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If antidepressants worked like antibiotics, you wouldn’t need a self-test to gauge their effectiveness. Your reduction in symptoms would occur so quickly that you’d know, without second-guessing yourself, whether you were taking a dud or a winner.
However, unlike antibiotics, antidepressants require a month or longer to work.
Often, you gradually increase your dose over several days and weeks until you are at a full dose. After that, you may need to wait a month or longer before the medicine takes full effect. Even then, some depression symptoms may linger. Other symptoms may surface on some days but not others. Still other symptoms may go away initially but return many months later.
“Because of this gradual and sometimes partial relief, it can be challenging to know if your treatment plan is working,” says Simon Kung, M.D., an associate professor of psychiatry at Mayo Clinic College of Medicine and Science.
The following tools and advice can help you thoroughly and reliably assess your treatment plan, allowing you to work more effectively with your healthcare professional when making treatment decisions.
When starting a new depression treatment
Consider how you want your antidepressant to help you feel.
“Most people tell me that they want to have interest in doing things again. They want to get some motivation back, and they want to be able to enjoy life,” Dr. Kung says.
In addition to knowing your goals for depression therapy, you may benefit from filling out the Patient Health Questionnaire 9 (PHQ-9), a tool healthcare professionals use to track depression symptoms. It involves rating how often you’ve experienced nine depression symptoms over the past two weeks, says Dr. Kung.
The PHQ-9 depression self-assessment
Use this chart to rate how often you’ve noticed depression symptoms in the past two weeks. You can also take the test online at Mayo Clinic’s online depression self-assessment. This online tool scores the assessment for you.
| Not at all | Several days | More than half the days | Nearly every day | |
| Little interest or pleasure in doing things | 0 | 1 | 2 | 3 |
| Feeling down, depressed or hopeless | 0 | 1 | 2 | 3 |
| Trouble falling or staying asleep, or sleeping too much | 0 | 1 | 2 | 3 |
| Feeling tired or having little energy | 0 | 1 | 2 | 3 |
| Poor appetite or overeating | 0 | 1 | 2 | 3 |
| Feeling bad about yourself — or that you are a failure or have let yourself and your family down | 0 | 1 | 2 | 3 |
| Trouble concentrating on things, such as reading the newspaper or watching television | 0 | 1 | 2 | 3 |
| Moving or speaking so slowly that other people could have noticed. Or the opposite — being so fidgety or restless that you have been moving more than usual | 0 | 1 | 2 | 3 |
| Thoughts that you would be better off dead, or hurting yourself in some way | 0 | 1 | 2 | 3 |
| Add up your score from each column. |
Add all columns to get your total score.
Then use this chart to understand your score.
| Score | What It Means |
| 0 | No symptoms typically associated with depression |
| 1-4 | Not typically associated with depression |
| 5-9 | Typically associated with mild depression |
| 10-14 | Typically associated with moderate depression |
| 15-19 | Typically associated with moderately severe depression |
| 20-27 | Typically associated with severe depression |
Monitor your symptoms
Retake the PHQ-9 assessment once a month and keep track of your scores. Compare them over time to see if your depression symptoms are improving, staying the same or getting worse, says Dr. Kung.
In addition to taking the PHQ-9 self-assessment, you might ask friends and family members if they’ve noticed positive or negative changes in your mood and behavior, Dr. Kung says.
Bring that feedback along with your PHQ-9 scores to your healthcare appointments. That information can help you and your healthcare professional decide whether you might benefit if you:
- Put greater emphasis on lifestyle changes or psychological skills.
- Increase the dose of your antidepressant medication.
- Add a second medicine or treatment.
- Stop your current medication or treatment so you can try a different one.
Until symptoms resolve, continue to see your healthcare professional once a month. However, if you’ve been doing well for several months, it’s okay to spread out your appointments to every 3 to 6 months, says Dr. Kung.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
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