How are you feeling right now? (Select all that apply) *

Overwhelmed, like I can't catch up

On edge, waiting for something bad to happen

Heavy, flat, numb

Irritable, snapping at people

Can't turn my brain off at night

Avoiding things I used to enjoy

When does it feel worst? (Choose one) *

In the middle of the night, when I'm alone with my thoughts

Around certain people (family, partner, colleagues)

Before deadlines or high-pressure situations

In social situations

When I have nothing to distract myself

Honestly? All the time

What do you usually do when it hits? (Select all that apply)

Scroll my phone until I'm exhausted

Try to "think positive" and push through

Snap at someone and feel guilty later

Drink/eat/smoke to take the edge off

Freeze – just wait for it to pass

Talk to someone I trust

 If you're honest, what do you need most right now? *

Permission to rest without guilt

Someone to tell me I'm not crazy

Practical tools that actually work

To understand WHY I feel this way

To feel less alone

I don't even know anymore

Full Name *

Phone *

Email *

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