SUDS Scale: Rate Your Current Distress From 0 to 100

There are two parts. Part 1 asks twelve short questions about one situation that is bothering you right now, each rated from 0 (not at all) to 4 (very much), for a check score from 0 to 48. Part 2 is the rating itself: you choose one number from 0 to 100 in steps of ten, and every step carries a written anchor. Your result is the number you chose in Part 2, shown with the anchor text for that step. The Part 1 total appears beside it as a second figure, so you can see whether the two agree.

The four areas in the breakdown, body signs, urge to escape, thinking and focus, and how long it has lasted, are our own grouping of our own items, three questions each. They are not validated subscales of anything, and the SUDS convention has no subscales to reproduce. The five bands over the 0 to 100 range are descriptive ranges written for this page. They are not clinical cutoffs: there is no published threshold at which a SUDS rating becomes a disorder, and nobody should read a 70 as a diagnosis of anything.

If your Part 1 check score is high and your rating is low, you may be rating how well you are coping rather than how much distress you are in. If the reverse is true, the fear of the feeling may be doing some of the work. Neither is wrong. Both are worth noticing, because an exposure plan built on ratings that drift is harder to use.

A SUDS rating is a self-report anchor. It records how much distress you say you are in, at a particular moment, on your own internal scale. That is its strength and its limit at the same time. Because the top of the scale is the worst distress you personally can imagine, your 80 and someone else's 80 are not the same quantity. The number is useful across your own ratings and close to meaningless between people, which is why no SUDS table of population norms exists.

It is also not a screening instrument. A high rating does not establish an anxiety disorder, and a low one does not rule anything out. If you want a screening measure for the pattern behind the distress, the anxiety test at Anxiety Test and the panic disorder screener at Panic Disorder Test are built for that job and cite the instruments they are based on.

Researchers have been blunt about the scale's weaknesses. A 2025 review by Mattera and Zaboski argued that SUDS mixes several things together, anxiety, frustration, hopelessness, low mood, that the rating period is often left vague, and that a single number can hide a lot of variation; they recommend naming the target explicitly when you ask for a rating, which is why Part 2 on this page asks about one situation rather than your day. Earlier work by Kim, Bae and Park found that the SUDS rating taken at the end of the first EMDR session was related to how much a clinician judged a patient to have improved by the end of treatment, while the rating at the start of that session tracked concurrent depression and anxiety, which is some evidence that the number carries real information. Both things are true: it is a useful working tool and a weak measurement instrument.

The original use is ordering an exposure hierarchy. You list the situations you avoid, give each one a SUDS rating, then sort them from lowest to highest and work upward at a pace you can sustain. The worksheet at Exposure Hierarchy Builder sets that out step by step, and Fear Ladder (Exposure Hierarchy) is the simpler version if a long list feels like too much to start with.

The second use is inside a session. In EMDR, the therapist asks for a SUDS rating on a target memory, works, and asks again, using the change as one signal among several. In exposure work, repeated ratings during a single exposure show the reader something hard to believe in advance: the number usually rises, plateaus, and comes down on its own, without escape and without anything bad happening.

The third use is tracking a wave in daily life. Writing down a number at the start, the peak and twenty minutes later turns panic from an endless event into something with a shape. The feelings thermometer at Feelings Thermometer is the same idea in a gentler format, and useful if numbers feel clinical to you. One caution worth knowing: Craske and colleagues have argued that the drop in fear within a single exposure is not what makes exposure work in the long run, so a session where your number stays high is not a failed session.

Write it down with three things beside it: the date and time, the situation in one line, and what you did next. A single SUDS rating tells you almost nothing. Ten of them, with that context, show you which situations are actually hardest, whether a number that felt unbearable last month now sits lower, and what you were doing on the days it dropped.

If the rating you gave today is high and it has been high often, that is worth a conversation with a professional rather than a tracking habit. SUDS is a tool used inside treatment, not a replacement for it; a therapist who works with anxiety will build a hierarchy with you, set the pace, and keep the plan honest. If your distress is tied to a specific memory, ask about EMDR and about trauma-focused approaches by name.

If you came here to rate how you feel right now and the number is near the top, stop measuring and take care of yourself first. Slow your breathing out, put your feet on the floor, call someone, and rate again in twenty minutes. The scale is there to serve you, not the other way around. If anger is the feeling you are rating, an anger thermometer maps body cues, thoughts and a coping step to each level from 0 to 10.