156. Dr. Judith Joseph: High-Functioning Depression, Anhedonia, and Reclaiming Joy

High-performing individuals often appear successful on the outside while quietly experiencing a loss of joy, emotional numbness, and chronic internal stress. This disconnect, often overlooked in traditional diagnostics, may signal a form of depression that goes unrecognized for years. In this episode of Extend, we sit down with Dr. Judith Joseph, psychiatrist, researcher, and author of High Functioning, to unpack the science of high-functioning depression and how anhedonia can manifest even in highly productive individuals. We break down why traditional mental health models often miss these patients, how pathological productivity masks deeper issues, and how the biopsychosocial model helps identify where joy is being lost across biological, psychological, and social domains. We also explore Dr. Judith Joseph's 5 Vs framework and how tools like validation, venting, values, vitals, and vision can help systematically restore daily points of joy and long-term emotional resilience. Dr. Judith Joseph is a board-certified psychiatrist, researcher, and media educator specializing in high-functioning depression and the science of happiness, known for translating complex psychiatric concepts into practical, evidence-based tools that help individuals reclaim joy and optimize mental well-being. What We Discuss: (06:03) High-functioning depression explained (08:50) Pathological productivity and busyness (10:07) Limits of traditional diagnosis (12:28) Anhedonia and loss of joy (14:00) Happiness vs joy (16:45) Biopsychosocial model (19:57) Biological drivers of mood (21:56) Metabolic health and inflammation (24:00) Social factors and relationships (26:09) Validation and venting (29:07) Values and meaning (31:39) Vitals and lifestyle factors (35:29) Technology and disconnection (37:18) Vision and planning joy (42:02) Psychoeducation and awareness Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Momentous: Head to livemomentous.com/fiber and use code DRSHAH for up to 35% off your first order. Learn more about Dr. Shah: Website: drshah.com https://www.drshah.com/ Clinic: next-health.com https://www.next-health.com/ Instagram: darshanshahmd https://www.instagram.com/darshanshahmd Learn more about Dr. Judith Joseph: Website : Dr. Judith https://drjudithjoseph.com/ Instagram: drjudithjoseph https://www.instagram.com/drjudithjoseph/ LinkedIn: Dr. Judith Joseph MD MBA https://www.linkedin.com/in/drjudithjosephmdmba/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:48Dr. Darshan Shah?

  High-functioning individuals often appear successful, productive, and control, yet many are silently experiencing a loss of joy, emotional numbness, and chronic internal stress. Traditional mental health models tend to focus on breakdown and dysfunction, which means this pattern can go unrecognized for years. In this episode of Extend, I'm joined with incredible science and physician, Dr. Judith Joseph. She's a board-certified psychiatrist. She's a researcher and an author of the book, High-Functioning, who focuses on high-functioning depression and hedonia and the science of happiness. Dr. Judith Joseph combines clinical research with real-world tools to help identify why so many high performers are feeling stuck,

• 1:33Dr. Darshan Shah?

  disconnected, or joyless despite their external success. We're going to unpack what high-functioning depression actually looks like, how anhedonia shows up in everyday life, and why busyness and pathological productivity can mask deeper emotional patterns. We also explore the biosocial model and Dr. Judith Joseph's 5 Vs framework to help you understand where you're losing joy and how to start rebuilding it. This conversation with Dr. Judith really resonated with me because this is exactly where I was 10 years ago. I'm reminded of the quote, "That external success does not mean you're internally healthy." Dr. Judith and I had a great conversation, and I am so excited for you to hear it.

• 2:22Dr. Darshan Shah?

  Oh my gosh, I'm so excited to have you on the show. This, I met you briefly. I'm like, I have to get her on the show. And this was at Jim Quick's conference, right? That's where we met.

• 2:31Speaker 01

  Yes.

• 2:32Dr. Darshan Shah?

  And, you know, your talk was incredible, a game changing talk because it resonated so personally with me and, you know, my struggles through life as well. And so I'm, thank you.

• 2:44Speaker 01

  Oh, it's, thank you for having me. A lot of doctors come up to me and they're like, your book is about me. And I talk about that in the book and I say like, in medicine, we're taught to pick something that's broken, heal people, but we don't even recognize when, okay, on the outside, things look great, but on the inside, people lack joy and that's a problem, right?

• 3:06Dr. Darshan Shah?

  Right.

• 3:06Speaker 01

  And I think it's because a lot of us as physicians, we're just taught to power through the pain. You know, a patient passes, you power through. Something bad happens, well, you pick yourself up. And so we're pathologically productive. So when we see that happening and our patients were like, oh, you're fine. Come back when you break down. And I wanted to change that.

• 3:24Dr. Darshan Shah?

  Yeah, it's such a problem. And I think what happens is because we live with that mindset from, you know, the first moment we get into school, right? All the way through finishing school, doing our residency, doing our career. And you just get desensitized to the amount of stress that you're putting yourself through and to normalize it.

• 3:45Speaker 01

  Well, not just that, also like when you ask for help and you have like depression, you have to report it, right? So there's a lot of disincentives to not ask for help, right?

• 3:55Dr. Darshan Shah?

  That's true.

• 3:55Speaker 01

  You go to medical school, many of us accumulate a ton of debt. Many of us have life debt because our youth was spent studying and caring for others and training. And so the idea of it all being possibly threatened by then asking for help when you're struggling is just something that people don't even consider. They're like, I will never get help. So a lot of healthcare professionals are struggling.

• 4:18Dr. Darshan Shah?

  Right. I think just a lot of people are struggling too, because it's such a grind culture now. And to succeed, it's almost unlimited amount of work you can put into your business, your career now. And, you know, the incentives are to put in as many hours as possible, right?

• 4:35Speaker 01

  Yeah.

• 4:36Dr. Darshan Shah?

  I see a lot of my friends, you know, I'm in a group called YPO, Young Presidents Organization, a lot of very high functioning individuals there, but I see the same. You called it toxic productivity, is that right?

• 4:47Speaker 01

  Pathological productivity.

• 4:49Dr. Darshan Shah?

  Yeah, where it's just like, if you're not doing something every moment of the day, there, you just feel uncomfortable. And now that becomes even more empowered by these devices that we carry around with us all the time, where you can constantly be working.

• 5:04Speaker 01

  Yeah. In my study, the first peer reviewed study that I published in high functioning depression in the world, that's what we found. We found a high correlation to busyness.

• 5:14Dr. Darshan Shah?

  Right.

• 5:15Speaker 01

  And the idea is that if you don't deal with your past pain, if you don't process it, what you end up doing, if you're someone who doesn't deal with your pain, you push it down.

• 5:24Dr. Darshan Shah?

  Right.

• 5:25Speaker 01

  And you distract. And so one of the questions I ask is, when you're sitting still, how do you feel? Do you feel empty? Do you feel restless when you're not working? So there's, they're humans doing, they're not human beings, right?

• 5:37Dr. Darshan Shah?

  Yeah.

• 5:37Speaker 01

  And that emptiness, that restlessness they feel, they self-soothe by using work, they self-soothe by using busyness on their phone, maybe excessive shopping, sometimes substances. But there's this need to try and avoid processing the pain by doing other things. And I don't think a lot of people recognize that that's a sign of high functioning depression.

• 5:58Dr. Darshan Shah?

  Mm hmm. Let's talk about high functioning depression. Could you give us like a definition of how to think about that?

• 6:03Speaker 01

  Well, in my lab, not too far from here, I do a lot of clinical studies, looking at pharmaceutical medications, enrolling patients into double-blind placebo-controlled studies, meaning that I don't know what they're on, my team doesn't know, they don't know what they're on. And many of the products go to market, some of them don't. But we use something called the DSM five and these structured type of interviews. So in the Diagnostic and Statistical Manual for Psychiatry, we're asking things like symptoms of depression, like, you know, are you having a lack of joy, or something called anhedonia, where you don't enjoy the things you used to have interest and pleasure in. Are you having a low mood? Are you having changes in your sleep, your energy, your appetite, you know,

• 6:45Speaker 01

  are you feeling guilty? All of these symptoms. And at the very end of the checklist, you have to either meet criteria for losing functioning, or having significant impairment in functioning, or be in distress or crisis.

• 6:56Dr. Darshan Shah?

  Hmm.

• 6:56Speaker 01

  Well, what happens when people come in? And we go through the checklist and those last two boxes aren't checked.

• 7:01Dr. Darshan Shah?

  Right.

• 7:02Speaker 01

  What do we say? Oh, well, you don't meet criteria, so come back when you break down. And I just thought, like, after seeing so many folks like this, why are we doing this? You know, in, in other fields of medicine with my friends who are oncologists, if you were to tell a patient, come back when you're in stage four cancer.

• 7:18Dr. Darshan Shah?

  Right.

• 7:19Speaker 01

  They'd be like, where did you go to medical school, right? If you're a cardiologist and you're like, come back when you have a heart attack.

• 7:24Dr. Darshan Shah?

  Right.

• 7:25Speaker 01

  They'd be like, are you even licensed, right? They don't wait for the breakdown. They're proactive, they're preventative, right? And that's the Renaissance that we're seeing in medicine.

• 7:34Dr. Darshan Shah?

  Yes.

• 7:34Speaker 01

  But in mental health, we're still in the dark ages. We still wait for those final checklist of you breaking down or you're in distress. Come back, you know, when, when you're like that.

• 7:43Dr. Darshan Shah?

  Wow.

• 7:44Speaker 01

  So let's prevent it. And so that's why I decided to study high functioning depression.

• 7:48Dr. Darshan Shah?

  Right, right. And so I think probably if you're a high functioning just individual, you, and like you said, you kind of suppress your traumas, you suppress your reaction to your life stresses, then you could potentially never check those last two boxes and you stay high functioning, but you're living in depression for decades.

• 8:08Speaker 01

  Right, some people are high functioning and they're joyful.

• 8:11Dr. Darshan Shah?

  Yeah.

• 8:11Speaker 01

  They don't have anhedonia, they're like killing it and they're like, I love this, I can't wait. But others, many of us, we're still showing up, we're getting the work done, we're joyless. We feel empty and we don't know what's wrong. We're like, well, everything on the outside looks good, what do I have to complain about? So a lot of those folks come to me and they're like, help me, something's off. I don't know what it is. And then I do my anhedonia inventory and I show them that, look, there's like very little joy in your life.

• 8:39Dr. Darshan Shah?

  Right.

• 8:39Speaker 01

  You know, like, do you know one of the symptoms of depression is anhedonia? You don't have to be sad, you don't have to be crying. You could be lacking joy and feeling numb and that's a red flag. So even if you're functioning, if you're lacking joy, that could be a sign that something else is happening.

• 8:55Dr. Darshan Shah?

  So, you know, for people that don't really know what anhedonia is, could you give us some of the items that are on your checklist so the people listening can be like, that's me, you know?

• 9:07Speaker 01

  You know, it's interesting because in in mental health, people often think, OK, happy is just one thing.

• 9:12Dr. Darshan Shah?

  Right.

• 9:12Speaker 01

  Joy is just one thing. But what we're learning is that joy is a plethora of sensations. So some of the things we'll ask is, when you tasted your food when you were eating, was it yummy? Like, was it, were you like, looking forward to it? When you were watching a movie and were you engaged? Were you, were you inspired by it? When you were walking in nature and you were looking at the sunset or looking at the water, did it give you that sense of awe? Right? When you were tired and you woke up from a nap, did you feel refreshed? Are you getting all this, the joyful experiences in life? When you're with your loved one, are you like into the, you know, the connection?

• 9:50Dr. Darshan Shah?

  Yeah.

• 9:51Speaker 01

  And so joy comes from all of these human experiences. And if you're feeling that joylessness, if you're feeling a lack of pleasure, a lack of interest, and things feel numb and blah, that could be a sign of anhedonia.

• 10:04Dr. Darshan Shah?

  Got it, got it. Is there a difference between the term joy and the term happiness?

• 10:10Speaker 01

  Yes.

• 10:10Dr. Darshan Shah?

  Yeah.

• 10:11Speaker 01

  So I have a private practice as well where I see patients for therapy.

• 10:14Dr. Darshan Shah?

  OK.

• 10:14Speaker 01

  And number one thing they'll say is, Dr. Judith, I just want to be happy. And my, that's my therapy practice. I just want to be happy. But then I have a research practice where we do the science of happiness, where we measure happiness using these inventories, these checklists and so forth. So in the private practice and the therapy practice, when I ask the patients, well, you know, what does happiness mean to you? They'll say things like, well, I will be happy when I finally have that big job or when I have the love of my life or when I have a family. It's always something external. Happiness is this idea, this external thing that has to happen for you to feel that way. Joy, on the other hand, is what we measure in the research. And what we're measuring are things called joy points, points of joy.

• 10:59Speaker 01

  Some of those questions that I mentioned, like when you ate your food, was it yummy? When you were lonely and you reached out to a loved one, did you feel connected? When you were stressed, could you self-soothe? When you were tired and you rested, did you wake up feeling refreshed? We're measuring these joy points and then we're adding them up. And we're seeing if you're becoming happier over time, right? So it's a huge shift because a lot of people, they're holding their breath for this external thing to happen for them to be happy. But they're missing out on the daily points of joy. They're leaving them on the table.

• 11:27Dr. Darshan Shah?

  So it's like joy is more what's happening in the present.

• 11:31Speaker 01

  On the internal.

• 11:32Dr. Darshan Shah?

  Internal, got it, got it. So for people listening that are thinking like, you know, that describes me. I'm just making it through life. I'm doing the things I have to do. I'm getting a lot done, right? I'm being productive, but I'm not feeling joy. What are some of the steps to get back into a place where you're feeling joy again?

• 11:53Speaker 01

  Well, I said, the number one thing is first understand the science of your happiness. And that's actually the motto of our lab, the science of your happiness. And there's a whole field called the science of happiness. But I wanted people to realize, you know, there's only one you. And there will ever, only ever be one you, ever, in the future of the universe, in the history of the universe. And when you think about that, like, it always gives me chills because it's like, the chances of you existing are so small, right? So you're definitely here for a reason. But often we're looking at what makes other people happy. And then we're trying that, like, let me read this book, I'll be happy. Let me listen to this podcast, let me do this self-help thing. But then we're still stuck and we're like, why didn't it work?

• 12:37Speaker 01

  Well, did you understand the science of your happiness? What makes you unique? Where are you losing your joy? If you don't understand where you're losing joy in your life, then how can you add that joy back, right? So first you have to understand your science. And you and I learned the biopsychosocial model early in medical school. But I felt like, you know, we write these nice evaluations and we stick that biopsychosocial in there and no one reads it. Like literally no one has ever been like, oh, I read my biopsychosocial, Dr. Judith. Like, let's talk about it. So let's teach patients how to do their own, right? So I'll literally sit with my patients and they'll draw their Venn diagram. Bio, biological, you know, psycho, which is psychological, social.

• 13:20Speaker 01

  And you start to figure out ways that you're losing your joy. So biologically, you know, what are your medical conditions? Many people have autoimmune conditions.

• 13:29Dr. Darshan Shah?

  Sure.

• 13:30Speaker 01

  They're in high inflammatory states. They're losing joy there.

• 13:33Dr. Darshan Shah?

  Sure.

• 13:33Speaker 01

  Personally, I have a thyroid issue. If my thyroid is not in check, I know I'm cranky, I'm tired, I'm irritable, right? So many women, they're in perimenopause or menopause, their hormonal fluctuations impact them, right? So where are you losing your joy biologically? And what are your risk factors? What's your family history? Psychologically, what are your mental health risk factors? Some of us have past trauma that's unresolved. I know personally, I came from very little, I have scarcity trauma. Came to this country with very little. So I was constantly working, fear of running out. But for others, it could be other past traumas, you know, relationship traumas, attachment traumas. Or, you know, just ADHD, neurodivergence, all these past medical histories come in for the psychological conditions.

• 14:15Dr. Darshan Shah?

  True.

• 14:16Speaker 01

  And then socially, what's happening in your day to day life? You know, who are you around? Who's draining your joy? Because you could eat all the kale in the world, but if you're with a toxic person, that's not gonna work, right? What's your work life like? You know, who are you around at work? What are you doing daily in terms of your habits? You know, are you drinking too much? Are you too sedentary? Are you eating foods that are highly processed? Are you smoking? Like, all of those things are the social factors, right?

• 14:41Dr. Darshan Shah?

  Yeah.

• 14:42Speaker 01

  So when you look at happiness as being, okay, there's biological, psychological, social factors. Then you start to see approaching this from a multidirectional

• 14:53Dr. Darshan Shah?

  Right.

• 14:53Speaker 01

  point of view, right? There's not one line to happiness. It's like, oh, I can get a point here in biological, I can get a point here in the psychological, social, right? Let me figure it out based on where I'm losing my joy. Let me be strategic, right, about where to add my joy back.

• 15:06Dr. Darshan Shah?

  Yes, that's a fantastic exercise for people to go through. Just get up on a whiteboard, make those three circles, biological, social, psychological, and write in there all the aspects where you feel you might be losing some joy. The biological piece, and I'm so glad you mentioned this, you know, because I think that this is a part of medicine, and specifically psychiatry, that's been ignored, is the biology of psychiatry, right? And there's so many, like you mentioned thyroid, the perimenopause, those hormonal issues, there's metabolic issues where you can be losing your joy and your happiness as well. There's, inflammation can lead to this as well. And so really, you know, understanding what those potential factors are, and also seeing

• 15:51Dr. Darshan Shah?

  a, you know, a physician or someone that can help you work through some of those as well, can actually help bring back joy in some way sometimes.

• 15:58Speaker 01

  Yeah, even things like what you eat. A lot of my clients will come in with these odd symptoms that don't make sense. And you're like, ah, is this depression? Is this anxiety? You find out their nutrition is not the greatest, they're not getting vitamins. Many people walk around with all these vitamin deficiencies and they have no idea.

• 16:16Dr. Darshan Shah?

  Right.

• 16:17Speaker 01

  And had they really thought about it as a science of your happiness, like, oh, let me just make sure it's not just psychological, right? Then they would have all of these avenues to supporting themselves. Not that it's just one direction, but that's an area you could have supported to add more points of joy.

• 16:32Dr. Darshan Shah?

  Right.

• 16:33Speaker 01

  You know, that's a three points you had today that you didn't have yesterday.

• 16:36Dr. Darshan Shah?

  Exactly. Vitamin D levels, for example.

• 16:39Speaker 01

  B12, folate.

• 16:41Dr. Darshan Shah?

  B12, folate, getting good nutrition from whole foods can lead to more happiness psychologically. And you just, just getting those points racked up, there's some easy ones you could check off there.

• 16:53Speaker 01

  There, there's a, literally a whole field called nutritional psychiatry.

• 16:56Dr. Darshan Shah?

  Ah.

• 16:57Speaker 01

  Where they study putting people in these randomized studies where some people are on the standard diet, others are in on these brain health diets, and they see mental health symptoms improve based on diet alone.

• 17:10Dr. Darshan Shah?

  Wow.

• 17:11Speaker 01

  If we really read that and we followed that, imagine how many people would be better supported just by what they're eating.

• 17:18Dr. Darshan Shah?

  Yeah, absolutely. I look at like the metabolic causes of also psychiatric conditions. And so there's so many people, you know, 90% of Americans are metabolically unhealthy right now. And just controlling your sugar intake and your carbohydrate intake and getting your metabolism back in order with more activity, exercise, and getting better sleep can also be very beneficial.

• 17:40Speaker 01

  Yeah, and a highly inflamed brain is not happy. A highly inflamed brain is not getting the connections that it needs. The neurons are, the brain cells aren't talking to each other, not connected.

• 17:50Dr. Darshan Shah?

  Right, exactly. Let's talk a little bit more about the social aspects of this because, you know, one of my favorite quotes that I love to talk to my patients about is, you know, you become the average of the five day people you surround yourself with, right? And so I really try to surround myself with positive people, people that are, um, add to my joy, add to my enjoyment of life. And really, whenever I meet someone that I even suspect is gonna have a negative influence in my thinking patterns, I just distance myself. And that served me really well. That wasn't always this way. This has only happened probably in the last 15 years or so. Prior to this, I would almost be more attracted to people that were a challenge for me, you know?

• 18:34Dr. Darshan Shah?

  Challenging to be around because I'm like, how do I fix this relationship? And then I realized that like, you know, is getting away from those challenging relationships and finding relationships that are easier that led to happiness more in the long term. So is this something that you talk about a lot?

• 18:49Speaker 01

  I do, I have a whole chapter dedicated to that. It's focusing on like masochistic traits. Now, masochistic personality disorder was removed from the DSM, the Bible psychiatry.

• 18:59Dr. Darshan Shah?

  Oh, it did?

• 19:00Speaker 01

  It was, it was problematic because it was often like victim blaming, like, oh, you end up in these situations that are bad for you, where you're getting hurt. So it's kind of victim blaming.

• 19:10Dr. Darshan Shah?

  Got it.

• 19:10Speaker 01

  Versus we should be looking at the person who's actually hurting the person.

• 19:13Dr. Darshan Shah?

  Yes.

• 19:14Speaker 01

  But, you know, there are some elements that they kept, that I think in masochistic personality disorder that are now reframed as people pleasing. You know, and in healthcare where we have this mentality of putting others first and sacrificing for others and never giving up on a case, not losing hope, I think we are more prone to being attached to people who are problematic, you know, because we're like, well, we don't want to give up on them. There's gotta be a way. We like to crack the case.

• 19:41Dr. Darshan Shah?

  Yes.

• 19:42Speaker 01

  But in some cases, there's no cracking.

• 19:44Dr. Darshan Shah?

  There's no cracking the case, right.

• 19:45Speaker 01

  It is what it is.

• 19:48Dr. Darshan Shah?

  Well said, exactly.

• 19:49Speaker 01

  Right. When people come to my lab, I have this big red magnet, and I've done this in talks where I had this magnet and I, and I have this, you know, this case of like the little black splinters of tiny magnets. And I say, you know, this is you around people who are not good for you. If you think you're unscathed, look what happens when you're in a room with them. And then I take the magnet, the red magnet around and then lift it up and it's covered in splinters, right? People literally can drain your life force from you. And there are studies showing that the people that you surround yourself with, they can make or break your physical health and your mental health. So you have to really be careful about who you spend your time, who you give your time, who you give your joy to.

• 20:32Dr. Darshan Shah?

  Yeah, it's so true. The magnet analogy, I saw you do that on the stage at a quick seminar and it was so poignant because you don't really realize that these splinters are surrounding you and becoming a part of your, a part of your existence until they really pile up, right? And then you're like, what is going on? And so I think just keeping yourself away from that as much as possible, you just get less of that energy.

• 21:01Speaker 01

  Yeah. The interesting thing is that that's my daughter's magnet case.

• 21:04Dr. Darshan Shah?

  Oh, it is.

• 21:05Speaker 01

  She's nine. She wants to be a scientist.

• 21:07Dr. Darshan Shah?

  Yes.

• 21:07Speaker 01

  So I buy her a bunch of science experiments and, and I actually talk to my daughter about these type of things, like not the way that I'm talking with you clearly, but in a way like, you know, when friends make you feel bad about yourself, it's usually about what they're going through. And sometimes they give off. These waves, and I try to use words like energy, that then make you feel bad. And like, sometimes when you feel bad, then you want to go and help the friend, because maybe there's something about you. But I have to explain that it's not you. And I use these type of like imagery, like the one that you saw. I have a balloon to show her venting. And I thought, you know what? Why am I just teaching small children like this? Let's see if this works with like, big brains.

• 21:49Dr. Darshan Shah?

  Yes.

• 21:49Speaker 01

  And people love it. They feel like they're going back to science class. You know, it's like Bill Nye meets Oprah.

• 21:54Dr. Darshan Shah?

  Yeah, exactly. It is, exactly. Oh, I would love for you to talk about the balloon, because I saw you do that, too.

• 22:00Speaker 01

  Yeah, so when I talk about the five Vs to healing from, you know, a lack of joy, the five Vs to thriving and really reclaiming your joy, I talk about validation. That's acknowledging how you feel and accepting it without judgment, because many of us, we just push it down. We don't want to accept it. That's our coping mechanism. But if you push down the pain, you'll also push down the joy, right? So I talk about validating and accepting emotions. The second V is venting. This is how you express your emotions. And when people come to my lab, I'll, they'll take turns with this big red balloon, trying to push it into a tank of water. And 100% of the time, that balloon pops up and makes a splash, right? And then we take turns deflating that balloon and then we push it down into the water. It goes without resistance.

• 22:46Speaker 01

  And so I use that as a symbol that if you don't learn how to express your emotions and get it out, it'll pop up in your health in ways you can't control. It pops up in your relationships. You start snapping at your partner, your kids. It pops up at work, right? In ways that are dysregulated. So really learning how to vent and express those emotions in a healthy way can help you to have more control and also better outcomes in general. And so the venting, it can be verbal, like talking to a therapist. But many of us don't, A, have the time,

• 23:19Dr. Darshan Shah?

  Right.

• 23:20Speaker 01

  or just the resources or can't find a therapist, right? So there are ways to vent to someone who's not a therapist. But there are rules around it. There's a do's and the don'ts. When you choose someone to talk to, they should be someone who you can trust, who's not going to tell your business, right? Someone where there's reciprocity. You go to them, they come to you. And also, there should be understanding that this is not trauma dumping. This is not just me unloading, you know, onto you. This is not me gossiping. I'm coming to you with the intention of resolving something, right? There's an intentional aspect to it. Because the data shows that when you vent, and you're just trauma dumping, and you're just venting to anyone who'll listen, you actually feel worse. You know, one of the papers said, "It's almost like pouring gas onto a fire. You feel worse."

• 24:05Speaker 01

  And also, when you vent, don't pick people who are in lower positions of power. Like, don't vent to your kids, right? Because they're not going to say, "Oh, I don't want to listen to you." They're going to listen because they're designed to attach to you. They don't want to be rejected by you, and they don't want to reject you. Don't vent to your employees. You know, these are people who are in a lesser position of power, and they're not going to say no to the boss. But then they'll go home and they'll vent to their families, and this is vicious cycle that happens, right? But venting doesn't just have to be verbal. It can be through writing. A lot of my patients like to write in journals. My artistic patients like to express it in their art. Or my faith-based patients like to pray. You know, just learn how to get that out in a healthy, intentional way.

• 24:44Dr. Darshan Shah?

  Yeah, such great advice.

• 24:49Dr. Darshan Shah?

  Hi, Dr. Shaw here. I want to take a minute to talk to you about cellular health. So in my clinics, I've actually seen 30-year-old people with cells that look like they're pushing retirement. And I've also seen 60-year-olds with cells that look like they're 40 years old. So what's the difference? It's really about how fast their telomeres are breaking down. Your cells, you see, are like phones, and they have limited cellphone battery. Poor sleep, stress, processed foods, all of these things can drain that battery way faster than it should. So this is the reason why I partnered with IM8. IM8 powers that cellular battery. It's not just another multivitamin. It's a comprehensive 92-ingredient formula, designed specifically for cellular health and longevity.

• 25:34Dr. Darshan Shah?

  I'm talking 900mg of vitamin C. Twenty oranges worth of DNA protection. The clinical dose of CoQ10 that you need to power your cellular engine. You also get zinc, selenium, vitamin E, alpha lipoic acid. All of these work synergistically for cellular repair and protecting your telomeres. So instead of taking a handful of pills every day and all these supplements, IMAID actually gives you everything that you need in one scientifically formulated system. And this isn't just a theory anymore. IMAID had partnered with Oxford University, the International Space Station, San Francisco Research Institute, and they've done studies and they've gotten this NSF certified to truly power your health. Most people are aging twice as fast as they should, unfortunately.

• 26:20Dr. Darshan Shah?

  You don't have to be one of them. Try IMAID. I actually have a discount secured for you if you go to drshah.com/ima or go to imadehealth.com/discount/drsah and you can get 20% off with my discount code, DrShah. You can also find the link below.

• 26:41Dr. Darshan Shah?

  You mentioned five Vs. We've talked about venting, we've talked about validation. Can you talk about the other three?

• 26:47Speaker 01

  Yeah, so values. Values is the third. Values are things that are priceless, not with price tags. And so many times, like in my office, if you come by, you'll see all of these. I have so many degrees, I can't hang them. Literally, some of them are under my bed.

• 27:03Dr. Darshan Shah?

  I can tell.

• 27:03Speaker 01

  I have to take care of that. But, um, you know, I used to chase the accolades, the achievements. And I was still joyless. It was always like that idea of happiness, on to the next. Well, this will make me happy. And it just wasn't. It wasn't doing that for me. The values that really bring you meaning and purpose are different than the superficial values. They're, for me, they're things like helping my community, really being connected to my family. You know, tapping into creativity.

• 27:30Dr. Darshan Shah?

  Right.

• 27:30Speaker 01

  Those are the things that I look forward to. Those are the things that my last five minutes on earth, I'm gonna be like, I wish I had more of that.

• 27:36Dr. Darshan Shah?

  Sure.

• 27:36Speaker 01

  You know, not like a JD.

• 27:38Dr. Darshan Shah?

  Yeah, I don't know, the paper on the wall, right?

• 27:41Speaker 01

  Right.

• 27:41Dr. Darshan Shah?

  I have the same problem. I have all these pieces of papers I've accumulated. And then you'll find this hilarious, but I actually like lost my medical school graduation certificate for a few, like for a few years.

• 27:54Speaker 01

  Wow.

• 27:55Dr. Darshan Shah?

  Because I took it off the wall because there was no room for it. Put something else up and it ended up behind a bookshelf somewhere. And I didn't even notice it was gone and that tells you.

• 28:04Speaker 01

  And those are hard to replace.

• 28:05Dr. Darshan Shah?

  They are, they are hard to replace. But it's like, it just tells you like those pieces of paper, you don't even notice it's gone for years sometimes. Because once you achieve it, it's done. And it's not like you're walking by and saying, you know, all the time and thinking like, oh, I'm so proud I got that. It's always on to the next thing, right? And so, yeah, at some point, collecting those pieces of paper becomes just, you know, you get no happiness from it anymore.

• 28:31Speaker 01

  I know, I know you and I both know people who have like fellowship upon fellowship upon. And you're like, when are you gonna stop that?

• 28:37Dr. Darshan Shah?

  Right, exactly.

• 28:39Speaker 01

  It's never enough, right? And it's different if, you know, you have that inner curiosity and that's, that really does light you up.

• 28:46Dr. Darshan Shah?

  Sure.

• 28:46Speaker 01

  But for many, it's out of scarcity. It's like, well, I have to always be on top of the net. I have to be the best, I have to get this. And it's not out of a joyful experience. It's really that out, like the external idea of happiness.

• 29:00Dr. Darshan Shah?

  That's true, that's true. And I think, I think, you know, now I look at it more as the joy of learning. I love learning new things just because I get joy from learning the new thing. It's not about the piece of paper anymore, right?

• 29:11Speaker 01

  Same.

• 29:11Dr. Darshan Shah?

  Yeah.

• 29:11Speaker 01

  Yeah.

• 29:12Dr. Darshan Shah?

  So, okay, we talked about validation and the other V.

• 29:16Speaker 01

  So the fourth is vitals. And this is where you come in, right? Medical doctors will tell you, sleep. They'll tell you, make sure that you're eating the right foods, getting the movement. But I snuck in three non-traditional vital signs that most doctors don't ask about. Like, when was the last time your doctor in the 15-minute visit asked you, like, if you're in a toxic relationship, right? They just don't.

• 29:38Dr. Darshan Shah?

  Right.

• 29:39Speaker 01

  They don't want to go there.

• 29:40Dr. Darshan Shah?

  Yeah.

• 29:41Speaker 01

  But your relationships, you know, the value of your relationships, the quality, impacts your physical health and mental health. Your relationship with technology is something that we're learning not just impacts children, but also adults.

• 29:53Dr. Darshan Shah?

  Mm-hmm.

• 29:53Speaker 01

  And there was a recent study out of one of the University of Texas schools, where they took the smartphone capacity away from these adults for about four weeks, and then they measured their happiness points. After four weeks, it looked as if those who had the smartphone removed were being treated with an antidepressant.

• 30:10Dr. Darshan Shah?

  Wow.

• 30:10Speaker 01

  So the researchers asked them, well, what was, what's going on? And what they reported was that they were sleeping better.

• 30:15Dr. Darshan Shah?

  Yeah.

• 30:15Speaker 01

  They were on their phones, they were out in nature, they were getting movement, they were talking to their loved ones, right? All those points of joy that we measure in the research, they were getting more of those points. So really understand how being on devices, how being connected to technology is impacting you. Right?

• 30:31Dr. Darshan Shah?

  Right.

• 30:31Speaker 01

  And there's this entire center called the Stanford Zoom Fatigue Center, where they study the impact of being on virtual meetings all day. And what they found is that people are just so tense on these virtual meetings, because it's not natural to see my face next to your face. I'm not supposed to see my face talking to you.

• 30:50Dr. Darshan Shah?

  Yeah.

• 30:50Speaker 01

  You know, I'm designed to talk to you, right? And then look at your body language and see, oh, are you connecting with me? Are you safe? Not like, oh, how did I fix my hair today? Like, what did I do? You know? So I think we're not really aware of how technology impacts adult brains. We are, it's all over the news about pediatric brains, but it impacts us too.

• 31:08Dr. Darshan Shah?

  Hmm.

• 31:09Speaker 01

  And then the third non-traditional vital sign is our work life, work-life relationship. Leaving work at work and having a home life.

• 31:16Dr. Darshan Shah?

  Yeah. Wow, there's so many things to consider, for sure. You so- Is it better, like if you are going to do a Zoom meeting, just to turn off the camera that's showing yourself and just only see the other person? I've not done this before, but it's, you're absolutely right. Like this connection that we're having right now, I don't see my own face next to you. Right? So this, you feel more connected when you're focused on the other individual rather than splitting your focus between yourself and the other individual.

• 31:43Speaker 01

  Yeah, it is better. Actually, it's one of their recommendations. And I just gave a talk to a large corporation and all of the employees, not one person disagreed. They were like, that is so true because when you're on a Zoom, the moment that comes, that meeting comes up and you're ready for it, your body just gets tight. You start like getting all stressed out. You start performing and then you're looking at like 10 faces, you know, at once. Again, not, not natural. You know, when we're in person, face to face in meetings, there's usually a round table. You're looking this way, you're looking that way. Not everyone's like performing at once. So it's very unnatural. It's draining and it's, we're losing our points of joy.

• 32:22Dr. Darshan Shah?

  Yeah. One of the things I talk to people about, um, when we talk about connection is I always bring up like, I love doing podcasts because finally, after years of not feeling connected to people, I feel connected again because I'm having a conversation with someone about a topic I care about and I'm not distracted by a device, for example. Right? And I think a lot of people are missing connection and actually feeling lonely despite having a hundred Zoom meetings a day, right? Because they're so distracted and they're not, they don't feel a connection anymore and they've even forgotten how to connect. And I think it's a big problem in society right now.

• 33:02Speaker 01

  It is. It's a point of joy.

• 33:03Dr. Darshan Shah?

  Right.

• 33:03Speaker 01

  You know, feeling connected to people, that's actually a point. You know, the fifth V is vision, planning joy. And I often use the example of my team in my lab, right? When we finish a study, like a big study.

• 33:15Dr. Darshan Shah?

  Yes.

• 33:15Speaker 01

  And we wrap it up, rather than just going on to the next, we celebrate. And it's important because if we just celebrated, okay, the study is done. It was, that was a beast. That was hard. That's a goal, an idea.

• 33:27Dr. Darshan Shah?

  Right.

• 33:28Speaker 01

  The external, the happiness. If we just celebrated that, there's always going to be another study, right?

• 33:32Dr. Darshan Shah?

  Yeah.

• 33:33Speaker 01

  But our team will always be the same. People go to grad school, or they go have babies and get married, right? That point of joy of connection, we lost that point if we didn't celebrate together. So we meet in our lab, we have our local bakery that we go to, right? That we get the pastries from, but we always do something together. So it's important to celebrate that point of joy of connection, not just this idea of this goal.

• 33:57Dr. Darshan Shah?

  That's so powerful. Yeah, I think, once again, we're always on to the next thing. And creating those celebratory moments is really powerful. I assume you're probably doing things like that with your family as well, maybe with your friends, right? I love that.

• 34:12Speaker 01

  I used to not do that, but every day I have this practice where, when I get my daughter to school on time, because her school is so strict, like even if you're a minute late, they make you wait outside, it's like the walk of shame.

• 34:23Dr. Darshan Shah?

  Yeah.

• 34:23Speaker 01

  But if I get her there on time, then I sit in my living room afterward and I just like have this delicious cup of coffee.

• 34:31Dr. Darshan Shah?

  Yeah.

• 34:31Speaker 01

  I got this coffee in the Caribbean and I figured out who made it and I've been ordering it ever since.

• 34:36Dr. Darshan Shah?

  Amazing.

• 34:36Speaker 01

  And it's like this, it's so delicious and I just sit there and that's my time. And I look forward to that point of joy every day.

• 34:43Dr. Darshan Shah?

  That's awesome.

• 34:43Speaker 01

  And that's the vision, that's like the thing, my win that I'm celebrating and I put it on my calendar. Everybody knows that, that's my time.

• 34:49Dr. Darshan Shah?

  Yes.

• 34:50Speaker 01

  So carve out that joy, whatever it is for you. It could be, you know, maybe the couple of minutes you have before you get home, in between work and going home or getting your kid, going for a walk, doing something that's joyful for you.

• 35:02Dr. Darshan Shah?

  Yeah, that's so powerful. Going back to devices as well, I think, you know, in going all the way back to the beginning of our conversation, finding those moments of joy in your day to day life, right? Like when you're eating a meal, for example, did you enjoy the taste you mentioned?

• 35:17Speaker 01

  Yeah.

• 35:17Dr. Darshan Shah?

  I think the phones also drain us of those moments because when you're eating with your phone in your hand, you don't even think about your food.

• 35:23Speaker 01

  No, you don't. You're not even tasting your food.

• 35:26Dr. Darshan Shah?

  Right.

• 35:26Speaker 01

  You're literally just shoving it in, you know? You're like... I mean, sometimes if like I'm really busy and I'm not practicing what I preach, I'll be like, what did I just eat? You know? So that just goes to show you that when you are not present, your body is so disconnected from your brain. And many people will say like, oh, where did the time go? Right?

• 35:46Dr. Darshan Shah?

  Right.

• 35:46Speaker 01

  So that's another indication that you need to be more present. You need to be experiencing that internal joy versus living in the future, because you're literally missing out on your life.

• 35:57Dr. Darshan Shah?

  Absolutely. And same when you're having a conversation with your phone, sitting next to you on your, on the table and responding to every buzz and deep on the phone. And, you know, I also, one piece of advice I give to all my patients too is, charge your phone outside of your bedroom at nighttime when you're sleeping. Almost 95% of people now use their phone as their alarm call.

• 36:18Speaker 01

  Yes.

• 36:18Dr. Darshan Shah?

  And it's the last thing they see at night, first thing they see in the morning.

• 36:21Speaker 01

  It is.

• 36:22Dr. Darshan Shah?

  And when you move the charger to a different place, whether it's in your closet, your bathroom, I actually keep my phone charger at the coffee machine where I make coffee in the morning, which is the farthest point in my house from my bedroom. And it just creates that physical separation, but more of like 10 or 15 minutes every single morning before I get a cup of coffee, they don't have my phone with me.

• 36:41Speaker 01

  Yeah.

• 36:41Dr. Darshan Shah?

  And it's, it's a powerful shift in your perspective.

• 36:44Speaker 01

  It is. Have you heard of the phone beds? Some people have like a little bed for their phone and they put it in another room.

• 36:50Dr. Darshan Shah?

  Yeah, that's like Arianna Huffington's thing, I think.

• 36:52Speaker 01

  Yes, yes.

• 36:53Dr. Darshan Shah?

  She's, wrote one of the first books on sleep. And that was such a great thing that she had mentioned. That's awesome. I'm really excited about reading your book.

• 37:01Speaker 01

  Oh, thank you.

• 37:01Dr. Darshan Shah?

  So tell me a little bit more about what people will learn from your book, High Functioning.

• 37:05Speaker 01

  I wanted people to have tools that were evidence-based, because again, not everyone has access to a therapist or a psychiatrist. In some parts of the United States, there's only one psychiatrist for every 30,000 people. So I really wanted to put practical tools in there that anyone could understand. And I did it that way intentionally because as I started to create social media content online, people were saying, I want more, I want any more information. And I felt like, you know, just doing short form wasn't a responsible way to do that. So I really wanted to put as much information as possible in one place. That's why I do a lot of interviews, podcast interviews, because people are getting their information digitally these days. They're not really getting it from their doctors directly.

• 37:50Speaker 01

  You don't have that much time with your doctor. Not everyone has access. And I was teaching doctors at a major institution how to do press interviews. That's how I got involved in media. But when I was in training, the director of the program said, we're opening a new wing. There are press here, like, we need people who are actually working in the wing to talk to the press. And that was me. And I was like, sure, I'll do it. And like, when I saw that article, I was like, oh, my gosh. Why don't we learn how to talk to the press? Because I sound terrible. So I went to my director and I was like, I sounded so terrible. Why don't we get this training? And he was like, why don't you create the training? And I was like, oh, okay. I was like, why do I have to say something? As if I don't have enough work.

• 38:32Speaker 01

  But I created this course and I'm so glad that he was Socratic in his method and made me teach myself and then others. Because that led to being on air, representing, you know, my several institutions on air. And then, when it was COVID time, the doctors were like, we need to learn how to talk, you know, to people using social media, not just on air interviews. So that's how I started creating this information on social media and it just blew up. So that led me to write this book and to really put this information out there. I know people need it. They need this information.

• 39:04Dr. Darshan Shah?

  They absolutely do. So this is like, almost like a DIY manual to get started.

• 39:09Speaker 01

  Yes.

• 39:09Dr. Darshan Shah?

  Before, if you don't have access or before you even see a therapist, it's a great way to get started down all of your teachings around joy and happiness and living a more fulfilled life.

• 39:19Speaker 01

  Yeah, absolutely. You don't have to wait to start to heal. Healing starts literally at home. And then, as you get more familiar, you educate yourself, then you know what to ask a health professional when you're there.

• 39:31Dr. Darshan Shah?

  Exactly.

• 39:31Speaker 01

  It's better to be prepared than to just show up and be like, fix me, right? Like, learn first.

• 39:37Dr. Darshan Shah?

  In, you know, in my field and functional medicine and longevity medicine, I find that my patients that have the best results of any treatment that we do have already read something, have already researched, have already done the work themselves prior to coming. Because then they've already checked off a lot of those simple boxes already. And we can take them to a higher level of, you know, protocols and treatments. Whereas if someone comes in, like, they don't know anything, and I'm sitting there talking to them about how they should avoid ultra-processed food, like, you're starting at a much different place. So I love it that this. For your work, this book kind of gives them that starting point.

• 40:14Speaker 01

  Yeah, there's actually a term for it. It's called psychoeducation. And it's the first step, you know, in therapy. Once you develop an alliance with a patient, then you start this process called psychoeducation. But you can start that psychoeducation at home.

• 40:28Dr. Darshan Shah?

  Yes.

• 40:29Speaker 01

  By reading, by learning, by listening to podcasts.

• 40:31Dr. Darshan Shah?

  Yes, everyone should get psychoeducated.

• 40:34Speaker 01

  Yes.

• 40:35Dr. Darshan Shah?

  For sure, because you need to know about how your psychology works.

• 40:38Speaker 01

  Yes.

• 40:38Dr. Darshan Shah?

  This is such an important book, and I'm so excited that you wrote it. And thank you so much for talking to my audience about this.

• 40:45Speaker 01

  Oh, my gosh, thank you so much. It was a joy.

• 40:48Dr. Darshan Shah?

  I love it. How can people find you and learn more from you? The book is called High Functioning, and people can order this now, right?

• 40:56Speaker 01

  Yes.

• 40:56Dr. Darshan Shah?

  Yes.

• 40:57Speaker 01

  They can order it wherever books are sold. Follow me on socials, Dr. Judith Joseph, and that's my website as well, drjudejoseph.com.

• 41:04Dr. Darshan Shah?

  I love it. You're so eloquent. You have so much incredible knowledge, and I really applaud you for doing the research and moving the field forward.

• 41:11Speaker 01

  Oh, thank you so much.

• 41:13Dr. Darshan Shah?

  We'll talk soon again.

• 41:14Speaker 01

  Okay.

• 41:17Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.