GAD-7 anxiety test with scoring

What the GAD-7 test is

The GAD-7 is a seven-question anxiety screener published in 2006 by Robert Spitzer, Kurt Kroenke, Janet Williams and Bernd Löwe (Archives of Internal Medicine, volume 166, pages 1092 to 1097). The authors developed and tested it with 2,740 adults at 15 primary care clinics in the US, checking the answers of a large subgroup against interviews with mental health professionals. Because it takes about two minutes and is free to use, it now turns up in doctors' offices, telehealth intake forms and research studies around the world.

Each question asks how often a problem has bothered you over the last two weeks: feeling nervous or on edge, not being able to stop worrying, worrying too much about different things, trouble relaxing, restlessness, irritability, and feeling afraid that something awful might happen.

The name comes from generalized anxiety disorder (GAD), but the test reaches further. A follow-up study by the same group (Kroenke and colleagues, Annals of Internal Medicine, 2007) found it also picks up panic disorder, social anxiety disorder and post-traumatic stress disorder reasonably well. A high score points to anxiety symptoms in general, not to one particular condition.

GAD-7 scoring

Every question uses the same four answers, scored 0 to 3:

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

Add the seven numbers and you have the total, from 0 to 21. There are no reversed items and no weighting. The original paper proposed cut-offs of 5, 10 and 15 as markers of mild, moderate and severe anxiety, and this tool uses exactly those bands:

Total score	Level	What it usually means
0-4	Minimal	Few anxiety symptoms over the last two weeks
5-9	Mild	Worth watching; mention it to your doctor if it lasts or affects work or home life
10-14	Moderate	The level at which clinicians usually suggest a fuller assessment
15-21	Severe	Speak with a doctor or licensed mental health professional soon

As an example, someone who answers "Several days" to four questions (4 points), "More than half the days" to two (4 points) and "Nearly every day" to one (3 points) scores 11, in the Moderate band.

The paper version ends with one more question that is not scored: how difficult these problems have made it to do your work, take care of things at home or get along with other people. This page leaves it out, but it is worth having your own answer ready, because a clinician will ask.

What a score of 10 or more usually prompts

Ten is the GAD-7's most important number. In the 2006 study, a cut-off of 10 identified 89 percent of people who had generalized anxiety disorder and correctly cleared 82 percent of people who did not. Put simply, most people with the condition score 10 or higher, and some people without it do too. That is why 10 is treated as the point to get a proper assessment, not as a verdict.

At that assessment, a doctor or licensed counselor will usually ask how long the worry has been going on, how much it gets in the way, and whether something else could explain it. Thyroid problems, heavy caffeine use, some medications, depression and substance use can all produce similar symptoms. From there you can talk through options together, which may include counseling, structured self-help or medication, or simply a plan to check again in a few weeks.

If your employer offers an employee assistance program (EAP), it is often the quickest route to a first conversation: a few free, confidential sessions, usually arranged by phone. The National Institute of Mental Health also has a plain-language overview of generalized anxiety disorder that is useful to read before an appointment.

Limits of the GAD-7

• It is a screening and reflection tool, not a diagnosis. It cannot rule out a physical cause or tell one anxiety disorder from another.
• It covers two weeks. A layoff announcement, a sick parent or a big deadline can push scores up for a while. That is real and worth noticing, but it is not the same as a lasting disorder, which a clinician judges over months.
• It relies on self-report, so the same week can score differently depending on how you read the questions on the day.
• It does not ask about mood or about thoughts of harming yourself. Anxiety and depression often travel together, so the PHQ-8 mood check is a sensible companion. If you are having thoughts of ending your life, call or text 988 at any hour, or call 911 if you are in immediate danger.

Worry that is mostly about your job, such as dreading Monday or feeling unable to switch off, can also be a sign of strain at work. The work burnout test looks at that side.

Frequently asked questions

What does a GAD-7 score of 10 mean?

A score of 10 is the bottom of the Moderate band. It means your answers are at the level where clinicians usually recommend a fuller assessment. Many people who score 10 or more do have an anxiety disorder, but not all of them, so treat it as a strong reason to talk to a doctor or licensed counselor rather than as a label.

Can I diagnose myself with the GAD-7?

No. A diagnosis takes a conversation with a clinician who can ask about duration, daily impact, physical health and other conditions. The GAD-7 is designed to flag who should have that conversation. Your score is still useful: bring it to the appointment, along with a few examples of how the worry shows up at work and at home.

Is the GAD-7 free to use?

Yes. The GAD-7 is copyrighted by Pfizer, but no permission is required to reproduce, translate, display or distribute it. That is one reason it appears in so many clinics, apps and employer programs.

What is the GAD-2?

The GAD-2 is the first two GAD-7 questions on their own, scored 0 to 6. It was described in the 2007 follow-up study as a quick first pass, and a score of 3 or more usually leads to the full GAD-7. Your first two answers on this page give you a GAD-2 score as well.