A peer-reviewed study in the journal Cureus revealed that elevated rates of high-functioning depression correlate directly with increased trauma and anhedonia, with parents and caregivers scoring the highest. Dr. Judith Joseph notes that because these individuals remain productive, their emotional distress often goes unnoticed compared to those exhibiting traditional depressive symptoms. To assist with early detection, Joseph developed a non-diagnostic self-assessment based on the Snaith-Hamilton Pleasure Scale to gauge whether individuals can still savor everyday accomplishments and praise. Addressing these suppressed emotional burdens early is vital to prevent patients from deteriorating…
Key points
High-functioning depression is not officially recognized in the DSM-5, which frequently c…: High-functioning depression is not officially recognized in the DSM-5, which frequently causes individuals to overlook symptoms until facing burnout.
Sustained suppression of emotional distress in demanding roles like medicine can eventual…: Sustained suppression of emotional distress in demanding roles like medicine can eventually push individuals into physical emergencies.
Dr. Judith Joseph provides a coping framework called the Five V's, encompassing validatio…: Dr. Judith Joseph provides a coping framework called the Five V's, encompassing validation, venting, values, vision, and vitals.
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Some people with clinical depression can't get out of bed. But what about those who exhibit other signs of depression who never stop moving, and may double down on their work?
Psychiatrist Dr. Judith Joseph says the second group often goes unnoticed, even by the people living it. She calls it "high-functioning depression": people who keep meeting their obligations at work and at home while quietly losing the ability to feel pleasure.
"When you are joyful, you have better physical health, you have better relationships, you have better productivity at work," Joseph said in an interview for the Your Turn podcast. "So why don't we prioritize it?"
At the center of Joseph's work is anhedonia: a reduced ability to feel joy, pleasure or interest in things that once brought those feelings. Joseph describes it as "the silent sister" of depression.
"One sister is depressed, and crying, and not getting out of bed, and getting all the attention," she says. "The other one is quiet and numb." Anhedonia may not seem like a crisis in the classic sense, Joseph says. "But…
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