You took a mental health assessment. You got a score. Now what?
One number doesn't tell you much. It shows where you are right now, but not whether things are getting better or worse. The real value comes from tracking that number over time.
Why tracking matters
Mental health changes gradually. Day to day, the shifts are hard to notice. You adapt. "Normal" drifts without you realizing it.
When you track consistently, you can see:
- Whether you're actually getting better (not just feeling like it)
- Whether a treatment is working
- Early warning signs before things get bad
- Patterns you'd never spot otherwise
This is called measurement-based care. It's how clinicians monitor treatment response. You can do the same thing for yourself.
What counts as real change?
Not every score fluctuation matters. You'll have good weeks and bad weeks. The question is: when does a change in score reflect a real shift in your mental health?
Research gives us specific numbers.
The 5-point rule
On the PHQ-9 (depression) and most similar assessments, a 5-point change is clinically meaningful. This threshold comes from the Reliable Change Index—a statistical measure that accounts for normal test-retest variation.
If your PHQ-9 drops from 14 to 9, that's real improvement.
If it drops from 14 to 12, that might just be noise.
Severity thresholds
Most assessments have cutoff scores that define severity levels:
PHQ-9 (Depression):
| Score | Severity |
|---|---|
| 0-4 | Minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-19 | Moderately severe |
| 20-27 | Severe |
GAD-7 (Anxiety):
| Score | Severity |
|---|---|
| 0-4 | Minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-21 | Severe |
Moving from one severity category to another is meaningful. Going from "moderate" (12) to "mild" (7) represents real progress, even if you're not at zero.
Response vs. remission
Clinical research distinguishes between two types of improvement:
Response: A 50% reduction in symptoms from your starting point. If you started at 16, response means dropping to 8 or below.
Remission: Reaching the "minimal" range (typically under 5 on the PHQ-9). This is the goal—symptoms are essentially gone.
Response means treatment is working. Remission means you've recovered. Both matter.
How often to track
During active treatment or change: Weekly or every two weeks. This is frequent enough to spot trends without being obsessive. Most clinical protocols use 2-4 week intervals.
When stable: Monthly is usually enough. You're watching for drift, not measuring active change.
During high-risk periods: Ramp up to weekly. Major life changes, seasonal transitions, medication adjustments—these are times when early detection matters most.
Minimum useful frequency: Monthly. Less frequent than that, and you'll miss patterns.
How to track well
Same assessment every time
Switching between PHQ-9 and DASS-21 mid-tracking makes comparison impossible. Pick one assessment and stick with it.
Same conditions
Take the assessment at the same time of day, same day of week, when possible. Scores can vary based on when you're measuring. Sunday evening feels different than Monday morning.
Record the date and context
Note anything unusual: bad sleep the night before, stressful week at work, just got back from vacation. This context helps explain outliers later.
Look at trends, not single points
A high score after a bad week doesn't mean you're relapsing. A low score during a vacation doesn't mean you're cured. Look at 4-6 data points before drawing conclusions.
What patterns tell you
Steady improvement
Scores gradually declining over weeks or months. This is what successful treatment looks like. The line doesn't have to be straight—expect bumps—but the overall direction is down.
Plateau
Scores stop improving but don't get worse. This might mean:
- You've hit your baseline (this is as good as it gets without additional intervention)
- The current approach has maxed out its benefit
- Time to try something different or add something new
Relapse pattern
Scores start climbing after a period of improvement. Catching this early—when the increase is 5 points instead of 15—gives you time to intervene.
Seasonal pattern
Scores consistently worse in certain months. Many people notice this in winter (seasonal affective patterns) but it can happen any time. Once you see the pattern, you can prepare for it.
Stress-responsive pattern
Scores spike during identifiable stressors and return to baseline after. This suggests situational factors rather than a chronic condition. Good to know.
When to worry
- Scores increase by 5+ points and stay elevated for 2+ weeks
- You cross from "mild" to "moderate" or higher
- Any positive answer on suicide/self-harm questions
- Scores aren't improving despite treatment (after 8+ weeks)
These are signals to talk to a professional if you haven't already, or to revisit your current treatment plan if you have.
When not to worry
- Small fluctuations (2-3 points) week to week
- One bad score after an obviously bad week
- Slower improvement than you expected (improvement is improvement)
- Not reaching zero (minimal symptoms is a reasonable goal)
Mental health isn't linear. The goal is a general downward trend, not perfection.
Tools for tracking
You can track on paper—a simple spreadsheet or notebook works fine. What matters is consistency, not sophistication.
Key things to record:
- Date
- Assessment used
- Total score
- Any subscale scores (if applicable)
- Brief context notes
Review your data monthly. Plot it if that helps you see trends. The pattern over time is more informative than any single score.
The bigger picture
Psychiatry lacks the equivalent of blood pressure or blood sugar—simple, objective measures that track health over time. Self-report assessments are the closest thing we have.
They're not perfect. They depend on self-awareness and honest reporting. Scores can be affected by how you're feeling in the moment.
But tracked consistently over time, they provide something valuable: objective evidence of change. Not just "I think I feel better" but "my scores have dropped 8 points over three months."
That's information you can use—to validate that something is working, to catch early warning signs, or to have a concrete conversation with your doctor.
Getting started
1. Pick an assessment: PHQ-9 for depression (see what your PHQ-9 score means), GAD-7 for anxiety (see what your GAD-7 score means), or DASS-21 for both plus stress (see what your DASS-21 score means).
2. Take it today. Record the date and score.
3. Set a recurring reminder—weekly if you're actively working on something, monthly if you're just monitoring.
4. After a few months, look back. What do you see?
The data is only useful if you collect it. Start now.
Related guides
Tracking can be especially valuable during specific life situations:
- Tracking mental health through divorce
- Tracking mental health after job loss
- Tracking recovery from burnout
- Tracking recovery from trauma
- Tracking mental health postpartum
- Tracking mental health while caregiving