You might look like you’ve got it all together—but inside, you’re barely hanging on. Let’s talk about it.
If you’ve been feeling burned out, emotionally drained, or like you’re just going through the motions, this episode is for you. I sat down with board-certified psychiatrist and author Dr. Judith Joseph, and what started as a conversation about high-functioning depression turned into a much bigger discussion—about joy, trauma, people-pleasing, burnout, and the societal pressure to always be “on.” Dr. Joseph breaks down the science of why so many of us feel stuck in cycles of overachieving and under-feeling—and how to break free from it.
We’re not just talking theory—we’re talking real, actionable practices. Dr. Joseph shares her five-part framework to help you reconnect with what truly matters and reclaim your joy, even in the middle of a busy, demanding life.
What you need to know:
High-Functioning Depression is Real and Often Overlooked
Many people suffering from depression don’t fit the stereotype—they’re high-achievers, outwardly successful, and “functioning.” Dr. Joseph explains that these individuals may be silently struggling with symptoms like anhedonia (the inability to feel joy), restlessness when not busy, and chronic people-pleasing. If you’re exhausted but can’t slow down, this could be you.
Your Trauma Might Be Driving Your Behavior—Without You Knowing It
Trauma doesn’t always look like a dramatic event. Scarcity, burnout, toxic relationships, and even childhood experiences shape how we move through the world. Dr. Joseph’s biopsychosocial model empowers people to understand how biology, psychology, and environment intertwine to affect their mental health.
Scarcity Trauma Is Real and It Affects Your Money
Dr. Joseph introduces the term “scarcity trauma” to describe the deep-seated fear of not having enough. This can lead to hoarding money, overspending to “feel normal,” or avoiding financial risk—even when it’s rational. If you’ve ever felt unsafe around money despite having enough, this is worth exploring.
People-Pleasing Can Be a Hidden Form of Masochism
Constantly putting others’ needs before your own isn’t noble—it may be a trauma response. Dr. Joseph unpacks how masochistic tendencies show up as chronic self-sacrifice, and how saying “yes” too often can lead to resentment and burnout. Learning to say “no” is key to healing and protecting your joy.
Joy Is Found in the Small, Intentional Moments
Joy doesn’t come from chasing big achievements or external validation. It’s found in the little things—savoring your coffee, acknowledging a small win, or choosing rest over hustle. Dr. Joseph urges us to stop being “human doings” and start being human beings again.
The Five Vs: A Roadmap to Reclaim Joy
Dr. Joseph offers a five-step practice to help people navigate hidden depression and reconnect with purpose.
- Validation – Acknowledge all emotions, not just the positive ones.
- Venting – Find safe, culturally appropriate ways to express your feelings.
- Values – Reconnect with what really matters beyond material goals.
- Vitals – Care for your physical, digital, and emotional well-being.
- Vision – Celebrate small wins and visualize a joyful, grounded life.
Notable quotes
“You are not a human doing. You are a human being.”
“People value you more when you say no. The yes-person does not get the respect.”
“The science of your happiness is based on you. Your unique biopsychosocial. There will only ever be one you—so why are you using someone else’s methods?”
Episode-at-a-glance
≫ 02:50 Symptoms and Signs of High Functioning Depression
≫ 08:36 The Science Behind Depression
≫ 15:06 The Five Pillar Process to Reclaim Joy
≫ 17:31 The Importance of Values and Vitals
≫ 23:20 Exploring High Functioning Depression
≫ 24:51 The Five V’s Methodology
≫ 26:37 Capitalism and Modern Depression
≫ 28:05 Masochism and People Pleasing
≫ 33:21 Scarcity Trauma and Financial Impact
≫ 42:48 Proactive Mental Health Management
Dr. Joseph’s Links:
Website: https://drjudithjoseph.com/
High Functioning book: https://highfunctioningbook.com/
Instagram: https://www.instagram.com/drjudithjoseph/
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Meet Dr. Joseph
Judith Joseph, M.D., M.B.A, is a Board Certified Psychiatrist. Dr. Judith is Chair of The Women in Medicine Initiative for Columbia University Vagelos College of Physicians & Surgeons. Dr. Judith is a clinical assistant professor of Child and Adolescent Psychiatry at NYU Langone Medical Center. She has conducted several clinical research studies in pediatric, adult, geriatric and women’s mental health as the Principal Investigator of her research lab, Manhattan Behavioral Medicine. Dr. Judith developed the T.I.E.S. method to address mental health symptoms in menopause. She is on the board of Let’s Talk Menopause, a national non-profit organization which recently advocated in December 2023 for the Menopause Research and Equity Act in the US Congress alongside Congresswoman Yvette Clarke. Dr. Judith is conducting the first of its kind research study in High Functioning Depression in her laboratories and has authored a book on High Functioning Depression with Little Brown Spark that was released in April 2025.
Transcript:
Tori Dunlap:
If you’ve been feeling tired, burned out, exhausted, or just like your life is lacking joy, this episode is for you. Today, we’re talking with Dr. Judith Joseph, board-certified psychiatrist and the author of High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy.
We started this conversation with Dr. Joseph to talk about high-functioning depression, but what we really ended up talking about are all the things we already know the names of: people-pleasing, burnout, and how the world we’re living in today is so different than the world our parents or grandparents lived in. And how that’s affecting everybody, not just those who suffer from clinical depression.
Dr. Judith Joseph:
If you go to your doctor and you’re like, “I feel blah, meh,” they’re going to be like, “Well, are you functioning?” And if you say yes, they’re like, “Well, I’ll see you when you’re not functioning.”
That’s why most of us don’t process our trauma. Rather than thinking about it and processing it and challenging it, we do. We work harder. That’s why it’s never enough money.
If you don’t know that you’re spending as a trauma response, then you’re not going to know how to address it. You’re using someone else’s tools who doesn’t have scarcity trauma on you, and you’re wondering why you’re not that person.
The science of your happiness is based on you, your unique biopsychosocial. There will only ever be one you ever, so why are you using someone else’s methods?
Tori Dunlap:
In this episode, we dive into the five pillar process Dr. Joseph shares with her patients that helps them find more joy and more meaning in their lives. Let’s get into it. But first, a word from our sponsors.
Can you tell me what work you do and why it is so important?
Dr. Judith Joseph:
I’m Dr. Judith. I’m a board-certified psychiatrist. That means I can do therapy and also prescribe the good stuff. I also run a research lab in Midtown Manhattan, and I’m one of the very few Black women principal investigators who runs a behavioral lab. So I do clinical research anywhere from ADHD in a four-year-old to dementia in an 89-year-old.
It’s really fun work, but I wanted to make sure that the labs weren’t just containing all the knowledge and that most people were getting information, so I started becoming a content creator about two years ago and putting things out there online that I found in my lab that I thought was interesting, and I had no idea that they would’ve gone viral.
I do a lot of different things under the umbrella of being a mental health expert and most recently an author of my new book, High Functioning, about high-functioning depression and the first study ever done in the world on high-functioning depression at my lab.
Tori Dunlap:
So that’s one of the biggest reasons we wanted to have you on the show is to talk about this concept of high-functioning depression, like you said. Can you break down what that is for listeners? And what does it look like in comparison to what we’ve typically associated with depression?
Dr. Judith Joseph:
So most people think depression is the get-out-of-bed depression. You’re crying all day, you’re not getting things done. And according to the Bible of Psychiatry, the DSM, we’re now on version five, you’re supposed to meet criteria for depression if you have all of these symptoms of depression and it impacts your functioning or you are in significant distress.
The problem with that is that there’s a ton of people out there, and I’ve met them, I’ve interviewed them, I’ve done research with them, where they have the symptoms of depression, but they’re actually coping with it by busying themselves. They’re overfunctioning, they’re exceeding functioning.
They’re the rocks, right? They’re the ones that can’t let their kids down, can’t let their staff down, can’t let their team down in the case of athletes, can’t let their fans down in the case of performers, so they wear this mask of productivity. So even if they’re struggling on the inside, you would never know.
And some of the unfortunate cases of high-functioning depression such as Miss USA in 2019 who passed and DJ Twitch, who was a beaming light on the Ellen Show and then passed and surprised us all, if you let high-functioning depression get to a point where you’re hopeless, it could be too late, because the same skills that help you to over-exceed can be the same skills that you use to succeed at ending your life. So it’s a really important thing to talk about.
And the issue is that those who struggle with HFD, they don’t want to talk about it. They don’t want to let others down. They don’t want to burden others. It’s a number-one thing I hear in people who are depressed, “I don’t want to be a burden,” but they don’t realize the rest of us want to help them. And I know I’ve had HFD for years, and I know I don’t like to burden others. I’m the rock. I’m the single mom. I take care of my eight-year-old, I take care of my lab, my team of all-woman researchers. I don’t want to let my fans down.
But there are times when you just have to, I say, “You are not a human doing. You are a human being.” So there are times you just have to be a human being, feel the feels, get through it, feel the pain, so that you can one day feel the joy.
Tori Dunlap:
My mentor said that exact same thing to me a couple of years ago, and it changed my life. You’re a human being, not a human doing.
Okay. I want to talk specifically about what this might look like for someone listening. So how do we know or how do we suspect that we have not just depression, but the high-functioning version of this?
Dr. Judith Joseph:
If you are really uncomfortable or restless when you have nothing to do and you’re just like, “I got to get something done.” I saw this meme the other day where there was this woman gathering sticks in her yard, and she would never do that, but she had nothing else to do. She was doing something that we used to do back in the pioneering-
Tori Dunlap:
She’s like, “I got to feel busy.”
Dr. Judith Joseph:
… days.
Tori Dunlap:
Yeah. “Let me get some kindling for the fire. The non-existent fire I’m about to make.”
Dr. Judith Joseph:
Yes. So it’s like the human doing. If you can’t just be, just sit in there and being bothers you, that is a gut feeling of high-functioning depression. Anhedonia. It’s a research term. It’s been around for over 100 years.
And I’m surprised every time I go to a research conference, I even asked researchers, “Do you know what anhedonia is?” They’re like, “No, what is that?” It is this hidden word in medical literature, and it is one of the hallmarks of hidden depression.
So it’s when you don’t enjoy things the way that you used to. You’re eating your favorite food, and you’re just like, “Eh,” and you’re just shoving it in your mouth. Or you’re watching a movie that you were really looking forward to and you can’t even follow the plot because you just zoned out, or you’re with your friends, and you’re just like, “When can I go home?” And you used to be the one enjoying the social interactions. It’s when you can no longer access the joy and the basic things that used to give you pleasure.
Anhedonia is a sneaky symptom. I call it the joy thief. It comes in the middle of the night and it steals your ability to enjoy things. But it’s one of those symptoms that I want people to know about because if you go to your doctor and you’re like, “I feel blah, meh,” they’re going to be like, “Well, are you functioning?” And if you say yes, they’re like, “Well, I’ll see you when you’re not functioning.” They don’t take anhedonia seriously. So when you are feeling it, name it, and say to your doctor, “I’m having anhedonia, and I know anhedonia is a possible symptom of depression.”
Anhedonia is also seen in substance abuse. A lot of us use our phones as our substance. We’re constantly getting that dopamine hit, and it’s numbing us so we can’t enjoy everything else. So I think that anhedonia is important.
And if you have a history of trauma, I have a trauma inventory on my website because, as a researcher, I know that not all trauma meets criteria for DSM-5 PTSD. So a lot of traumas get overlooked, but it doesn’t mean that they’re not emotionally significant, meaning that they shape the way you see yourself in the world and the way others see you in the world and the way you interact with the world. So there are emotional traumas that in science, they don’t tick off and say, “Oh, they’re significant.”
But in real world, I’m bridging the real world with science, in real world, these things impact us. So things like growing up with not a lot of food in your cupboards, having not a lot of money to pay your bills, going through a bankruptcy, going through a business divorce, going through an actual divorce, right? Having a toxic friend or a toxic partner, these are all emotional traumas that impact us.
And some of us busy ourselves and distract and don’t take the time to process the pain. We don’t want to feel it. We want to avoid it. Avoidance is a trauma response, so that’s a risk factor as well. So anhedonia, trauma.
And also, one of the things I found in my research is masochism. It’s a lesser-known term, and in psychiatry worlds, we stopped using the word because we pulled it out of the DSM, the bible of psychiatry, but it was there up until the ’80s. A lot of women were being diagnosed as being masochists, but today’s terms would describe it as people-pleasing. So again, you don’t want to let people down. You’re the rock. Your whole identity is tied in your role, so those are risk factors.
Tori Dunlap:
Can we talk a bit about the science of what’s happening in your brain and your body when you have high-functioning depression?
Dr. Judith Joseph:
Depression is one of those really difficult things to pinpoint, but what we know are correlations and not exact causation, or else we would cure it, right? With the science of depression, I have patients all the time who come in and they’re like, “I just want to see a lab sample. I want to see that this is my depression.”
And I always tell them, “I wish it were the case. The science is not there.” There are people who image brains and say, “Oh, this is depression.” No. There’s correlation and then there’s causation. We don’t know what the exact cause is just yet.
But what we do know based on our treatments that have worked is that there are changes in the brain where neurotransmitters such as serotonin, dopamine, norepinephrine, and even GABA, which is more of the anxiety-associated neurotransmitter, glutamate, which is more of an excitatory neurotransmitter, we know that medications that target symptoms of depression using these neurotransmitters tend to work. And we know that if we light up the brain using fMRIs and we tag some of these things, we see differences in a brain that’s depressed versus a brain that’s not depressed.
The issue is that there are many different types of depression. So in one of my research studies, I look at postpartum depression. What happens in the brain right before you give birth is there are changes in progesterone, and those shifts can really impact the brain so that you have symptoms of depression, but to say that progesterone is behind a depression in someone who is not pregnant would be incorrect. And that’s why I think it’s not satisfying in the psychiatry world for a lot of patients because it’s like, “Well, I just want to know what causes it.” And I say, “There are many things that cause it.”
So one of the, I think, satisfying tools I use in my book is the biopsychosocial model, and I’m on the mission to democratize mental health, because in some parts of the country, there’s only one psychiatrist for every 30,000 individuals. And the biopsychosocial is something I learned in medical school that I do with my clients and that I teach in my book, basically to understand the science of your happiness, because you’re different than everyone else. There’s only one you, there will only ever be one you, so let’s understand the science of your happiness.
So I asked my clients to draw three intersecting circles, and in the first one, think about the biological risk factors. So biologically, do you have a family history of depression? Do you have a medical condition that puts you at risk for depression, like an autoimmune condition? Do you take medications that worsen your risk factors for depression?
And then psychologically, what are your past traumas? Are you someone who had childhood abuse? Are you someone who had scarcity trauma? Lack of resources? Are you someone who is not as resilient, and when you have obstacles come your way, you shut down? Are you someone who has attachment issues, right? That’s in the psycho part of the biopsychosocial.
And then the social factor is who’s around you every day? What are you doing every day? Are you moving? Are you in a toxic work environment? Are you in environments that are toxic? As in the environment is toxic, not just the social environment, but literally there are toxins in your environment. So all of these things play a role in your depression and in your mood, and that’s why to say one thing causes depression is absolutely incorrect. I challenge people when they say, “Oh, this is the cause,” because it’s like, “But everyone has a unique biopsychosocial.”
And as I explain, a young man with depression versus a woman who just gave birth with depression, or a person that just gave birth with depression, they’re going to have different biological factors because the person who just gave birth is going to have their hormones fluctuating, whereas the person who has non-postpartum is not going to have progesterone fluctuating.
So it’s really interesting, I think it’s exciting, and it makes my work challenging to really understand the biopsychosocial factors, and I think it’s actually empowering for an individual to understand that they’re actually complex. They didn’t do anything wrong. They just have a unique biopsychosocial, and there are multiple causes of this depression.
So it, in a way, takes the blame off of that person because one of the symptoms of depression is guilt, blame, and shame. And so if you can see a picture and you’re like, “This is what’s causing it,” it can be not just empowering, but it’s a relief.
Tori Dunlap:
When we talk about this version that we’re discussing of depression, the high-functioning version, can you give me concrete examples of how this might show up in somebody’s life? How it might show up in their money, how it might show up in their relationships, how it might show up in the stories they’re telling themselves?
Dr. Judith Joseph:
Absolutely. So I recently wrote an example of someone who is an entrepreneur, going back to the risk factors of high-functioning depression. They had a previous bankruptcy, and that was a scarcity trauma for them. And they had no idea that this fear of failure and fear of going back to losing everything was driving their inability to access joy because they were just doing, doing, doing, and they didn’t ever process that pain, and they had no idea how it was seeping into their lives.
And they had the classic symptoms of depression, feeling tired, not being able to focus, feeling guilty, feeling as if maybe they did something wrong, maybe it was their fault, not the fact that there was a massive financial crisis and a lot of businesses were lost.
They also had some of the biological risk factors. They had multiple COVID infections. We don’t even know how COVID is going to impact the brain in the long run, but that’s inflammation in the brain. They never had a real chance to recover from that. They just kept going, going, going. So they had that trauma and then the social stressors of employees that they had to pay out. It’s a lot.
So their unique biopsychosocial presented as busying themselves, burying themselves in work, having those symptoms of depression, not enjoying things, not being able to sleep, poor concentration, guilt, but they were actually exceeding functioning, right? Their business was doing better than ever. They were killing it. People thought they had it figured out. “Wow, you’re resilient!” That’s something they heard all the time.
And they said to me, “If only knew I’m hanging on by a thread.” And I said, “Well, maybe they should know. I wonder what’s the worst thing that could happen if you actually told people what you were feeling?”
And that’s why I developed the five Vs, my methodology, because I always say that your joy for a human being and the science of your happiness is in your hand. We were designed to experience joy and happiness. We were built that way. So I ask my clients to envision the joy in their hand, and then the five Vs will allow them to release their joy.
So the first one is validation. Acknowledge how you feel. We tend to only validate how we’re feeling when we’re happy. We’ll post the happy posts. But you got to start validating both the positive and the negative emotions. All of your feelings are valid. People with high-functioning depression, they push it down. They’ll only tell you when things are going great and they’ll hide when things are going poorly.
Number two is venting. Express it. So how do you get that emotion out? Many people based on their cultural backgrounds, they’re not comfortable talking about it. So I say, “Well, let’s figure out what’s a culturally competent way for you to express your emotions.” I’ve traveled over 30 countries learning about cultures. Some people find it better to pray, some people find it better to paint, some people find it better to wear their feelings, and others need to talk, right? Talking to a therapist, a faith leader, a loved one.
I say one of my favorite ways of venting, and people never guess it, but I’m like, “A good cry makes me feel so good.” When you cry and you express your emotions that way, those stress hormones go down, that oxytocin goes up, you feel better. That’s why you feel good after a good cry. Crying feels so good, but many people are very uncomfortable with crying.
And then I go into the dos and don’ts of venting, so when you are venting to people, make sure you’re not trauma dumping, right? Make sure you’re asking consent. I have a social media reel that’s coming out about that. Make sure you ask them, “Is it okay to vent? Is this a good time?” If it’s a subject they’re not comfortable with, maybe ask for permission.
One thing that we tend to do is we vent to people who we probably shouldn’t be venting to, so if it’s your employee or if it’s a child, maybe think twice about that, right? I lay out really concrete dos and don’ts to venting.
Tori Dunlap:
This episode is so eye-opening for me, and Dr. Joseph and I will be right back after the break with the rest of her five Vs to finding more joy, how to figure out if you’re suffering from high-functioning depression, or if it’s just capitalism, and how to prevent mental health crises before they happen. More when we come back.
Dr. Judith Joseph:
Number three is values. These are things that are priceless, not things that have price tags, but we are steady chasing the things with the price tags. We think that those things will make us happy.
But research shows us that the things that really bring us purpose and meaning are things such as our values with causes we believe in, values with family, values with loved ones. Not the things like monetary value, homes, cars, et cetera. And in fact, the research says that when we chase the things that are concrete, like, “Okay, when I get that big job, I’ll be happy. When I get that house, I’ll be happy. When I get that partner, I’ll be happy.” We’re still not happy, we’re still not satisfied, we’re still chasing the next thing. So try to tap into the real purposeful values daily.
Personally, I do that by learning about Black history and scientists in STEM, and I teach my daughter about it because she doesn’t always get all of that in school. And then when I post about it, because I usually vent using socials, and when I post about my values, I’m validating it, right? I’m going back to the three Vs. But I also feel as if I’m sharing with my community.
And then my community gives me that feedback. So when you are tapping into your values, this is a good litmus test. A good barometer is that you will get the feedback that you’re impacting other people’s lives. You don’t just change your life. That meaning and purpose is contagious. That joy is contagious.
And then the fourth is vitals. And I talk about six unique vitals. We all know the basics, right? Getting good sleep, getting good movement, eating the right foods, but I include other things in there such as your relationship with technology because a lot of data’s coming out about how our brains are impacted by excessive tech, excessive digital exposure, and excessive social media, and we really need to educate ourselves about that, so I put in methods in there for people to set healthy limits with tech.
And then our relationships with people. The number-one predictor of your longevity and your happiness are your relationships with people. If you’re in a toxic friendship, a toxic relationship, that’s literally draining your life source, right? So these are important, but no one pulls you aside when you’re growing up and says, “Make sure you pick the right person.” They don’t tell you that that’s going to be the predictor. What they tell you is, “Don’t get pregnant. Make sure you’re married before you have babies,” but they don’t tell you.
Imagine if someone pulled us aside at five, and they were like, “Did you know that if you pick a toxic person, you’re going to be miserable, and you’re going to be physically unhealthy?” No one tells us that. But it’s true. The way they warn us about alcohol and cigarettes, they should warn us about toxic people, because they will literally drain your life source. And then work-life balance is in the vitals as well because people with high-functioning depression have a hard time with boundaries, so I put in concrete ways.
And then lastly, vision. I put that in there because I mentioned that many of us, we’re always onto the next. We get one goal, onto the next. When I finished my MD, got to get the MBA; when I did one fellowship, got to do another. It’s just onto the next, and it’s if you don’t celebrate your wins, even the small ones, then you’re not programming your brain to really incorporate joy.
And it’s all about those little points in research. People come in and they say, “I want to be happier,” but in our assessments, the word happy is not there. We use points and we add them up to measure happiness. So try to get your points of joy every day. And I don’t mean go out with your girlfriends and celebrate with a steak dinner or whatever. After you drop your kid off, sit down and pat yourself on the back and have a nice sip of coffee. That’s what I do every day when I get my kid to school on time, because I’m Caribbean by nature, and I’m always running a bit late. I’m on island time.
So when I get my kid to school on time, I pat myself on the back, and I’m like, “Good job,” have my oat milk latte, and I savor it. And it sounds cheesy and corny, but it goes a long way because you’re programming yourself to get joy out of simple things. You’re not chasing those things that are not purposeful. You’re chasing the little joys and you’re programming yourself to also honor yourself, because again, we only get one body, so I need to slow down.
Another way to schedule your joys, I’m a leader, I run my lab. We have regular parties where we talk about all the great things we did, and how we help people, and patients that really impacted us, and how we feel like we’re doing good in the world. These are little moments of joy. Every time someone passes a training, I say, “Put it in your binder. That’s a big deal.”
And it sounds cheesy. We all have trainings at work, we all have things we have to do. Every time you do something you’re supposed to do, say, “Wow, I did that. I finished it,” instead of, “I’m onto the next.” Give yourself a treat.
And we used to do that as children. When we were kids, you get a sticker in your binder and all that stuff, but we stopped doing it. It’s just like, “Well, you’re supposed to do it. You’re a grownup.” But we have to get back to that where we’re actually celebrating the small pleasures in life, and that’s what makes us happier versus happy chasing this idea of something that will actually not make us happy when we chase it.
Tori Dunlap:
The way you’re describing high-functioning depression sounds like the experience of being a woman. And so if I’m listening, if I’m just listening to you as Tori, as me, yet alone someone who is listening to this show, I am seeing has to keep it all together, yup; has to be the rock of the family or the rock of the relationship or the rock of the friendship, like, “Yep”; has to do all this work and do all these things, and I cannot take time for yourself.
This sounds like the condition of being a woman under capitalism, no? How do I determine concretely, “Oh, no. This is actually a mental health issue for me”?
Dr. Judith Joseph:
Well, remember the biopsychosocial model?
Tori Dunlap:
Right.
Dr. Judith Joseph:
The social part in my book, capitalism is actually in the social factor, right? The pressures of society?
Tori Dunlap:
Yeah.
Dr. Judith Joseph:
And it’s interesting because depending on the audience you speak to, there’s a podcaster, Mel Robbins, and I did an episode with her, and I posted a little one-minute thing about high-function depression. All of the comments said, “It sounds like being a man.” And then I posted a similar thing with a woman acting it out, it was myself acting it out, and then the comments were like, “It’s like being a mom.”
And I’m like, “Well, it’s not just a mom. It’s not just a man. It’s that teacher who puts her students before herself, who stays late and doesn’t even eat dinner. It’s that doctor or nurse who are taking care of their patients and they haven’t had a rest in days. It’s that immigrant student who can’t let his family down because everyone’s dreams are on their back. It’s anyone who wears a mask of productivity to hide pain. It’s the athlete who even if they have an injury, they’re going to push themselves because they don’t want let the team down. The performer, right? There are a lot of performers who say they have high-functioning depression. They’re smiling and lighting up the room, but they don’t want to be on that stage. They have anhedonia.” So I think it’s many of us.
Tori Dunlap:
Well, the way you’re describing it sounds like the experience of being a person. If we are the person who is experiencing that, because I think we’ve all experienced it or are experiencing it, how do we try not to let people down? How do we continue to do our jobs? How do we continue to show up as a good partner and a friend and a team member while also making sure that we are not sacrificing what we need? Our own needs?
Dr. Judith Joseph:
And that’s what I lay out in my book is that when you go to a doctor, unless you’re broken, no one’s going to do anything about it, so we are actually going to prevent a mental health crisis. We’re going to prevent people from going from high-functioning to low-functioning, or prevent from going to high-functioning to substance abuse, or prevent them from having a physical breakdown by using the five Vs.
By A, practicing validation, saying, accepting how you feel, right? Many people don’t. They just say, “Well, everyone’s like that. Why am I complaining?” So you’re going to start validating. You can’t do the other Vs without that first one. You’re going to start practicing the venting and using the methods that I use to vent in my book. You’re going to start tapping into your values daily so that you’re anchoring your dopamine on those solid joys and not the fleeting ones.
You’re going to start taking care of your body because the biopsychosocial is important, by getting good sleep, eating foods that I lay out there that feed your brain, by limiting exposure to toxic to people who make you fall into masochistic, people-pleasing ways, and there’s a people-pleasing quiz in there, and you’re going to start scheduling out your joy.
That’s why I had to create this methodology based on several things including mindfulness, positive psychology, evidence-based things that have worked to improve the science of happiness, but that people don’t even know exist, right? Because there is nothing for the rest of us. There’s only stuff out there for people once they’ve broken down, once they stop functioning. That’s how our healthcare system responds. We don’t react unless-
Tori Dunlap:
It’s reactive. Yeah.
Dr. Judith Joseph:
… there’s a problem, right?
Tori Dunlap:
Yeah. Yeah.
Dr. Judith Joseph:
So my whole goal is to prevent it by first validating that there are so many people out there who don’t even know that there’s another way to live. They just think this is life.
But it wasn’t always like that, and you’re spot-on with capitalism, because we weren’t always this way. There was a time when as humans, we didn’t work past 5:00 because the sun was down, or 4:00, in fact, right? But the world was changed-
Tori Dunlap:
And we didn’t have 40-hour work weeks. Yeah.
Dr. Judith Joseph:
We didn’t have corporate greed, we didn’t have half the problems we have, climate change, and so forth. We didn’t have these issues before. We didn’t have social media.
So I always say that this is not your grandma’s depression. Why are we using the terminology and the treatments for your grandma’s depression when your grandma didn’t deal with all these things, right? We have to change or else we’re going to be even further behind in this mental health epidemic because we’re treating a depression that is no longer pervasive. There’s something new.
And I may sound like an alarmist, but I’m seeing it every day. We feel it every day. We see the numbers with the CDC. We see what’s happening to our youth. If we are reactive, we are too late. There’s only one psychiatrist for every 30,000 people in parts of this country. We cannot afford to react. We have to prevent.
And it starts with the individual. It starts with the person who’s listening to this. It’s about you recognizing the anhedonia, recognizing the trauma, and doing something about it before it gets worse.
Tori Dunlap:
There are so many parallels to what Dr. Joseph is saying that can be tied into finances, especially the idea that we often don’t seek help until things are already bad. Whether it’s with money or mental health, being proactive can be the piece that sets you apart. When we come back, Dr. Joseph is talking about masochism, the simple practice to do if you’re a recovering people-pleaser, and how depression can affect our money.
You were talking about masochism, and I would love to dive into that because like you were saying, we have a certain perception of what we think this looks like, when really, I think this shows up for so many of us in how we talk to ourselves. So can we talk about how masochism shows up in depression and how the way we view ourselves really greatly affects our day-to-day life?
Dr. Judith Joseph:
I think one of the lesser-known symptoms of depression is self-blame, and I’m always surprised when I tell people that that’s a symptom, and they’re like, “Really? Thought that was just me.” Internalizing what’s happening in your life as being your fault is a way that human beings have coped with not being in control for centuries. If we blame ourselves, then we feel like, “Okay, at least we know who did it,” when that’s not the case. Bad things happen to good people all the time, right, you know?
So one of the things that people who have masochism do is they don’t think they’re worthy of good things, and in fact, they self-sacrifice their joy for other people, and it actually backfires. When I work with my clients, we do exercises to see what their unconscious desires are, and the unconscious is always like, “Well, if I do X, they will do,” and it’s just not the case.
What ends up happening is that when you’re doing, and overdoing, like high-functioning people do, the person ends up resenting you because they feel on their unconscious level that you don’t trust them, that you think they’re incompetent, or that you’re kind of annoying, you’re a know-it-all, and it backfires.
So with my clients, I always ask them to imagine that your hands are under you. Sit on your hands and just see what happens if you do nothing. They’re always surprised that the situation is better when they do less. It shocks them because, again, they’re humans doing. They’re not human beings. So again, it’s a practice of just be for a little bit. Even if it’s uncomfortable, let your brain get exposed to that feeling of not doing and just being, and slowly, that discomfort will go away. Slowly, we’ll see that it’s capable.
The other thing that people who are people-pleasers do that is masochistic, I don’t like self-sabotage, but they will knowingly go into situations or unknowingly go into situations where they’re bound to get hurt, right? And that’s why masochism was pulled out of the DSM. I think it was version three.
And the reason they pulled it out was because a lot of people in science and in medicine research were using it to explain why mostly women were ending up in these abusive relationships, domestic violence relationships, so they felt that it was victim-blaming. And I think it was appropriately pulled out for that reason.
However, they threw the baby out with the bath water. What they should have probably done was revamped it and said, “These are personality traits that are masochistic,” and not throwing it all out. And in fact, some people still do use that language, but it was pulled out of the DSM-5. That’s why a lot of people don’t know the word. When people think of masochism, they think of it in sexual ways, but it’s not the case.
So I had to reframe it and call it people-pleasing on social media because if you use the word masochism, the algorithm will block you because it thinks you’re doing something you’re not supposed to be doing. But essentially, when you tend to be in these relationships where you are sacrificing your own joy for the sake of someone else, where you’re constantly being taken for granted, when you’re in these dynamics that are harming you but you still find yourself back in them, it’s important, A, to recognize it.
With my clients, I always say, just ask yourself, are you being masochistic now? Any decision you’re making, any big life choice, is it a masochistic decision? That is so helpful. Some of my clients would be like, “I was just about to say yes to this project, and I thought out loud, am I being masochistic?” And they were like, “Yes, I am. I don’t even want to do this. I don’t even have the capacity to this. Why am I saying yes?” So I asked them to challenge it and say no. What’s the worst thing that happens?
Because in their mind, their mind has these automatic thoughts that the person’s going to think I’m lazy, the person’s going to think I’m not ambitious, or the person won’t value me anymore, and it’s the opposite. People value you more, the more you say no. They respect you more when you set limits, when you actually say, “Listen, I have a lot on my plate right now.” The yes-person does not get the respect. So it’s really interesting, and I think explaining to people that this is something that we used to talk about regularly in psychiatry, but it’s no longer there.
Having that language is so helpful. I talk about something called affect labeling in my book, where when human beings don’t know what they’re feeling, it makes them anxious, it makes them react, and if you can name something, it’s powerful in itself. That act of naming and identifying is therapeutic in itself. So having the language and the names and the terms is really helpful.
Whereas you have other schools saying, “There’s too much labeling.” But if we don’t label, if we don’t name, we don’t know what we’re dealing with, then that’s why we have to have classifications to understand these things.
Tori Dunlap:
When we talk about money and high-functioning depression, you mentioned an example already of the scarcity mindset, and we’ve talked about that a lot on this show, this idea of the other shoe’s going to drop at any time. We even have asked our audience, what is your biggest money fear?
And over and over and over again, it’s something bad’s going to happen and I’m not going to be prepared, right? Even if you have sometimes millions and millions of dollars, you think, “That’s not enough,” right? So can you talk to me about some of the other ways that this might show up that directly affects our finances and affects our money?
Dr. Judith Joseph:
Scarcity trauma is something that I coined because there was scarcity mindset out there, but there was no scarcity trauma. In my trauma research, and as someone who’s personally come from scarcity, I came to this country when I was four years old from Trinidad. It was very difficult for my family.
And I didn’t even realize that the amount of work, the amount perfectionism that I was experiencing was related to not wanting to ever be in a position of need again. I wasn’t even aware of that, and I’m a psychiatrist. So I was like, “Listen, if it took me this many years to process this, I need to create a reel about it.” It went viral. People were like, “Oh my God.” People from Poland are like, “This is me.” People from Africa are like, “This is me.” It’s all over the world, there’s scarcity, so there are certain themes we have in common no matter where we are.
But when you think about trauma, hallmarks of trauma, one of them is avoidance, right? You want to avoid the thing that makes you feel so uncomfortable, so you don’t think about it. That’s why most of us don’t process our trauma, and we don’t ever want to be in a situation like that again. So rather than thinking about it and processing it and challenging it, we do. We work harder. That’s why it’s never enough money.
We also are afraid to take risks. Some of the cognitive symptoms of trauma have to do with risk-taking. So whereas someone else who’s not had this scarcity trauma would say, “That’s a no-brainer, I’ll do it,” the person who does will probably not do it, and they may actually lose out. They think that they’re actually saving and protecting, but they’re actually losing out on that big risk that would have paid off, because it’s actually not that big of a risk.
Tori Dunlap:
This happened to me with my parents. Yeah. My parents are very, very risk averse, and both of them, especially my dad, did not grow up with a lot of money. My dad was pretty poor. And so when I was thinking about leaving my very stable 401K health insurance 9:00 to 5:00 to run my business full-time, they were like, “Absolutely not. What are you doing?”
And I joke now with them of, “Hey, aren’t you glad I didn’t listen to you?” But even if you don’t have this scarcity mindset, your parents might, your partner might, your coworker might, your boss might, right? So I think a lot of us do have it directly, but we encounter people on a day-to-day basis too, that also have it, that sway our decisions, or that make us feel a certain way, hesitant to take a risk.
For me, it wasn’t that big of a risk, right? I could have go and got another job if it didn’t work out. I had savings. It wasn’t like I was sacrificing everything in order to do this, but it felt like a risk because I grew up in an environment that was like, “Make the quote-unquote, right, steady, stable choices.”
Dr. Judith Joseph:
And that’s why I had to name it as scarcity trauma and not mindset. Mindset is just one aspect, which is cognitive, but trauma encapsulates so many more things than just cognitive capacities.
Tori Dunlap:
Right. It’s your body. It’s the response-
Dr. Judith Joseph:
Everything.
Tori Dunlap:
… that you have that you can’t explain. It’s like, “Why do I feel like this is so terrifying? This doesn’t make any sense. I feel like a bear’s chasing me even though I know I’m safe.” Yeah.
Dr. Judith Joseph:
Yeah. It’s emotional and it’s physiological and it’s cognitive, and that’s why I felt like I had to name it scarcity trauma. The other thing is that it’s generational. What you’re describing when it’s not you directly, it’s a generational trauma that is not processed that gets passed on to the next generations.
I experienced that too. When I told my parents I didn’t want to be an anesthesiologist, and I left after two years of doing that program, they’re like, “Are you crazy?” My dad was like, “You’re crazy. You’re going to work with crazy people.” And it was a big thing. And now they’re like, “Oh, wait. Actually, you did okay,” but it was as if the world was going to end.
But it’s important to understand this. It’s important to know, and in my book, I talk about how to write your family tree so that you understand how these types of traumas get passed down when they’re not processed, so that the trauma ends with you, so that you begin to process the trauma, so you’re not passing it on.
A researcher in Switzerland just asked to come here to study at my lab scarcity trauma because they had never heard of it. And this is the thing. If your therapist has never come from scarcity, they’re never going to ask you about it. And the majority of therapists, they don’t. They come from upper middle class. They’ve never experienced scarcity, so they would never ask about it.
They may interpret your behaviors as being cheap if you’re like, “Well, I can’t do therapy because it’s expensive,” and they’re looking at your watch, and they’re looking at your car, and they’re like, “What do you mean?” But they don’t know that you’re coming from a position of scarcity and that you’re afraid that even one investment would backfire.
I’ve seen people eating food even if they’re not hungry, getting sick, because that mindset, that behavior was passed down from their families where you have to clean the plate. It doesn’t make any sense. You’re not even hungry. Your doctor says you actually have to stop eating sweet things because you may be pre-diabetic. I’ve seen people not break up in relationships because they have scarcity trauma because they imagine-
Tori Dunlap:
That’s what’s comfortable.
Dr. Judith Joseph:
… that a divorce would bankrupt them and they don’t want to make a change. They don’t want to have any type of loss in their finances, so they stay in toxic relationships that are draining their life, or stay in toxic jobs because of that same thing: the false sense of security when you don’t realize you’re robbing yourself because you only get one life. So there’s so many ways. I could talk about scarcity trauma for days, but there’s so many ways it impacts you.
And trauma and depression are linked, so they’re very closely linked. Many people with trauma have depression, and many people with depression have trauma. So that’s why it’s important to recognize how the biopsychosocial works in that biopsychosocial bubble.
In psycho, there’s actually trauma there, there’s a list of traumas, and if you’re not sure if you have trauma, I developed a trauma inventory based on the CDC, Kaiser, ACEs, and then the modified ACEs, and then my own inventory. It’s on my website and you can take the trauma quiz.
The reason I developed it is because most of the inventories look at childhood trauma, but I truly believe that adult traumas impact us too. Yes, our brain somewhat forms fully by 25, but our brains are changing. Just because most of the structures are formed doesn’t mean they don’t change. So things that do happen in your young adulthood impact you and how you see yourself in the world and how you interact in the world, so I wanted to make sure there was a comprehensive trauma inventory that people could use.
Tori Dunlap:
I imagine this impacts our spending as well. Because often, you’re talking about dopamine hits, talking about coping mechanisms, right? Spending, I think is a version of that. So how might high-functioning depression impact the way we spend our money?
Dr. Judith Joseph:
High-functioning depression that stems from scarcity trauma may impact our spending in ways that sound counterintuitive. So I’ve seen people who have scarcity trauma penny pinch and hoard, which is I think intuitive, but I’ve also seen the opposite, where people spend to get back to a baseline that they feel comfortable at.
So for example, they’re not used to having abundance, they’re not used to being comfortable. They’re used to being in fight or flight, so they’ll spend until they’re back to that baseline where they’re living on the edge. One of the symptoms of trauma is doing things that are considered dangerous or risky, and no one ever thinks of spending as risky, but it is, right? When I do these assessments that were developed out of the VA, there are things that they ask on there, speeding and using drugs recklessly, and so forth.
But spending recklessly impacts your livelihood, and many people don’t realize that they spend because they’re not familiar or comfortable with abundance. And that’s always like a light bulb moment. People will come up to me after I say that at a talk, and they’ll be like, “Thank you. Every time I set a budget, every time I said, ‘I’m going to be better this year,’ it just happens.” And I’m like, “Well, now you know, so you can practice grounding techniques, you can practice trauma coping techniques so that you soothe your fight or flight, so you’re mindful, so that you’re present, so that you’re not just spending recklessly.” And these things do work.
But if you don’t know that it’s a trauma, if you don’t know that you’re spending as a trauma response, then you’re not going to know how to address it. You’re using someone else’s tools who doesn’t have scarcity trauma on you, and you’re wondering why you’re not that person. And then you’re blaming yourself again, right? Self-blame, self-guilt, for not doing better when you’re actually not using the tools that address the science of your happiness.
And that’s why I want people to start saying that. What is the science of my happiness? The science of your happiness is based on you. Your unique biopsychosocial. There will only ever be one you ever, and I think it’s so powerful. I get chills whenever I say that. So why are you using someone else’s methods? There will only ever be one you, so understand the science of your happiness.
Tori Dunlap:
When we come back from break, we’re wrapping up the conversation with Dr. Joseph by asking what we can do to start protecting our mental health more proactively. Stay tuned.
If someone’s listening, what is one big thing that they can do today to start managing their brains? Managing what potentially might be that high-functioning depression a little bit better?
Dr. Judith Joseph:
Say this every day. I am not a human doing. I am a human being. If you could practice just being, being still, just for five minutes a day, it could change your life. I know, because it’s changed my life.
I’m late on the game of mindfulness. It’s embarrassing to say I went to Columbia, I trained at Columbia, I have fancy degrees. I didn’t start really understanding mindfulness until I became a mother. Really just realizing that everything is not in your control. You cannot do everything. Sit still and be.
And when you do that, everyone around you will see it. They’ll pick up on it. They’ll say, “Wow, what do you have? What are you doing? Something seems different,” because you have learned how to be comfortable just being. And it sounds easy and cheesy, but it takes practice, but if you do it a little bit every day, you will be grounded. You will start to get to know yourself. You’ve just forgot who you are, but you will find yourself again. So practice saying that: I am not a human doing. I’m a human being.
Tori Dunlap:
This was so impactful. Thank you so much. Plug away, my friend. Where can people find your book and all of your work?
Dr. Judith Joseph:
Thank you. It was such a pleasure speaking with you today, and I’m so fortunate that you’re sharing this information with your followers so that they understand the science of their happiness.
So you can find me @drjudithjoseph on all socials, and you can take my quizzes. They’re free. I have an anhedonia quiz, high-functioning quiz, trauma quiz, and a T.I.E.S Quiz, because many of us in our 30s and early 40s don’t even realize that a lot of our burnout is due to hormones.
So understand how your biology is different and how perimenopause has all these symptoms that doctors don’t understand, because we only got one course in menopause, and it’s wrong, but we have to educate ourselves. So these are all resources on my website that are free, and access them, share them with friends, understand the science of your happiness.
Tori Dunlap:
I love it. Thank you.
Dr. Judith Joseph:
Thank you.
Tori Dunlap:
Thank you as always for being here, Financial Feminist. Thank you to Dr. Joseph for joining us. You can get her book, High Functioning: Overcome Hidden Depression and Reclaim Your Joy. It is out now wherever you get your books.
We appreciate you subscribing, we appreciate you sharing this episode, especially with somebody who could really use it. It’s the best way of supporting our show and supporting feminist media. We appreciate you being here. As always, thank you, and we’ll see you back here soon. Bye.
Thank you for listening to Financial Feminist, a Her First 100K Podcast. For more information about Financial Feminist, Her First 100K, our guests and episode show notes, visit financialfeministpodcast.com. If you’re confused about your personal finances and you’re wondering where to start, go to herfirst100k.com/quiz for a free personalized money plan.
Financial Feminist is hosted by me, Tori Dunlap. Produced by Kristen Fields and Tamisha Grant. Research by Sarah Sciortino. Audio and video engineering by Alyssa Midcalf. Marketing and Operations by Karina Patel and Amanda Leffew. Special thanks to our team at Her First 100K, Kailyn Sprinkle, Masha Bakhmetyeva, Sasha Bonar, Rae Wong, Elizabeth McCumber, Daryl Ann Ingman, Shelby Duclos, Meghan Walker, and Jess Hawks. Promotional graphics by Mary Stratton, photography by Sarah Wolfe, and theme music by Jonah Cohen Sound. A huge thanks to the entire Her First 100K community for supporting our show.
Tori Dunlap
Tori Dunlap is an internationally-recognized money and career expert. After saving $100,000 at age 25, Tori quit her corporate job in marketing and founded Her First $100K to fight financial inequality by giving women actionable resources to better their money. She has helped over five million women negotiate salaries, pay off debt, build savings, and invest.
Tori’s work has been featured on Good Morning America, the New York Times, BBC, TIME, PEOPLE, CNN, New York Magazine, Forbes, CNBC, BuzzFeed, and more.
With a dedicated following of over 2.1 million on Instagram and 2.4 million on TikTok —and multiple instances of her story going viral—Tori’s unique take on financial advice has made her the go-to voice for ambitious millennial women. CNBC called Tori “the voice of financial confidence for women.”
An honors graduate of the University of Portland, Tori currently lives in Seattle, where she enjoys eating fried chicken, going to barre classes, and attempting to naturally work John Mulaney bits into conversation.
