Updated
Published screening questionnaire – not a diagnosis
PHQ-9 – Persistent low mood self-check
The PHQ-9 measures recent depressive symptoms. The separate history questions help distinguish recent changes from a longer pattern; they are not included in the score.
Answers are processed only in this page by this assessment. They are not submitted, monitored or automatically saved. No name, email or account is required. Use a private device and clear your answers when finished.
For adults aged 18 and over. This self-check cannot diagnose or rule out a condition. Concerns about a child require an age-appropriate professional assessment.
Over the last 2 weeks, how often have you been bothered by the following problems?
Additional context – not included in any questionnaire score
PHQ-9: Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer. The PHQ Screeners materials permit reproduction, display, distribution and electronic use. Scores describe reported symptoms, not a diagnosis or safety assessment. Original instrument and scoring information.
What a dysthymia assessment needs to establish
The clinician considers whether there is a persistent depressive pattern, how it affects you and whether another explanation or additional condition is relevant. Duration matters, but it is not the only question. Current severity, periods of improvement, functioning, physical health and safety also need attention. The MedlinePlus description of persistent depressive disorder explains why a longer history is part of the assessment.
An appointment is not an examination of your ability to remember dates or use diagnostic language. You can begin with an ordinary description such as feeling low for a long time or finding that everyday life takes unusual effort. The professional should explain what further information is useful and why, rather than expect you to arrive with a diagnosis already established.
A recent depression score cannot describe several years
The PHQ-9 asks about a specified recent period. It can support discussion of current depressive symptoms, but it does not show whether those symptoms have been present continuously, whether there were sustained recoveries, or what happened during earlier episodes. A person with a longstanding problem may score differently during a better or worse fortnight without that number resolving the overall diagnosis.
The depression assessment and PHQ-9 page explains that instrument separately. The worksheet here is not another version of it. No responses are added together, and there is no threshold for persistent depression. A low recent score does not invalidate longstanding difficulties, while a high score does not establish their duration or identify the right treatment.
Build a timeline without forcing precision
Use a few broad markers: the first period you remember, major changes, times when symptoms eased and recent deterioration. A move, a job change, an illness or a relationship transition may help organise memories. Include the periods that do not fit a simple story. They can be clinically informative rather than inconvenient exceptions that need to be explained away.
It is acceptable to write that a date is approximate or that you cannot remember. Do not repeatedly reconstruct the past until it appears to satisfy a diagnostic threshold. If records from earlier care are available, discuss whether they would be helpful. The assessment should use them thoughtfully and with appropriate permission, not make perfect documentation a condition of receiving support.
Describe the hidden effort as well as visible functioning
A clinician needs to know what you can still do and what has become costly. Completing work does not explain whether you have energy for meals, relationships or activities afterwards. You might describe decisions that take much longer, social plans you no longer make, or responsibilities maintained only by letting everything else fall away. These details are often more useful than saying that you are functioning well or badly.
Include things that remain meaningful or manageable. An assessment is not a competition to present the worst possible picture. Understanding existing strengths and support can shape a realistic plan. A fictional example is someone who can enjoy time with one trusted friend but finds most other activities exhausting; that difference deserves exploration rather than being used to dismiss the problem.
Why the clinician asks about other mood states
Questions about periods of increased activity, unusually elevated or irritable mood, or reduced need for sleep help clarify the wider mood history. People do not always mention these periods because they may remember them as productive or welcome. Their timing and consequences can affect diagnosis and treatment. The NIMH overview distinguishes depressive conditions from bipolar presentations.
These questions do not mean that the professional has already decided you have another disorder. Describe what happened without trying to prove or exclude a label. Similarly, marked agitation, confusion, unusual beliefs or experiences of hearing or seeing things need their own assessment. A self-report worksheet cannot examine these experiences or determine whether it is safe to wait for routine care.
Physical health, medicines and sleep belong in the picture
Longstanding fatigue and concentration problems can involve more than mood. Tell the clinician about medical diagnoses, pain, sleep difficulties, alcohol or other substances, and prescribed or non-prescribed products. The purpose is not to assume that one of these explains everything, but to identify questions that could change the recommendation. Appropriate physical examination or investigations may be considered when there is a clinical reason.
Do not stop medication, change sleep patterns or undertake dietary restrictions to make the assessment clearer. Bring an accurate account of your usual circumstances. If several clinicians are involved, explain their roles and ask how information can be shared appropriately. The insomnia guide describes one relevant overlap, but it does not replace evaluation of your particular sleep or health concerns.
Make earlier treatment experiences useful
Note what was tried, roughly how long it lasted and what changed. It may help to distinguish a supportive consultation from a structured therapy course, or a medicine stopped because of adverse effects from one reviewed after an adequate trial. You do not need to remember every technical detail. Describe what you know and any questions that previous care left unanswered.
A clinician can use this information to discuss a different approach or identify barriers that can be addressed. Earlier disappointment should not be used to blame you or assume that care is futile. NICE guidance on chronic symptoms includes reviewing suitable treatment options. Our dysthymia treatment page explains questions to ask about that recommendation.
What you should understand after the appointment
Ask for the working explanation, any remaining uncertainty and the next appropriate step. A recommendation should identify the professional involved, the initial focus, likely appointment format and the first review point. It should also explain whether further medical or specialist assessment is needed. You can ask why one option is being suggested over another and discuss practical limits before committing.
Clarify who receives a summary and how family or existing professionals may be involved. A relative can help with arrangements without automatically seeing private clinical material. At VAYEMA, assessment comes before a treatment plan. Where several providers need to work together, care coordination can help with agreed practical communication without replacing clinical responsibility.
When to seek help before completing the worksheet
New or worsening thoughts of self-harm, severe deterioration, an inability to care for basic needs or unusual experiences should be discussed promptly with an appropriate professional. If you may act on suicidal thoughts, cannot stay safe or have a medical emergency, contact local emergency services or attend an emergency department. Do not use a long history of depression as a reason to discount a present change.
The worksheet is not monitored, and writing something here does not notify a clinician. Contact the relevant service directly through an appropriate urgent channel. For a routine appointment, you can bring only the notes you find useful or attend without them. Preparation is intended to reduce the burden of explaining, not create a new barrier to receiving care.
Frequently asked questions about dysthymia self-checks
Is this a validated dysthymia test?
No. It is an original, unscored preparation worksheet. The prompts help describe duration, impact and questions, but have no diagnostic cut-off or probability estimate. A professional assessment is needed to understand whether persistent depressive disorder or another explanation fits. Completing every prompt is not required to seek help.
What if I cannot remember when symptoms started?
Say that the starting point is uncertain. Use broad life stages or records where helpful, without guessing to satisfy a timeframe. The clinician can explore what you do remember and explain the limits of any conclusion. Uncertainty about dates should not prevent discussion of your current difficulties and support needs.
Can another person complete these notes for me?
Someone can help you organise your own account with your agreement. Their observations should be distinguished from your experience rather than presented as a diagnosis of you. A clinician may find both perspectives useful. Relatives seeking help separately can discuss their own concerns without completing a clinical assessment on your behalf.
Do I need a high PHQ-9 score to request assessment?
No. A recent symptom score does not determine whether longstanding difficulties deserve attention. Explain what is affecting life, including changes that a questionnaire may not capture. The understanding guide describes why duration and hidden effort matter alongside current symptoms. A score is not an eligibility test for care.
Are my answers sent to the clinic?
No. The tool keeps notes in the open page and does not send them to the inquiry inbox. You may review, clear or deliberately download them. A downloaded file remains on your device and should be stored privately. Use a clinical communication channel agreed with the professional for anything you choose to share.
Can the notes decide which treatment I need?
No. They repeat your observations without interpreting them. Treatment depends on clinical assessment, history, safety, health and preference. The aim is to help you ask useful questions, not select medication, an intensive programme or a particular professional automatically. You can discuss the recommendation before agreeing to any ongoing care.
Resources and references
MedlinePlus: persistent depressive disorder. National Institute of Mental Health: depression, diagnosis and symptom history. NICE NG222: assessment and chronic depressive symptoms. The worksheet is not a reproduction of a validated screening scale and does not provide clinical interpretation.