Signs of high-functioning depression: psychiatrist Dr Judith Joseph on the 'joy thief'
Signs of high-functioning depression: psychiatrist Dr Judith Joseph says busy, successful people can lose joy while still coping, and what to watch for.
You can meet every deadline, run the house and still feel nothing. Psychiatrist Dr Judith Joseph, who trained at Columbia University and New York University and researches what she calls high-functioning depression, describes the signs on The Mel Robbins Podcast. The video above plays the part of the episode where she defines it and explains what to do.
The short version
- High-functioning depression is not a formal diagnosis. Joseph uses it for people who keep functioning but have lost their sense of joy.
- The sneaky symptom is anhedonia, a drop in pleasure that she calls a “joy thief”.
- Other signs she lists: low energy, poor concentration, changes in sleep and appetite, feeling numb or “blah”.
- In men it can look like irritability, anger, checking out or drinking, rather than sadness.
- Busyness can be a way of not feeling. Overwork and endless scrolling are warning signs, not proof you are fine.
- Her first advice is to talk to a doctor about the symptoms.
What is high-functioning depression?
Joseph describes people who look successful from outside: “You’re meeting deadlines, you’re collecting accolades, but you’re just not really feeling a sense of joy.” They are often “the rock of the family”, the one everyone leans on. Many never call themselves sad or depressed, because of culture, a lack of words for feelings, or past experiences that taught them to push through.
She is clear that the diagnostic manual doctors use, the DSM-5, does not have this category, and that people who are still functioning are sometimes told to come back when things are worse. Her typical day for such a person: waking before the alarm, eating without tasting the food, working through lunch and doom-scrolling late at night.
What is the ‘sneaky symptom’ of depression?
For Joseph it is anhedonia, losing the ability to enjoy things. It creeps in while you stay busy, and she says people can talk themselves out of their own feelings. She mentions possible links with brain chemistry, inflammation, genes, unresolved trauma and constant social media, and stresses that these are correlations, not proven causes.
If you notice your joy shrinking but do not want to seek help yet, she still suggests speaking to a doctor and using screening questionnaires as a starting point, and points out that therapy is not the only option people have.
Our take
The label is debated. Some clinicians worry that “high-functioning” makes depression sound mild, and Joseph herself does not claim it is a separate illness. But the core point is solid: the World Health Organization counts a loss of pleasure or interest in activities, alongside low mood, as a core part of a depressive episode when it lasts most of the day for at least two weeks, and you do not have to be unable to get out of bed to be unwell.
In Pakistan this pattern is common and rarely named. The eldest son who supports the family, the mother who runs a joint household, the student topping the class while feeling empty: all are praised for coping. Men in particular are expected to show anger rather than sadness, which matches what Joseph describes. Seeing a doctor is not weakness, and a GP is a reasonable first stop.
Try this today
- Write down three things you used to enjoy. Rate how much you enjoy them now, from 0 to 10.
- Eat one meal today away from your phone and your desk, and notice the taste.
- Name your feeling in one word, out loud or on paper. Joseph says naming a feeling helps the body feel less afraid.
- If the numbness has lasted more than two weeks, book a doctor’s appointment.
This article is for general information and is not medical advice. If you are having thoughts of harming yourself, please reach out today to the Umang Pakistan helpline, a doctor, or someone you trust.
Other parts of the episode
Sources
This story was researched and drafted with AI assistance, then checked and edited by our editor before publishing.
