List of Limitations on Major Life Activities
This page lists ways in which psychiatric disabilities may limit major life activities. While not
exhaustive, the list is intended to assist advocates in analyzing whether a person with a psychiatric
impairment is a "person with a disability" under the ADA, as defined by the Supreme Court's
rulings in the Sutton, Murphy and Kirkingburg decisions. See our discussion of the implications
of these decisions and potential new directions for advocacy. The Bazelon Center created this list with the assistance of psychiatrists, psychologists, researchers, consumers and attorneys, as a tool to help advocates focus on
limitations that may remain even if other limitations are controlled by medication or therapy.
A note of caution: The major life activities mentioned in the list are not necessarily ones that
have been established as major life activities through case law. Persuasive arguments may be
made, however, that each of the activities included on the list is a major life activity. Whether the
limitations are substantial (as they must be for the person to qualify under the ADA as having a
disability) will vary from one individual to another, but the list offers suggestions about what
types of limitations may arise for individuals with psychiatric disabilities.
Limitations on Major Life Activities
Social/Emotional:
- interaction with others (e.g., speech difficulties such as pressured speech, lack of clarity,
withdrawal or responding with difficulty or too quickly; self absorption; inability to relate to or
listen to others, including inability to relate due to paranoia, delusions, hallucinations,
obsessive compulsive ideation, negativity; inability to regulate mood and anxiety; inability to
maintain appropriate distance from others)
- forming and maintaining relationships with others
- communication with others (e.g., answering questions, following directions, using intelligible
speech, recognizing and expressing emotions appropriately, expressing needs, following a
sequence)
Cognitive:
- concentration (as a major life activity itself and also resulting in limitations on other major life
activities, such as interaction with others, self care)
- making decisions
- complex thinking (e.g., planning, reconciling perceptions from different senses (seeing and
hearing), sorting relevant from irrelevant details, problem solving, changing from one task to
another)
- abstract thinking (e.g., difficulty generalizing or transferring learning from one setting to
another, such as difficulty transferring skill of cooking in one kitchen to another kitchen)
- memory (long or short term)
- attention
- perception
- distinguishing real from unreal events
- initiating and completing actions
- processing information
Physical:
- taking care of personal needs, such as eating, dressing, toileting, bathing, hygiene, household
chores, managing money, following medication or treatment regimens, following safety
precautions
- eating (e.g., inability to regulate amounts appropriately or to maintain appropriate diet; need for
strict eating schedule)
- sleeping (e.g., inability to fall asleep, obtain restful sleep, or sleep without interruption;
excessive sleeping)
- reproduction
- sexual activity
- traveling
Limitations Caused by Medications
Social/Emotional:
- interaction with others (due to agitation, flattened affect, or withdrawal caused by medication)
- concentration
- ability to perform daily activities
Cognitive:
- concentration
- thinking (e.g., slowed thought process)
Physical:
- seeing (e.g., blurred vision)
- reproduction (e.g., sexual dysfunction or possibility of birth defects)
- sexual activity (e.g., sexual dysfunction)
- writing, grasping, lifting (e.g., loss of fine motor control, uncontrolled muscle movement, or
muscle rigidity)
- speaking (e.g., slurred speech)
- sleeping (e.g., inability to fall asleep, obtain restful sleep, or sleep without interruption;
excessive sleeping)
- eating (e.g., restrictions on types or amounts of foods or eating times due to medication regimes,
or due to liver damage or high blood pressure caused by medication)
- eliminating waste (e.g., incontinence, diarrhea, urgency or frequency of need to urinate or
defecate)
- walking/ambulation (e.g., excessive weight gain, muscle rigidity)
- driving (e.g., drowsiness, loss of fine motor control, uncontrolled muscle movement, or muscle
rigidity)
- self care
- working (e.g., most of limitations listed above)
Limitations on Work Activities
Social/Emotional:
- giving directions
- requesting clarification
- initiating interpersonal contact
- asking for feedback on job performance
- responding appropriately to negative feedback
- initiating corrective action
- providing explanations
- describing events
- using intelligible speech
- responding appropriately to supervision
- maintaining relationships with supervisors
- responding appropriately to supervisors
- maintaining relationships with coworkers
- responding appropriately to coworkers
- adapting to a new supervisor
Cognitive:
- understanding, remembering, carrying out directions
- assessing own performance
- making decisions
- seeking information
- exercising judgment
- problem solving capacity (managing multiple pressures or stresses, balancing work and home
life, solving routine problems that make it possible to work—e.g., getting up on time, taking
public transportation, wearing appropriate clothing, doing laundry)
- recognizing when to stop doing one task and move on to another
- learning new tasks
- transferring learning
- adapting to a change in work assignment (e.g., in corporate re-organization)
- focusing on multiple tasks simultaneously
- screening out environmental stimuli (e.g., noise, visual distractions, etc.)
- processing information (e.g., understanding, analyzing or synthesizing)
- maintaining boundaries of responsibility
Physical:
- maintaining fixed work schedule (e.g., need for flexible schedule or breaks or modified hours
due to the impairment, the effects of medication, or the need for appointments to receive
treatment; need for leave to receive acute treatment)
- maintaining work pace
- maintaining stamina throughout the work day
You will want to be extremely cautious about bringing claims based on an individual's being
substantially limited in the major life activity of working. While this list includes limitations on
work activities, we urge that you focus on substantial limitations on major life activities other
than working, as the viability of claims based on work limitations has been severely limited by
the Supreme Court's decisions.
It is important to remember that the greater the limitations in work activities, the more likely it is
that the person will be found unqualified to perform the essential functions of a job. Thus, even if
an individual is substantially limited in performing a broad range of jobs, it is helpful to focus
instead on his limitations in other major life activities, such as eating, sleeping or reproduction or
muscle impairments and speech impairments, to the extent possible.
Be cautious also about claims that an individual is substantially limited in major life activities that
are strongly related to work performance for example, concentration, maintaining attention,
interacting with others. As with claims that a person is limited in working, these claims pose risks
that the person may be found unqualified to perform the job.
Limitations Remaining Despite Mitigating Measures
- any of the above may recur intermittently despite medication or therapy.
- may be at risk of any of the above occurring despite medication or therapy.
- any of the above may be residual limitations remaining despite medication or therapy.
The list was prepared by Jennifer Mathis, jenniferm@bazelon.org.
(Posted 8/11/99)
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