GAD-7 (Anxiety Screening)

The GAD-7 is a short form with seven questions, and it measures how much anxiety has troubled you over the past two weeks. It is a screening tool, not a diagnosis: screening means checking whether a problem is likely, so that someone can look at it properly.

The result shows whether anxiety is worth a closer look, and roughly how strong it is now. A qualified professional makes the diagnosis.

The GAD-7 turns up in a family doctor's rooms, a therapy intake, a clinic, and in online questionnaires, and it is used in much the same way across the world. Robert Spitzer, Kurt Kroenke, Janet Williams and Bernd Löwe developed it in 2006, and it is one of the most widely used anxiety measures in care and research.¹

It was released free of charge, with no copyright restriction; any clinician may print, translate or use it without asking permission. That is part of why you see it so often.

What the GAD-7 is, and what it is not

GAD-7 is short for Generalised Anxiety Disorder-7. It is a self-report questionnaire: you fill it in yourself, rather than having a clinician score you.

You answer seven short questions about how often anxiety symptoms have bothered you over the last two weeks. The answers add up to a single score, and it takes about two or three minutes.

It puts a rough number on something that is otherwise hard to describe. That number shows a clinician how much anxiety is affecting you, and gives the two of you a shared starting point.

The questionnaire can also be repeated later, to show whether things are shifting. It is a useful measure, validated against the judgement of trained clinicians.¹ Validated here means its results were checked against those clinical judgements.

It is not a diagnosis: a score cannot tell you whether you have an anxiety disorder, which one it is, or what you should do next. Only a qualified professional can do that, by talking with you about your history and your life.

The seven questions

The GAD-7 asks how often, over the past two weeks, you have been bothered by the following. Answer as honestly as you can, and think about your typical days, not only your best or worst ones.

• Feeling nervous, anxious, or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Trouble relaxing
• Being so restless that it is hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid, as if something awful might happen

Each question has the same four answers: not at all, several days, more than half the days, and nearly every day. There are no right or wrong answers; the aim is an honest account rather than a tidy one.

How the score is worked out

Each of the four answers is worth points, running from 0 for not at all up to 3 for nearly every day.

Add the seven answers together. The total falls between 0 and 21, and the higher the total, the more anxiety you have described. The developers suggested reading it in four broad bands.¹

A score of 10 or more is the point most often used to signal that a fuller assessment is worthwhile. That level is called a cut-off, and it does not divide people into ill and well.

In the study that introduced the tool, a cut-off of 10 correctly identified about 89% of people who did have generalised anxiety disorder. It correctly cleared about 82% of those who did not.¹

That is good for a two-minute questionnaire, though it is not perfect. The score is a reason to talk to someone, not a conclusion in itself.

What your score actually means

A clinician does not read the number on its own. They set it beside everything else you tell them: what has been happening in your life, how long you have felt this way, and what the anxiety stops you doing. What you make of it yourself matters too.

The same score of 12 can mean very different things for two different people, and only the conversation shows the difference.

A higher score means anxiety is having a real effect now, and it is worth taking to a professional. It does not mean something is permanently wrong with you, or that this is how things will stay. Anxiety is among the more treatable mental health difficulties, and many people feel much better with the right support.

A lower score does not mean your distress is imaginary. If something is troubling you, raise it even if the total looks small. The GAD-7 asks about a particular set of symptoms over a particular fortnight, and nothing more.

One of the tool's real uses is that it can be repeated. Taking the GAD-7 again a few weeks or months later shows whether a score is rising, holding steady, or easing. That helps you and a clinician see whether an approach is working.

When the score can mislead

A screening tool gives up detail for speed.

• It covers only two weeks. A recent stressful patch can push the score up, and a calm fortnight can leave a longer-running problem unrecorded. The number describes a fortnight, not your whole history.
• Physical causes can imitate anxiety. An overactive thyroid, too much caffeine, and some medicines can all produce restlessness, a fast heartbeat or a sense of dread. That is one reason a professional looks at more than the score before drawing conclusions.
• Anxiety and low mood often occur together. Many people who score high on the GAD-7 also have symptoms of depression. A high score is a reason to assess more widely, rather than to assume anxiety explains everything.
• Language and culture shape the answers. Words like restless or on edge mean different things across languages and communities, and distress is not always described in the same terms. A score is read with that in mind, not in isolation.

None of this makes the GAD-7 less worth doing; it means the score is one piece of evidence, judged by a person.

What it can and cannot tell apart

The GAD-7 was built to measure generalised anxiety disorder, which is anxiety marked by persistent worry, hard to control, across many areas of life.

The original study also tested it as a broader anxiety screen, and at the same cut-off of 10 it picked up a fair share of people with panic disorder, social anxiety disorder and post-traumatic stress disorder. It did so less reliably than for generalised anxiety.¹

The GAD-7 was not designed to tell these conditions apart. It measures anxiety as a single overall level, rather than sorting it into types.¹

A raised score can say anxiety is present and worth exploring. Naming which form of anxiety, if any, is work for a clinical assessment, not for the questionnaire.

Using your score to get help

If your score is in the moderate or severe range, the next step is to talk it through with a professional. The same applies if a lower score comes with real distress. That could be a family doctor, a psychologist, a counsellor or another mental health practitioner, depending on where you live.

Talking therapies help a great many people with anxiety. Cognitive behavioural therapy in particular has a strong record: it is a structured treatment that works on thought patterns and on behaviour.

Where treatment is needed, it is decided with you. It may involve therapy, practical changes, medication, or some combination. Any medication is a prescriber's decision, made alongside a doctor. Everyday supports such as sleep, movement and staying connected are not a cure on their own, but they support the treatment rather than replace it.

You can read our guide to finding the right therapist and search the TherapyRoute directory for a qualified professional near you or online.

If you have thoughts of harming yourself, treat that as a reason to reach out today. You can contact your local emergency services, a trusted person, or the crisis lines listed here.

This article is for general information and is not a substitute for professional assessment or care. The GAD-7 is a screening tool and cannot diagnose an anxiety disorder. If anxiety is affecting your life, consider reaching out to a qualified mental health professional.

References

1. [1] Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalised anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. doi.org/10.1001/archinte.166.10.1092.