PHQ-9 and GAD-7 — The Two Screens Used in Primary Care Every Day
Walk into a primary-care visit anywhere in the United States and there's a good chance you'll be handed a clipboard with two questionnaires: the PHQ-9 (9 questions about depression) and the GAD-7 (7 questions about anxiety). They're the most-administered self-report mental-health instruments in healthcare. They're also free, public-domain, takes about 4 minutes total — and you can take them at home, before the visit, to give yourself and your provider a head start.
What they actually measure
Both ask "over the past 2 weeks, how often have you been bothered by..." with a 4-point scale: not at all (0), several days (1), more than half the days (2), nearly every day (3).
The PHQ-9 covers the 9 DSM criteria for major depressive disorder — anhedonia, depressed mood, sleep problems, fatigue, appetite changes, self-criticism, concentration, psychomotor changes, and thoughts of self-harm. Total range 0–27.
The GAD-7 covers the 7 most common anxiety symptoms — feeling on edge, uncontrolled worry, excessive worry, trouble relaxing, restlessness, irritability, fear of bad outcomes. Total range 0–21.
The score buckets
PHQ-9: - 0–4: minimal - 5–9: mild - 10–14: moderate (the threshold where most clinical guidelines recommend a treatment conversation) - 15–19: moderately severe - 20–27: severe
GAD-7: - 0–4: minimal - 5–9: mild - 10–14: moderate - 15–21: severe
The numbers aren't arbitrary. They come from validation studies in tens of thousands of patients across decades. Sensitivity and specificity at the moderate cutoff are both around 80–90%, which is unusually good for a self-report instrument. They genuinely correlate with what a structured psychiatric interview would find.
Why item 9 always matters
Item 9 of the PHQ-9 asks about "thoughts that you would be better off dead, or of hurting yourself in some way." Even a score of 1 on this item — "several days" — gets clinical attention regardless of the total score. You can have an overall PHQ-9 of 6 (mild range) but a 1 on item 9, and that 1 is what your provider will follow up on.
This isn't about overreaction. It's about not waiting until things get worse. The 988 Suicide & Crisis Lifeline (call or text 988 in the US) is free, confidential, 24/7, and not what most people imagine — they listen, they don't judge, and they don't dispatch anyone unless you ask them to.
Why this is screening, not diagnosis
A high PHQ-9 doesn't mean you have major depressive disorder. It means a clinician should have a conversation with you to figure out whether what's going on fits MDD, fits something else (grief, adjustment disorder, bipolar depression, medical causes like thyroid disease or B12 deficiency, medication side effects), or is something that doesn't have a diagnostic label at all.
This is the same for the GAD-7. A high score points at "anxiety is interfering with life" — whether that's GAD, panic disorder, OCD, PTSD, social anxiety, or just a really stressful life period is a clinician's call.
Self-administered screens are good at finding people who need a conversation. They're bad at diagnosing what specifically is happening. Treat them as the start of the conversation, not the end.
What changes at moderate or higher
This is the threshold where most clinical guidelines (USPSTF, NICE, APA) suggest something more than watchful waiting. "Something more" doesn't necessarily mean medication — therapy alone is first-line for many cases, especially milder ones. Lifestyle interventions (sleep, exercise, sunlight, alcohol reduction) genuinely move the needle for some people. Medication is on the table for moderate-to-severe scores or for people whose previous attempts at non-medication approaches haven't been enough.
The point of screening at home is to walk into the visit with the score already calculated, so the conversation can be about what to do — not about reconstructing whether things have been bad enough to mention.
The phrasing that actually works
Most providers know the PHQ-9 and GAD-7 by heart. You can say:
> "I took the PHQ-9 at home and scored 12, which puts me in the moderate range. I'd like to talk about what to do next."
That sentence saves 5 minutes of the 15-minute appointment.
Skip the clipboard
The Depression & Anxiety Screening tool gives you both questionnaires with auto-scoring, severity buckets, the item-9 safety panel that triggers regardless of total, and clinical-handoff language with suggested phrasing for your visit. History saving is opt-in (off by default) — single-pass mode is the default so you can take it without persisting anything.
Like the rest of the /health suite, it stays on your device. No account, no upload, no analytics on your answers.
The short version
PHQ-9 and GAD-7 are the most-used mental-health screens in primary care, and they're free for you to take at home. Score 10+ on either is the threshold for "let's talk about what to do." Item 9 of the PHQ-9 always matters, even at low totals — that's a feature of the instrument, not a quirk. And taking the screen before the visit gets you 5 minutes of the appointment back.