Do You Have Derealization/Depersonalization

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Derealization is a mental disturbance where the body feels detached from the brain. People often feel as though there surroundings are not real and can possibly be a dream or fake. They have trouble with doing everything day things and usually can also have anxiety.

Depersonalization is when the person feels as though them-self as a human is not real. They feel they are not in control of what they do and often have a hard time not think about reality and whats not.

Created by: toxicatedkilljoy
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1. What is your age?
Under 18 Years Old
18 to 24 Years Old
25 to 30 Years Old
31 to 40 Years Old
41 to 50 Years Old
51 to 60 Years Old
Over 60 Years Old
2. What is your gender?
Male
Female
3. Do you ever feel as if your surroundings aren't real?
Yes
No
Sometimes
Rarly
4. Do ever feel that you're not in controls of you emotions?
Yes
No
Sometimes
Rarly
5. Have you been diagnosed with anxiety (or have had a pass with anxiety) and do drugs, drink alcohol, or have been evolved in a major incident leading to stress and/or depression?
Yes
No
6. Do you feel in control of your actions? (Physically)
Yes
No
Sometimes
Rarly
7. Do you have a good memory? (Even of the simplest things?)
Yes
No
It's okay
Depends on what is priority or not needed to me
Only for common sense kinds of things
Only for complicated things/survival deeds
8. On a scale of 1-10, how often do you have nightmares?
1-3
4-6
7-10
Above Average
0
9. How often do you feel that you do not really exist at a certain moment?
Too often
Average
Never
Rarly
Sometimes
If I am alone/bored
10. How often does your thoughts go foggy and/or vision?
Often
Sometimes
Rarly
If I'm thinking-deeply
Never
11. Can you separate reality and what is not?
Yes
No
I can but it's difficult
12. Do you feel as if your mind is disconnected from your body?
Yes
No
Sometimes
13. Do you lose track of time often? (Days, weeks, hours)
Yes
No
Sometimes

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