What Is the PHQ-9?
The PHQ-9 (Patient Health Questionnaire-9) is one of the most widely used depression screening tools worldwide. Based on DSM-5 diagnostic criteria for major depressive disorder, it uses 9 questions to assess depressive symptoms over the past two weeks.
What the 9 Questions Measure
Each PHQ-9 item corresponds to a core symptom of depression:
- Anhedonia: Little interest or pleasure in doing things
- Depressed mood: Feeling down, depressed, or hopeless
- Sleep disturbance: Trouble falling/staying asleep or sleeping too much
- Fatigue: Feeling tired or having little energy
- Appetite changes: Poor appetite or overeating
- Low self-worth: Feeling bad about yourself — or that you are a failure or have let yourself or your family down
- Concentration difficulty: Trouble concentrating on things, such as reading or watching television
- Psychomotor changes: Moving or speaking so slowly that others could notice — or being fidgety/restless
- Self-harm thoughts: Thoughts that you would be better off dead or of hurting yourself in some way
How PHQ-9 Is Scored
Each item is scored based on frequency over the past two weeks:
- 0 = Not at all
- 1 = Several days
- 2 = More than half the days
- 3 = Nearly every day
Score Interpretation
| Total Score | Severity | Recommended Action |
|---|---|---|
| 0-4 | None/Minimal | Maintain a healthy lifestyle |
| 5-9 | Mild | Monitor your mood; consider exercise, social connection, and mindfulness |
| 10-14 | Moderate | Consider consulting a counselor or psychologist |
| 15-19 | Moderately Severe | Strongly recommend seeking professional help; medication may be warranted |
| 20-27 | Severe | Contact a mental health professional immediately or call a crisis line |
Special Attention: Item 9
Item 9 (thoughts of self-harm or suicide) deserves special attention regardless of the total score. If you scored 1 or higher on this item:
- Occasional passive thoughts: Tell family or a trusted friend; schedule a mental health appointment
- Specific plans or means: Call a crisis hotline immediately (in the U.S.: 988 Suicide & Crisis Lifeline; UK: 111 option 2; Australia: 13 11 14)
- If you feel unable to keep yourself safe: Go directly to the nearest emergency room
You don't have to go through this alone. Reaching out is an act of courage.
Depression Is Not Just "Feeling Sad"
Many people mistakenly think depression is "overthinking" or "not being strong enough." In reality, depression is a condition with clear biological underpinnings involving dysregulation of serotonin, norepinephrine, and dopamine neurotransmitter systems.
Depression is not a character flaw, and it cannot be overcome simply by "thinking positive."
Beyond the PHQ-9
PHQ-9 is a screening tool, not a diagnostic instrument. A high score doesn't guarantee a depression diagnosis, nor does a low score rule one out. Diagnosing depression requires comprehensive evaluation by a psychiatrist or clinical psychologist.
Additional factors to consider:
- Duration of symptoms (typically at least 2 weeks)
- Degree of functional impairment
- History of manic episodes (to rule out bipolar disorder)
- Medical conditions or medications that could mimic depression
Next Steps
Complete our online PHQ-9 depression screening for immediate feedback. Remember: this is informational only, not medical advice.