Mental health clinicians use these same 9 questions every day - and you can score yourself with the same tool right now. The PHQ-9 takes under 3 minutes to complete. Here is how to do it accurately and actually understand what your number means.
Most online depression quizzes end the same way: a vague label and a suggestion to "see someone." That is not useful. Walk through every question here, score yourself accurately, and leave with a concrete next step tied to your actual result.
The PHQ-9 (Patient Health Questionnaire-9) was developed with support from Pfizer Inc. and is now in the public domain. According to Pfizer's grant of rights, clinicians and individuals may use it freely. It is one of the most widely validated depression screening tools in the world.
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What the PHQ-9 Actually Measures
The PHQ-9 screens for Major Depressive Disorder (MDD). The American Psychiatric Association's DSM-5 defines MDD using nine core symptom clusters, and the PHQ-9 maps directly onto all nine. That alignment is not a coincidence - it was designed that way.
Knowing this structure helps you answer each question honestly. These are not questions about whether you feel sad. They ask whether specific, clinically defined symptoms have been present over the past two weeks.
Before You Begin: The 2-Week Rule
Every question asks about the past two weeks - not your worst day ever, not last month, not how you feel right now in this moment. The 2-week window is essential to the tool's accuracy. Keep this in mind as you read each question below.
Step-by-Step: All 9 PHQ-9 Questions Explained
Each question uses the same four-point frequency scale:
| Score | Frequency |
|---|---|
| 0 | Not at all |
| 1 | Several days |
| 2 | More than half the days |
| 3 | Nearly every day |
Read each question and choose the number that best reflects your experience over the last 14 days. Write your score down as you go. You will add them up at the end.
Question 1: Little interest or pleasure in doing things
This screens for anhedonia - the loss of enjoyment or motivation. Anhedonia is one of the two core symptoms of MDD according to DSM-5 criteria. Notice it does not ask whether you feel sad. You might feel completely numb or simply flat. That counts.
Ask yourself: Have activities you normally enjoy felt hollow or unappealing? Did hobbies, socializing, or even eating feel pointless?
Question 2: Feeling down, depressed, or hopeless
This is the second core symptom - depressed mood. "Hopeless" is an important word here. Hopelessness is a distinct feature that often predicts severity. If most days felt gray, heavy, or like things would never improve, score this honestly.
Question 3: Trouble falling or staying asleep, or sleeping too much
This screens for sleep disturbance, which includes both insomnia and hypersomnia. Depression can push sleep in either direction. Some people cannot sleep. Others sleep 12 hours and still feel exhausted. Both patterns are clinically relevant.
Question 4: Feeling tired or having little energy
This targets fatigue and energy loss - distinct from simple sleepiness. You might sleep 8 hours and still feel like moving through sand. Simple tasks - cooking, replying to a text, getting dressed - may feel disproportionately draining.
Question 5: Poor appetite or overeating
This screens for appetite and weight changes. Like sleep, appetite disturbance can go either way. Depression suppresses appetite in some people and drives emotional eating in others. Both patterns qualify. Think about your actual eating behavior over the past two weeks, not your ideal or average.
Question 6: Feeling bad about yourself - or that you are a failure or have let yourself or your family down
This screens for feelings of worthlessness or excessive guilt. The DSM-5 distinguishes between healthy self-reflection and pathological guilt. If you found yourself ruminating on past mistakes, feeling like a burden, or concluding you are fundamentally inadequate, this question applies to you.
Question 7: Trouble concentrating on things, such as reading the newspaper or watching television
This targets cognitive dysfunction. The examples in the question are intentionally low-effort tasks. If you cannot follow a TV show or retain what you just read, that is a meaningful cognitive symptom. Many people dismiss this as stress. In the context of the other questions, it matters.
Question 8: Moving or speaking so slowly that other people could have noticed - or the opposite, being so fidgety or restless that you have been moving around more than usual
This is psychomotor change - one of the most misunderstood questions. It is not asking if you feel slow emotionally. It is asking about observable physical changes. Has anyone commented that you seem sluggish? Have you felt physically agitated, pacing, unable to sit still? Either direction counts.
Question 9: Thoughts that you would be better off dead or of hurting yourself in some way
This screens for suicidal ideation - covered in full detail below. For now, answer it honestly. A score above zero here does not automatically mean you are in crisis. Read the dedicated section before drawing any conclusions.
Understanding Question 9: Suicidal Ideation
Question 9 makes many people uncomfortable. Some skip it. That is a mistake. Here is what a positive response actually means - and what it does not mean.
What a positive response means
Answering "several days" or higher on Question 9 means these thoughts have been present. It is a signal worth taking seriously. It does not mean you are about to act. It does not mean you are broken. It means you should talk to someone who is trained to help.
What a positive response does not mean
Passive thoughts - like "I wish I wasn't here" or "everyone would be fine without me" - are different from active plans or intent. The PHQ-9 does not distinguish between passive and active ideation. A trained provider can. That is exactly why a positive response on Question 9 should prompt a conversation, not panic.
What to do if you scored above 0 on Question 9
- If you are in immediate distress: Call or text 988 (Suicide and Crisis Lifeline) right now. You can also call the SAMHSA National Helpline at 1-800-662-4357, available 24/7, free, and confidential.
- If you are not in immediate danger: Schedule an appointment with a mental health provider and mention that Question 9 was positive. Use those exact words. It communicates urgency without dramatizing.
- If you are unsure: Call 988. The counselors are trained for exactly this kind of uncertainty.
How to Score Your PHQ-9
Add up your scores from all 9 questions. The minimum possible is 0; the maximum is 27.
| Total Score | Severity Level | Typical Clinical Response |
|---|---|---|
| 0 - 4 | Minimal | Self-monitoring, general wellness check |
| 5 - 9 | Mild | Watchful waiting, counseling may be suggested |
| 10 - 14 | Moderate | Clinical referral typically recommended |
| 15 - 19 | Moderately Severe | Active treatment planning, medication often discussed |
| 20 - 27 | Severe | Immediate clinical attention strongly recommended |
According to the American Psychiatric Association, these bands align with diagnostic thresholds used in formal clinical intake. A score of 10 or higher - with symptoms present for at least two weeks - often meets the screening threshold for further evaluation for MDD.
Step 4: Match Your Score to a Concrete Next Step
Most online tools stop at the label. Here is exactly what to do based on your score.
Score 0-4: Minimal - Self-Care Monitoring
Your score suggests minimal depression symptoms right now. That is good news. The recommended next step is self-monitoring.
- Retake the PHQ-9 in two to four weeks.
- Log your score with the date. A trend matters more than a single result.
- Prioritize sleep, movement, and social connection - these are the most evidence-supported self-care pillars.
- If your score climbs above 5 on a future test, move to the next category.
Score 5-9: Mild - Watchful Waiting or Counseling
Mild scores often indicate early-stage or situational depression. Many people at this level benefit from structured support before symptoms worsen.
- Consider talking to a counselor, therapist, or your primary care physician.
- Open Path Collective offers therapy sessions at reduced cost (often $30-$80 per session) for people who cannot afford standard rates. Visit their website to search by location and specialty.
- Retest in two weeks. If your score holds at 5 or above across two readings, a clinical conversation is worth having.
- Employee Assistance Programs (EAPs) at many workplaces include free therapy sessions - check your benefits portal.
Score 10+: Moderate to Severe - Structured Clinical Referral
A score of 10 or higher means a clinical evaluation is strongly recommended. This is not a judgment. It is a signal that your symptoms have reached a level where professional support can make a real difference.
Here are your concrete options:
- SAMHSA Treatment Locator: Visit findtreatment.gov or call the SAMHSA National Helpline at 1-800-662-4357. This service is free, confidential, and available 24 hours a day. According to SAMHSA, it connects callers to local treatment facilities, support groups, and community-based organizations.
- Community Mental Health Centers: Most counties operate sliding-scale mental health clinics. Search "[your county] community mental health center" to find one near you.
- Open Path Collective: A network of therapists offering reduced-cost sessions. Membership is a one-time small fee, after which you access therapists at significantly below market rates.
- Your primary care physician: Many PCPs can prescribe antidepressants and provide referrals. If you have a doctor, start there. Bring your PHQ-9 score.
- Telehealth platforms: Services like community health telehealth options have expanded access significantly. Ask your insurance provider what is covered.
If your score is 20 or above, please reach out to a provider this week - not next month. Severe scores reflect significant suffering, and effective treatment exists.
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Common Mistake: The "Worst Day" Error
This is the single most common scoring mistake. People answer the PHQ-9 based on their worst recent day, not the two-week average the tool specifically asks for.
The reason this matters: everyone has bad days. A brutal Monday after poor sleep and a stressful event might score a 15 on its own, but if the other 13 days sat around a 5, your true two-week score is much lower.
The PHQ-9 asks about frequency - how many days in the past two weeks did this symptom appear? "Nearly every day" means exactly that. Not "on my worst day."
Answering based on your worst day inflates your score and can cause unnecessary alarm. It may point you toward a higher level of care than your actual pattern warrants - wasting limited mental health resources and adding anxiety of its own.
To score accurately, mentally scan the past 14 days as a whole. Think in terms of days out of fourteen. If a symptom appeared on three or four days, that is "several days." If it was present on nine or ten days, that is "more than half."
Other Mistakes to Avoid
- Skipping Question 9: Understandable but counterproductive. Question 9 carries clinical weight. Skipping it gives you an incomplete picture and may cause you to underestimate your score's meaning.
- Treating the score as a diagnosis: The PHQ-9 is a screening tool, not a diagnostic test. A score of 12 does not mean you have MDD. It means you should talk to someone who can make that determination properly.
- Taking the test during an acute crisis: If you just experienced a loss, ended a relationship, or had a severe panic attack, wait 48 hours before completing the PHQ-9. Acute distress can temporarily inflate scores in ways that do not reflect your general pattern.
- Not recording your score: Write it down. Log the date. This is especially important if you plan to track changes over time.
- Ignoring a score under 5: A minimal score with a specific "1" on Question 9 still warrants attention. Look at the profile of your answers, not just the total.
Who the PHQ-9 Is For
The PHQ-9 is validated for adults aged 18 and older, and is widely used in primary care settings, mental health clinics, and research studies. According to Pfizer Inc., the PHQ-9 is part of the broader Patient Health Questionnaire family and is freely available for clinical and research use.
It is commonly used with adults experiencing depressive symptoms, people with chronic illness (where depression is often co-occurring), patients in substance use treatment programs, and anyone seeking a baseline before starting therapy. The PHQ-9 is not designed for acute psychiatric emergencies. If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room.
How This Tool Relates to a Real Diagnosis
A PHQ-9 score is a starting point - not an endpoint. The DSM-5 criteria for Major Depressive Disorder, published by the American Psychiatric Association, require that symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning. A score alone cannot measure impairment. Only a licensed clinician can do that through a full clinical interview.
What the PHQ-9 does is narrow the window. It tells you - and your provider - whether depressive symptoms are likely present and roughly how severe they are, making clinical conversations more efficient and more precise.
Think of it like a blood pressure reading. A high reading means you should see a doctor. It does not mean you have heart disease. The PHQ-9 works the same way.
Frequently Asked Questions
Can I retake the PHQ-9 every week to track my depression over time?
Yes - and this is one of the PHQ-9's most underused strengths. The tool is validated as a longitudinal monitoring instrument, not just a one-time screen. Clinicians routinely use it to track treatment progress at every visit. A change of 5 points or more in either direction is considered clinically meaningful. To get the most from it, log each result with the date - a simple note or spreadsheet works fine. Tracking over 4 to 8 weeks gives you a trend line that is far more informative than any single score. If your score is rising week over week, that is a signal to seek support sooner rather than later.
My score came back "moderate" but I feel fine most days - should I be worried?
Not necessarily - but do not dismiss it either. The PHQ-9 measures the past two weeks as a whole, and depression is episodic by nature. You might feel okay today while still having had enough symptomatic days in the recent window to score in the moderate range. A moderate score reflects a pattern, not a permanent state or a definitive diagnosis. The right move is to bring the result to a provider and discuss it. They can explore whether the score reflects a genuine depressive episode, a temporary stressor response, or something else entirely. Dismissing a moderate score without that conversation is not recommended.
Is the PHQ-9 accurate for teenagers, or is there a different version I should use?
The PHQ-9 is used in practice with adolescents aged 12 and older, and research supports its reliability in that age range. However, the PHQ-A (Adolescent version) exists specifically for teens and uses language and examples more relevant to their experience - such as school performance instead of work. The PHQ-A is freely available through the same Pfizer public domain grant as the original PHQ-9. For teenagers under 16, parental or guardian involvement is generally recommended both for accessing results and for follow-up care. Clinicians working with adolescents should be familiar with both versions and can advise on which is appropriate.
Does taking antidepressants affect my PHQ-9 score?
Yes, and that is intentional. If you are on medication, your PHQ-9 score reflects your current symptom level - not your baseline before treatment. This is actually how clinicians use the tool to evaluate whether a treatment is working. If you scored 18 before starting medication and score 8 after six weeks, that 10-point drop shows meaningful improvement. If you are currently on medication and scoring your PHQ-9 for the first time, note that on your log. Share it with your prescriber so they can interpret the result in the context of your treatment history.
Can the PHQ-9 be used if I think I have anxiety, not depression?
The PHQ-9 screens specifically for depressive symptoms aligned with DSM-5 MDD criteria. It does not screen for anxiety disorders directly. However, depression and anxiety frequently co-occur - many people experience both. If you are concerned about anxiety specifically, a companion tool called the GAD-7 (Generalized Anxiety Disorder 7-item scale) screens for anxiety in the same format. Many providers administer both together during intake. If your PHQ-9 score is low but you still feel something is off, mention anxiety symptoms explicitly to your provider. The PHQ-9 result does not rule out anxiety.
Where to Go From Here
You now have a score, a severity label, and a concrete next step. That is more than most people get from an online tool.
A few reminders before you close this page:
- Write down your score and today's date.
- If your score is 10 or above, take action this week - not someday.
- If Question 9 was positive at any level, talk to someone. The SAMHSA National Helpline (1-800-662-4357) is free and available right now.
- If your score is under 5, retake the PHQ-9 in a few weeks to track any changes.
- No score - high or low - replaces a real conversation with a clinician who knows you.
The PHQ-9 was designed to bridge the gap between how people actually feel and what gets communicated in a clinical setting. Now you have the vocabulary to bridge that gap yourself.
For more information on finding the right support, see our guides on how to find a therapist and depression treatment options. If cost is a barrier, read our overview of low-cost mental health resources by state.
Researched and written by Robert Williams at depression tests. Our editorial team reviews depression tests to help readers make informed decisions. About our editorial process.