PHQ-9 Depression Screening Calculator
A clinically validated screening tool used by healthcare professionals worldwide to assess the presence and severity of depressive symptoms. Based on DSM-5 diagnostic criteria.
Last Updated: February 2026
About the PHQ-9 Assessment
The Patient Health Questionnaire-9 (PHQ-9) is one of the most widely used and validated depression screening instruments in the world. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, and Kurt Kroenke in 1999, it is used by primary care physicians, psychiatrists, psychologists, and other healthcare providers to:
- Screen for the presence of depressive symptoms
- Assess the severity of depression
- Monitor treatment response over time
- Guide clinical decision-making
📋 What This Screening Measures
The PHQ-9 evaluates nine symptoms that correspond directly to the diagnostic criteria for Major Depressive Disorder as defined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). These symptoms include changes in mood, sleep, appetite, energy, concentration, and thoughts about self-worth or self-harm.
⚠️ Important Disclaimer
This is a screening tool, NOT a diagnostic instrument. Only a qualified healthcare professional (physician, psychiatrist, psychologist, or licensed counselor) can diagnose depression. A high score indicates that you should speak with a mental health professional for proper evaluation and personalized treatment recommendations.
PHQ-9 Depression Screening Questionnaire
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Understanding PHQ-9 Scores
The PHQ-9 score is calculated by adding together the responses to all nine questions. Each question is scored 0-3, giving a total score range of 0-27. Healthcare providers use these score ranges to guide clinical decisions:
What is Depression?
Major Depressive Disorder (MDD), commonly called depression, is a serious mental health condition that affects how you feel, think, and handle daily activities. It's much more than feeling sad or going through a rough patch—depression is a medical illness that requires understanding and treatment.
Depression by the Numbers
Depression is one of the leading causes of disability worldwide and a major contributor to the overall global burden of disease. However, with proper diagnosis and treatment, the vast majority of people with depression can achieve significant improvement.
Key Facts About Depression
- It's a medical condition, not a character flaw. Depression involves changes in brain chemistry, structure, and function.
- It's treatable. Effective treatments include therapy, medication, lifestyle changes, and combinations of these.
- It can affect anyone. Depression doesn't discriminate by age, gender, race, or socioeconomic status.
- It's not "just sadness." Depression is persistent, affecting multiple aspects of life for weeks, months, or years without treatment.
- Recovery is possible. Most people who receive appropriate treatment experience significant improvement.
Sources: World Health Organization (WHO), National Institute of Mental Health (NIMH), American Psychiatric Association (APA)
Recognizing Depression Symptoms
Depression symptoms can vary from person to person, but generally fall into four categories: emotional, physical, cognitive, and behavioral. To be diagnosed with Major Depressive Disorder, symptoms must be present for at least two weeks and represent a change from previous functioning.
😔 Emotional Symptoms
- Persistent sad, anxious, or "empty" mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities (anhedonia)
- Irritability or frustration
- Feelings of numbness or emotional "flatness"
🛏️ Physical Symptoms
- Fatigue or decreased energy
- Sleep changes (insomnia or oversleeping)
- Appetite changes (significant weight loss or gain)
- Unexplained aches, pains, headaches, or cramps
- Digestive problems without clear cause
- Psychomotor changes (moving/speaking slowly or restlessness)
🧠 Cognitive Symptoms
- Difficulty concentrating or focusing
- Trouble making decisions
- Memory problems
- Negative, self-critical thoughts
- Rumination (repetitive negative thinking)
- Thoughts of death or suicide
🚶 Behavioral Symptoms
- Withdrawing from friends and family
- Neglecting responsibilities
- Decreased productivity at work/school
- Giving up activities once enjoyed
- Neglecting personal hygiene
- Increased use of alcohol or drugs
🚨 When to Seek Immediate Help
Seek immediate help if you or someone you know is experiencing:
- Thoughts of suicide or self-harm
- Making plans or acquiring means to end life
- Giving away possessions or saying goodbye
- Talking about being a burden to others
- Sudden calmness after a period of severe depression
Call 988 (Suicide & Crisis Lifeline), go to your nearest emergency room, or call 911.
What Causes Depression?
Depression doesn't have a single cause. Research shows it results from a complex interaction of genetic, biological, environmental, and psychological factors. Understanding these factors can help reduce stigma and inform treatment approaches.
🧬 Biological Factors
- Brain chemistry: Imbalances in neurotransmitters (serotonin, norepinephrine, dopamine) affect mood regulation
- Brain structure: Research shows differences in certain brain regions in people with depression
- Genetics: Having a first-degree relative with depression increases risk 2-3x. However, genes aren't destiny—environment matters too
- Hormonal changes: Thyroid problems, menopause, pregnancy, and postpartum changes can trigger depression
- Medical conditions: Chronic illness, pain, cancer, diabetes, and heart disease increase depression risk
🌍 Environmental Factors
- Trauma: Physical, emotional, or sexual abuse, especially in childhood
- Major life stress: Job loss, divorce, financial problems, death of loved one
- Social isolation: Lack of supportive relationships and community
- Substance abuse: Alcohol and drug use can cause or worsen depression
- Certain medications: Some blood pressure meds, sleeping pills, steroids
🧠 Psychological Factors
- Personality traits: Low self-esteem, pessimism, perfectionism, self-criticism
- Thinking patterns: Negative cognitive patterns, rumination, catastrophizing
- Coping styles: Avoidance, suppression, or unhealthy coping mechanisms
- Early life experiences: Childhood neglect, inconsistent caregiving, early loss
Risk Factors for Depression
Certain factors increase the likelihood of developing depression:
- Personal or family history of depression
- Major life changes, trauma, or chronic stress
- Certain physical illnesses (chronic pain, cancer, stroke, etc.)
- Certain medications
- Alcohol or substance use disorders
- Being female (women are about twice as likely to develop depression)
- Social isolation or lack of support
Sources: National Institute of Mental Health, American Psychiatric Association, Harvard Medical School
Treatment Options for Depression
Depression is highly treatable. According to the American Psychiatric Association, 80-90% of people with depression eventually respond well to treatment. Most people achieve significant improvement and can resume their normal activities.
🗣️ Psychotherapy (Talk Therapy)
Psychotherapy is highly effective for depression, especially mild to moderate cases. It can be used alone or combined with medication.
💊 Medication
Antidepressant medications are often effective, especially for moderate to severe depression. They work by affecting brain chemicals (neurotransmitters) involved in mood regulation.
- SSRIs (Selective Serotonin Reuptake Inhibitors): Most commonly prescribed. Examples: Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Celexa (citalopram)
- SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Examples: Effexor (venlafaxine), Cymbalta (duloxetine), Pristiq (desvenlafaxine)
- Atypical Antidepressants: Wellbutrin (bupropion), Remeron (mirtazapine)
- Tricyclic Antidepressants (TCAs): Older medications, still effective but more side effects
- MAOIs: Usually prescribed when other medications haven't worked
Important: Antidepressants typically take 2-6 weeks to show full effect. Never stop taking medication suddenly without consulting your doctor. Work with your healthcare provider to find the right medication and dosage for you.
🌿 Lifestyle Changes & Self-Care
Lifestyle modifications can significantly support depression treatment and recovery:
- Regular Exercise: Studies show exercise can be as effective as medication for mild-moderate depression. Aim for 30 minutes most days.
- Sleep Hygiene: Maintain consistent sleep schedule. Aim for 7-9 hours per night.
- Nutrition: A healthy diet (Mediterranean diet has shown benefits) supports brain health.
- Social Connection: Maintain relationships and social activities, even when you don't feel like it.
- Limit Alcohol: Alcohol is a depressant and can worsen symptoms.
- Mindfulness & Meditation: Practices like MBCT (Mindfulness-Based Cognitive Therapy) can prevent relapse.
- Stress Management: Learn healthy coping strategies for stress.
⚡ Other Treatments
For treatment-resistant depression or severe cases:
- Electroconvulsive Therapy (ECT): Highly effective for severe, treatment-resistant depression. Modern ECT is safe and effective.
- Transcranial Magnetic Stimulation (TMS): Non-invasive brain stimulation. FDA-approved for treatment-resistant depression.
- Ketamine/Esketamine: Newer treatments showing rapid effects for treatment-resistant cases. Spravato (esketamine) is FDA-approved.
- Vagus Nerve Stimulation (VNS): Implanted device for treatment-resistant cases.
Sources: American Psychiatric Association Practice Guidelines, NIMH, Mayo Clinic
About the PHQ-9 Assessment
Development and Validation
The PHQ-9 was developed as part of the PRIME-MD (Primary Care Evaluation of Mental Disorders) diagnostic instrument. It was specifically designed as a brief, self-administered tool that could be used in busy clinical settings.
Key validation studies:
- Kroenke et al. (2001): Original validation study in primary care settings found excellent diagnostic performance
- Sensitivity: 88% (correctly identifies 88% of people with depression)
- Specificity: 88% (correctly identifies 88% of people without depression)
- Validated across diverse populations, age groups, and clinical settings
- Available in over 80 languages
Clinical Use of the PHQ-9
Healthcare providers use the PHQ-9 for multiple purposes:
- Screening: Identifying individuals who may have depression
- Severity Assessment: Determining how severe symptoms are
- Treatment Monitoring: Tracking symptom changes over time
- Research: Standardized measure for clinical trials
📊 Scoring Methodology
Each of the 9 questions is scored 0-3:
- 0 = Not at all (0 days)
- 1 = Several days (1-6 days in 2 weeks)
- 2 = More than half the days (7-11 days)
- 3 = Nearly every day (12-14 days)
Total scores range from 0-27. A score of 10 or higher has been identified as the optimal cutpoint for detecting Major Depressive Disorder.
Limitations
While the PHQ-9 is an excellent screening tool, it's important to understand its limitations:
- It's a screening tool, not a diagnostic instrument
- Self-reported symptoms may differ from clinical interview findings
- Some medical conditions can cause symptoms that overlap with depression
- Cultural factors may influence how symptoms are reported
- A single administration provides a snapshot; depression symptoms fluctuate
PHQ-9 vs. Other Depression Assessments
| Assessment | Questions | Time | Best For |
|---|---|---|---|
| PHQ-9 | 9 | 2-3 min | Quick screening, treatment monitoring |
| Beck Depression Inventory (BDI-II) | 21 | 5-10 min | Comprehensive assessment, research |
| Hamilton Rating Scale (HAM-D) | 17-21 | 15-20 min | Clinician-administered, clinical trials |
| PHQ-2 | 2 | <1 min | Ultra-brief screening |
Sources: Kroenke K, Spitzer RL, Williams JB. J Gen Intern Med. 2001; Levis B, et al. BMJ. 2019
Frequently Asked Questions
No. The PHQ-9 is a screening tool, not a diagnostic instrument. A high score indicates that you should seek evaluation from a qualified mental health professional who can conduct a comprehensive assessment, rule out other conditions, and make a diagnosis if appropriate. Only a licensed healthcare provider can diagnose Major Depressive Disorder.
This calculator uses the exact same questions and scoring methodology as the clinical PHQ-9 used by healthcare providers. However, self-administered screenings may differ from those administered by a trained professional. Factors like interpretation of questions, current mood, and honesty of responses can affect results. For the most accurate assessment, discuss your results with a healthcare provider.
The PHQ-9 asks about symptoms over the past 2 weeks. If you're monitoring your mental health on your own, you might take it every 2-4 weeks to track changes. If you're in treatment, your healthcare provider may recommend more frequent assessments (weekly or biweekly) to monitor treatment response. A decrease of 5+ points generally indicates clinically significant improvement.
A score of 10 or higher suggests you should speak with a healthcare provider. Here are your options:
- Contact your primary care doctor—they can evaluate depression and provide treatment or referrals
- Find a therapist through Psychology Today or GoodTherapy
- Call SAMHSA's National Helpline: 1-800-662-4357 (free, confidential, 24/7)
- For immediate crisis support, call or text 988
- Consider online therapy options like BetterHelp or Talkspace
No. All calculations happen entirely in your web browser. We do not collect, store, transmit, or share any of your responses or results. Your mental health information remains completely private on your device. We take your privacy seriously, especially for sensitive health information.
Depression is highly treatable, and most people experience significant improvement with appropriate treatment. Many people recover fully and don't experience another episode. However, for some people, depression can be a recurring condition that requires ongoing management—similar to managing diabetes or high blood pressure. With proper treatment and self-care strategies, people with recurring depression can live full, productive lives.
📚 Sources & References
Primary PHQ-9 Research:
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. PubMed
- Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. BMJ. 2019;365:l1476. PubMed
- Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282(18):1737-1744. PubMed
Clinical Guidelines:
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- American Psychiatric Association. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. APA Guidelines
Health Organizations:
- World Health Organization. (2023). Depression Fact Sheet. WHO
- National Institute of Mental Health. (2024). Depression. NIMH
- Mayo Clinic. Depression (major depressive disorder). Mayo Clinic
Last Updated: February 2026
Review Schedule: Quarterly or when new clinical guidelines are published
⚕️ Medical Disclaimer
This PHQ-9 depression screening calculator is provided for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Important points:
- The PHQ-9 is a screening tool, not a diagnostic instrument. Only a qualified healthcare provider can diagnose Major Depressive Disorder or other mental health conditions.
- A high score does not necessarily mean you have depression; a low score does not guarantee you don't. Many factors affect screening results.
- Other medical conditions can cause symptoms similar to depression. A healthcare provider can rule out other causes.
- If you are currently in treatment for depression, continue following your provider's recommendations.
If you are experiencing thoughts of self-harm or suicide:
- Call or text 988 (Suicide & Crisis Lifeline) - available 24/7
- Text HOME to 741741 (Crisis Text Line)
- Go to your nearest emergency room
- Call 911 or your local emergency number
Always seek the advice of your physician, psychiatrist, psychologist, or other qualified mental health provider with any questions you may have regarding depression or any other mental health condition.
Privacy: All calculations are performed in your browser. We do not collect, store, or share any personal health information you enter.