 Psychodynamic or psychoanalytic presuppositions may posit underlying distresses that are masked, or submerged, within the psyche; and the elusive phenomenology of some conditions suggests the presence of nameless existential anxieties hidden from awareness (Ratcliffe 2008, 2017). But such explanations aside, distress has been widely regarded as a ubiquitous, if not unfailing, feature of disorder. In symptom-focused accounts laying stress on the consequences of the syndrome, distress becomes prominent as a form of disabling dysfunction (Stein et. al. 2010). Instead of separate criteria (and either singly or jointly sufficient for disorder, as in the respective DSM and ICD definitions above), suffering and dysfunction are conjoined on a “distress-impairment” analysis, where disorder status is assigned with (and defined as) distress that is “unmanageable or disabling” (Bolton 2013). Whether this analysis applies to the whole class of mental disorders as presently understood is doubtful: its plausibility increases with what has been called “distress related conditions”, such as depression and anxiety, that are “more constitutive of the illness” (Bolton 2012: 10; see also  §4).