WEBVTT - Session 456: The Realities of High Functioning Depression 0:00:10.840 --> 0:00:14.480 Welcome to the Therapy for Black Girls Podcast, a weekly 0:00:14.560 --> 0:00:19.320 conversation about mental health, personal development, and all the small 0:00:19.360 --> 0:00:22.480 decisions we can make to become the best possible versions 0:00:22.520 --> 0:00:26.600 of ourselves. I'm your host, doctor Joy hard and Bradford, 0:00:27.000 --> 0:00:32.040 a licensed psychologist in Atlanta, Georgia. For more information or 0:00:32.200 --> 0:00:35.600 to find a therapist in your area, visit our website 0:00:35.720 --> 0:00:39.440 at Therapy for Blackgirls dot com. While I hope you 0:00:39.479 --> 0:00:43.479 love listening to and learning from the podcast, it is 0:00:43.520 --> 0:00:46.400 not meant to be a substitute for a relationship with 0:00:46.479 --> 0:00:57.360 a licensed mental health professional. Hey, y'all, thanks so much 0:00:57.400 --> 0:00:59.520 for joining me for session four fifty six of the 0:00:59.520 --> 0:01:02.640 Therapy for Black Girls Podcast. We'll get right into our 0:01:02.680 --> 0:01:15.080 conversation after a word from our sponsors. When we think 0:01:15.080 --> 0:01:18.280 about depression, there's a common image that comes to mind, 0:01:18.720 --> 0:01:23.280 sleeping all day or not enough, withdrawing from responsibilities, and 0:01:23.280 --> 0:01:27.120 feeling an overall inability to function. And while that image 0:01:27.160 --> 0:01:29.960 is accurate, it doesn't tell the whole story of what 0:01:30.040 --> 0:01:34.200 depression can look like. For many people, especially black women, 0:01:34.680 --> 0:01:37.200 depression can show up on the complete opposite end of 0:01:37.200 --> 0:01:41.280 the spectrum. Instead of withdrawing, we give too much thrusting, 0:01:41.280 --> 0:01:45.520 ourselves into our jobs, family responsibilities, and over committing to 0:01:45.560 --> 0:01:48.760 whatever keeps us constantly in motion, and in trying to 0:01:48.840 --> 0:01:52.800 overcome racial oppression and gender discrimination, we mass that pain 0:01:52.880 --> 0:01:57.280 under layers of hyperactivity and perfectionism. This is what's referred 0:01:57.320 --> 0:02:01.680 to as high functioning depression, up getting things done and 0:02:01.760 --> 0:02:05.200 even excelling while feeling completely disconnected from what makes you 0:02:05.240 --> 0:02:08.840 feel grounded. Here to unpack what that really looks like 0:02:09.000 --> 0:02:11.040 is a guest you may have heard on the show before, 0:02:11.520 --> 0:02:16.040 doctor Judith Joseph. In her book High Functioning, Overcome your 0:02:16.080 --> 0:02:19.959 Hidden Depression and Reclaim Your Joy, she explores how depression 0:02:19.960 --> 0:02:23.920 can hide behind competence and accomplishment, particularly for people who 0:02:24.000 --> 0:02:26.520 have been conditioned to cling to resilience in their most 0:02:26.560 --> 0:02:30.840 challenging moments. If something resonates with you while enjoying our conversation, 0:02:31.360 --> 0:02:34.120 please share with us on social media using the hashtag 0:02:34.240 --> 0:02:37.520 TVG in session, or join us over in our patreon 0:02:37.639 --> 0:02:40.080 To talk more about the episode. You can join us 0:02:40.080 --> 0:02:44.200 at community dot therapy for Blackgirls dot com. Here's our conversation. 0:02:49.200 --> 0:02:50.520 Welcome back, doctor. 0:02:50.320 --> 0:02:52.800 Judith, thanks for having me. It's good to see you again. 0:02:53.360 --> 0:02:56.160 Likewise likewise, so the last time we chatted, we were 0:02:56.160 --> 0:02:58.720 talking all about how your mental health might be impacted 0:02:58.720 --> 0:03:01.680 by social media. And a lot has happened for you 0:03:01.760 --> 0:03:04.399 since we livet So you've released your first book called 0:03:04.440 --> 0:03:07.240 High Functioning Depression, and I would love to hear from you, 0:03:07.280 --> 0:03:10.880 doctor Judius, because you are well rid and well versed 0:03:10.919 --> 0:03:14.520 in so many topics. What made high functioning depression the 0:03:14.600 --> 0:03:16.160 topic for your first book. 0:03:16.280 --> 0:03:19.080 Well, I think a lot of people walk around wearing 0:03:19.120 --> 0:03:22.960 this mask of pathological productivity. On the outside, they look 0:03:23.000 --> 0:03:26.400 put together. You'd never know that they were struggling inside, 0:03:26.440 --> 0:03:32.280 without joy, lacking interest, because frankly, they're not functioning right, 0:03:32.320 --> 0:03:35.160 They're still functioning showing up their rocks. They're the ones 0:03:35.200 --> 0:03:38.160 that people turn to for help. They're the friend who 0:03:38.200 --> 0:03:41.240 seems like they have it all put together. And in 0:03:41.280 --> 0:03:44.800 mental health, unfortunately, we wait for people to break down 0:03:44.840 --> 0:03:48.520 before we start interveading, whereas in other areas of health, 0:03:48.800 --> 0:03:51.560 we don't wait until people have like stage four cancer. 0:03:51.600 --> 0:03:54.680 We're like, let's catch the cancer, let's reduce the risk. Right, 0:03:54.720 --> 0:03:56.480 We're not waiting people have a heart attack. We're saying, 0:03:56.720 --> 0:03:59.560 let's address the risk of heart disease. In mental health, 0:03:59.600 --> 0:04:02.320 we're still waiting for people to break down. And I 0:04:02.320 --> 0:04:05.200 just kept seeing people in my practice coming in who 0:04:05.920 --> 0:04:09.840 were struggling with the lack of joy, something called ann hodonia. 0:04:09.960 --> 0:04:11.960 They didn't know what it was. They'd never heard of it, 0:04:12.440 --> 0:04:15.040 and I had to educate them that this is something 0:04:15.040 --> 0:04:18.040 that's in the medical literature. We know of it, but 0:04:18.120 --> 0:04:21.039 many people don't know what it's called. So there is 0:04:21.080 --> 0:04:22.960 a way to reclaim your joy. And when I wrote 0:04:23.000 --> 0:04:26.680 High Functioning, I was very intentional about the cover of it, 0:04:27.080 --> 0:04:29.039 where I wanted people to be walking in a bookstore 0:04:29.080 --> 0:04:31.359 and see, oh, look, high functioning. That's me. Let me 0:04:31.400 --> 0:04:33.200 open this and be like, hold on, wait a second, 0:04:33.200 --> 0:04:37.599 I think I'm depressing. The subtitle is about overcoming hidden 0:04:37.600 --> 0:04:40.840 depression because many of us hide our emotions, especially as 0:04:40.880 --> 0:04:43.719 black women. We push it down, we put our own 0:04:43.720 --> 0:04:46.160 emotions to aside, we take care of others. And this 0:04:46.200 --> 0:04:47.679 book is about reclaiming joy. 0:04:48.839 --> 0:04:51.160 So it's interesting and I appreciate that you're calling out 0:04:51.160 --> 0:04:54.080 antadonia because it is one of the classic, like Hallwark, 0:04:54.120 --> 0:04:57.159 depressive symptoms, and you're saying that you found a lot 0:04:57.200 --> 0:05:00.160 of your patients just didn't even know that it was 0:05:00.200 --> 0:05:02.520 a thing that they needed to be connected to why 0:05:02.520 --> 0:05:04.400 do you think that is given that it is one 0:05:04.440 --> 0:05:07.600 of the things we are typically looking for to diagnose oppression. 0:05:08.720 --> 0:05:12.080 Interestingly enough, I went to a very large therapy conference 0:05:12.120 --> 0:05:16.839 and I went around collecting content and asking different therapists 0:05:16.880 --> 0:05:19.799 what is antadonia? What is antadonia? A lot of therapists 0:05:19.800 --> 0:05:22.480 had never heard of ant hoadonia. And I think there's 0:05:22.520 --> 0:05:27.200 this inherent bias within healthcare where we look for people 0:05:27.240 --> 0:05:30.320 to break down. We're looking for very obvious signs. We're 0:05:30.320 --> 0:05:32.520 looking for someone crying, We're looking for someone not getting 0:05:32.520 --> 0:05:35.760 out of bed. We're not looking for someone who's feeling 0:05:35.800 --> 0:05:39.479 nothing or lacking joy, and we overlook it. If you 0:05:39.520 --> 0:05:42.520 go to your doctor and you're like, I'm not sleeping 0:05:42.520 --> 0:05:46.600 while my eating habits have changed, but I'm still functioning, 0:05:46.880 --> 0:05:49.159 They're not going to say, well, are you still enjoying life? 0:05:49.240 --> 0:05:53.159 They're going to say, are you suicidal? Are you breaking down? 0:05:53.800 --> 0:05:56.240 You know, like what's happening in terms of your functioning. 0:05:56.960 --> 0:06:00.480 They're really not looking for whether or not you're enjoying life, 0:06:00.520 --> 0:06:04.960 that you're actually seeking pleasure or interested in things, because 0:06:05.720 --> 0:06:08.839 in our healthcare system, that's not considered a crisis. That's 0:06:08.880 --> 0:06:12.679 not a problem that healthcare professionals can fix. So we're 0:06:12.880 --> 0:06:16.559 very reactive in our approaches to mental health versus being 0:06:16.640 --> 0:06:20.919 proactive and looking for signs of ant hodonia. When you 0:06:20.960 --> 0:06:23.599 eat your food, does it taste good? When you connect 0:06:23.640 --> 0:06:25.599 with a loved one? Do you feel seen and heard 0:06:26.240 --> 0:06:28.440 when you're listening to music? Does it light you up? 0:06:28.880 --> 0:06:32.160 If we were to ask those type of questions, then 0:06:32.200 --> 0:06:35.760 we would uncover ant hodonia. But we're not asking that. 0:06:35.800 --> 0:06:38.880 We're asking are you suicidal? Are you having thoughts you 0:06:38.880 --> 0:06:41.239 don't want to live anymore? So, because we're always looking 0:06:41.279 --> 0:06:46.200 for the crisis, the clear crisis, we're missing the existential crisis. 0:06:46.640 --> 0:06:49.560 Is life even worth living for you? And I think 0:06:50.400 --> 0:06:54.400 many healthcare professionals, especially doctors and nurses, they probably struggle 0:06:54.480 --> 0:06:57.320 with ant hodonia too. When you think about it, they're 0:06:57.320 --> 0:07:01.200 in fast paids lives. They're taught inherently to take care 0:07:01.240 --> 0:07:04.800 of everyone else but themselves. Patient comes first. They work 0:07:04.839 --> 0:07:07.760 long shifts, they don't even like pee or go for 0:07:07.800 --> 0:07:12.800 bathroom breaks or eat properly right, So they're already inherently 0:07:12.880 --> 0:07:16.040 and hedonic. So why would you look for something that 0:07:16.080 --> 0:07:19.360 you're experiencing that you've normalized. Why would you even look 0:07:19.520 --> 0:07:21.880 for that in your own patients. You'd be like, well, 0:07:22.320 --> 0:07:24.960 you're not in crisis, you're not societal'll come back next year, 0:07:25.000 --> 0:07:27.080 come back when you break down. And so I think 0:07:27.120 --> 0:07:31.520 that it's a shift that needs to occur within healthcare, 0:07:32.120 --> 0:07:35.160 some would say first, in order to really address it 0:07:35.240 --> 0:07:36.320 in the general population. 0:07:37.680 --> 0:07:39.240 And I know you are kind of one of the 0:07:39.280 --> 0:07:42.960 first doing kind of large scale research on high functioning depression. 0:07:43.320 --> 0:07:45.480 And I think when I think about like Black women 0:07:45.560 --> 0:07:48.000 in the way that depression often shows up for us, 0:07:48.320 --> 0:07:51.040 right like in large point due to our socialization, that 0:07:51.120 --> 0:07:53.600 like stuff just has to keep going, like you can 0:07:53.640 --> 0:07:56.040 deal with your mood later, like you just got to 0:07:56.120 --> 0:07:59.680 keep going. I would be curious to know if Black 0:07:59.680 --> 0:08:03.680 women don't over index in terms of high functioning depression. 0:08:03.680 --> 0:08:05.160 Can you talk a little bit about the work that 0:08:05.160 --> 0:08:07.520 you've done and what your research is showing in terms 0:08:07.520 --> 0:08:09.200 of Black women in high functioning depression. 0:08:09.920 --> 0:08:12.400 The interesting thing about my study is that it's the 0:08:12.400 --> 0:08:15.160 first study and high functioning depression in the world. And 0:08:15.200 --> 0:08:17.920 when I was writing it up and submitting it to 0:08:17.960 --> 0:08:22.400 IRBs and in the process of ParaView, I remember the 0:08:22.440 --> 0:08:24.400 people who were reviewing it, were like looking for other 0:08:24.440 --> 0:08:26.920 papers in the world, and they just kept looking and 0:08:26.960 --> 0:08:28.600 then they were like, wait, this is the first study 0:08:28.600 --> 0:08:30.960 in the world, and I was just shocked it is 0:08:31.000 --> 0:08:33.720 the first one. We do need more research in this area. 0:08:33.760 --> 0:08:36.160 But what we found in this first study is that 0:08:37.160 --> 0:08:42.400 there seems to be a high correlation between caregiving and antedonia, 0:08:42.480 --> 0:08:45.240 which is not rocket science, right. If you are taking 0:08:45.240 --> 0:08:49.319 care of other people all the time, and because that's 0:08:49.360 --> 0:08:52.600 your priority, you're not really prioritizing yourself. You're not going 0:08:52.679 --> 0:08:54.960 to have interest in things you once enjoyed, You're not 0:08:55.000 --> 0:08:58.200 going to be feeling joy, and so that was not 0:08:58.480 --> 0:09:02.400 a surprising finding. Another finding was that there's a high 0:09:02.440 --> 0:09:07.120 correlation between HFD and trauma, and that was interesting because 0:09:07.720 --> 0:09:12.400 our hypothesis is that people who are trying to outrun 0:09:12.480 --> 0:09:16.679 past pain may be using busying as a coping mechanism. 0:09:16.800 --> 0:09:21.240 So when you think of the classic trauma responses, usually 0:09:21.240 --> 0:09:24.600 people want to avoid people, places, and situations that trigger 0:09:25.200 --> 0:09:30.240 negative emotions. But with high functioning folks, people avoid negative 0:09:30.240 --> 0:09:33.520 emotions by just taking on other tasks. So these are 0:09:33.559 --> 0:09:36.120 the people who will say when I sit still, I 0:09:36.160 --> 0:09:39.319 feel restless. When I'm not busy. I feel empty why 0:09:39.360 --> 0:09:42.840 because their go to coping mechanism is too busy to distract. 0:09:43.200 --> 0:09:46.680 And you know, initially it doesn't look all that bad, right, 0:09:46.800 --> 0:09:50.400 it looks productive, pathologically productive, because on the outside you're 0:09:50.440 --> 0:09:53.280 doing all these great things. People are saying you're killing it, 0:09:53.760 --> 0:09:57.600 but secretly it is actually killing you, right, because over time, 0:09:57.679 --> 0:10:00.960 you're going to neglect your basic needs. Over time, your 0:10:01.000 --> 0:10:05.160 body may break down. You may actually develop a depression 0:10:05.200 --> 0:10:08.120 where a depressive episode where you stop functioning, or you 0:10:08.160 --> 0:10:10.679 may start to cope with your pain in ways that 0:10:10.679 --> 0:10:14.840 are not healthy, like excessive drinking, other excessive behaviors that 0:10:14.880 --> 0:10:17.760 are not really healthy for you. So something's going to 0:10:17.800 --> 0:10:21.120 give eventually. And so we found those two correlations as trauma. 0:10:21.760 --> 0:10:23.640 And when we were interviewing patients, we didn't just do 0:10:23.640 --> 0:10:25.920 a survey. We I have a lab in Manhattan. We 0:10:26.440 --> 0:10:30.080 had the research staff, myself interview people, collect the data. 0:10:30.120 --> 0:10:31.800 Because what we found is that when you send out 0:10:31.800 --> 0:10:34.319 surveys tends to not be as accurate as when you're 0:10:34.360 --> 0:10:37.360 talking to people. And sometimes people don't understand something they 0:10:37.400 --> 0:10:40.280 ask for clarification. So when we were talking with people, 0:10:40.360 --> 0:10:42.319 we were surprised to learn that a lot of times 0:10:42.880 --> 0:10:46.000 people didn't even realize that, like, oh, this painful thing 0:10:46.040 --> 0:10:48.439 that happened was a trauma and I didn't know how 0:10:48.440 --> 0:10:50.079 it shaped me. I just kind of just pushed it down, 0:10:50.600 --> 0:10:53.080 never talked about it, and just kept going. And so 0:10:53.120 --> 0:10:56.520 when we did our trauma inventories, we were very intentional 0:10:56.559 --> 0:11:01.280 about including things that we typically don't see a PTSD diagnosis. So, 0:11:01.480 --> 0:11:04.000 in order to meet criteria for PTSD, your trauma has 0:11:04.000 --> 0:11:07.280 to be either life threatening or assault, you know, like 0:11:07.320 --> 0:11:09.800 something like a combat or a motor vehicle accident or 0:11:10.320 --> 0:11:14.320 someone attacking you. But if things like let's say a 0:11:14.400 --> 0:11:19.240 severe bankruptcy and that left you homeless in the real world, 0:11:19.240 --> 0:11:22.880 a therapists say, oh, that's traumatizing, but according to textbook standards, 0:11:23.200 --> 0:11:25.080 that doesn't count as a trauma. So we wanted to 0:11:25.200 --> 0:11:28.920 include these experiences that are painful that shape the way 0:11:28.920 --> 0:11:30.959 that you view yourself and the way that you view 0:11:30.960 --> 0:11:32.360 yourself in the world. 0:11:32.800 --> 0:11:35.560 And doctor, did you find that there were any particular 0:11:35.800 --> 0:11:38.840 like categories of trauma that seem to be more correlated 0:11:38.840 --> 0:11:40.000 with high functioning depression. 0:11:40.880 --> 0:11:44.960 Definitely the big T traumas, so more severe traumas like 0:11:45.040 --> 0:11:49.600 being physically attacked. The ones that typically meet criteria for PTSD, 0:11:50.360 --> 0:11:53.920 those tend to be highly correlated. And that makes sense 0:11:54.040 --> 0:11:57.280 because you know, one of the symptoms of trauma and 0:11:57.280 --> 0:12:00.400 there are like over thirty symptoms of trauma. People think 0:12:00.440 --> 0:12:04.480 it's just like hypervigilance or flashbacks or nightmares. There are 0:12:04.480 --> 0:12:07.439 thirty plus and so one of the symptoms of trauma 0:12:08.320 --> 0:12:14.520 is actually like internalizing self blame, shame, and guilt. And 0:12:14.559 --> 0:12:17.880 we know that this is like the human brain's way 0:12:18.000 --> 0:12:20.880 of coping with how did something bad happen to me? 0:12:20.960 --> 0:12:24.000 Why did something bad happen to me? And many times 0:12:24.280 --> 0:12:27.800 when bad things happen to us, our brains automatically goes 0:12:27.800 --> 0:12:31.040 into this like very regressive default mode, like a child 0:12:31.080 --> 0:12:33.240 would think like, oh, I must have done something bad, 0:12:33.480 --> 0:12:38.360 there must be something about me, versus a more mature 0:12:38.720 --> 0:12:41.560 or a higher level of thinking about it would be, oh, 0:12:41.640 --> 0:12:43.959 bad things happen to good people all the time, Right, 0:12:44.040 --> 0:12:47.400 I didn't do anything. But our brains do that as 0:12:47.440 --> 0:12:50.400 a way of kind of controlling the situation because we 0:12:50.400 --> 0:12:53.120 don't like uncertainty. So it's like, something bad happens to 0:12:53.160 --> 0:12:56.880 me because I'm bad, right, And so many times folks 0:12:57.760 --> 0:13:01.480 don't have their trauma process, will go on this path 0:13:01.520 --> 0:13:04.360 in life where they people please, where they've been over backwards, 0:13:04.440 --> 0:13:08.480 where they don't feel worthy of rest because they don't 0:13:08.480 --> 0:13:13.280 feel worthy internally. And that is a trauma response that 0:13:13.360 --> 0:13:16.400 many folks don't even connect. They don't even make that 0:13:16.440 --> 0:13:19.719 correlation because they haven't fully doubt what their trauma. They're 0:13:19.720 --> 0:13:20.720 still trying to outrun it. 0:13:22.280 --> 0:13:34.840 More from our conversation after the break. So, I wonder 0:13:34.960 --> 0:13:37.840 if you can talk about if we're talking about some 0:13:38.000 --> 0:13:41.600 symptoms that aren't necessarily like your classic depressive symptoms and 0:13:41.640 --> 0:13:44.200 some that are, so what would it look like Is 0:13:44.240 --> 0:13:47.600 this a diagnosis that people are getting of high functioning depression? 0:13:47.880 --> 0:13:50.440 Like how would you talk with your therapists or your 0:13:50.440 --> 0:13:53.120 psychiatrist about Like, Hey, I read this book, but I 0:13:53.160 --> 0:13:55.320 think that this might be me Like what kinds of 0:13:55.360 --> 0:13:57.880 things would you be looking for to figure out? Like, Oh, 0:13:58.000 --> 0:13:59.280 is this something I'm struggling with. 0:14:00.120 --> 0:14:02.760 What's interesting is that years ago, when I first started 0:14:02.760 --> 0:14:04.680 creating content about high functioning depression, I had a lot 0:14:04.720 --> 0:14:08.240 of therapists saying, Oh, that's not real. Why are we 0:14:08.280 --> 0:14:10.360 talking about high functioning depression? We need to be talking 0:14:10.360 --> 0:14:13.439 about clinical depression. What I said was, listen, there's enough 0:14:13.440 --> 0:14:16.040 depression to go around for all of us, right, Like, 0:14:16.400 --> 0:14:19.320 let's not try to compete with each other. But now 0:14:19.360 --> 0:14:21.520 I have therapists reaching out to me saying thank you 0:14:21.520 --> 0:14:24.400 for this book because I have so many clients who 0:14:24.400 --> 0:14:26.440 are still killing it, who are still crushing it, who 0:14:26.480 --> 0:14:29.920 are still showing up, but they are struggling with antedonia. 0:14:30.400 --> 0:14:33.680 They're using work, they're using business as a coping mechanism, 0:14:33.720 --> 0:14:36.680 and frankly, there's like nothing out there for them. And 0:14:36.760 --> 0:14:40.480 so now I think a lot of therapists are realizing 0:14:40.560 --> 0:14:44.600 that depression has many different faces. That not everyone stays 0:14:44.640 --> 0:14:48.440 in bed, not everyone's crying, not everyone's shutting down, some 0:14:48.760 --> 0:14:55.080 people can't sit still, and many times it's misdiagnosed as anxiety. 0:14:55.200 --> 0:14:57.200 And not to say that the two don't travel together, 0:14:57.920 --> 0:15:01.400 but anxiety has a lot of physical symptoms. When you 0:15:01.440 --> 0:15:04.440 look at generalized anxiety disorder, there are a lot of 0:15:04.640 --> 0:15:10.200 physical physiological symptoms of anxiety like tummy, a tension in 0:15:10.280 --> 0:15:14.120 your body, heart racing, sweaty palms, feel like you're going 0:15:14.160 --> 0:15:18.400 to pass out, and you don't see anadonia there. And 0:15:18.440 --> 0:15:20.440 so the key thing a lot of these therapists are 0:15:20.440 --> 0:15:23.920 seeing is something called anadonia, this lack of interest, this 0:15:24.040 --> 0:15:27.080 lack of pleasure. And it's one thing if your client 0:15:27.800 --> 0:15:31.280 is busy and productive and enjoying it. But what these 0:15:31.320 --> 0:15:33.960 therapists are telling me is that they have these clients 0:15:34.000 --> 0:15:36.440 that look great on the outside. They're doing many things, 0:15:36.800 --> 0:15:39.560 but they don't enjoy it and they can't slow down. 0:15:40.000 --> 0:15:43.480 And that is the key, right, because as human beings, 0:15:44.000 --> 0:15:46.560 we were built with the DNA for joy. It's literally 0:15:46.680 --> 0:15:49.560 built into our genetic code. So if you are not 0:15:50.160 --> 0:15:54.240 experiencing joy, if you've lost your ability to reclaim joy, 0:15:54.680 --> 0:15:56.800 that is a problem. Right. It's not going to get 0:15:56.840 --> 0:15:59.560 you admitted to hospital. It's not a medical emergency, but 0:15:59.600 --> 0:16:02.320 it is an existential crisis and it's something that you 0:16:02.360 --> 0:16:06.040 are deserving of. So if you're lacking joy, don't ignore it. 0:16:06.440 --> 0:16:08.640 So that is what you would really kind of qualify 0:16:08.760 --> 0:16:11.920 is like the homework of high functioning depression is this antedonia, 0:16:12.000 --> 0:16:13.640 and like the lack of joy. 0:16:14.120 --> 0:16:16.680 The lack of joy, the antedonia and the inability to 0:16:16.720 --> 0:16:20.400 sit still, right, because that's what makes it different than 0:16:20.760 --> 0:16:25.240 this anxiety, right, the inner restlessness. What we found in 0:16:25.240 --> 0:16:27.680 our clinical research study is this inability to sit still 0:16:27.680 --> 0:16:31.880 because you're outrunning pain. You think you're chasing happiness, but 0:16:31.960 --> 0:16:34.920 you're trying to outrun something you haven't processed in the past. 0:16:35.600 --> 0:16:39.560 When people finally click that together, they really want to understand, well, one, 0:16:39.600 --> 0:16:44.160 did I actually stop experiencing joy? When did this painful 0:16:44.360 --> 0:16:47.960 situation occur? Like, I need to figure this out. And 0:16:47.960 --> 0:16:51.120 this is important because this can actually help you to 0:16:51.200 --> 0:16:53.080 start to change the way that you cope with pain. 0:16:53.200 --> 0:16:56.840 Rather than pushing it down, you may start to validate it. 0:16:56.880 --> 0:16:59.080 And that's why I put the five v's in my 0:16:59.120 --> 0:17:02.320 book because I want it people to use a simple method, 0:17:02.640 --> 0:17:06.199 a step by step path towards reclaiming joy, and it 0:17:06.240 --> 0:17:07.160 starts with validation. 0:17:08.160 --> 0:17:10.199 So can you talk more about the five vs? 0:17:11.000 --> 0:17:14.159 Five is a number that's been popping up in a 0:17:14.160 --> 0:17:18.600 lot of my travels. I traveled the world studying mental 0:17:18.600 --> 0:17:22.480 health issues, and five I think pops up across the 0:17:22.520 --> 0:17:25.439 globe because most of us have five fingers, right, and 0:17:25.520 --> 0:17:30.639 so validation is the first fee. When you think about validation, 0:17:31.760 --> 0:17:36.199 validation is acknowledging how you feel and accepting it no 0:17:36.280 --> 0:17:39.560 matter what, without judgment. It usually is this analogy of 0:17:40.160 --> 0:17:42.320 imagine you're in a dark room, pitch black, you can't 0:17:42.320 --> 0:17:46.199 see anything, and you hear a loud crash. Well, some 0:17:46.240 --> 0:17:48.680 of us would start freaking out, some of us start screaming, 0:17:48.720 --> 0:17:51.359 some would start swinging, some of us would start running. 0:17:51.800 --> 0:17:54.680 But if you turn the light on and you saw 0:17:54.720 --> 0:17:58.080 that it was an inanimate object that fell and you're safe, 0:17:58.200 --> 0:18:01.640 then you're like, oh, certainty has gone away. We feel 0:18:01.640 --> 0:18:05.199 at ease. So when you acknowledge how you feel and 0:18:05.200 --> 0:18:07.800 you turn the light on on what's really happening. That's 0:18:07.800 --> 0:18:12.120 how many of my clients feel. Sometimes I have men 0:18:12.160 --> 0:18:14.399 come to my office and they're like, I am so angry. 0:18:14.400 --> 0:18:17.720 My wife says, I need anger management. We peel back 0:18:17.720 --> 0:18:19.760 on that emotion, like, are you really angry? What makes 0:18:19.800 --> 0:18:22.520 you think you're angry? Well, I was yelling, and I said, 0:18:22.760 --> 0:18:26.240 well that's a behavior, right, yelling could be anger, but 0:18:26.280 --> 0:18:29.000 it could be something else. Well, I slammed doors. Again, 0:18:29.119 --> 0:18:32.520 it's a behavior. What did you really feel? And then 0:18:32.560 --> 0:18:34.240 we take some time and we figured it out and 0:18:34.280 --> 0:18:38.560 the person's actually quite worried. They're worried about not providing, 0:18:38.600 --> 0:18:41.080 they're worried about being a failure. And so that's why 0:18:41.080 --> 0:18:45.080 it's important to name your emotion and name and acknowledge 0:18:45.080 --> 0:18:48.680 your experiences, because only then when you turn that light 0:18:48.760 --> 0:18:53.000 on can you actually figure out the appropriate mechanism. Because 0:18:53.880 --> 0:18:56.359 the tools for anger, you know this, very different than 0:18:56.359 --> 0:19:01.400 the tools for worry, and so validation can be self validation. 0:19:01.600 --> 0:19:04.680 It could be you acknowledging it and accepting it for yourself. 0:19:05.200 --> 0:19:09.159 We can validate other people with my tools in the 0:19:09.160 --> 0:19:12.280 book The Quizzes. I find these rating scales to be 0:19:12.440 --> 0:19:16.560 very validating because in medicine, if you have like a 0:19:16.680 --> 0:19:19.399 heart condition or you can go for a test, you 0:19:19.440 --> 0:19:22.440 can get an EKG. If you have high cholesterol, you 0:19:22.480 --> 0:19:24.960 can go for blood work. But for mental health we 0:19:25.000 --> 0:19:27.119 don't have that as yet. So I need it to 0:19:27.800 --> 0:19:33.360 have these measures, these ways to validate using actual tools, 0:19:33.800 --> 0:19:36.879 and so validation could be in the form of a 0:19:37.000 --> 0:19:40.000 rating scale. If you're wondering, oh do I have Antedonia 0:19:40.520 --> 0:19:43.400 created these rating skills based on some of the other 0:19:43.480 --> 0:19:45.159 research tools that I use in my lab for my 0:19:45.200 --> 0:19:47.720 clinical studies, so that you can say, okay, what level 0:19:47.760 --> 0:19:49.879 do I have of anaedonia? And some of my clients 0:19:49.920 --> 0:19:51.840 will flo out the Anadonia rating scale and they'll be like, 0:19:51.840 --> 0:19:54.200 oh my gosh, like, I don't enjoy half the things 0:19:54.200 --> 0:19:55.679 I used to do right, and I would not have 0:19:55.800 --> 0:19:59.040 known had I not filled out this rating scale. So 0:19:59.040 --> 0:20:02.800 there are many ways to validate the second V is venting. 0:20:03.359 --> 0:20:06.679 So in my lab, I'll have people take turns with 0:20:06.760 --> 0:20:09.920 this big balloon, and we'll take turns dunking it into 0:20:09.920 --> 0:20:12.919 a big tank of water, and one hundred percent of 0:20:12.960 --> 0:20:16.240 time that balloon pops up. Why because you can't out 0:20:16.240 --> 0:20:18.560 math physics right, It's going to pop up one hundred 0:20:18.560 --> 0:20:22.160 percent of time. And then we'll take turns deflating this balloon, 0:20:23.000 --> 0:20:25.719 and what happens. We can easily push this balloon, deflate 0:20:25.720 --> 0:20:28.159 a balloon at the bottom of the tank. And so 0:20:28.440 --> 0:20:32.720 I like this analogy because if you don't express your emotions, 0:20:32.760 --> 0:20:35.800 if you don't get it out right, then you imagine 0:20:35.800 --> 0:20:39.120 that at balloon, your emotions will pop up in your health. Right, 0:20:39.359 --> 0:20:41.879 many of us have these migraines, we have these tummy pains, 0:20:41.920 --> 0:20:44.840 we don't even know what's going on, body aches. It'll 0:20:44.840 --> 0:20:47.239 pop up in our relationships, so we snap at our 0:20:47.280 --> 0:20:49.560 loved ones. It'll pop up out work. So that's why 0:20:49.560 --> 0:20:53.680 it's important to get in the practice of expressing how 0:20:53.720 --> 0:20:56.880 you feel and Venting can be done verbally, It could 0:20:56.880 --> 0:20:59.280 be done in a therapy setting with a therapist. It 0:20:59.320 --> 0:21:03.399 could be done with journal writing. Validating. Venting can be 0:21:03.440 --> 0:21:08.199 done through expressions such as prayer for people who are 0:21:08.240 --> 0:21:11.520 faith based, so you can vent in many different ways. 0:21:11.680 --> 0:21:14.040 You got to find a way that's healthy for you. 0:21:14.160 --> 0:21:17.879 What about the other three? Well, and before I go 0:21:17.920 --> 0:21:21.159 into the other three venting their dos and don't, right, 0:21:21.200 --> 0:21:23.359 you don't want to be trauma dumping on people. I 0:21:23.359 --> 0:21:26.520 always tell my clients, if you're venting to your kids, 0:21:27.280 --> 0:21:29.679 I'd rather vent to me because your child isn't going 0:21:29.760 --> 0:21:31.960 to say, Mommy, I don't want to talk to Your 0:21:32.000 --> 0:21:34.560 child will listen because they want to feel connected to you. 0:21:34.640 --> 0:21:36.560 They don't want to be rejected. But they're going to 0:21:36.600 --> 0:21:39.920 worry about you, right, So think think about who you're 0:21:39.960 --> 0:21:42.119 venting to. Is it someone in a lower position of 0:21:42.119 --> 0:21:44.680 power than you? Is this person going to resent you 0:21:44.720 --> 0:21:48.360 like an employee? And also be very intentional about it. 0:21:48.880 --> 0:21:50.720 Are you venting just to get people on your side 0:21:50.720 --> 0:21:53.240 and you don't really care about the resolution or are 0:21:53.240 --> 0:21:55.639 you really intentional about Okay, I have a problem, I 0:21:55.680 --> 0:21:58.000 need to get it solved. I'm going to be unbiased. 0:21:58.000 --> 0:22:00.400 I'm going to ask people who I trust to give 0:22:00.400 --> 0:22:03.800 me honest feedback. Right, and before you vent to people 0:22:03.840 --> 0:22:05.840 if it's not your therapist, because if you pay a therapist, 0:22:05.880 --> 0:22:08.360 you can say whatever you want, right. But when you're 0:22:08.520 --> 0:22:11.119 venting to people in your life, really check in and 0:22:11.160 --> 0:22:14.280 ask for emotional consent. Ask is this okay? Time? Is 0:22:14.280 --> 0:22:17.760 this going to trigger you? Right? So, there are dos 0:22:17.800 --> 0:22:20.800 and don'ts to venting, And what's exciting doctor Joy is 0:22:20.800 --> 0:22:25.359 that there's recent research on why proper venting Why, Like 0:22:25.560 --> 0:22:28.159 there's evidence based venting why it's important because if you're 0:22:28.280 --> 0:22:30.960