PHQ-9 Depression Symptom Tracker
The PHQ-9 is a validated questionnaire used to measure depression severity. Track your symptoms over time to see if treatment is working. Your score helps you and your doctor understand your progress.
PHQ-9 Questions (0-3)
How to use this tool: Complete the questionnaire for the past two weeks. Your score will help you and your provider understand your depression severity.
Starting an antidepressant can feel like stepping into a fog. You hope it will lift the weight, but instead, you might feel dizzy, sleepy, or worse-like your body is betraying you. And if you’re not tracking what’s happening, it’s easy to lose sight of whether things are getting better or just different. The truth is, antidepressant efficacy and side effect burden aren’t just doctor’s concerns-they’re daily realities for you. The good news? You don’t have to guess. There are clear, proven ways to track progress and speak up when something’s off.
Why Tracking Matters More Than You Think
About 30 to 40% of people don’t get relief from their first antidepressant. That’s not failure-it’s normal. What changes outcomes isn’t luck. It’s knowing what’s happening. A 2022 review found that 74% of people on antidepressants experience at least one side effect. Sexual dysfunction, weight gain, nausea, insomnia-these aren’t rare. They’re common. And if your doctor doesn’t ask about them, you might assume they’re just part of the deal. They’re not. Structured monitoring-using the same tools every time-cuts remission time in half. Studies show patients who track symptoms and side effects are 50-60% more likely to reach remission than those who don’t. This isn’t theory. It’s backed by the STAR*D trial follow-up and the 2023 World Federation of Societies of Biological Psychiatry guidelines. You’re not just taking a pill. You’re in a partnership with your treatment. And you need data to guide it.The Three Tools You Can Use Right Now
You don’t need a lab or a fancy app to start. Three simple tools are all you need:- PHQ-9: Nine questions about how you’ve felt over the past two weeks. Each answer is scored 0 to 3. Add them up. A score of 15 or higher means moderate to severe depression. A drop of 50% in four weeks? That’s a sign your medication is working.
- BDI (Beck Depression Inventory): 21 questions that dig deeper into thoughts and physical symptoms. A score above 29 suggests severe depression. Many people find it more detailed than PHQ-9, especially if they’re struggling with guilt or hopelessness.
- ASEC (Antidepressant Side-Effect Checklist): A 15-item list of common side effects-dry mouth, tremors, sweating, sexual problems. Rate each from 0 (none) to 4 (severe). Keep this in your phone or notebook. You’ll see patterns: ‘I feel nauseous every morning but it fades by noon,’ or ‘My libido dropped after week 3.’ That’s gold.
What to Track Daily (And Why)
You don’t need to log everything. Pick three things and stick with them:- Mood (1-10 scale): Not ‘good’ or ‘bad.’ Be specific. Was it a 3 because you cried at work? Or a 6 because you got out of bed but didn’t talk to anyone? Write it down before bed.
- Side effect intensity: Pick the top 2-3 you’re worried about. Rate them daily. If sleeplessness spikes after taking your pill at night, you know when to adjust timing.
- One functional goal: Did you shower? Call a friend? Go to the store? These matter more than scores. A 2020 study showed people who focused on real-life goals (like ‘return to work 3 days a week’) recovered faster than those chasing ‘feeling better.’
When to Speak Up-and How
Too many people stay silent. A 2022 NAMI survey showed 74% had side effects, but only 39% felt their provider addressed them. That’s not okay. You have the right to be heard. Here’s how to prepare:- Bring your tracker: Don’t say, ‘I feel weird.’ Say, ‘My PHQ-9 went from 18 to 12, but my ASEC shows sexual side effects jumped from 2 to 4. I’m still sleeping less.’
- Ask for alternatives: If sexual dysfunction is killing your quality of life, ask about bupropion (Wellbutrin). It’s less likely to cause this. If fatigue is the issue, maybe switching from a sedating SSRI to an NDRI makes sense.
- Request TDM if needed: Therapeutic Drug Monitoring checks how much drug is actually in your blood. A 2022 study found 50-70% of non-responders had levels too low-even if they took the pill daily. If you’ve been on the same dose for 8 weeks with no change, ask: ‘Could my levels be off?’
What Doesn’t Work (And Why)
Not all tracking tools are equal. Many apps promise help but deliver noise.- Generic mood apps: If they don’t use PHQ-9, BDI, or ASEC, they’re just diaries. They can’t measure change accurately.
- Guessing based on how you feel ‘today’: Depression lies. One good day doesn’t mean the medication’s working. One bad day doesn’t mean it’s failing. Look at trends over weeks.
- Ignoring side effects: Sexual dysfunction, weight gain, or dizziness aren’t ‘just side effects.’ They’re signals. A 2022 study found 61% of people stopped SSRIs because these weren’t managed. You don’t have to suffer in silence.
Real Stories, Real Results
On Reddit, one user, u/AnxiousEngineer, said their psychiatrist never used scales after 9 months on sertraline. They felt invisible. Then they started tracking PHQ-9 weekly. At week 8, their score dropped from 19 to 10. They brought it to their next appointment. Their doctor said, ‘I didn’t realize you were improving this much.’ They adjusted the dose. Within two weeks, they were sleeping through the night. Another person tracked sexual side effects on ASEC. They saw a steady climb from 1 to 4 over six weeks. They switched from escitalopram to bupropion. Within a month, their libido returned. Their PHQ-9 stayed at 8. These aren’t outliers. They’re people who used the tools available to them. You can too.What’s New in 2025
The FDA cleared Rejoyn in January 2024-the first digital therapeutic that requires weekly PHQ-9 completion. Mental health platforms like Lyra and Quartet now build monitoring into every depression treatment plan. In the U.S., 45% of psychiatrists use structured scales regularly-up from 28% in 2018. Pharmacogenetic testing (like GeneSight) is becoming more common. It checks your genes to predict how you’ll respond to certain antidepressants. A 2023 JAMA Psychiatry study showed it reduced side effects by 30% and improved response rates by 20% in just 8 weeks. It’s not perfect-but it’s a step forward. Still, only 18% of prescriptions include Therapeutic Drug Monitoring, even though guidelines recommend it for 35% of cases. That gap is where you can make a difference-by asking.Your Next Steps
Start today. No waiting. No perfection needed.- Download the PHQ-9 from the American Psychiatric Association’s website (free, no login needed).
- Print the ASEC checklist or save it in your notes app.
- Track your mood and one functional goal daily for 14 days.
- At your next appointment, bring your logs. Say: ‘I’ve been tracking my symptoms and side effects. Here’s what I’ve seen. What do you think?’
How long should I wait before deciding if my antidepressant is working?
Most people start seeing symptom improvement between weeks 4 and 6. A 50% reduction in PHQ-9 or BDI scores by week 6 is a strong sign the medication is working. If there’s no change by week 8, it’s time to talk about adjusting the dose or switching medications. Don’t wait longer than that-delaying can prolong suffering.
Can I stop my antidepressant if the side effects are too bad?
Never stop abruptly. Stopping suddenly can cause withdrawal symptoms like dizziness, brain zaps, nausea, or worsening depression. Instead, document your side effects using the ASEC checklist and schedule a call with your provider. They can help you taper safely or switch to a different medication with fewer side effects. Many people find relief by switching from an SSRI to bupropion or mirtazapine.
Are digital apps like Moodfit or Sanvello reliable for tracking?
Apps can help with consistency, but they’re not as accurate as paper-based scales. Studies show mobile apps have test-retest reliability around 0.72, while PHQ-9 and BDI scores on paper score above 0.85. Use apps to remind you to track, but enter your scores manually into a printable version of PHQ-9 or ASEC for the most reliable data. Your doctor needs numbers they can trust.
What if my doctor doesn’t use these tools?
Many doctors still rely on casual check-ins, especially in primary care. That doesn’t mean you can’t bring your own data. Print your PHQ-9 and ASEC scores. Say: ‘I’ve been tracking my symptoms and side effects. Here’s what I’ve noticed. Can we use this to guide our next steps?’ Most providers appreciate the initiative. If they resist, consider seeking care from a psychiatrist who specializes in measurement-based care.
Is Therapeutic Drug Monitoring worth asking for?
Yes-if you’ve been on the same dose for 6-8 weeks with no improvement. A 2022 study found that 50-70% of people who don’t respond to antidepressants have blood levels below the therapeutic range, even when they take the medication exactly as prescribed. TDM can reveal if you’re metabolizing the drug too quickly or too slowly. It’s not routine, but it’s available. Ask your doctor to order it through a certified lab.
Can side effects go away on their own?
Some do-especially nausea, dizziness, or sleepiness-in the first 2-3 weeks. But others, like sexual dysfunction, weight gain, or emotional numbness, rarely fade without intervention. If a side effect lasts longer than 6 weeks and impacts your life, don’t assume it’s permanent. Talk to your provider. There are often alternatives, dose adjustments, or add-on treatments that can help.
How do I know if I’m improving beyond just mood scores?
Look at your daily life. Can you get out of bed without forcing yourself? Do you want to call a friend? Did you cook a meal? Attend a meeting? Return to work part-time? Functional recovery often comes before full symptom relief. A 2020 study showed people who focused on real-life goals recovered faster than those who only chased lower depression scores. Your life is the real test-not just the numbers.
Akash Chopda
November 24, 2025 AT 04:57the app is a backdoor for pharma to collect your data
they already know when you cry
they're using it to adjust your dose remotely
you think you're in control but you're just a data point
Nikki C
November 26, 2025 AT 02:16she looked at my scores and said oh wow you've been improving more than you thought
turns out i was getting better but my brain kept lying to me
tracking didn't fix me but it gave me proof i wasn't broken
Alex Dubrovin
November 26, 2025 AT 13:50day 4 i got out of bed before noon
no big win right
but it felt like i won the lottery
small things matter more than you think
Jacob McConaghy
November 27, 2025 AT 16:30just paper and honesty
i printed the asec and wrote down every weird feeling
by week 3 i saw my libido dropped right after my pill
switched to wellbutrin and my sex life came back
and my depression didn't
you're not weak for needing help
you're smart for asking for the right kind
Natashia Luu
November 29, 2025 AT 04:28Adam Hainsfurther
November 30, 2025 AT 13:46then i realized i was the one being controlled by my own silence
my doctor never asked about side effects
so i started writing them down
now she asks me what i’ve seen before i even sit down
it’s weird how just speaking up changes everything
stephanie Hill
December 2, 2025 AT 10:35then i lost my entire identity for 8 months
no sex no joy no spark
they said wait it’ll pass
it didn’t
when i finally brought my asec scores they looked at me like i’d betrayed them
like i was asking too much
but i wasn’t asking for magic
i was asking to be human again
akhilesh jha
December 4, 2025 AT 00:56they say take pill and be quiet
i tracked my mood and told my mom
she said you are overthinking
but when she saw my scores drop
she started asking me how i felt every night
tracking didn't cure me
but it gave me words when i had none
Jeff Hicken
December 5, 2025 AT 07:58my phq-9 went down but i still wanna die
they just wanna make you feel better about being broken
the pill does nothing
the tracking is just a distraction
they dont care if you live or die
they just want you to stop complaining
Vineeta Puri
December 6, 2025 AT 13:06Victoria Stanley
December 8, 2025 AT 04:24felt like homework
but after 2 weeks i noticed i was smiling at stupid things
like the barista remembering my order
or my cat purring on my lap
i didn’t realize i was healing until i saw the pattern
you don’t need to feel happy to be getting better
just notice the tiny things
Andy Louis-Charles
December 8, 2025 AT 12:16took me 5 minutes
no app needed
no login
no ads
just me and my feelings
thank you for this
🫡
Douglas cardoza
December 9, 2025 AT 07:30got lazy after a week
then i missed my mom’s birthday
realized i hadn’t called anyone in 10 days
so i started again
not for the scores
for me