PHQ-9 Depression Screening Calculator

What the PHQ-9 actually measures

Little interest or pleasure in doing things. Feeling down, depressed, or hopeless. Those two items open the questionnaire because, together, they carry the most diagnostic weight — the original validation study required at least one of them to be present before a depressive disorder was even considered.

Kurt Kroenke, Robert Spitzer, and Janet Williams built the PHQ-9 by taking the nine symptom criteria from the DSM-IV definition of major depressive disorder and turning each into a plain-language question. That's unusual for a screening tool. Most depression scales ask about related but non-diagnostic symptoms — loneliness, general distress, low self-esteem — and then need a second step to map a high score onto an actual diagnosis. The PHQ-9 skips that step: the same nine answers that produce your severity score are also, in aggregate, the criteria a clinician would use to consider one.

None of that makes it a diagnostic instrument on its own, and it was never meant to be. It's a screener — a fast, standardized way to notice a pattern worth discussing with someone qualified to interpret it.

How the scoring actually works

Each of the nine items gets a score from 0 to 3, depending on how often it applied to you over the past two weeks: not at all, several days, more than half the days, or nearly every day. Add the nine numbers and you get a total between 0 and 27.

Item 9 is the outlier. Because it asks about thoughts of self-harm or being better off dead, the developers treat it as clinically meaningful at any frequency above zero — even 'several days' is worth a closer look, not just 'nearly every day' the way it would be for the other eight items. That's a deliberate design choice, not an inconsistency in the math.

Picture two people who both land on a total of 12. One scored mostly 1s and 2s spread evenly across all nine items — a diffuse, low-grade slog. The other scored zeros everywhere except a 3 on sleep and a 3 on appetite, tied to a recent job loss. Same number, different pictures. The total is a useful summary, not the whole story, which is part of why clinicians ask about which items scored highest, not just how high the sum climbed.

Severity bands, from minimal to severe

Once you have a total, the developers' own scoring guide breaks it into five bands. They aren't arbitrary — each cutoff corresponds to a measurable jump in the likelihood of major depression in the original validation data.

A score of 10 or higher is the single cutoff the original researchers found most useful: in their sample of more than 6,000 primary care and obstetric-gynecology patients, it identified major depression with 88% sensitivity and 88% specificity.

Why an actual questionnaire, not a slider

Search for 'PHQ-9 online' and you'll mostly find two kinds of pages. One is a scanned PDF, meant to be printed and scored by hand with a column of pluses. The other is a clinician-facing calculator — a handful of medical reference sites do the arithmetic for you, aimed at people who already know the instrument and just need the number fast.

What's harder to find is a version built for someone taking it about themselves, for the first time, without a login wall, that also explains the resulting number in plain language instead of clinical shorthand. That's the gap this page tries to close: the real nine items, the real scoring, and an interpretation you don't need a medical degree to read.

Depression rarely travels alone

Anxiety and depression overlap often enough that clinicians routinely screen for both at the same visit. If several of your answers clustered around fatigue, irritability, or trouble concentrating, it's worth also running the GAD-7 anxiety screener — the two instruments were designed as a pair and are frequently read together.

Stress is a related but separate question: is what you're feeling a reaction to current pressure, or something that persists regardless of circumstance? The Perceived Stress Scale asks about that distinction directly, and comparing the two scores can clarify which one is driving the other.

Work exhaustion deserves its own mention, too. Item 4 (tired or low on energy) and item 7 (trouble concentrating) look almost identical to core burnout symptoms, and it's genuinely hard to separate them from a symptom list alone. If work has gotten noticeably harder to bear lately, the burnout assessment covers ground the PHQ-9 doesn't — cynicism, detachment, and the specific kind of exhaustion that comes from a job rather than from mood in general.

Where a self-report score can mislead you

A questionnaire can't see context. Grief looks a lot like depression on paper — low mood, disrupted sleep, poor appetite — and the PHQ-9 doesn't ask whether your symptoms started after a loss. Thyroid problems, chronic pain, certain medications, and sleep disorders can all produce scores in the moderate or even severe range without depression being the underlying cause.

There's also an honesty problem, though it isn't really about honesty. People tend to underreport symptoms they find embarrassing and overreport whatever feels most urgent in the moment. A single score, taken once, is a snapshot with real limits.

Which is exactly why the tool was designed to be repeated. Retaking it every two weeks and watching the trend tells you more than any one number — a five-point drop after starting treatment is generally considered a meaningful clinical response, according to the researchers who built the scale.

Language and culture shape how people answer, too. Someone raised to downplay emotional complaints may under-score genuine symptoms; someone in the middle of a health scare may over-score physical ones like fatigue or appetite that have nothing to do with mood. None of that invalidates the tool — it just means the number works best as a conversation starter, not a verdict read in isolation.

Bringing your score to a conversation

A PHQ-9 result — printed, or just screenshotted from this page — is a useful thing to hand a doctor. It gives them a starting point instead of an open-ended 'how have you been feeling.' Mention which items scored highest, not only the total; two people can land on the same number for very different reasons.

If your score sits at 10 or above, or if item 9 came back anything other than zero, treat that as a reason to talk to someone soon, not as a verdict on its own. If it's under 5, that's reassuring, but a single low score after a hard stretch doesn't make checking in again later pointless. Depression fluctuates. The point of a screener you can retake for free is that you're never limited to one measurement.

This matters just as much on a video call as in an exam room. Telehealth appointments run short, and a clinician who can see your score and your highest-scoring items before you start talking will use that time better than one working from scratch. Keep a note of the date and total each time you retake it — three data points spaced two weeks apart say more than any single visit could.