Clinics rarely run one of these without the other. Depression and anxiety overlap so often that scoring both has become the default, and people are usually handed the two on the same sheet.
Here is how to score each, and how to read them together.
The quick answer
PHQ-9: 9 questions, 0 to 27.
| Score | Severity |
|---|---|
| 0-4 | None or minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-19 | Moderately severe |
| 20-27 | Severe |
GAD-7: 7 questions, 0 to 21.
| Score | Severity |
|---|---|
| 0-4 | Minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-21 | Severe |
Both use the same 0 to 3 answer scale, both ask about the past two weeks, and both use 10 as the threshold that usually prompts a fuller conversation.
Neither is a diagnostic test. A high score on either means a proper assessment is worth having, not that you have the condition.
How to score them
The mechanics are identical, which is part of why they pair so well.
1. Each question is answered "not at all" (0), "several days" (1), "more than half the days" (2), or "nearly every day" (3)
2. Add the answers. That is the whole score.
3. There is no weighting, no reverse scoring, and no items to drop
The PHQ-9 has a tenth question about how difficult the symptoms make daily life. It is not added to the total. It is recorded separately, and it is often the more useful answer of the lot.
Reading the two together
This is the part a single score cannot give you.
Both under 5. Nothing flagged. If the person came in worried anyway, the questionnaires have not captured what is bothering them, and that is worth asking about directly.
One elevated, one low. The more informative result. A PHQ-9 of 16 with a GAD-7 of 3 points somewhere quite different from the reverse. The treatment emphasis differs accordingly.
Both elevated. The most common pattern by far. Roughly half of people who screen positive for one screen positive for the other. Two moderate scores are not the same as one severe score. It usually means treating the shared ground rather than picking a side.
Both high and roughly equal. Consider whether something underneath is driving both: sleep, a medical condition, or a substance. Two parallel scores are not automatically two separate problems.
What each one asks that the other does not
The PHQ-9 covers appetite, sleep, concentration, psychomotor change, and self-worth. Several of those are physical, which is why medical illness can push the score up on its own.
The GAD-7 is almost entirely about worry, restlessness, and irritability. It has no physical items beyond restlessness, and it does not cover panic, phobias, or specific fears.
Only the PHQ-9 asks about self-harm. That is question 9, and any answer above zero warrants a direct conversation whatever the total says. The GAD-7 has no equivalent item, so a GAD-7 alone never surfaces this.
Tracking change
Both scales are built to be repeated, and this is where the pairing earns its keep.
- A 5-point drop on either is the usual marker of meaningful improvement
- Dropping below 10 suggests a partial response
- Dropping below 5 is often described as remission
- Changes of two or three points are normal fluctuation, not progress
Retesting every two to four weeks during active treatment is typical. The two scores often move at different rates. Anxiety frequently improves before mood does, so a flat PHQ-9 next to a falling GAD-7 is not a failure.
Common questions
Do I add the two scores together?
No. There is no combined total, and adding them produces a number that means nothing. Report them separately.
Which one comes first?
It does not matter. Many clinics use the PHQ-4 first, which is two items from each. They only run the full versions if that screens positive.
Can I score these myself?
Yes, both are designed for self-completion, and the arithmetic is simple addition. Interpreting a high score is where a clinician matters.
What if the scores contradict how I feel?
Both ask only about the past two weeks. A rough spell that has since passed will still show up. A long-standing difficulty you have adapted to may not. Say so when you hand the scores over.
The bottom line
Score each one by adding its answers. Read 10 as the point where a conversation is warranted. Then look at the gap between the two, which usually says more than either number alone.
For a fuller comparison of what each one is for, see PHQ-9 vs GAD-7.