You completed the PHQ-9 questionnaire and scored 15. That number probably feels heavy right now, and I want you to know that taking the time to assess yourself was a courageous step. A PHQ-9 score of 15 falls in the “moderately severe depression” category, and it means you deserve professional support.
This is not a diagnosis. It is a screening result that strongly suggests you should talk to a healthcare provider soon, not eventually.
Understanding PHQ-9 Score Ranges
The Patient Health Questionnaire-9 asks about nine symptoms of depression over the past two weeks. Each symptom is rated from 0 (not at all) to 3 (nearly every day), giving a total score between 0 and 27.
The severity categories are:
- 0 to 4: Minimal depression. Symptoms are few and mild. No treatment typically needed
- 5 to 9: Mild depression. Some symptoms present. Watchful waiting, lifestyle changes, or brief counseling may be appropriate
- 10 to 14: Moderate depression. Clinically significant symptoms. Treatment with therapy, medication, or both is recommended
- 15 to 19: Moderately severe depression. This is where you fall. Active treatment with medication and therapy is strongly recommended
- 20 to 27: Severe depression. Immediate treatment needed. Medication is usually essential, combined with therapy
What a Score of 15 Looks Like in Daily Life
People scoring around 15 on the PHQ-9 typically experience several of these symptoms on most days:
- Feeling down, depressed, or hopeless for much of the day
- Little interest or pleasure in activities you used to enjoy
- Significant changes in sleep, either too much or too little
- Fatigue and low energy that makes even small tasks feel exhausting
- Difficulty concentrating on work, reading, or conversations
- Changes in appetite or weight
- Feelings of worthlessness or excessive guilt
- Moving or speaking noticeably slower, or feeling restless and fidgety
At this severity level, depression is usually interfering with your ability to function at work, maintain relationships, and take care of yourself. You might be getting through each day but it takes everything you have.
Question 9: Thoughts of Self-Harm
The PHQ-9 includes a question about thoughts that you would be better off dead or thoughts of hurting yourself. If you scored 1 or higher on this question, please reach out for help immediately:
- 988 Suicide and Crisis Lifeline: Call or text 988
- Crisis Text Line: Text HOME to 741741
- Emergency services: Call 911 or go to your nearest emergency room
Thoughts of self-harm at any score level require immediate professional attention. You do not need to wait for a PHQ-9 score of 20 to “earn” help.
Recommended Treatment at This Score Level
Clinical guidelines for a PHQ-9 score of 15 to 19 recommend active treatment. This typically involves a combination of approaches:
Psychotherapy
Cognitive Behavioral Therapy (CBT) is the most studied treatment for depression. It helps you identify and change thought patterns that feed depression. Other effective approaches include:
- Behavioral Activation: Focuses on gradually increasing meaningful activities, even when motivation is absent
- Interpersonal Therapy: Addresses relationship difficulties that contribute to or worsen depression
- Acceptance and Commitment Therapy: Helps you engage with life meaningfully even while experiencing painful emotions
Therapy typically meets weekly and shows measurable improvement within 8 to 12 sessions for most people with moderate to moderately severe depression.
Medication
At a score of 15, clinical guidelines suggest medication should be discussed alongside therapy. SSRIs (selective serotonin reuptake inhibitors) are the most commonly prescribed first-line medications:
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
These medications take 4 to 6 weeks to reach full effect. Side effects are usually mild and often resolve within the first two weeks. If the first medication does not help, your doctor can try a different one. Finding the right medication sometimes takes patience.
Lifestyle Interventions
These are not replacements for therapy and medication at this severity level, but they can support your recovery:
- Exercise: 30 minutes of moderate exercise 3 to 5 times per week has evidence comparable to antidepressants for mild to moderate depression. At your severity level, it works best as an add-on to other treatments
- Sleep hygiene: Depression and sleep problems feed each other. Consistent wake times, avoiding screens before bed, and keeping your bedroom cool and dark can help break the cycle
- Social connection: Depression makes you want to isolate. Even small interactions like texting a friend or sitting in a coffee shop can interrupt the isolation spiral
- Reduced alcohol: Alcohol is a depressant. Even moderate drinking can worsen depression symptoms and interfere with medication
What to Expect From Treatment
Most people with moderately severe depression respond well to treatment. Here is a realistic timeline:
- Weeks 1-2: You have started treatment. It may not feel like much is changing yet. Medication side effects may be present but are usually mild
- Weeks 3-4: Subtle improvements in sleep, energy, or appetite may begin. Others might notice changes before you do
- Weeks 6-8: Medication reaches full effect. Therapy skills start becoming more automatic. PHQ-9 scores typically begin dropping
- Months 3-6: Significant improvement for most people. Many see their PHQ-9 drop below 10
- Months 6-12: Continued improvement and consolidation. Relapse prevention becomes a focus of therapy
Treatment is not a straight line. Bad days do not mean treatment is failing. They mean you are still in the process of getting better.
Monitoring Your Progress
Retake the PHQ-9 every 2 to 4 weeks during active treatment. Your provider will likely ask you to complete it at each visit. Track the trend rather than focusing on any single score.
Consider also monitoring your anxiety levels with the GAD-7 anxiety screening, since depression and anxiety frequently co-occur. If both conditions are present, treatment may need to address both.
The DASS-21 assessment can give you a broader picture by measuring depression, anxiety, and stress simultaneously.
Frequently Asked Questions
Is a PHQ-9 score of 15 considered severe?
No, 15 falls in the “moderately severe” range. Severe depression is defined as a score of 20 to 27. However, moderately severe depression still warrants active treatment with therapy and often medication.
Can I treat a PHQ-9 score of 15 without medication?
Some people at this severity level improve with therapy alone, but guidelines recommend at least discussing medication. Therapy combined with medication typically produces better outcomes than either alone at this severity level. The decision should be made collaboratively with your healthcare provider.
How long will I need treatment?
Guidelines recommend continuing antidepressant medication for at least 6 to 12 months after achieving remission. Stopping too early significantly increases relapse risk. The length of therapy varies but typically ranges from 12 to 20 sessions for a first episode of depression.
