TLC: Improved Mental Health With SUDS: A Simple Practice to Measure and Reduce Stress


A woman with a hand to her forehead looking stressed
Image via The Lincoln Center for Family and Youth

Stress is an unavoidable, completely normal part of life.

However, when we’re unaware of how much distress we’re experiencing, or deny that stress is affecting our perceptions and responses, the cumulative impact of it can lead to anxiety issues and physical health problems.

In fact, according to the American Psychological Association, people under stress — particularly chronic stress — are more susceptible to inflammation, headaches, insomnia, depression, high blood pressure, heart disease, and other health issues.

Ironically, becoming aware of stress without a way to address it can exacerbate the negative effects on people’s mental and physical well-being.

This is where the Subjective Units of Distress Scale (SUDS) comes in. Because of its simplicity, the SUDS can be an especially helpful tool in learning to assess and reduce feelings of stress and anxiety, phobias, or other mental challenges. It can also serve to explore the effectiveness of various interventions as people work to improve their mental health.

How Does SUDS Work?

Using the Subjective Units of Distress Scale (SUDS) is simple.

At the moment of a stress trigger or intervention, people simply rate and record their level of distress or anxiety on a scale of 0–10. A score of 0 indicates no distress or anxiety, and 10 indicates extreme distress or anxiety.

Like a temperature or blood pressure reading, the goal of using the SUDS is to provide a heightened awareness of one’s personal emotional distress level at any given moment. The rating can be influenced by thoughts, feelings, and physical sensations. Therefore, answers are subjective and unique to the person and the moment — there are no “right” or “wrong” answers.

Keep a Stress Awareness Log

To maximize the effectiveness of using the SUDS, individuals can track their mental and emotional stress journey by keeping a stress-awareness journal.

Logging each SUDS entry can include the date, time, and place of the rating, the SUDS score, and a quick note about any context (what was said, done, observed, or experienced to trigger or reduce stress or anxiety).

Over time, this stress awareness log can help people recognize trends in their own stress levels, including what causes stress to increase or decrease, and what interventions are most effective.

In addition to helping individuals become more self-aware and attuned to their own levels of stress, the SUDS can be used to develop stress awareness within families, classrooms, or work groups — especially when people in the group are experiencing shared stressors.

Using the SUDS together can help people grow in empathy and insight into how each member of the group is being uniquely impacted by various stressors, and what is effective in helping to reduce their stress.

For additional tools to reduce the impact of stress on your life, here are some links that can be helpful:

About TLC

The Lincoln Center for Family and Youth (TLC) is a social enterprise company serving the Greater Philadelphia Area. Among its five divisions, TLC offers School-based Staffing Solutions, Mobile Coaching and Counseling, and Heather’s Hope: A Center for Victims of Crime. These major programs are united under TLC’s mission to promote positive choices and cultivate meaningful connections through education, counseling, coaching, and consulting.

Find out more about The Lincoln Center for Family and Youth.

About the Author

MaryJo Burchard (Ph.D. in Organizational Leadership) is co-founder and principal of Concord Solutions, a Virginia-based consultancy firm focused on helping leaders and organizations thrive while facing major disruption. Concord Solutions offers consulting, coaching, training, research, and keynote speaking surrounding trauma-informed leadership and assessing and building change readiness, trust, and belonging.

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