Do you have any feelings of anxiety during the day?
Yes , a bit
No
I have panic attacks pretty often
Yes, a lot but not something dramatic
Where do you feel more anxious, or what do you feel more anxious about?
Are you psychologically certified to have a mantal illnes ?
Yes
No
If yes , please write which one(-s)
How often people get to notice characteristics of yours connected to that illness ?
1
2
3
4
5
6
7
8
9
10
Have you ever been through a "depression phase"
Yes
No
I have general depression
What would you like others to do when your mental illness is acting up?
How do you feel about people these days?
(TW: su1c1de) have you ever thought of killing yourself?
Yes but didn't do it
No, I would never
Yes, I've tried
How would you try to prevent your mental illness from acting up ?
Lastly, this survey is anonymous. if you would like to share any of your feelings you could do it. Your wards will not be published
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