A patient sat across from me last month and said, almost apologizing, "I don't know if this counts as anxiety. I'm probably just stressed." She'd been waking at 3 a.m., bracing for a phone call that never came. Her chest felt tight on the freeway. She wasn't sure any of it was worth my time.
It was. And we had a simple tool to start the conversation.
The GAD-7 anxiety screening is a short, seven-question survey I use in my Los Angeles practice to put a number on something that usually feels too vague to name. It doesn't diagnose you. It opens a door. Here is what it measures, what your score means, and why I lean on it so often.
What is the GAD-7 anxiety screening?
The GAD-7 is a seven-item questionnaire that asks how often, over the last two weeks, you've been bothered by things like feeling nervous, not being able to stop worrying, or feeling on edge. You answer each one on a small scale, from "not at all" to "nearly every day."
Add up the answers and you get a score from 0 to 21. That single number gives us a starting point. GAD stands for generalized anxiety disorder, but the screen is useful well beyond that one diagnosis.
It takes about two minutes. You can fill it out in the waiting room, on your phone, or over a telehealth visit if coming in isn't practical that week.
How do I know if my GAD-7 score is serious?
Higher scores suggest more intense anxiety, but no single number decides everything on its own. Roughly speaking, the GAD-7 sorts results into minimal, mild, moderate, and severe ranges. A higher score tells me your symptoms are showing up more often and weighing on you more.
What I care about just as much is the last question: how hard these feelings make your daily life. Two people can land on the same score and need very different things. One is sleeping fine and managing. The other hasn't had a calm morning in weeks.
So I read the number, then I read you. The score is a conversation starter, not a verdict.
Why do you screen for anxiety in primary care?
Because anxiety rarely shows up wearing a name tag. It hides in physical complaints, and people often come to me for those first.
I see it as racing heart, stomach trouble, headaches, and the kind of exhaustion that sleep doesn't fix. Patients with insomnia are often dealing with worry that won't switch off at night. Anxiety and depression also travel together, which is why I'll sometimes pair the GAD-7 with a depression screen to see the fuller picture.
A quick screen catches what a busy visit might otherwise miss. In a small membership practice, I have the time to actually ask, and the GAD-7 makes sure I do it consistently rather than only when someone happens to bring it up.
What happens after the screening?
We talk. The number is the beginning of the visit, not the end of it.
If your score is low and you feel fine, that's reassuring on its own, and we have a baseline for next time. If it's higher, I want to understand what's driving it. Sleep? A specific stressor? Caffeine? Thyroid issues and a few other medical conditions can mimic anxiety, so I sometimes check labs before assuming anything.
From there, options might include:
- Practical changes to sleep, movement, and caffeine that genuinely move the needle for a lot of people
- A referral to a therapist, since talk therapy is one of the most effective tools we have for anxiety
- A discussion about medication when symptoms are heavier or persistent
And I repeat the GAD-7 over time. That's one of my favorite parts. When we try something and your score drops on the next visit, you can see the progress in black and white. That feedback matters, especially on the weeks when it doesn't feel like anything is working.
Is the GAD-7 the same as a diagnosis?
No. A screening tool flags the likelihood that something's there; it doesn't confirm a condition by itself. A real diagnosis comes from a full conversation about your history, your symptoms, how long they've lasted, and how much they're affecting your life.
I tell patients to think of the GAD-7 like stepping on a scale. It gives you useful information. It doesn't tell you the whole story, and it certainly doesn't tell you who you are.
If you've been carrying a low hum of worry and quietly wondering whether it's "enough" to mention, please mention it. There's no threshold you have to cross to deserve help, and a two-minute questionnaire is a gentle, low-pressure place to start. I'd be glad to walk through it with you and figure out the next step together. Reach out anytime and we'll find a time to talk.