PHQ-9 Self-Test
Answer all 9 questions to get your score. Reference period: the last two weeks.
Why every question matters
The PHQ-9 looks innocent. Nine questions, four answer levels, a score at the end. But each item measures a different facet of depressive symptoms. If you understand the questions, you can read your own state more precisely.
In this article I walk through every question. What it measures, why it's there, and what to watch for when answering it.
The scale, briefly
Each question refers to the last two weeks and is rated on a 0 to 3 scale:
- 0: Not at all
- 1: Several days
- 2: More than half the days
- 3: Nearly every day
Maximum 27 points. You'll find the score ranges and severity levels in our guide to clinical questionnaires.
The 9 items at a glance
Item 1: Little interest or pleasure in doing things
Measures anhedonia, the loss of pleasure. Anhedonia is one of the two core symptoms of depressive episodes in the DSM-5.
What to watch for: It's not about "less pleasure than other people", but less pleasure than your own normal. Compare with your own baseline.
Item 2: Feeling down, depressed, or hopeless
Measures depressed mood, the second core symptom. If item 1 or item 2 is high, that's diagnostically relevant.
What to watch for: Hopelessness is more serious than plain sadness. If over the last two weeks you've often felt nothing will get better, that belongs here.
Item 3: Trouble falling or staying asleep, or sleeping too much
Measures sleep disturbance, in both directions. Insomnia and hypersomnia are both symptoms.
What to watch for: If you sleep poorly because of a baby or shift work, that's not what this question means. It's about sleep problems whose cause is internal.
Item 4: Feeling tired or having little energy
Measures vegetative exhaustion — fatigue that sleep doesn't fix.
What to watch for: If you're physically ill, you'll also lack energy. That makes the PHQ-9 less precise in those phases. Mentally separate physical from psychological causes.
Item 5: Poor appetite or overeating
Again, both directions. Loss of appetite and food cravings are both symptoms.
What to watch for: Diets or deliberate dietary changes don't count. This is about involuntary changes.
Item 6: Feeling bad about yourself, sense of failure
Measures cognitive distortion in self-image. Self-criticism up to feeling that you've let your family or yourself down.
What to watch for: Realistic self-criticism after actual failure isn't the same as a generalised sense of failure. It's the second variant that matters here.
Item 7: Trouble concentrating
Measures cognitive impairment. Concentration problems with everyday things like reading, watching TV or working.
What to watch for: Distractions from smartphones or open offices aren't what this means. It's about concentration that's blocked from the inside.
Item 8: Moving or speaking so slowly — or being restless — that other people noticed
Measures psychomotor changes — movement or speech patterns that shift.
What to watch for: The only item with an external marker. If nobody has told you that you seem slower or more restless, the answer is usually 0.
Item 9: Thoughts that you would be better off dead, or of hurting yourself
The critical item. Measures suicidal thoughts.
What to watch for: If you mark a 1 or higher here, get support. Even fleeting thoughts count. This isn't failure — it's a signal that deserves to be heard. A study by Simon et al. (2013) showed that even a value of 1 on item 9 is associated with a 10-fold increased suicide risk in the following 12 months. This item isn't a bonus — it's clinically decisive.
In the US, you can reach the 988 Suicide & Crisis Lifeline 24/7 by calling or texting 988. In the UK, contact Samaritans at 116 123 or jo@samaritans.org. International directory: findahelpline.com.
How to use the score
Your PHQ-9 score is a snapshot. Its value comes from the trajectory. Track it regularly and look at:
- Trend across weeks. Rising, falling, stagnating?
- Which items dominate? Vegetative (3 to 5) or cognitive (6 to 7)?
- Shifting items. Do symptoms appear in a typical order when things worsen?
Those patterns say more than the total score.
The PHQ-9 is not a verdict
An important reminder. The PHQ-9 is a screening instrument, not a diagnosis. A high score doesn't mean you have depression. A low score doesn't mean everything is fine.
It's a tool that helps you be honest with yourself and structured in conversations with your therapist or doctor. No more, but no less.
Read more
- PHQ-9, GAD-7 & more gives you the big picture of all validated questionnaires.
- Is my medication working? How to use mood data shows how to use PHQ-9 trajectories for treatment decisions.
- Recognising patterns in your mood complements the PHQ-9 with daily tracking.
- Recognising burnout before it's too late shows when the PHQ-9 helps as an early warning signal.
- Original validation study: Kroenke et al. (2001)
- Sensitivity for change measurement: Löwe et al. (2004)
- Cutoff validity in primary care: Manea et al. (2012) meta-analysis