Feeling Down? Take a Depression Self-Test: PHQ-9

Depression is a serious and growing concern in Malaysia, affecting one million people aged 15+ in 2024, a doubling since 2019 (NHMS 2023). If you’re wondering, “Am I depressed?” the PHQ-9 is a valuable self-screening tool. This guide helps you understand its questions, scoring, and what your results might indicate.

Causes of Depression

Depression is a complex condition, and there’s rarely a single cause. Instead, it often results from a combination of interacting factors. Understanding these can help in recognizing the condition and seeking appropriate help:

• Biological Factors:
  • Brain Chemistry: Imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine are thought to play a role in regulating mood.
  • Genetics: Depression can run in families, suggesting a genetic predisposition, though not everyone with a family history will develop it.
  • Hormonal Changes: Fluctuations in hormones, such as those during pregnancy, postpartum, or menopause, can contribute.
• Psychological Factors:
  • Personality Traits: Individuals with low self-esteem, who are overly self-critical, or pessimistic may be more vulnerable.
  • Coping Mechanisms: How individuals cope with stress and negative emotions can influence their susceptibility.
• Social and Environmental Factors:
  • Stressful Life Events: Major life changes, such as bereavement, job loss, divorce, financial problems, or traumatic experiences (e.g., abuse, neglect, violence), are significant triggers.
  • Chronic Illness or Pain: Living with long-term physical health conditions or chronic pain can increase the risk of depression.
  • Isolation: Loneliness and a lack of social support can be contributing factors.
  • Substance Use: Alcohol and drug abuse can worsen or directly cause depressive symptoms.

It’s important to remember that these factors often interact, creating a “downward spiral” where one issue exacerbates another, leading to the development or worsening of depression.

Understanding the Patient Health Questionnaire (PHQ-9)

The PHQ-9 is a widely used, self-administered screening tool that helps evaluate the presence and severity of depressive symptoms over the past two weeks. 

It consists of nine questions, each corresponding to a key symptom of depression. By reflecting on how often you’ve experienced these symptoms, you can get a preliminary understanding of whether you might be experiencing depression and to what degree.

The PHQ-9 Questions

Over the last 2 weeks, how often have you been bothered by any of the following problems? Please choose the answer that best describes you for each question.

Scoring Key:

• 0 = Not at all
• 1 = Several days
• 2 = More than half the days
• 3 = Nearly every day

   

1. Little interest or pleasure in doing things?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
2. Feeling down, depressed, or hopeless?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
3. Trouble falling or staying asleep, or sleeping too much?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
4. Feeling tired or having little energy?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
5. Poor appetite or overeating?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
7. Trouble concentrating on things, such as reading the newspaper or watching television?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
8. Moving or speaking so slowly that other people could have noticed? Or, the opposite — being so fidgety or restless that you have been moving around a lot more than usual?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)
9. Thoughts that you would be better off dead or of hurting yourself in some way?

    

   • Not at all (0)
   • Several days (1)
   • More than half the days (2)
   • Nearly every day (3)

How to Score Your PHQ-9 Test

To calculate your total score, simply add up the numbers (0, 1, 2, or 3) corresponding to your answer for each of the nine questions. Your total score will range from 0 to 27.

Interpreting Your PHQ-9 Score

Once you have your total score, you can use the guide below to understand what it might suggest about the severity of your depressive symptoms.

A Special Note on Question 9 (Thoughts of self-harm): If you answered “Several days,” “More than half the days,” or “Nearly every day” to question 9 (thoughts of being better off dead or hurting yourself), please seek immediate help. This indicates a potential risk of self-harm. You can contact a local emergency hotline, go to the nearest emergency room, or reach out to a trusted mental health professional right away. Your safety is paramount.

What to Do After Taking the Test

Regardless of your score, if you are concerned about your mood, mental health, or well-being, the most important step is to talk to someone.

1. Consult a Healthcare Professional: Share your PHQ-9 results with your primary care doctor or a mental health specialist. They can conduct a comprehensive assessment, rule out any underlying physical conditions, and provide an accurate diagnosis.
2. Explore Treatment Options: Depending on the severity of symptoms, treatment for depression can include psychotherapy (talk therapy), medication, lifestyle changes, or a combination of these.
3. Prioritize Self-Care: Engage in activities that support your mental well-being, such as regular exercise, a balanced diet, sufficient sleep, mindfulness, and connecting with loved ones.
4. Build a Support System: Lean on friends, family, or support groups. You don’t have to face these feelings alone.

For expert psychiatry services for depression, anxiety, and stress in Kuala Lumpur, consider reaching out to Amarantine Clinic. Our team of mental health professionals offers compassionate care and personalized treatment plans to help individuals navigate their mental well-being.

Taking the First Step Against Depression

It takes courage to acknowledge feelings of being depress and to seek help. The PHQ-9 is a simple yet powerful tool to begin that journey of self-awareness. Remember that depression is a treatable condition, and with the right support, you can improve your mental health and reclaim your quality of life. Don’t hesitate to reach out to professionals who can guide you on the path to recovery. If you are in Kuala Lumpur and seeking dedicated psychiatric care, Amarantine Clinic psychiatry services are available to support you. Your well-being is worth it.

Resources:

1. National Institutes of Health Malaysia (NHMS), 2023.
2. Kementerian Kesihatan Malaysia (KKM), Self-Test.
3. American Psychological Association (APA): Patient Health Questionnaire-9 (PHQ-9).