And now, as I know your method, I'm trying to do it much more intentionally, but I love learning. So I'm always on the go for those things. What is one thing that you're currently learning about or studying that has you excited?

I started off my career doing really groundbreaking work in postpartum depression. And I find it so fascinating that, you know, mothers, women are told to carry a baby for, you know, 8 to 9 months and, you know, gain all this weight and have their body image change. Experience these biochemical shifts in their brain. And then baby comes out. And this human is literally depending on you for life. And you're told to— you should be happy. You should be happy. You just had a— like, this is— I call pregnancy a major medical condition. I tell my, my clients who gave birth, make sure you put it as a part of your medical history, because it's like a major surgery, right? Some of us actually do have major surgery with C-sections. Some of us have traumatic births. But even the The whole idea of pushing a little human out of your body, that's major. That's major trauma, physical trauma and medical trauma to your body. So, you know, I find it fascinating that we're told to be happy. And what's interesting and how invalidating it is, is that 80% of people who give birth experience the blues, right? But, but I would say 100% of them are told to be happy. So it is so invalidating. And so I've been studying postpartum depression for years, and it's— and to see how women's health has evolved is really remarkable. And now I'm really looking at perimenopause and menopause, because when you think about the vulnerable pockets in a woman's life, you know, it's the hormonal fluctuations. You're going through your period in your adolescence, you're going through PMDD, which is sometimes the moods that come with your periods. Monthly, not just once a year, monthly. And then we have, you know, postpartum depression if some of us, you know, choose to give birth. Not everyone has PPD, but we have blues. I told you 80% of people report blues. And then perimenopause, which basically doctors know nothing about. It's not really been studied. And menopause, which, you know, most Doctors only get one class in, so like the the hormonal fluctuations that we go through as women—it's just so so invalidating. You know, so that's an area that I'm really passionate about. And women are twice as likely to have depression, twice as likely to have anxiety compared to men. I mean, that boggles my brain. There's so much we don't know, and I really think that this is the future of health: learning how. Again, the science of your happiness is different than a man's happiness, right? Understanding the differences and really doing something about it. And so one of the exciting ventures right now is I'm doing psychedelic research in postpartum depression, and that has been very exciting for me. But I can't wait to see what's next. And I just really am hopeful. And I think that hopefully we're starting to become more open-minded about what makes us so different and unique and not using that to exclude us, but to embrace us and to validate all of us. Because when we're inclusive, that just makes the world, I think, a better place.

I love that. And this, um, it's very important because I did go through the postpartum blues too. And it, it's, you know, I didn't have that burst of joy. And then you start to feel like something is wrong with you because you You're like, well, but I don't feel that way. And no one told me about it. I had no idea what to expect. It kind of went in there like blindfolded. And that was just— I think it's an important conversation, especially women's health, because the hormones do work differently. And I see that so we can support each other in the way that makes sense and also extend A deeper level of understanding, knowing what's really happening underneath rather than just, you know, we're all wearing masks and pretending like everything is okay when it's not. And I appreciate you for bringing this conversation to public and making it more and more available. We're so excited that, you know, you were able to join with us. And how can people find out more about the work that you do and continue to support you?

Thank you. This was a great conversation. I appreciate your vulnerability and open-mindedness. You can follow me at Dr. Judith Joseph. I'm on all the socials and my website, drjudithjoseph.com. And you could take my free quizzes, sign up for my newsletter, and listen to my podcast, The Vault, where I interview All these incredible experts. And at the end of every episode, I ask them, when was a time when you were high functioning and on the outside you look great, but on the inside you were struggling? And there's not been one guest that has said, oh, that never happened to me. You know, it happens to us all. So it's important to talk about these things openly. Then we can change as a society.

Amazing. Thank you. And I recommend everyone getting this book. Amazing. And Yeah, I think we get to learn a lot from this book, as I mentioned before, not only about this hidden depression, but it really is, you know, it's really about personal growth and it's about transformation. So thank you, Dr. Judith, for being with us today. Truly appreciate your time. And, you know, and I look forward to speaking with you again in the near future.

Thank you for having me. It was a pleasure.

Wow. Amazing. I hope you got a lot of value from this conversation today. It was certainly my pleasure, and I'm so grateful to have been your host for this episode. And as always, you can find more ways to fuel your brain's potential on our YouTube channel, where we post the extended versions of all the episodes. Or you can follow @kwiklearning or @JimKwik on social media. Make sure to hit the subscribe button and leave a comment under this episode to let us know your thoughts. This is Alexis Bank. Until next time, be limitless.