Depression test (PHQ-9): what it asks, what your score means and when to see a doctor

No depression test can tell you on its own whether you have depression. Short, tested questionnaires such as the PHQ-9 show which symptoms you have and how strong they are. A doctor makes the diagnosis. This guide is by Dr. Pedro Yelamo Vera, an English-speaking GP licensed in Spain (Colegiado No. 484814280) who sees patients by video in English and Spanish.

Is there a reliable test to know if I have depression?

There are reliable tests to screen for depression, but none can diagnose it alone. The best known come from the Patient Health Questionnaire (PHQ). They are a fixed set of questions. You can answer them in a few minutes, and your doctor uses them as a starting point.

No blood test can diagnose depression. A doctor may still ask for one. It can rule out other causes of similar symptoms, such as anaemia or a thyroid problem.

What is the PHQ-2?

The PHQ-2 is the short version, with just two questions. It asks how often, over the last two weeks, you have felt down or lost interest and pleasure in things. Each answer scores 0 to 3. In the study that tested it, a score of 3 or more was the best point to look further. If it is positive, the next step is usually the full PHQ-9.

What does the PHQ-9 depression test ask?

The PHQ-9 asks about nine areas. They match the medical criteria for depression. Each one looks back over the last two weeks. In plain words, it covers:

• mood: feeling sad, empty or hopeless;
• interest: no longer enjoying things you used to like;
• sleep: trouble falling or staying asleep, or sleeping too much;
• energy: feeling tired or drained;
• appetite: eating much less or much more than usual;
• self-worth: feeling bad about yourself, a failure, or that you have let people down;
• focus: trouble concentrating, such as when reading or watching TV;
• pace: moving or talking more slowly, or being so restless you cannot sit still;
• thoughts of death or of harming yourself.

Each area is scored by how often it happens, from 0 (not at all) to 3 (nearly every day). The total runs from 0 to 27.

What does your PHQ-9 score mean?

The score shows how strong the symptoms are. It does not give a diagnosis. The bands come from the first study by the authors of the form (Kroenke and colleagues, 2001):

• 0 to 4: minimal symptoms;
• 5 to 9: mild;
• 10 to 14: moderate;
• 15 to 19: moderately severe;
• 20 to 27: severe.

In that study, a score of 10 or more picked up major depression well, but not in every case. A low score does not rule anything out if you feel unwell. One rule matters most. If you have had any thoughts of death or self-harm, talk to someone today, whatever your total.

Why is a test not a diagnosis?

A questionnaire does not know your life. Grief, stress, alcohol, some medicines or a thyroid problem can all cause similar symptoms. To diagnose depression, symptoms must last at least two weeks. They must be there most of the day, nearly every day. One of them must be low mood or loss of interest. A doctor checks this by talking with you, asking about your health and, if needed, ordering a test.

Where can I take a free depression test?

The safest place to take a free depression test is with your own GP. Doctors use tested versions, and someone goes through the result with you. Many versions online are untested or changed. If you take one on your own, treat the result as a guide and bring it to your visit.

The form has the same name in English and Spanish, and in the UK and the US: PHQ-9. MedlinePlus, the US health library, lists it as a screening tool.

What does the doctor do after the test?

After the test, the doctor does a full check:

• asks how you feel, since when, and how it affects work, family and social life;
• reviews your health, your medicines and your use of alcohol or drugs;
• may order blood tests to rule out other causes;
• always asks, calmly, about thoughts of death or self-harm.

Then the doctor may suggest talking therapy, such as cognitive behavioural therapy (CBT). They may refer you to a mental health team. Or they may discuss an antidepressant. Medicine is only chosen after this check, and it needs follow-up. This practice does not prescribe benzodiazepines or sleeping pills by video.

What about the GAD-7 anxiety test?

For anxiety, doctors use the GAD-7. It has seven questions about the last two weeks. They cover nerves, worry that is hard to control, restlessness, irritability and fear that something bad will happen. It was tested to spot generalised anxiety disorder and gauge how strong it is. Like the PHQ-9, it guides but does not diagnose. Anxiety and depression often come together, so doctors often use both.

When to see a doctor

• You have felt low, or enjoyed nothing, nearly every day for more than two weeks.
• Your PHQ-9 score is 10 or more, or a lower score still worries you.
• You find it hard to work, study or look after your home or family.
• Your sleep or appetite has changed a lot.
• You already take treatment and it is not helping, or you want it reviewed.

When to call 112

If you are thinking about suicide or harming yourself, do not wait for an appointment. In Spain, call 024. It is a free, confidential, 24-hour line for people with suicidal thoughts and for their families. UK readers can also call Samaritans on 116 123.

• Call 112 if your life is in danger now.
• Call 112 if you have already harmed yourself or taken an overdose.
• Call 112 if someone close to you has tried to end their life or says they will do it now.

Frequently asked questions about depression tests

Getting a medical assessment

If your depression test result worries you, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about depression care, anxiety, depression and antidepressant follow-up in Spain and postpartum depression. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the advice of your doctor.