Speaker 1: Pushkin.
Speaker 2: We were built with the DNA for joy. We're supposed
Speaker 2: to derive pleasure from the basic things in life. If
Speaker 2: you're not deriving pleasure from those things, that is a problem.
Speaker 2: That's a warning sign, because we're supposed to be able
Speaker 2: to experience joy.
Speaker 3: Doctor Judith Joseph is a psychiatrist and a clinical researcher.
Speaker 3: These days, joy is a key part of her life,
Speaker 3: but that wasn't always the case. Just a few years ago,
Speaker 3: things looked great from the outside. She was crushing it
Speaker 3: at work and collecting accolades, but on the inside she
Speaker 3: was struggling.
Speaker 2: And I thought, well, if I'm like this and it
Speaker 2: snuck up on me, I wonder how many people like
Speaker 2: me experience I wonder how many people are hiding behind
Speaker 2: a mask of pathological productivity and they're using that busyness
Speaker 2: to cope with something that they have not processed and
Speaker 2: something that's unresolved.
Speaker 3: On today's show, The Mask of Pathological Productivity, I'm Maya Schunker,
Speaker 3: a scientist who studies human behavior, and this is a
Speaker 3: slight change of plans, a show about who we are
Speaker 3: and who we become in the face of a big change.
Speaker 3: Doctor Judith Joseph is the founder of a research lab
Speaker 3: that explores novel treatments for mental health conditions, conditions like anxiety, depression,
Speaker 3: and ADHD. She's also a professor of psychiatry at NYU
Speaker 3: and a practicing psychiatrist. Judith says that back in med school,
Speaker 3: she surprised her family by choosing to go into psychiatry.
Speaker 2: When I went to medical school, I was the first
Speaker 2: person to graduate from college in my family, the first
Speaker 2: doctor in my family. And so if I went to
Speaker 2: my family and I said I want to be a psychiatrist,
Speaker 2: they'd be like, what, that's not a real doctor. My
Speaker 2: dad is a pastor. He still is a pastor. So
Speaker 2: I was a pastor's kid, went to church three times
Speaker 2: a week. And now that I look back, I have
Speaker 2: these memories of people coming into the church and people
Speaker 2: who were thought to have demons. But now I'm like, oh,
Speaker 2: my gosh, that was actually untreated schizophrenia, or people who
Speaker 2: had mood swings, and you know, I think, well, that
Speaker 2: was actually a substance induced mood disorder. And people with
Speaker 2: severe depression who were told to just pray themselves out
Speaker 2: of it. You know, I see all of these things
Speaker 2: that could have been addressed from a mental health perspective,
Speaker 2: but from a cultural perspective, they were called something completely different.
Speaker 2: And when I actually told my parents that I was
Speaker 2: switching from antisysiology to psychiatry, my dad was like, well,
Speaker 2: why you want to work with them crazy people? You
Speaker 2: know they're from the Caribbean. And I said, well, Daddy,
Speaker 2: the brain is part of the body too, and so
Speaker 2: if someone were to have asthma, you wouldn't tell them
Speaker 2: to pray out of it. You'd say, oh, you should
Speaker 2: really go to a doctor and get an inhaler and
Speaker 2: think about all the allergens that are triggering that. But
Speaker 2: for some reason, in many cultures, it is still pervasive,
Speaker 2: this idea that if you have, you know, a mental
Speaker 2: health condition, somehow you should be able to pull yourself
Speaker 2: out of it. That's different than physical health. But we
Speaker 2: know that the brain is connected to the body, and
Speaker 2: I believe it's the most important organ.
Speaker 4: But that's my bias as.
Speaker 3: A psychiatrist, it's my bias as a cognitive neuroscientist.
Speaker 1: We share the same bias. Judents.
Speaker 3: You know, you had your own struggles with mental health
Speaker 3: early in the pandemic, and I'm wondering if you can
Speaker 3: bring me back to that period of time and set
Speaker 3: the scene about what was going on in your life.
Speaker 2: I was giving this talk to very busy, large hospital
Speaker 2: system in April twenty twenty, and they had asked me
Speaker 2: to give the talk because a lot of the healthcare
Speaker 2: professionals were very anxious, very stressed out, and concerned about
Speaker 2: their mental health.
Speaker 4: No one knew what was going to happen.
Speaker 2: The world was in a state of uncertainty, and I
Speaker 2: was supposed to be one of the voices of hope
Speaker 2: giving people skills. But halfway through that talk, I just
Speaker 2: felt like, I think I'm depressed, Like it kind.
Speaker 4: Of stuck up on me. You know.
Speaker 2: In the past, given a talk like that would have
Speaker 2: been really pleasurable for me, you know, but I just
Speaker 2: felt kind of muh bleh. And I just felt really
Speaker 2: lost because the hopelessness was palpable in that presentation. People
Speaker 2: were writing in things like they don't know if they're
Speaker 2: going to be able to see their family, they don't
Speaker 2: know if they could infect people, and it's just like, well,
Speaker 2: I don't know how I'm doing. How am I going
Speaker 2: to help you? I can't even take care of myself.
Speaker 2: That was the moment I had in that moment. But
Speaker 2: you know, on the outside, everything looked perfect. I I
Speaker 2: had just gotten onto this prestigious board of women from
Speaker 2: this MV League institution. My lab was the only lab
Speaker 2: in the building still running. You know, I was still
Speaker 2: taking care of my team, my employees. I had a
Speaker 2: little cute kid at home, perfect marriage, what it looked
Speaker 2: like on the outside.
Speaker 4: But I couldn't slow down.
Speaker 2: In fact, I think that I was probably at the
Speaker 2: height of the most I've ever worked in my entire life.
Speaker 2: My worst fear was not being able to provide from
Speaker 2: my team for my family, letting my patients down.
Speaker 4: So I was coping with that.
Speaker 2: By overfunctioning, overproducing, overworking. I could not sit still, and
Speaker 2: I thought, well, how did I let this happen? I
Speaker 2: internalized that shame and blame, like I should know better.
Speaker 2: I'm a psychiatrist, I studied depression. How did this snake
Speaker 2: up on me?
Speaker 4: And I think a.
Speaker 2: Lot of therapists go through this. We deal with a
Speaker 2: lot of emotions, grief, We deal with this vicarious trauma
Speaker 2: because we hear people's pain all the time, and we
Speaker 2: just we put on that mask because we have to
Speaker 2: show up for others, so many of us feel alone.
Speaker 2: But I thought, well, if I'm like this and it
Speaker 2: snuck up on me, I wonder how many people like
Speaker 2: me experience this. I wonder how many people are hiding
Speaker 2: behind a mask of pathological productivity and they're using that
Speaker 2: busyness to cope with something that they have not processed
Speaker 2: and something that's unresolved.
Speaker 3: You've written that you were caught off guard hearing yourself
Speaker 3: say that you felt depressed because you were so functional
Speaker 3: and so productive.
Speaker 2: Well, it's interesting because every day I have to use
Speaker 2: the DSM five to diagnose people, the Diagnostic Statistical Manual.
Speaker 2: So symptoms of depression are low concentration, things like guilt,
Speaker 2: low energy, changes in your appetite, changes in your sleep,
Speaker 2: You feel restless, you can't sit still. Depression by definition,
Speaker 2: does not require a low mood, and I don't think
Speaker 2: people know that. By definition, you could either have a
Speaker 2: low mood, you know, the classic depression, crying sadness or
Speaker 2: anne Hondonia, which is a lack of interest and pleasure
Speaker 2: in things that you once enjoy. So there are a
Speaker 2: lot of people out there who don't look sad, but
Speaker 2: they're struggling with Anne Hondonia and they don't even realize
Speaker 2: that you don't have to be sad to meet criteria
Speaker 2: for a depression. And listen, I was someone who experienced this,
Speaker 2: and I knew the criteria. I looked at the data
Speaker 2: sent every day, and it still snuck up on me.
Speaker 2: So I just thought people need to know about this.
Speaker 2: Antonia in research is such a boring term, But when
Speaker 2: I started talking about online, it just blew up and
Speaker 2: I was like, why are people so interested in this
Speaker 2: boring term. It's because they could finally name what they
Speaker 2: were experiencing. It was validating because they knew something was off,
Speaker 2: they knew something didn't feel right, they just didn't have
Speaker 2: a name for it. And in psychology there's a term
Speaker 2: called affic labeling. If you can identify the emotion, if
Speaker 2: you can name it accurately, that in itself decreases your
Speaker 2: own certainty because not knowing and then thinking, well, why
Speaker 2: am I not feeling better? What's wrong with me? That
Speaker 2: uncertainty just makes you feel more stressed. And it's really
Speaker 2: hard to be joyful in at peace when you don't
Speaker 2: know what's happening. So naming the antaedonia identifying it in
Speaker 2: itself is very powerful.
Speaker 3: Yeah, what happened next? What did it take for you
Speaker 3: in that moment to try and seek help.
Speaker 4: Here's the thing.
Speaker 2: As someone who is used to being the good girl,
Speaker 2: the people pleaser, I wasn't even aware as to how
Speaker 2: I was people pleasing in my own therapy. I didn't
Speaker 2: want to tell my therapist that I was experracy anadonia
Speaker 2: because I didn't want to let her down. And I'm
Speaker 2: a therapist.
Speaker 3: You are speaking my language, so it's like, yeah, wow, continue,
Speaker 3: I just need to say that I feel so seen
Speaker 3: right now.
Speaker 4: Oh thank you.
Speaker 2: I mean initially I did feel a lot of shame
Speaker 2: and blame, but I didn't share with my therapist. And
Speaker 2: she said, you know, I knew something was going on.
Speaker 2: I just I was waiting for you to say it.
Speaker 2: I knew something was going on. She says, whenever you
Speaker 2: get really busy, something's off. And you've been really busy again,
Speaker 2: back to that pathological productivity. Yeah, I go to for
Speaker 2: coping with pain is busying myself. But in the trauma research,
Speaker 2: in the PTSD research that I do, most people think
Speaker 2: of avoidance as avoiding people, places, or situations that trigger you.
Speaker 2: But those of us who use busyness, we avoid dealing
Speaker 2: with our pain by trying to outrun it with work,
Speaker 2: by taking on side projects. There's something within us that
Speaker 2: doesn't allow us to rest. So we're constantly moving. We're
Speaker 2: constantly busy. When we are not busy, we feel empty.
Speaker 2: When we are not working, we feel restless.
Speaker 4: We just do, and it doesn't necessarily have to be work.
Speaker 2: Maybe it's cleaning out your garage, maybe it's taken on
Speaker 2: a side hustle, maybe it's taken on other people's problems
Speaker 2: or projects.
Speaker 4: You just can't sit still.
Speaker 2: You're avoiding processing what's really happening with and so that
Speaker 2: was me. So she said to me, you know, you've
Speaker 2: been so busy. I just knew something was off. I
Speaker 2: was just waiting for you to tell me, and I'm
Speaker 2: so glad that you did.
Speaker 3: You also started to notice around this time that so
Speaker 3: many other people were sharing a similar constellation of symptoms.
Speaker 3: You eventually identified this as high functioning depression, but you
Speaker 3: saw that there was little clinical research on this condition,
Speaker 3: and so you and your lab decided to start focusing
Speaker 3: on it. Since high functioning depression is likely a new
Speaker 3: term for a lot of listeners. I'd love if you
Speaker 3: could define it for us.
Speaker 2: It's that type of depression where you don't look sad
Speaker 2: and you're weepy. It's that type of depression where you
Speaker 2: don't feel joy. Clinical depression happens when you meet the
Speaker 2: criteria for certain symptoms of depression like changes in your sleep,
Speaker 2: changes in your appetite, low energy, restlessness or being sluggish, guilt, hopelessness, etc.
Speaker 2: And you have to have either low mood, depressed mood,
Speaker 2: or an hedonia. But you also have to meet that
Speaker 2: final box of I'm not functioning. And so a lot
Speaker 2: of folks don't meet that checkbox. They can't slow down,
Speaker 2: they're like me, they're running from something, or they're busy.
Speaker 2: But if you don't, at the very bottom check that
Speaker 2: box of your lacking functioning or you're in significant distress,
Speaker 2: your healthcare professional will just say, well, come back when
Speaker 2: you break down. And so I thought, well, how come
Speaker 2: we don't ever look at these other types of depressions.
Speaker 2: When you look at what's happening in medicine these days,
Speaker 2: especially in the longevity space, it is the complete opposite.
Speaker 2: We're saying, let's not wait for stage four cancer, let's
Speaker 2: educate patients and catch the cancer risks. Or with the
Speaker 2: menopause space, we're seeing people saying educate women about hormones,
Speaker 2: educate them about their diet and their movement. Because we
Speaker 2: want to prevent a heart issue, we want to prevent
Speaker 2: a bone breaking from ostroporosis. So in other fields of
Speaker 2: medicine we're experiencing this renaissance of preventative care, but in
Speaker 2: mental health, we're still waiting for people to check that
Speaker 2: box before we do something. And I wanted to focus
Speaker 2: on those of us who don't break down. We were
Speaker 2: built with the DNA for joy. We're supposed to derive
Speaker 2: pleasure from the basic things in life. But if you're
Speaker 2: not deriving pleasure from those things, and some of the
Speaker 2: things that are on that rating scale are things like
Speaker 2: when you eat a meal, do savor it? When you're
Speaker 2: having a sip of tea, does it refresh you? When
Speaker 2: you take a rest, when you take a nap, do
Speaker 2: you wake up refreshed?
Speaker 4: Like?
Speaker 2: These are all things that are supposed to be points
Speaker 2: of joy for human beings. So if you're not able
Speaker 2: to access that, that is a problem. That's a warning sign.
Speaker 2: It doesn't look as flashy as crying in bed and
Speaker 2: staying in bed all day. But it is still a
Speaker 2: crisis because we're supposed to be able to experience joy.
Speaker 3: Yeah, I'm just thinking about one of my best friends
Speaker 3: in the whole world, and she's described what I'm now
Speaker 3: registering as anaedonia as being almost like seeing the world
Speaker 3: in gray scale. So she's like, there's nothing palpably wrong
Speaker 3: in any given moment. But I don't, like you said,
Speaker 3: I just don't feel joyful about the things, Like I
Speaker 3: almost feel a sense of remove when I'm in experiences
Speaker 3: that would otherwise have brought me joy. And just like
Speaker 3: reflecting on how valuable this conversation would be for someone
Speaker 3: like her, who has, never, like you said, met the
Speaker 3: criteria for depression. She goes to a doctor. Doctors like,
Speaker 3: you're keeping up your job, You're still in a happy marriage,
Speaker 3: things are stable for you, Like what gives why are
Speaker 3: you here? But like you said, humans are designed to
Speaker 3: feel joy, and so it's important that we allow people
Speaker 3: that access right to.
Speaker 1: One of the most primal needs of human beings.
Speaker 2: Joy doesn't mean that you're everything is perfect. It doesn't
Speaker 2: mean that you have no problems. Joy is acts a
Speaker 2: saying those experiences where you're able to find pleasure. So
Speaker 2: if you're in your life and you're not connecting with
Speaker 2: your partner, you're not finding that satisfaction anymore. You're eating
Speaker 2: your food and you don't even taste it, you're just
Speaker 2: kind of shoving it in. These are all points of
Speaker 2: joy that you're losing. So it's worth investigating. It's worth
Speaker 2: understanding what's happening in your life because joy is your
Speaker 2: birthright as.
Speaker 4: A human being.
Speaker 2: If you're not feeling it anymore, it's a red flag
Speaker 2: that you need to dig a little deeper and figure
Speaker 2: out what's happening.
Speaker 3: Yeah, I mean, I really do think we put such
Speaker 3: a premium on the alleviation of suffering, but we rarely
Speaker 3: think about the inverse, which is the reclamation of joy.
Speaker 2: Well, many of us are trying to outrun suffering, like
Speaker 2: myself included.
Speaker 4: So what did I do.
Speaker 2: I chased accolades, chase success, money, hoard at all these resources,
Speaker 2: but I was left feeling completely joyless. So you think
Speaker 2: you're trying to alleviate your suffering, but you're actually robbing
Speaker 2: yourself of joy.
Speaker 3: We'll be back in a moment with a slight change
Speaker 3: of plans. After years of research, Judith and her colleagues
Speaker 3: published the first empirical study on high functioning depression. Judith's
Speaker 3: new book is called High Functioning, Overcome Your Hidden Depression
Speaker 3: and Reclaim Your Joy. It draws on original research, patient stories,
Speaker 3: and her personal journey with the condition. Are there particular
Speaker 3: populations of people who are more predisposed to high functioning
Speaker 3: depression and if so, why do you think it's more
Speaker 3: prevalent in these populations.
Speaker 2: Well, I've done the only study in high function depression,
Speaker 2: so it's hard to make a claim. But what I
Speaker 2: do know about depression is that depression tends to impact
Speaker 2: women twice as likely as men.
Speaker 4: Whenever I hear that number, I'm like what, But then
Speaker 4: I'm like, okay, yeah, that makes sense. There are a
Speaker 4: lot of reasons for.
Speaker 2: Us, psychologically and socially. I also think that underserved populations
Speaker 2: go through a lot of trauma. And we know that
Speaker 2: black populations have high rates of PTSD, and some studies
Speaker 2: indicate the highest, And yet we're the population that seems
Speaker 2: to survive just about everything thrown at us. We survive slavery,
Speaker 2: civil rights, injustices, but a lot of that unprocessed trauma
Speaker 2: will catch up to us. We do have to acknowledge
Speaker 2: our mental health, and even though we have high rates
Speaker 2: of trauma, we're not as likely to seek treatment. And
Speaker 2: that's from a host of different reasons, access to care,
Speaker 2: the social determinants of health, and not having enough providers
Speaker 2: that even look like US healthcare professionals are at high
Speaker 2: risk for depression, and the rates of societality and residence
Speaker 2: in medical residence is higher than the general population, so
Speaker 2: the healers are on healed. I think it's really hard
Speaker 2: for doctors to address antedonia as a symptom and a
Speaker 2: problem in their patients because they probably feel a lot
Speaker 2: of antadonia themselves, and.
Speaker 4: They're like, well, why would I diagnose something that I expect.
Speaker 3: Welcome to the club being human, right, this is my
Speaker 3: baseline state?
Speaker 1: Yeah, exactly.
Speaker 3: Yeah, that makes so much sense before we get into
Speaker 3: some first steps people can take. If they are listening
Speaker 3: to this conversation and thinking, oh my god, Judith, I
Speaker 3: definitely have high functioning depression. I just want to quickly
Speaker 3: ask about the journey you've had as one of a
Speaker 3: very small percentage of black physicians in the US trying
Speaker 3: to put forth a somewhat revolutionary and controversial idea, novelty
Speaker 3: of any kind, and feels like this will receive pushback,
Speaker 3: but I want to know what the experience was like
Speaker 3: to like challenge conventional wisdom and put forth this idea.
Speaker 3: Given that just under three percent of physicians in the
Speaker 3: US are black women.
Speaker 2: Yes, and less than two percent of psychiatrists are black,
Speaker 2: so it's like wow. But yeah, Initially when I was
Speaker 2: doing this work, I got a lot of messages from people,
Speaker 2: psychologists and psychiatrists messaging me, calling me, emailing me, Oh,
Speaker 2: this is just another thing you're trying to pathologize. But
Speaker 2: fast forward now it's the opposite. I have doctors reaching
Speaker 2: out to me saying your book has changed my life,
Speaker 2: thank you for speaking to this. Can you come to
Speaker 2: my hospital. The majority of us are experiencing this.
Speaker 1: And what do you think is responsible for that change?
Speaker 2: Well, you know, I think that people are a bit
Speaker 2: more traumatized.
Speaker 4: Now, I'll else to say it. A lot has happened
Speaker 4: in the past five years.
Speaker 2: Yeah, I think people have been through so much politically,
Speaker 2: There's been wars and death and violence and so many changes, and.
Speaker 1: There's like a reckoning of some kind.
Speaker 4: Just so much bad news.
Speaker 2: Yeah, it starts to wear on you and then you're
Speaker 2: just like, you know, I'm not okay. And I also
Speaker 2: think that a lot of people are becoming more open
Speaker 2: to the idea of those of us who are put
Speaker 2: together having struggles. You know, There've been a couple of
Speaker 2: high profile, unfortunately suicides in the past couple of years,
Speaker 2: and so I think it's opening up this language for
Speaker 2: people to say depression does look different, it's not what
Speaker 2: I thought it was, or even to say, yes, I
Speaker 2: am depressed, or I experience that. I've had people that
Speaker 2: I respect and who are not very open about what
Speaker 2: they experience personally come up to me and say, I
Speaker 2: think I experienced that, and I just I don't think
Speaker 2: I knew what it was. And these are physicians, We're
Speaker 2: taught this stuff, you know. So I think it's really
Speaker 2: been a stark change from when I started this.
Speaker 4: Work to now.
Speaker 3: Yeah, and I think I mean another hypothesis is that, look,
Speaker 3: as we talked about before, right, you can only diagnose
Speaker 3: and consider, you can only consider something a real category
Speaker 3: if you're not in denial about having it yourself. Right,
Speaker 3: And so one of the things we talked about is
Speaker 3: maybe so many healthcare professionals are like, hey, this is
Speaker 3: just status quo, like this is what it means to
Speaker 3: live life. And I think one service of COVID is
Speaker 3: that it was shining a light actively on the mental
Speaker 3: health of first responders right for the first time, and
Speaker 3: the effects weren't immediate, but over time, we as a
Speaker 3: society came to appreciate the profound psychological burden that they
Speaker 3: face day to day. And I wonder if that allowed
Speaker 3: for a reckoning of sorts too. For the first time,
Speaker 3: as a culture, we gave space for first responders to
Speaker 3: say I'm not okay, and it was that recognition that
Speaker 3: allows them to then say I'm not okay, which means, yes,
Speaker 3: this might be a real thing. High functioning depression might
Speaker 3: in fact be a real category.
Speaker 4: I think that's spot on.
Speaker 2: You're right, because after the pandemic, people were holding their
Speaker 2: breath to get back to normal, and when normal never happened,
Speaker 2: They're like.
Speaker 4: Okay, this ain't going away.
Speaker 2: We're five years out, almost six years out. Something's got it,
Speaker 2: something's off, you know. And I think you're right that
Speaker 2: time that distance away from you know, that event, people
Speaker 2: are realizing it's not getting better. In fact, some of
Speaker 2: my symptoms are getting worse, so I have to do
Speaker 2: something about it.
Speaker 3: Yeah, high functioning depression currently isn't listed in the DSM,
Speaker 3: the Diagnostic Statistical Manual, so that's the official handbook for
Speaker 3: diagnosing mental illness. How do you think about this? I mean,
Speaker 3: the DSM has terrible and problematic history on the one hand.
Speaker 1: On the other hand, it.
Speaker 3: Is a guide used by most healthcare professionals today. I
Speaker 3: just wonder how you think about that tension and what
Speaker 3: role it will play in the future of your work.
Speaker 2: Well, think about it things like postparm depression. There was
Speaker 2: a time when post palm depression was not in the DSM,
Speaker 2: but we wouldn't say it didn't exist. Burnout wasn't in
Speaker 2: the DSM.
Speaker 5: Yeah.
Speaker 3: Also, wasn't homo sexuality pathologized at something?
Speaker 4: It was?
Speaker 2: Yeah, homosexuality was in there as a disorder. Yeah, you know,
Speaker 2: we do need a diagnostic manual to conduct studies, but
Speaker 2: at the same time we have to acknowledge it to things.
Speaker 4: Can be true.
Speaker 2: There are problems with our current manual and we have
Speaker 2: to keep an open mind. And if we continue down
Speaker 2: this road of let's wait till people break down to
Speaker 2: do something about it.
Speaker 4: Then we are doing the public a huge disservice.
Speaker 2: We need to empower people because in some parts of
Speaker 2: America there's only one psychiatrist for every thirty thousand people.
Speaker 2: You know, in New York you have to wait for
Speaker 2: six to eight weeks sometimes to get a psychiatrist. So
Speaker 2: we have to think about things differently. We don't have
Speaker 2: the professionals to meet the need. We have to train
Speaker 2: people about how to identify these symptoms so they can
Speaker 2: support themselves before they break down.
Speaker 3: Sure, but you do see it as a longer term
Speaker 3: goal to try and advocate for inclusion of high functionivasion
Speaker 3: in the DS.
Speaker 2: Or different forms of depression, because it's not just one
Speaker 2: form for.
Speaker 3: Someone who's seeing themselves in all that you've just described anedonia,
Speaker 3: hyper productivity. What recommendations do you have for treatment, Well, I.
Speaker 4: Would say start with validation.
Speaker 2: I call these the five v's Validation, venting, value, use, vitals,
Speaker 2: and vision.
Speaker 4: I like invalidation too.
Speaker 2: If you're in a dark room and you hear a
Speaker 2: loud crash and you don't see it, some of us
Speaker 2: will start screaming, some of us start running, someone start
Speaker 2: swinging because we're afraid but when you turn that light
Speaker 2: on and you see what fell, or if it was
Speaker 2: an object that fell, you're safe, you feel calm. Many
Speaker 2: of us who are high functioning, we don't take the
Speaker 2: time to acknowledge and accept how we feel. We just
Speaker 2: push it down, We say we'll deal with it next time,
Speaker 2: and then we just keep ongoing. The first step is
Speaker 2: to acknowledge and name how you feel. If you're listening
Speaker 2: to this and you realize that you have anadonia, you're
Speaker 2: not enjoying things and you're lacking joy, name it, accept it,
Speaker 2: and acknowledge it. If you're someone who's feeling very, very
Speaker 2: stressed and anxious, name it, acknowledge it. If we don't
Speaker 2: accept and acknowledge how we feel and we just keep
Speaker 2: on this path of being this human doing and not
Speaker 2: a human being, we're missing out on these precious moments
Speaker 2: in life where we can be accessing joy.
Speaker 4: And I think that step is.
Speaker 2: Really difficult for many people because if you were raised
Speaker 2: in a household where people didn't really talk about feelings,
Speaker 2: or maybe you're in a relationship where you're not validated often,
Speaker 2: or you're in a field of work where the workplace
Speaker 2: doesn't really validate you. You just it becomes your coping mechanism.
Speaker 2: But when you continue to push down your feelings, you
Speaker 2: also numb yourself to feeling joy too. So you have
Speaker 2: to feel the feels. You have to go through it,
Speaker 2: you know, like I did. It wasn't easy for me
Speaker 2: to acknowledge that I wasn't okay, and I fared it.
Speaker 2: I fared saying it out loud. I avoided it. But
Speaker 2: being able to get comfortable with that discomfort allowed me
Speaker 2: to take the steps that I needed to heal.
Speaker 4: And to change.
Speaker 1: Beyond validation, what else do you recommend?
Speaker 4: Venting is very powerful.
Speaker 2: When I bring people into my lab, I'll fill up
Speaker 2: a red balloon and I'll ask each purchase meant to
Speaker 2: try and push that balloon into this tub of water,
Speaker 2: and one hundred percent of time that balloon pops up.
Speaker 2: Why you can't out math physics? Right?
Speaker 4: Physics is physics.
Speaker 2: But then when I ask all those people to then
Speaker 2: try and deflate the balloon, they let the air out,
Speaker 2: then that balloon glides in the water, or you could
Speaker 2: easily push it down. If we don't learn how to
Speaker 2: express our feelings, it will pop up in our relationships
Speaker 2: in a nasty fight.
Speaker 4: It'll pop upbout work.
Speaker 2: It'll pop up when we're driving home from work and
Speaker 2: we cut someone off. It can pop up in our health.
Speaker 2: So being able to express your emotions intentionally, not just
Speaker 2: like going out in trauma dumping, not just telling anybody
Speaker 2: how you feel all the time, but if that's to
Speaker 2: a therapist, that's really powerful. When I started talking to
Speaker 2: my therapist about how I was feeling, it just felt
Speaker 2: like a load had been lifted off of me.
Speaker 4: And then I wonder, why did I do this sooner?
Speaker 4: That was silly.
Speaker 2: But for those of us who aren't in therapy, talking
Speaker 2: to a trusted faith leader or to a family friend,
Speaker 2: you know, being careful about who you talk to. You
Speaker 2: don't want to talk to your people who are in
Speaker 2: lower positions than you, like your kids, because they're going
Speaker 2: to listen, but they're going to worry about you, and
Speaker 2: so that's an unfair power dynamic, or to your employees.
Speaker 2: But venting it can also be in writing, like journaling.
Speaker 2: It could be through singing, through praying, through crying, just
Speaker 2: express those emotions to release some of that anxious energy.
Speaker 2: For a very long time, I was chasing the accolades,
Speaker 2: the achievements, but I forgot why I actually went into
Speaker 2: my role. I wanted to learn out of curiosity, this
Speaker 2: thirst for knowledge. And when I started to seek knowledge
Speaker 2: and curiosity versus the accolades, I started to feel a
Speaker 2: sense of purpose again. And so I classify value as
Speaker 2: things that are priceless, not with the price tags. So
Speaker 2: many of us chase these things that we think will
Speaker 2: make us happy, but they end up causing us more stress.
Speaker 2: So try and tap into things that actually bring you
Speaker 2: meaning and purpose. For me, it was connection with others
Speaker 2: and curiosity and learning others. It could be things like
Speaker 2: nature or their faith or community.
Speaker 4: And then the.
Speaker 2: Fourth vas vitals, and that's really honoring the fact that
Speaker 2: you only get one body and brain and really taking
Speaker 2: care of that. When I was in my highest high
Speaker 2: functioning ways, I'd go through a day and I'd like,
Speaker 2: at the end of the day, I'd be like, oh
Speaker 2: my gosh, I didn't even go to the bathroom. I'd
Speaker 2: be running to the bathroom as soon as I got home,
Speaker 2: you know, not eating properly, just eating the fastest thing
Speaker 2: I could get my hand on. Take the time to
Speaker 2: take care of your body. Pencil in those breaks in
Speaker 2: between your zooms. What's the worst thing that could happen
Speaker 2: if you go and use the bathroom. What's the worst
Speaker 2: thing that happened if God forbid ate your salad without
Speaker 2: looking at a screen, or trying to cram in a
Speaker 2: meeting while you ate. These are all the things that
Speaker 2: are the simple things in life. And there was this
Speaker 2: recent study where they took the smartphone capacity away from
Speaker 2: these phones and people for two weeks could only use
Speaker 2: their phones as if it were just like a flip phone,
Speaker 2: like protecting and calling. And what they found was that
Speaker 2: after two weeks, their mood scores went up as if
Speaker 2: they were being read it with an answer depressant. Why
Speaker 2: Because they were sleeping more, they were eating and tasting
Speaker 2: their food, they were out in nature, they were connecting
Speaker 2: more with others. They were getting all those points of
Speaker 2: joy that I was talking about that we actually add
Speaker 2: up to determine how people are becoming happy in depression research. Right,
Speaker 2: they were actually getting those points because they weren't so
Speaker 2: busy on their phones.
Speaker 4: So really honor your body in that way.
Speaker 3: It's so funny you mentioned that there was this moment,
Speaker 3: maybe it was like a year or two ago where
Speaker 3: I was sitting down to have lunch and I had
Speaker 3: my laptop and it was playing something, but that wasn't
Speaker 3: stimulating enough because I feel like this level of stimulation,
Speaker 3: I think it's addictive. It feeds on itself. It's like
Speaker 3: adapting this sugar. You just need more and more of it.
Speaker 3: So that I'm also on my phone scrolling like Instagram
Speaker 3: as this video plays as I'm eating my lunch, and
Speaker 3: I'm like, when was the last time you sat down
Speaker 3: to eat anything without your phone? And it was astonishing
Speaker 3: how infrequent that experience was for me, certainly during lunchtime.
Speaker 2: Well, you know, I'm glad you brought that up, because
Speaker 2: I'm so intentional about my lunch these days. Because there
Speaker 2: was a period in time where I had to take
Speaker 2: acid pills every day because I was just shoving it
Speaker 2: in in front of a meeting, putting on mutes so
Speaker 2: I could crunch my salad some people in the here
Speaker 2: that I was eating and then off right, and then
Speaker 2: I have, let's say ask, I'm like, what was I thinking?
Speaker 2: One of the basic joys is eating food and savoring it.
Speaker 2: There was no need for that.
Speaker 4: You know, no one was going to.
Speaker 2: Lose anything if I actually God forbid ate my salad
Speaker 2: in peace.
Speaker 1: Yes, exactly, exactly, but many of us lose.
Speaker 2: That point of joy, that's simple point of joy because
Speaker 2: we think that we're not deserving of it. And then
Speaker 2: the fifth fee is vision, and vision has two prongs.
Speaker 2: It's celebrating your winds and planning joy. And the celebrating
Speaker 2: of the winds is something that I just I mean,
Speaker 2: there was a large point in my life when I
Speaker 2: kid you not my ivy le degrees were under my bed.
Speaker 4: What was that for? Take your degrees and hang them up.
Speaker 2: If you do something at work, plan a small celebration,
Speaker 2: you know, like with my lab. When we finish our trainings,
Speaker 2: everyone has to put it in a binder. And if
Speaker 2: one of us finishes a big milestone, we'll meet in
Speaker 2: the lab. We'll have like cupcakes, or we'll have a lunch.
Speaker 2: We celebrate the small things that we used to take
Speaker 2: for granted. It's important to have these things to look
Speaker 2: forward to, to bond together and to represent the fact
Speaker 2: that you didn't have to do what you did, but
Speaker 2: you did it. And rather than going on to the
Speaker 2: next let's take some time and reflect on this great
Speaker 2: thing that you did. And it's a huge mind shift,
Speaker 2: and so I tell myself that all the time. Like
Speaker 2: the Judith I am today is so different than five
Speaker 2: years ago because when I finished a training, I have
Speaker 2: to do so many trainings for research.
Speaker 4: I'm like, I did this training, I like put it
Speaker 4: up on the board.
Speaker 2: That's act and I'm like, now I'm worthy of a break,
Speaker 2: and it's something I have to do myself, Like totally,
Speaker 2: I did this, and now I get this break and
Speaker 2: it has drastically changed my quality of life. And this
Speaker 2: is not like big stuff, but it's so important. It
Speaker 2: sends a message that I am a human being. I'm
Speaker 2: not a human doing.
Speaker 3: What is your experience like today, Judith, Like, as someone
Speaker 3: who has high functioning depression, Like, do you still consider
Speaker 3: it an active diagnosis? Is it something you continue to
Speaker 3: work through? Or probably yes?
Speaker 2: The bookstore is not something that encourages healing from high
Speaker 2: functioning depression.
Speaker 4: Let me just put it that way.
Speaker 3: I was just gonna say, there is such an irony
Speaker 3: to your story, right, which is that you had this
Speaker 3: breaking point, but then through the work you've done on
Speaker 3: high functioning depression, you kind of elevated into this superstar psychiatrist.
Speaker 3: And I'm imagining your time is even more tax than
Speaker 3: before given all your obligations. And so what is your
Speaker 3: relationship like with high functioning depression? Like, how do you
Speaker 3: keep things in check?
Speaker 2: Well, you know, I had to let go of a
Speaker 2: lot of things that I used to hold tight to.
Speaker 2: There you used to be just belief that no one
Speaker 2: can do it better than you, and I had to
Speaker 2: challenge that worst case scenario. Many times we think, if
Speaker 2: you don't do X, the worst thing will happen. And
Speaker 2: now I've let go of so many things and I
Speaker 2: just trust people more. I'm letting the worst thing happen,
Speaker 2: which is nothing happened, Nothing that happened.
Speaker 1: Yeah, in fact, I okay to ask for you.
Speaker 2: I'm not in every single space, I'm not in every
Speaker 2: single meeting.
Speaker 4: I just let go.
Speaker 2: And you know, I told you that this antedonia is contagious.
Speaker 2: This joy is contagious too. When you relax and you
Speaker 2: let people who want to help you help you, they're
Speaker 2: so happy to help you. When you start to prioritize
Speaker 2: joy and you slow down and you save your life,
Speaker 2: others around you will see that too and they will
Speaker 2: change as well.
Speaker 4: It is. It's contagious.
Speaker 3: As someone who you've mentioned you've experienced anedonia. I just
Speaker 3: want to know if you can reflect on, like this
Speaker 3: past week, what were your top moments of joy, just
Speaker 3: to give people hope that they can reclaim what you've experience.
Speaker 2: I got a new serum for my skin, and it's
Speaker 2: something that I look forward to every day. As a child,
Speaker 2: you know, my mom had four kids, and I grew
Speaker 2: up in this tiny, one bedroom apartment, and you know,
Speaker 2: when we bathed, she had to bathe us all together.
Speaker 2: When she loationed us, she had to loation us all together.
Speaker 2: So I was not someone who was raised gently like
Speaker 2: caressing my face and skin. It was always this rushed,
Speaker 2: hurried type of process. And I realized this later in
Speaker 2: life that these type of rituals are really important for
Speaker 2: sending a deeper message that you care about yourself, that
Speaker 2: you're worthy.
Speaker 4: So I look forward to my skin routine.
Speaker 1: I love it.
Speaker 2: I look forward to my bedtime routine. I just as
Speaker 2: someone who used to pride themselves on like I only
Speaker 2: got four hours of sleep or five hours. I am
Speaker 2: like eight hour at night person. Like I pride myself
Speaker 2: on that I protect my sleep. Sleep feels yummy again,
Speaker 2: you know, like that sleep when you're a kid and
Speaker 2: you used to feel like, oh yeah, I get this
Speaker 2: yummy sleep again. And then nature. I'm Portunida, I'm from
Speaker 2: the Caribbean. I grew up going to the beach every weekend.
Speaker 2: I made it a point, and I was intentional to
Speaker 2: live close to the water in Manhattan and really be
Speaker 2: close to the water and close to nature. So that's
Speaker 2: what brings me joy, very simple.
Speaker 3: I know, I love it, and I was just gonna
Speaker 3: see you mentioned Anaedonia can be contagious, but your joy
Speaker 3: is contagious.
Speaker 1: I've got the biggest.
Speaker 3: Smile plastered on my face right now just hearing about
Speaker 3: those moments. So I'm so glad you shared them with me,
Speaker 3: and thank you so much for coming on the show.
Speaker 4: Thank you.
Speaker 3: If you or someone you love is struggling with depression,
Speaker 3: health is available, call the National Alliance on Mental Illness
Speaker 3: Helpline at one eight hundred ninety five ZO six' two six'
Speaker 3: four for free confidential support. And resources you could also
Speaker 3: find the number in our show notes and join me
Speaker 3: next time for my Conversation With, jessica slice an author
Speaker 3: who writes about living. With disability she talks about how
Speaker 3: her disability renewed her relationship.
Speaker 5: With herself for all THOSE years i thought that it
Speaker 5: was in my control to, be perfect or to form a,
Speaker 5: perfect life or to be, good enough and, BECOMING disabled,
Speaker 5: i mean so little isn't my? Control NOW and i
Speaker 5: like my life as a disabled person far MORE than
Speaker 5: i liked my.
Speaker 3: Life before that's next TIME On A slight Change. Of
Speaker 3: plans see. YOU Then A slight Change of plans, is
Speaker 3: created written and executive produced By Me. Maya Schunker The
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Speaker 3: Editor Kate, parkinson morgan Our Producers britain Cronin And, megan
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Speaker 3: course a very special Thanks To. Jimmy lee you CAN
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Speaker 1: Maya schunker see you. Next week