• Madeline Leitner

Do I have a problem? Distress and Impairment


Problem behaviors often cause distress and impair our ability to function in other areas of life.

It is common to minimize problem behaviors, act like they don’t exist, and rationalize why the behavior is ok.


Excessive drinking, disordered eating, cell phone/social media abuse, snapping at loved ones, people pleasing, and perfectionism: Problem behaviors, just to name a few, are behaviors that you engage in despite the fact that they no longer serve you in a positive or healthy way.


You continue to engage in these behaviors because they are comfortable, habitual, and were most likely adaptive to you at some time. Denial and rationalizations often blind you from seeing the severity of the problem in a realistic way, and keep you stuck in these maladaptive behavioral patterns.


So, how do you know if your behaviors are a problem? Looking at distress and impairment can help.Distress and Impairment are two assessment markers that can help you easily identify the severity of your problem and if it is time to seek help and support.


Let’s start off with distress. Distress is the degree to which you experience physical, emotional, and/or spiritual pain and suffering due to engagement in the behavior. The more distress you experience as a result of the behavior, the more likely it is that you have a problem worth exploring.


For example, do you experience intense anxiety after waking up from a night of drinking? Do you experience irritability and headaches due to calorie restriction? Do you feel shame and low self-worth after comparing yourself to others on Instagram? Do you have impaired organ function or abnormal labs due to the behavior’s effect on the body?


Try asking yourself how intense these symptoms of distress are on a scale from 1-10. Self- assessment requires reflection and honesty- be on the lookout for attempts to minimize symptoms!


Now, moving on to impairment, the second assessment marker that can help you determine the extent of your problem behaviors. Impairment is the degree to which the problem behavior inhibits your ability to interact and perform in other areas of your life. This includes areas such as, relationships and social connections, occupation and education, health and wellness, and general life responsibilities.


For instance, do you find yourself calling in sick to work after a drinking binge? Are you isolating and turning down social outings in order to drink in private, sit in front of a screen, or avoid eating in public? Are you prioritizing the behavior over getting exercise, meditating, or spending time with your partner? Do you feel stretched too thin, with no time for yourself because you perpetually say “yes” to every person and their request?


Answering yes to any of these questions indicate that your behaviors are impairing your ability to function optimally in other areas of your life. Similarly to distress, try asking yourself, to what degree on a scale from 1-10 is my behavior getting in the way of my values, priorities, and responsibilities?


Remember, breaking through denial and being honest about the severity of your problem is difficult. You may have been rationalizing your behavior for many, many years. I invite you to use this simple self-assessment tool- distress and impairment, to help gain insight to your problem behaviors and their true impact on your life.

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© 2018 by Madeline Leitner

MSW, LCSW