What the GAD-7 Is
The GAD-7 is a seven-question test for anxiety. It takes about two minutes, it is scored out of 21, and it is one of the most widely used anxiety screeners in primary care.
It was developed by Drs. Robert Spitzer, Janet Williams, Kurt Kroenke and colleagues, and validated in 2006 across 15 primary care clinics with 2,740 patients. In 2010 Pfizer, which funded the original work, released it without copyright restriction and at no charge. That is why you can take it here, in full, for free, with nothing stored.
It screens. It does not diagnose. A score tells you whether a conversation with a clinician is warranted, and roughly how urgent that conversation is.
Take the GAD-7
Answer for the last two weeks — not today, and not the worst week you have ever had. Everything stays in your browser.
GAD-7 — score it yourself
Over the last 2 weeks, how often have you been bothered by the following problems?
Nothing you enter here is saved, sent anywhere, or seen by us. It stays in your browser and disappears when you close the page.
0 of 7 answered
Please read this before you finish
You have answered that thoughts of harming yourself have been present. That answer matters more than your total score, and it deserves a response today — not at your next appointment.
Call or text 988 for the Suicide & Crisis Lifeline, free and 24 hours a day. Or call Postpartum Support International on 1-800-944-4773, or text "Help" to 800-944-4773.
If you are in immediate danger, call 911 or go to an emergency room. You are not in trouble, and you will not lose your baby for saying this out loud.
- Take the number to a clinician — your ob-gyn, midwife, primary care doctor or your baby’s pediatrician are all legitimate doors.
- Say what the questionnaire did not ask about, if that is the real problem.
- Screening is not diagnosis. A score starts an appointment; it does not end one.
GAD-7 developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute. Validated in Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.
How the GAD-7 Is Scored
Each of the seven questions is worth 0 to 3 points, so the total runs from 0 to 21. Unlike the Edinburgh Postnatal Depression Scale, nothing is reverse scored — you simply add it up.
| Score | Severity | What usually happens next |
| 0–4 | Minimal | No action indicated by this measure alone |
| 5–9 | Mild | Worth mentioning; often monitored and repeated |
| 10–14 | Moderate | Further assessment; treatment usually offered |
| 15–21 | Severe | Active treatment indicated |
10 is the number that matters. In the original validation study, a cut point of 10 or higher identified 89% of people who did have generalized anxiety disorder and correctly cleared 82% of those who did not. According to PubMed, that is from Spitzer RL, Kroenke K, Williams JBW, Löwe B, Arch Intern Med 2006;166(10):1092–7, DOI 10.1001/archinte.166.10.1092.
A score of 10 or more is not a diagnosis. It means the odds are high enough that a proper assessment is the right next step.
The GAD-7 After a Baby
This is the part that is missing almost everywhere else the GAD-7 appears, and it is the reason this page exists on a postpartum site.
Routine screening after birth is built around depression. The EPDS is a depression instrument; so is the PHQ-9. But postpartum anxiety is about as common as postpartum depression, and a woman whose main problem is fear rather than sadness can score in the reassuring range on a depression screen and be told she is fine.
The GAD-7 asks about worry directly. If a depression questionnaire has not matched your experience, this is the one to bring to the appointment instead — or as well.
Two things worth knowing about using it in the postpartum period:
- Some anxiety after a baby is appropriate. Vigilance about a newborn is not a malfunction. The GAD-7 is asking whether that vigilance has become constant, uncontrollable and exhausting — which is a different thing.
- It was first validated in general primary care. Later studies in pregnant and postpartum women confirm it measures anxiety reliably, but some found a lower cut point (7) works better in pregnancy, so treat a borderline score as a reason to talk rather than a verdict either way.
What the GAD-7 Does Not Ask About
Seven questions cannot cover everything, and the postpartum period produces a great deal the GAD-7 was never built to find.
- Intrusive thoughts and postpartum OCD. Unwanted images of harm coming to your baby are not asked about anywhere on this form. They are common, they horrify the people who have them, and that horror is exactly what distinguishes them from something dangerous.
- Anger. Item 6 asks about irritability, but postpartum rage is bigger than irritability and often the loudest symptom of a mood disorder.
- Panic attacks. The GAD-7 measures generalized worry. Discrete surges of terror with chest pain and breathlessness are a different presentation needing different treatment.
- Birth trauma. Flashbacks and avoidance after a frightening delivery will not show up here.
- Postpartum psychosis. No self-report form catches this, because insight is usually lost. It is recognized by the people around her.
If any of those describe you better than “worrying too much,” say so out loud at the appointment. The questionnaire did not ask, which is not the same as it not counting.
GAD-7, GAD-2 and the Other Screeners
| Tool | Measures | Items | Free to use |
| GAD-7 | Generalized anxiety | 7 | Yes |
| GAD-2 | Anxiety, ultra-brief | First 2 GAD-7 items | Yes |
| PHQ-9 | Depression severity | 9 | Yes |
| EPDS | Perinatal depression | 10 | No — permission needed to republish |
The GAD-2 is simply the first two questions of the GAD-7, used as a fast filter. A GAD-2 score of 3 or more is the usual trigger to complete the full seven.
What to Do With Your Score
- Take the number to a person. Your ob-gyn, midwife, primary care doctor or your baby’s pediatrician are all legitimate doors, and none of them will find the conversation strange.
- Say which items drove the score. “It was mostly the restlessness and the fear something awful will happen” is more useful to a clinician than a total.
- Find a therapist who treats perinatal anxiety. Cognitive behavioral therapy helps reduce anxiety in pregnancy and after birth, and some medications, including SSRIs, carry a relatively low risk during breastfeeding.
- If you want to talk to someone tonight, Postpartum Support International runs a free HelpLine at 1-800-944-4773, or text “Help” to 800-944-4773 in English, 971-203-7773 in Spanish.
- In a crisis, call or text 988.
Frequently Asked Questions
What is a normal GAD-7 score?
In the general population the average score is about 3, and only about 5% of people score 10 or higher. The GAD-7 measures the last two weeks rather than a fixed trait, so a 4 during an unusually hard two weeks means something different from a 4 in an ordinary one.
Is a GAD-7 score of 10 bad?
It is the threshold clinicians use to look further. At 10 or above, the test correctly identifies about nine in ten people who do have generalized anxiety disorder. It is a reason to book an appointment, not a diagnosis.
Can I take the GAD-7 while pregnant?
Yes. Anxiety in pregnancy is common and under-screened, and the GAD-7 is widely used in perinatal settings.
Is the GAD-7 free to use?
Yes. Pfizer released the PHQ family and the GAD-7 in July 2010 without copyright restriction and at no charge, and the form itself carries the line “No permission required to reproduce, translate, display or distribute.” Clinicians, researchers and websites can all use it without a license or a fee.
Does this website store my answers?
No. The tool runs entirely in your browser. Nothing is transmitted, nothing is saved, and closing the page erases it.
How often can I retake it?
As often as is useful. Because it asks about the last two weeks, retaking it more than once a two weeks mostly measures the same window. Many clinicians repeat it every few weeks to track whether treatment is working.
