Dr. Judith Joseph: "Happiness Is an Idea, Joy Is an Experience" | Aspire Archives

Added: 2026-05-30

[00:00:00]Because everyone wants to be happy. And when my patients come to my private practice, the first thing they'll say is, "Dr. Judith, I just want to be happy." But when I have patients in my research lab, you won't find the word happy on any of the rating scales for psych for psychiatry. So, what you'll find are these things called points of joy. If you're tired, when you rest, do you feel refreshed? When you're hungry, when you eat your meal, do you savor it?

[00:00:27]When you're lonely and you cuddle with your kid or your pet, are you feeling connected? We add up all those points and that equals happiness.

[00:00:35]>> Wow.

[00:00:35]>> But in the real world, people are like, I just want to be happy. And then I ask my patients, okay, well, what does happiness mean for you? And they're like, when I get that job, when I get that partner, when I have that house, the kid. But when people get those things, the science shows us they're still not happy, right? And that can seem so out of reach, that idea of happiness. So I explain to my patients that happiness is an idea. Joy is an experience.

[00:01:00]>> Oh yeah. I love that.

[00:01:01]>> You can get a little bit every day. If you didn't get a point today, you can get a point tomorrow. And this the motto of my happiness lab is understand the science of your happiness. There is only one Emma. There will only ever be one Emma in the future of the universe and the history. So why do we use tools that make other people happy when we don't even understand the science of our own happiness? And how individual is that?

[00:01:25]Because when I read your framework, I there's not a page in the book where I wasn't like, I get that. I understand. I watched this and actually we have to kind of go back a second because I watched this Tik Tok video of you over and over and over again. And it was actually like digging into the idea of what even is high functioning depression. So will you tell us like what does it mean and how does it manifest? So in my lab I use something called the DSM5. It's the Diagnostic Statistical Manual for Psychiatry.

[00:01:52]>> Oh, one second.

[00:01:54]>> You might have to say that one slightly slower for me this time in the morning.

[00:01:58]>> It's the Bible of psychiatry basically.

[00:01:59]>> Okay, I got it.

[00:02:00]>> So, I pull it out and it's big and you open it and then you're going down the checklist. And what we do when we uh identify depression is we look at symptoms like okay, poor concentration, low mood, >> anhidonia, something that means a lack of pleasure and interest and joy, not being able to feel rested, all these things. But at the very bottom of the checklist is is it impairing your functioning or is it causing significant distress? And what I found in 2020 and beyond is that I would go down the checklist and most of the people wouldn't check that box. In fact, the people I was treating, they were actually overfunctioning. So what happens is you go to your doctor, you have all these symptoms of depression, but you don't check the box of lacking functioning. And they say, "Well, come back. Come back when you break down."

[00:02:47]>> Yeah. It is a broken model and I truly believe the majority of us are overfunctioning. We're pushing through pain. We have symptoms of depression that are not being addressed because we haven't broken down.

[00:02:58]>> And we're seeing this in longevity science. You know this, right? Like we're trying to catch the cancer before it starts. We're trying to catch the heart disease before it causes a heart attack. We're trying to prevent osteoporosis with the HRT and the menopause treatments. But in psychiatry, we're like kind of in the dark ages. We wait for you to break down before we fix you. I'm trying to change that. Let's identify these high functioning individuals who push through their pain, who have these symptoms, and let's prevent the breakdown from happening to begin with.

[00:03:26]>> But this is the part that makes so much sense for me because when you are if you are building a business, if you're in a career, if you are pushing yourself, you're getting stuff done every single day. You are not sitting in a dark room.

[00:03:40]you do not relate and put yourself in that, you know, kind of situation where you're thinking about I'm depressed.

[00:03:48]This is something that's affecting me.

[00:03:49]But you're actually saying that you can get up every morning, be doing the absolute most, and have high functioning depression. That is a reality for so many people. It is. And the thing that gets these high functioning folks like myself on my into my office and sitting in my couch in the chair is I don't something's off. like when I'm not busy I feel restless when I'm not working I feel empty and I just don't enjoy things and I tell them that is something called anhidonia it's an old term >> anhidonia >> anhidonia it sounds like an exotic model from like Europe right but it's not anhidonia means a lack of pleasure and interest in things that you once enjoyed >> so this is like pre-burnout this is not when people say you know I've had enough quitting my job I'm totally burned out I've got to reset This comes way before that.

[00:04:39]>> Yeah. Well, burnout um is something that's occupational, right?

[00:04:43]>> So, by definition and burnout was only added to the medical literature only like a couple years ago.

[00:04:49]>> Really? Only recently. Is this part of the medical literature?

[00:04:52]>> Anhyonia.

[00:04:52]>> No. Andhonia and also high functioning depression.

[00:04:55]>> High functioning depression is not in the medical literature because you don't check the box of not functioning. You're overunctioning.

[00:05:00]>> Wow.

[00:05:01]>> But you literally are breaking new ground with this information and yet we can all identify with it. We we can't >> so simply that's incredible to me. But the anidonia thing, that's what people that's what they come to me with. Like my artists who are like, I'm up there performing and the crowds are going wild, but I feel kind of like dead inside, right? I don't enjoy it anymore, but I can't stop. I have to keep going.

[00:05:23]It's the person who's like showing up every day at the office and they used to love work. They used to love their business, but now it's like doesn't excite them anymore, but they're doing it anyway, right? It tends to be people who others depend on. The rock, the entrepreneur, the mom, the teacher, the doctor, right? You can't slow down. And so after a while, you don't identify.

[00:05:44]You don't tap into depression. You tap into that feeling of meh or blleh.

[00:05:49]>> And that's a red flag. That's high functioning.

[00:05:51]>> And what is the difference between high functioning depression and then just like anxiety?

[00:05:56]>> Uh so anxiety and depression are like the flip side of a coin kind of. You know, it's interesting because in my world, we address the treatment of both the same because they tend to travel together, right? But and also anxiety is more, I think, acceptable. Like if you tell someone like, "Oh, I have anxiety."

[00:06:12]They're like, "Oh, yeah. Who doesn't?"

[00:06:14]But if you tell someone that they're you're depressed, they're like, "Oo, uh, okay."

[00:06:18]>> Well, nobody wants that diagnosis, right? That means like, "I've got to get on medication. Like, I'm not going to be able to function as usual." That's why I think that the high function in definition piece of this is for me the complete light bulb of it all. Right?

[00:06:31]It's like that's when you can suddenly be like, but wait a minute, I'm doing everything and I'm doing it to the best of my ability and I get up and I go out and I get all of these things done, but actually there's something not quite like right here. There's something not quite fusing there. Absolutely. That's why depression needs a rebrand. It's not someone in bed crying, weeping. It's someone who gets up, shows up, but doesn't feel excited about life, is not grasping joy. And that's the anhidonia.

[00:06:59]And it's important to identify it and to have names because imagine if you were in this room and someone close the door and turn off the lights and you heard this loud thud. Some of us would start swinging, other of us would run for the door. But if you turn the light on and you saw, oh well that was just a bookshelf that just kind of fell.

[00:07:18]>> You're like that's why it's important to name and identify the feeling because human beings don't like uncertainty. We have to have a name for it. And then when you know, oh it's it's anhidonia, right? I can do something about this.

[00:07:32]Then there's that therapeutic relief of anxiety. So naming the feeling is an intervention in itself. It's a therapeutic intervention when you can identify what you're struggling with. I mean, and you're a doctor, so you can identify these things, but could you identify them for yourself? Like, how did you even come to starting this type of research? I'm a board-certified psychiatrist, award-winning, all the things, all the accolades. I didn't even know when I was depressed. I remember because I was, it was in 2020, and I was giving this talk to this large healthcare institution and they were coming to me for help because they were freaking out. They didn't know what was going to happen. And I remember like talking to them and giving them tools and then I was like, "Oh my gosh, I I think I'm depressed." Like I felt numb.

[00:08:16]I felt overwhelmed, but I couldn't stop.

[00:08:18]On the outside, I had just gotten onto this prestigious board at an Ivy League institution. I was getting all of these like praises in the press for like helping people. I had a small child at home. My husband at the time was a frontline worker. It I it looked like I had the perfect life. No one knew that I was struggling behind this mask of pathological productivity, but I couldn't slow down.

[00:08:42]>> Pathol when you say that pathological productivity. It's like a knife. It's like >> Yeah.

[00:08:47]>> I feel like that is just the one phrase that you say that I think every like so many people will be able to relate to that pathological productivity. That is just like a sign of our times, is it not? Like that is what we're all doing and how we all feel so much of the time.

[00:09:06]>> It is. And in my research, I found that it's tied to trauma. So when you do PTSD studies, like for combat veterans, right, >> you look at things like avoidance of triggers, right? So if someone looks at something and they get triggered, they want to avoid it.

[00:09:19]>> But for us pathologically productive people, we avoid processing our pain by busying ourselves with work. And that's why we keep adding on the work and the projects. We know deep down we shouldn't, but we can't because we're running from processing and dealing with our past.

[00:09:35]>> Wow. Wow. So, you're in this vicious circle. You're doing too much. And in order for you to get through that, you just add more things on >> and you can't stop. And you cannot stop.

[00:09:46]And you actually were your own patient in some way. You you like self diagnosis. You know, I sat there and I was like, if I don't realize that anhidonia snuck up on me and I study anidonia >> and I'm depressed and I didn't know that. How many people are just like me?

[00:10:04]And at first I was ashamed. Like I didn't even tell my therapist.

[00:10:08]>> Oh wow.

[00:10:08]>> And one of the symptoms of trauma that's unprocessed is shame. That's why people don't like to talk about their traumas.

[00:10:14]They blame themselves. The first thought was how did I not know this? Why didn't I identify it in myself? Right? Shame and blame. and that prevents you from getting help. But over time, I opened up to my therapist and she was like, "Oh, you you know, you can always tell me these things and we work through it. We process the trauma." And so I thought, "I have to make this available to everyone through the study because there are many people who are struggling who won't get help because doctors are waiting for them to break down. I can't let that happen." And we know from the numbers now that the rising rates of anxiety and depression, we have to prevent these things. We can't wait for them to hap to break down. We don't have enough providers. So, is high functioning anxiety actually classified as a mental illness at this point?

[00:10:56]>> No, it's not. High functioning anxiety and high functioning depression are just not. Um, and the reason is because in mental health, you have to break down.

[00:11:05]You got to check that box first, right?

[00:11:07]>> It just sounds like you're Yeah. I mean, it's so crazy. Like, why would And also, why would you go out and check that box for yourself? Like, you never would because by the virtue of you being high functioning, you're like, "No, I'm going to get out and do something like do another thing." So, you're never going to get to that place where you're like, "This is what's happening to me in in that clearer term, right? It's just that's not that's that wouldn't be right for somebody who's high functioning."

[00:11:30]>> Yeah. It doesn't feel good for them because they've forgotten who they are.

[00:11:33]They've tied their identity and their value to their role to doing more to being successful to getting more out of the day to like squeezing one more thing in to exhausting themselves. And it's so incredibly funny to me because I just, you know, when you say, you know, get back home and haven't been to the bathroom all day, I'm like, that is me.

[00:11:52]I do that all the time. You know, it's just it's just incredible. I think that what's so fascinating about your book is that you've really contextualized the idea of what high function in depression is and how it manifests itself for so many people. But the part that was truly enlightening and so unbelievably exciting for me was this science of happiness and the way that you kind of had the five Bs. And again, I looked at that, I read it and I was like, well, this is this is easy. This is not complicated stuff. This makes so much sense. And I really want you to dig into the into the five Bs. But is it that simple? because what you're talking about is a really complex problem that takes years and years to create these patterns and you know to to live a life like this. So is it that easy to turn off the switch and behave completely differently because your book kind of sets us up in a way that's like check off these five B's and you'll be fine.

[00:12:52]And I just wonder like is it that simple?