Mental Disorder/Illness Survey

What mental disorder do you suffer from?

Please select all that apply.

• Depression
• Anxiety (all types: GAD, Social Anxiety, Agoraphobia, Phobias, Obsessive-Compulsive Disorder, Panic Attacks, Post-Traumatic etc)
• Bipolar Disorder
• Asperger's Syndrome-Autism
• Anorexia Nervosa or other eating disorders
• Schizophrenia
• Addiction Disorder
• Dissociative Disorder (e.g Depersonalisation)
• Somatic symptom disorders
• Other.
• I may have one or some of these or other but it's not officially diagnosed.

How long have you been struggling with your disorder?

• 1-5 years
• 5-10 years
• 10+ years
• Other

Have you sought professional help?

• Yes,I have a psychiatrist/psychologist.
• Yes, I've talked to the school nurse.
• No.
• Other.

To what degree does your disorder interfere with your life?

• Severe.
• Mild.
• Little.
• Zero degree.
• It has aggravated/lessened.

Has your disorder brought about other types of disorder such as depression?

• Yes, it has caused other disorders too.
• Yes, but it's a mild case.
• No.
• Other.

Has your disorder caused you such pain that you considered/done:

Please select all that apply.

• Self harm.
• Suicide.
• Harming others.
• Other.
• No.

Are you receiving medical treatment?

• Yes, I take medications.
• Yes (other).
• No.
• Other.

Are the symptoms of your disorder:

• Physical.
• Mental.
• Both.
• Other.

Have you talked to anyone about your disorder?

Please select all that apply.

• Only my psychiatrist.
• My parents.
• My friends.
• Other.

Do you feel you can sometime be cured entirely?

• Yes, there is hope :)
• Probably it can be lessened but not eradicated.
• No, I don't think so.
• No, because this disorder cannot be cured.
• Other.

Remember to stay strong and see the bright side. And realize that you're not alone :) Did you like this survey?

• Yes, it was great.
• I like it because I could express myself and feel better.
• It was okay.
• Not really.
• Other.