PHQ-9 and GAD-7 Explained: Understanding Mental Health Scores

If you've ever visited a therapist or psychiatrist, chances are you've filled out a questionnaire before the session started. Two of the most commonly used ones are the PHQ-9 and the GAD-7.

The names sound clinical, but they're surprisingly straightforward. Understanding what they measure — and what they don't — can help you make better sense of your mental health.

PHQ-9: Measuring depression symptoms

PHQ-9 stands for Patient Health Questionnaire-9. It's a 9-item screening tool developed by Drs. Kroenke, Spitzer, and Williams, and it's used worldwide to assess the severity of depressive symptoms.

What it asks

Each question starts with: "Over the last 2 weeks, how often have you been bothered by the following?"

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling asleep, staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself — or that you're a failure
7. Trouble concentrating on things
8. Moving or speaking noticeably slowly (or the opposite — being restless)
9. Thoughts of self-harm or that you'd be better off dead

How scoring works

Each item is scored from 0 to 3:

• 0 — Not at all
• 1 — Several days
• 2 — More than half the days
• 3 — Nearly every day

Total scores range from 0 to 27.

Score interpretation

Score	Severity
0–4	Minimal or none
5–9	Mild depression
10–14	Moderate depression
15–19	Moderately severe depression
20–27	Severe depression

A score of 10 or above is the typical threshold where professional follow-up is recommended.

GAD-7: Measuring anxiety symptoms

GAD-7 stands for Generalized Anxiety Disorder-7. It's a 7-item screening tool that assesses the severity of anxiety symptoms over the past two weeks.

What it asks

Same framing: "Over the last 2 weeks, how often have you been bothered by the following?"

1. Feeling nervous, anxious, or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5. Being so restless that it's hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid, as if something awful might happen

Score interpretation

Score	Severity
0–4	Minimal anxiety
5–9	Mild anxiety
10–14	Moderate anxiety
15–21	Severe anxiety

A score of 10 or above typically warrants further evaluation.

ASRM: Screening for mania

There's a third scale worth knowing about: the Altman Self-Rating Mania Scale (ASRM). It's a 5-item questionnaire that screens for manic or hypomanic symptoms — elevated mood, excessive energy, and impulsivity.

The ASRM is most commonly used in the context of bipolar disorder screening. A score of 6 or above suggests possible manic symptoms.

Tracking both ends of the mood spectrum — depression and mania — gives a more complete picture of your mental health. In mentalog, the ASRM is the first score you receive, available after just 7 days of check-ins.

Why these tools matter

PHQ-9 and GAD-7 are popular for good reason:

• They're validated — Decades of research confirm their reliability across populations, languages, and healthcare settings
• They're quick — 5 minutes total for both
• They create a common language — A PHQ-9 score of 14 means the same thing whether you're in New York, London, or Tokyo
• They track change over time — Repeated assessments show whether treatment is working

The problem with periodic questionnaires

Here's the catch: both tools ask about the past two weeks. But answering accurately requires you to remember two weeks' worth of emotional experiences — something humans are notoriously bad at.

Memory research shows we tend to:

• Overweight recent days (recency bias)
• Remember extreme moments more than typical ones (peak-end rule)
• Judge the whole period by our current mood (mood-congruent recall)

So if you're having a particularly bad day when you fill out the PHQ-9, your score might come out higher than your actual two-week experience warrants. And if you're having a good day, you might underreport.

A better approach: daily tracking + automated scoring

What if instead of trying to remember two weeks at once, you recorded a quick mood snapshot every day?

That's the core idea behind mentalog. You do a 30-second daily check-in — rate your mood on a 5-point scale and tap a few emotion and activity tags. After 14 days, the app automatically estimates your PHQ-9 and GAD-7 scores based on the tag frequency patterns in your data.

No survey fatigue. No memory distortion. Just daily micro-observations that add up to a much clearer picture.

Important caveats

A few things to keep in mind:

• These scores are screening tools, not diagnoses. A high score doesn't mean you have clinical depression or an anxiety disorder — it means further evaluation is warranted.
• Context matters. A PHQ-9 spike during finals week or after a breakup might reflect a normal stress response, not a clinical condition.
• Estimated scores from daily tracking (like mentalog provides) are approximations based on tag-to-symptom mapping. They don't replace a formal clinical assessment.
• If your scores are consistently elevated, please talk to a healthcare professional. Early intervention makes a significant difference.

Curious about your emotional patterns and estimated scores? Start a 30-second daily check-in with mentalog. Your first report is ready after just 7 days.