Checking In on Your Mind: The Cantril Ladder, WHO-5, and PHQ-4

Personality shifts over years. Your state of mind can shift from one week to the next. Nadapge’s check-in is not a personality test. It is a quick look at how you are doing right now, using three short, well-studied scales. Here is what each one measures and how to read it.

1. The Cantril ladder

Psychologist Hadley Cantril designed this question (Cantril, 1965). Picture a ladder with steps numbered 0 to 10. The top is the best possible life you can imagine for yourself; the bottom is the worst. Then answer two questions:

• Which step are you standing on now?
• Which step do you expect to be on in five years?

Gallup combines the two answers into three groups:

Group	Rule
Thriving	Now 7 or higher, and five years from now 8 or higher
Struggling	Everyone not in the other two groups
Suffering	Now 4 or lower, and five years from now 4 or lower

Because the ladder asks you to step back and evaluate your life as a whole, it reflects overall life evaluation more than today’s mood.

2. The WHO-5 Well-Being Index

The WHO-5 asks how often over the past two weeks you have felt cheerful and in good spirits, calm and relaxed, active and vigorous, woke up feeling fresh and rested, and found daily life filled with things that interest you. Each item is rated from 0 (at no time) to 5 (all of the time).

Scoring and interpretation

Add the five items for a raw score of 0 to 25, then multiply by 4 to get 0 to 100. A systematic review of the literature summarizes the common guidelines (Topp et al., 2015):

• 50 or below suggests low well-being and is a reason to look more closely for depression.
• 28 or below suggests likely depression, and a professional assessment is recommended.
• A change of about 10 points between check-ins is considered meaningful.

The WHO-5 is brief, but its validity has been supported across many countries and settings.

3. PHQ-4: a quick look at anxiety and low mood

The PHQ-4 is a four-item screener (Kroenke et al., 2009). It asks how often over the past two weeks you have been bothered by feeling nervous, anxious, or on edge; not being able to stop or control worrying; little interest or pleasure in doing things; and feeling down, depressed, or hopeless. Each item is rated 0 to 3.

• Total score 0 to 12: 0-2 normal range, 3-5 mild, 6-8 moderate, 9-12 severe
• An anxiety subscore (first two items) of 3 or more, or a depression subscore (last two items) of 3 or more, suggests a fuller evaluation is worthwhile.

A large general-population study supported using the PHQ-4 this way (Löwe et al., 2010).

Three scales, three angles

• The ladder captures how you judge your life overall, which is strongly shaped by circumstances such as work, money, and relationships.
• The WHO-5 captures positive mood and energy over two weeks. Higher is better.
• The PHQ-4 captures anxiety and depressive symptoms over two weeks. Higher means more distress.

Mixed patterns are common. You might rate your life a 7 on the ladder yet have a low WHO-5 and raised anxiety during a two-week deadline crunch. That reads as a hard stretch, not a collapsing life. If all three point the wrong way for several weeks in a row, though, it is time to reach out rather than tough it out.

Screening is not diagnosis

These are screening tools: they help answer “is it worth looking into this more?” A high PHQ-4 does not mean you have depression or an anxiety disorder, and a good score does not mean nothing is wrong. Only a qualified professional can make a diagnosis, through a proper assessment. If your scores cross the thresholds, or daily life has felt hard for more than two weeks, it is a good idea to seek support. The same goes if you are sleeping or eating much less, or basic tasks like getting to work or school feel overwhelming, whatever your score. Asking for help is a way of taking care of yourself, not a sign of weakness.

Where to get help

If you are thinking about harming yourself, reach out now.

• Anywhere in the world: findahelpline.com lists free, confidential crisis lines by country.
• Immediate danger: call your local emergency number.
• In South Korea: Suicide prevention line 109 (24 hours, free); mental health crisis line 1577-0199 (24 hours); emergencies 112 or 119; and community mental health welfare centers in every city and district.

How to use this

1. Check in on the same day and time each week, such as Sunday evening.
2. Watch the trend over three or four weeks, not a single score. One low week is common.
3. If your WHO-5 stays at 50 or below for two weeks or more, or your PHQ-4 crosses a threshold, tell someone close to you and book an appointment with a professional.
4. In good weeks, jot down one thing that helped. It becomes your personal toolkit for harder weeks.

Use the mind check-in to see all three scales together and track how they change week to week.