The PHQ-9 produces a single number between 0 and 27, and that number does a lot of work: it sorts symptoms into one of five severity bands, guides what clinicians recommend next, and tracks whether things are improving over time. But if you've just taken the test — or you're holding a paper copy and a pencil — the scoring can raise questions. How do nine questions add up to 27? Where do the cutoffs come from? And why does the last question get special treatment no matter what the total says?
This guide walks through the entire scoring system, band by band. If you'd rather skip the arithmetic, our free online PHQ-9 test calculates everything automatically and gives you an instant interpretation.
The Basic Math: 9 Questions × 0–3 Points
The PHQ-9 asks how often each of nine problems has bothered you over the last two weeks. Every question uses the same four answer options, each worth a fixed number of points:
| Answer | Points |
|---|---|
| Not at all | 0 |
| Several days | 1 |
| More than half the days | 2 |
| Nearly every day | 3 |
Your total score is the simple sum of all nine answers. Nine questions times a maximum of 3 points each gives the range: 0 to 27. There's no weighting, no reverse-scored items, no hidden formula — every question counts equally, and higher always means more frequent symptoms. This simplicity is deliberate: the scale was built by Drs. Kurt Kroenke, Robert Spitzer, and Janet Williams (validation published in 2001) so that a busy primary care office could score it in seconds.
That's the whole calculation. The interpretation is where the substance lives.
The Five Severity Bands
The published PHQ-9 cut-points divide the 0–27 range into five bands. Here's what each one means in practice.
0–4: Minimal Depression
Scores in this range indicate that depressive symptoms are largely absent or infrequent. Most people without depression score here. Typically no clinical action is suggested beyond ordinary self-care.
Two caveats keep this band honest. First, a low score describes the past two weeks, not your life — retest later if things change. Second, some people genuinely struggling score low, whether because they minimize symptoms or because their main problem (anxiety, for instance) isn't what the PHQ-9 measures. We cover that nuance in what is a normal PHQ-9 score. If the number says fine and you don't feel fine, trust your experience and consider talking to someone anyway.
5–9: Mild Depression
Symptoms are present but limited in frequency or breadth — perhaps low mood and poor sleep several days a week, while the rest of the items stay quiet. For this band, clinicians often suggest watchful waiting: keep an eye on symptoms, support the basics (sleep, movement, social contact), and repeat the PHQ-9 in a few weeks to see which direction things are moving. A mild score that keeps climbing on retest tells a more important story than any single result.
10–14: Moderate Depression
Ten is the most important number on the scale. In the original validation research, a score of 10 or higher was the threshold that best identified people likely to meet criteria for major depression — catching most true cases while keeping false alarms reasonably low. Later meta-analyses have repeatedly confirmed that this cut-point performs well. (Our article on PHQ-9 accuracy digs into those numbers.)
Practically, a score of 10–14 means depressive symptoms are frequent and broad enough that a professional evaluation is worth scheduling — not as an emergency, but as a real to-do. Treatment at this level often starts with talk therapy, sometimes medication, depending on the full clinical picture.
15–19: Moderately Severe Depression
At this level, multiple symptoms are occurring more than half the days or nearly every day, and daily functioning — work, relationships, basic routines — is usually feeling the strain. The standard guidance is to seek an evaluation promptly rather than waiting to see whether things improve on their own. Active treatment, frequently combining psychotherapy and medication, is commonly discussed for scores in this band.
20–27: Severe Depression
Scores of 20 and above mean most of the nine symptoms are present nearly every day. People scoring here are often struggling to function and may have been carrying this weight for a long time. A prompt professional evaluation matters at this level, and effective treatment exists for severe depression — high scores respond to care too. If a score in this range comes with any thoughts of self-harm, treat that as the headline (more on this below) and reach out to the 988 Suicide & Crisis Lifeline — call or text 988, free, 24/7 in the US.
Here are all five bands at a glance — the same cut-points our online test applies to your answers:
| Score | Severity | Commonly suggested next step |
|---|---|---|
| 0–4 | Minimal | Usually none; retest if things change |
| 5–9 | Mild | Watchful waiting; repeat the PHQ-9 |
| 10–14 | Moderate | Professional evaluation worth scheduling |
| 15–19 | Moderately severe | Prompt evaluation; active treatment often discussed |
| 20–27 | Severe | Prompt evaluation; crisis support if Item 9 is elevated |
One boundary note: the bands are conventions for interpretation, not walls in reality. A 9 and an 11 describe more similar experiences than the labels "mild" and "moderate" suggest. Read your score as a region, not a verdict.
The Tenth Question That Isn't Scored
If you've seen a paper PHQ-9, you may have noticed a final question after the nine scored items: if you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? The options run from "not difficult at all" to "extremely difficult."
This functional-impairment question adds zero points to your total — it isn't part of the 0–27 score at all. But clinicians care about it, because diagnosis of depression isn't just about symptoms existing; it's about symptoms interfering with your life. Two people can both score 12 while one is managing and the other is barely holding their job together. If you take the PHQ-9 on paper, don't skip this item — and whatever your score, it's worth asking yourself the same question honestly.
Question 9: The Score Isn't the Whole Story
The ninth item asks about thoughts that you would be better off dead, or of hurting yourself. It's scored 0–3 like every other question — but it carries a special rule that overrides the total score: any answer above "not at all" deserves attention on its own.
The arithmetic makes the reason plain. Someone can answer "several days" on Item 9 and still total only 3 or 4 points — landing in the "minimal" band. The band label doesn't matter in that case; the item does. The scale's own authors recommend that any non-zero response on Item 9 trigger a follow-up conversation regardless of severity band, and our test flags it the same way.
If that's you — at any score, in any band — please don't file it under "my total was low, so it's fine." Call or text 988 (Suicide & Crisis Lifeline, 24/7), or text HOME to 741741 to reach the Crisis Text Line. If there's immediate danger, call 911. Our line-by-line guide to the questions discusses Item 9 in more depth.
Paper vs Online: Does a PHQ-9 Calculator Change Anything?
No — and that's the point. Whether you sum a paper form by hand, use a standalone PHQ-9 calculator, or take a scored online version, the arithmetic and the cut-points are identical, because they come from the published instrument, not the format.
What an online version adds is convenience and guardrails: the sum is computed instantly with no arithmetic slips, the correct severity band is applied automatically, an elevated Item 9 is flagged with crisis resources immediately, and you get an interpretation alongside the raw number. What it can't add is a diagnosis — no format of the PHQ-9 diagnoses depression. If you're scoring by hand, double-check two common mistakes: skipped questions (all nine must be answered for the 0–27 range to hold) and misread columns on the grid-style paper form.
Using Your Score Over Time
A single PHQ-9 score is a snapshot of two weeks. Its real power shows up in sequence. Because the scoring is consistent and sensitive to change, clinicians routinely use repeat administrations to track whether treatment is working — a score moving from 16 toward 8 over a couple of months is meaningful evidence of improvement, and a score drifting upward is an early warning worth acting on. If you're self-monitoring, retaking the test every few weeks under similar conditions gives you the same trend line, and a series of dated scores is a genuinely useful thing to bring to a first appointment.
The Bottom Line
PHQ-9 scoring is deliberately simple: nine questions, 0–3 points each, summed to a 0–27 total, read against five published bands — minimal (0–4), mild (5–9), moderate (10–14), moderately severe (15–19), and severe (20–27). The threshold of 10 is the research-backed signal for a professional evaluation, the unscored difficulty question captures real-life impact, and Question 9 outranks the total: any non-zero answer there is a reason to reach out — 988 is always available.
Ready for your number? Take the free PHQ-9 test — two minutes, automatically scored, with your band and what it means explained instantly.