A PHQ-9 score is a number between 0 and 27 that measures the severity of depression symptoms over the past two weeks. The questionnaire asks nine questions, each scored from 0 (not at all) to 3 (nearly every day), and the total determines whether your symptoms fall into minimal, mild, moderate, moderately severe, or severe categories. A score of 10 or higher is the widely used threshold for possible major depression.
What the PHQ-9 Measures
The PHQ-9 stands for Patient Health Questionnaire-9. It was developed by Drs. Robert Spitzer, Janet Williams, and Kurt Kroenke, and it maps directly onto the nine diagnostic criteria for major depressive disorder. Each item asks how often you’ve experienced a specific symptom over the last two weeks, with four response options: not at all (0), several days (1), more than half the days (2), or nearly every day (3).
The nine symptoms it covers are:
- Little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself, or that you’re a failure or have let your family down
- Trouble concentrating on things like reading or watching television
- Moving or speaking noticeably slowly, or the opposite: being unusually fidgety or restless
- Thoughts that you would be better off dead or of hurting yourself
Because these nine items mirror the clinical definition of depression, the PHQ-9 works both as a screening tool and as a way to track how symptoms change over time with treatment.
What Each Score Range Means
Your total score places you in one of five severity categories. These ranges come from clinical research and are used in primary care offices, therapy practices, and hospitals worldwide.
- 0 to 4: Minimal symptoms. This range is considered a community norm. Most people without depression score here, and no clinical action is typically recommended.
- 5 to 9: Mild symptoms. You may be experiencing some depressive symptoms, but they’re not yet at a level that meets the threshold for major depression. Providers often recommend self-management strategies, education, and periodic rescreening to see if symptoms worsen or resolve.
- 10 to 14: Moderate symptoms. This is the range where major depression becomes a likely explanation. A score of 10 is the most commonly used cutoff for a positive depression screen. At this level, treatment with therapy, medication, or both is generally recommended, along with a follow-up plan.
- 15 to 19: Moderately severe symptoms. Scores in this range suggest depression that is significantly affecting daily life. Guidelines call for prompt initiation of treatment, whether that’s therapy, medication, or a combination.
- 20 to 27: Severe symptoms. The highest range indicates serious depression. Both therapy and medication are typically recommended together, often with a referral to a mental health specialist.
Why the Score of 10 Matters
A score of 10 is the dividing line that clinicians pay the most attention to. Research has established that this cutoff reliably distinguishes people who are likely experiencing major depression from those who are not. It’s the threshold used in most clinical settings to decide whether a full diagnostic evaluation is warranted.
That said, a score of 10 doesn’t automatically mean you have major depression. The PHQ-9 is a screening tool, not a diagnosis. It flags the possibility so a provider can dig deeper, asking about your history, ruling out other causes (like thyroid problems or medication side effects), and determining whether a formal diagnosis fits. Similarly, scoring below 10 doesn’t guarantee you’re fine. If even a few symptoms are causing real disruption in your life, that’s worth discussing regardless of the number.
Question 9 and Suicide Risk
The final question on the PHQ-9 asks about thoughts of being better off dead or of hurting yourself. This item carries special weight. Any positive answer on question 9, even “several days,” signals the need for a more thorough safety assessment. In clinical settings, a provider who sees a positive response on this question will follow up with additional questions to evaluate the level of risk and determine what kind of support is needed. If you or someone you know is experiencing these thoughts, reaching out to a crisis service like the 988 Suicide and Crisis Lifeline (call or text 988) provides immediate support.
The PHQ-2: A Shorter Version
You may also encounter the PHQ-2, which uses only the first two questions from the PHQ-9: loss of interest or pleasure, and feeling down or hopeless. It works as a quick pre-screener. A score of 2 or more on the PHQ-2 is considered positive, and that result triggers the full PHQ-9 to get a complete picture. Many clinics use this two-step approach to save time, reserving the longer questionnaire for people whose initial answers suggest depression may be present.
How the PHQ-9 Is Used Over Time
One of the most practical uses of the PHQ-9 is tracking change. If you start therapy or begin medication, your provider may ask you to complete the questionnaire at regular intervals, often every few weeks or at each appointment. A drop of 5 or more points generally indicates meaningful improvement. Watching the score trend downward over time gives both you and your provider concrete evidence that treatment is working, or a signal to adjust course if it isn’t.
The U.S. Preventive Services Task Force recommends depression screening for all adults, though there is no established guideline on exactly how often to repeat it. A reasonable approach is to screen anyone who hasn’t been screened before, then use clinical judgment to decide when rescreening makes sense based on risk factors, life events, and ongoing symptoms. For people who are pregnant or in the postpartum period, ongoing reassessment is particularly important since risk can shift during that time.
What Your Score Doesn’t Tell You
The PHQ-9 captures the severity of nine specific symptoms, but depression is more complex than a single number. The score doesn’t reveal what’s causing your symptoms, whether they overlap with anxiety or another condition, or how well you’re functioning at work or in relationships. Two people with a score of 14 can have very different experiences: one might struggle mostly with insomnia and fatigue, while the other deals primarily with feelings of worthlessness and difficulty concentrating.
The questionnaire also relies entirely on self-report, which means your score reflects how you interpret and rate your own experiences. Some people tend to minimize their symptoms, while others may rate them higher during a particularly rough week. This is one reason providers treat the score as a starting point for conversation rather than a definitive verdict. It’s a reliable, well-validated tool, but it works best as part of a broader clinical picture, not as a standalone diagnosis.