Psychiatrist Outlines Five Tools to Combat High-Functioning Depression Among High Achievers

Highly successful individuals may appear outwardly thriving but still struggle with a hidden form of depression, according to psychiatrist Dr. Judith Joseph.

“High-functioning depression” is not a clinical diagnosis, but the term is used to describe individuals who maintain daily responsibilities while grappling with underlying mental health issues. Symptoms can include hopelessness, fatigue, and a loss of interest in previously enjoyed activities, even as sufferers continue to achieve personal or professional goals.

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“People with high-functioning depression, they’re overly functioning. When they sit still, they feel empty,” said Joseph, a board-certified psychiatrist and author of "High Functioning." She notes that some individuals channel trauma or emotional pain into productivity, often to the detriment of their well-being.

To help those experiencing this condition, Joseph developed a therapeutic framework called “the five V’s,” based on her clinical work. The approach is intended to offer small, manageable tools that can be incorporated into daily life.

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The Five V’s for Managing High-Functioning Depression

Validation: Acknowledge and accept your emotions. Naming feelings accurately helps reduce confusion and internal conflict.

Venting: Express emotions through healthy outlets like conversation, journaling, or creative activities. Joseph advises asking for “emotional consent” before unloading on others.

Values: Reconnect with what brings meaning and purpose beyond status or achievements. “Tap into those every day,” she said.

Vitals: Pay attention to the mind-body connection, including nutrition, sleep, and physical activity, as well as social and digital wellness.

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Joseph emphasizes a gradual approach: “Tap into one or two every day with the intention of ‘I’m going to try to get one point of joy today.’”