GAD-7 Anxiety Screening

The seven items of the GAD-7 capture the core symptoms of generalized anxiety disorder per DSM criteria: excessive worry, inability to control worry, restlessness, difficulty relaxing, irritability, feeling afraid, and functional impairment from these symptoms. Each item is rated 0 (not at all) to 3 (nearly every day) for the past two weeks, summing to total scores from 0 to 21. The two-week window aligns with assessment of recent symptom severity, not the 6-month minimum required for full DSM diagnosis of generalized anxiety disorder. A high score reflects severe recent symptoms; a clinical diagnosis requires the persistence and pervasiveness criteria in addition to severity.

Score thresholds map to clinically-validated severity bands. 0–4 represents minimal anxiety symptoms — within the range of healthy adults during stressful periods. 5–9 represents mild anxiety — significant but often manageable with lifestyle changes (exercise, sleep, mindfulness, caffeine reduction). 10–14 represents moderate anxiety — generally warrants professional evaluation and structured treatment. 15–21 represents severe anxiety — typically requires immediate treatment, often combining therapy and medication evaluation. The cutoff of 10 has 89% sensitivity and 82% specificity for generalized anxiety disorder. The scale also detects panic disorder, social anxiety, and PTSD with reasonable sensitivity though it was not specifically designed for those conditions.

Anxiety and depression are clinically intertwined — 60%+ of patients with one diagnosis also meet criteria for the other. The PHQ-9 and GAD-7 are typically administered together in primary care settings to capture both. If your GAD-7 score is elevated, consider also taking the PHQ-9. Comorbid presentations are common and generally require integrated treatment rather than treating one condition before the other. SSRIs and SNRIs are effective for both anxiety and depression and often used as first-line treatment for comorbid presentations. Cognitive behavioral therapy (CBT) is similarly effective across both conditions. If you screen positive on both, your provider will likely address both in an integrated treatment plan rather than sequentially.

The GAD-7 screens for generalized anxiety disorder specifically. Other anxiety conditions — panic disorder, social anxiety disorder, specific phobias, OCD, PTSD — produce some elevation but require separate instruments for specific screening (PDSS, SPIN, Y-BOCS, PCL-5 respectively). Anxiety also accompanies many medical conditions (hyperthyroidism, cardiac arrhythmias, side effects of medications, withdrawal from caffeine or alcohol) that should be ruled out before assuming primary anxiety disorder. The GAD-7 is also not appropriate for: children under 18 (use SCARED instead), severe cognitive impairment, acute psychiatric crisis. Use the GAD-7 alongside professional assessment, never as a substitute for it. If results concern you, talk to a healthcare provider.