Depression Questions.

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1. How old were you when you started self-harming?

• Younger than 4
• 4-5
• 6-7
• 8-9
• 10-11
• 12-13
• 14-15
• 15-16
• 16-17
• 18-19
• 20-21
• Older than 21

2. How often do you self-harm?

• More than once a day
• Once a day
• Several times a week
• Once a week
• Two or more times a month
• Once a month
• Several times in a year
• Once a year
• I have stopped
• I am trying to stop

3. What method of self-harm do/did you primarily use?

• Cutting
• Burning
• Hair-pulling

• Scratching
• Interference with the healing of wounds
• Hitting or bruising
• Bone breaking
• Cutting and scratching
• Cutting and Burning
• Hitting Head against walls 
• Binging
• Purging
• Starving
• Other

4. If You Self Harm What ual Orientation Are You?

• Straight Male
• Straight Female
• Biual Male
• Biual Female
• Homoual Male
• Homoual Female
• Transgender Male
• Transgender Female
• Questioning Male
• Questioning Female
• Panual Male
• Panual Female
• Prefer not to answer

5. Which Of These, If Any, Are Something You Struggle With Along With Self-harm?

• Anorexia
• Bulimia
• Anorexia and Bulimia
• EDNOS
• Suicidal Ideas
• Various Psychiatric Disorders
• Learning Disabilities
• None of the Above
• Other

6. Do You Think That You (as An Individual) Need Professional Help To Stop Self-harming?

• Yes, the only way I could stop is with professional Help
• No, I have stopped on my own
• No, I Have Stopped On My Own Though I Still Struggle Often And Sometimes Mess Up
• I Have No Desire To Stop And Therefore Don’t Need Professional Help
• Yes, I Have Stopped With Professional Help
• I don’t think I could ever stop with or without Professional help
• Prefer not to answer
• Not sure. 
• No, And I Don’t Want To Stop.
• No, But I Would Like To Be Able To Stop.
• Yes, But I Am Not Doing Very Well.
• I Have Stopped But I Still Mess Up Every Once In A While.
• I Am Completely Self Harm free

8. Does Anyone Know About Your Self Harm?

• No. No One Knows.
• Some People May Have A Vague Idea Of Something
• Yes, But Only My Closest Friend
• Yes. But Only Some Of My Family Member(s)

• Yes, Some Friend(s) And Family Member(s) Know
• Yes, All (or Most Of) My Friends Know
• Yes, All (or Most Of) My Family Knows
• Yes, Most Of The People In My Life Know
• Who ever sees this post

9. How many years have/had you been self-harming?

• 1 or less years
• 2 years
• 3 years
• 4 years
• 5 years
• 6 years
• 7 years
• 8 years
• 9 years
• 10 or more years

10. If You Self-harm, Were You Abused Or Neglected (either As A Child Or Later In Life)?

• No
• Yes, I Was Emotionally Abused
• Yes, I Was Physically Abused
• Yes, I Was ually Abused
• Yes, I Was Emotionally And Physically Abused
• Yes, I Was Physically And ually Abused
• Yes, I Was ually And Emotionally Abused

• Yes, I Was Emotionally, Psysically And ually Abused
• Yes, I Was Neglected
• Yes, I Was Neglected As Well As Being Abused

11. Were you ever bullied?

• Yes, since before I was 8. I am still bullied.
• Yes, since before I was 8. It has stopped since then.
• Yes, starting when I was 9 or 10. I am still bullied.
• Yes, starting when I was 9 or 10. It has stopped since then.
• Yes. It started when I was 11-14 years old. I am still bullied.
• Yes. It started when I was 11-14 years old.
• Yes. It started when I was older than 14. I am still bullied.
• Yes. It started when I was older than 14. It has stopped since then.
• No. I do taunt, tease, exclude, target, or mock others on occasion, however.
• No. I see others getting bullied and don’t do anything.
• No. I don’t get bullied and I stand up for those who do.
• No. I never see bullying. 
• Other.

12. Would you label yourself as emo?

• Yes
• No

13. Do others label you as emo?

• Yes
• No
• Some People

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14. What would you or others label you as? (chose all that apply)

• Prep
• Goth
• Emo
• Punk
• Nerd
• Hipster
• Poser
• Skater
• Jock
• Scene
• Gangster 
• Other
• I don't do labels
• There aren’t really any labels above that fit me
• Normal

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15. What is your reaction when you see other people’s self-harm scars/cuts/marks? (choose all that apply)

• I want to get to know them
• I wonder what they went through to feel that was a way out
• I want to get as far as possible from them so no one will find out about my own self-harm
• I will acknowledge them as someone who shares something in common with me
• I would never even acknowledge them
• Fear
• Interest
• Sadness
• Happiness
• Don’t really care
• No reaction
• Surprise
• Relief
• Jealousy