How to tell ordinary stress from burnout, anxiety and depression, what the PHQ-9 and GAD-7 scores mean, and exactly what happens when you call India's free helpline on 14416.
Dr. Geeta S. K.
August 12, 2025
11 min read
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The short answer: Ordinary stress eases when the pressure eases. If low mood, worry or hopelessness has lasted more than two weeks and is changing your sleep, appetite or ability to get through the day, that is no longer just stress and it deserves proper assessment. India has a free helpline, Tele-MANAS on 14416, open at every hour in Kannada and many other languages. This guide helps you tell the difference honestly.
What you will learn
The plain difference between stress, burnout, anxiety and depression
The two-week rule doctors actually use
Why anxiety in Indian women so often shows up as body symptoms first
The two short questionnaires used to measure this, and what the scores mean
Exactly what happens when you call 14416, and what it costs
Stress, burnout, or something more?
These words get used as if they mean the same thing. They do not, and the difference decides what helps.
Stress is a response to pressure. It rises when demands rise and settles when they ease. Burnout is what happens when that pressure never lets up: exhaustion, growing distance from people and work, and a sense of not coping. Anxiety and depression are health conditions. They persist even when the situation improves, which is the part that confuses women most.
What you notice
What it points to
Eases when the difficult week ends
Ordinary stress
Exhausted and detached, but lifts on a real break
Burnout
Worry that will not switch off, most days, for weeks
Possible anxiety condition
Low mood or no interest in anything, most of the day, for weeks
Possible depression
Present even when life has genuinely improved
Needs assessment, not more willpower
I want to be careful here. This table helps you decide whether to seek help. It does not diagnose you, and no article can. That is a conversation with a doctor or counsellor.
The two-week rule
If you take one thing from this page, take this. Two weeks is the point to stop waiting and get it looked at.
When low mood, loss of interest, or constant worry has been present most days for more than two weeks, and it is affecting your sleep, your eating, or your ability to do your normal work, have it assessed. Not because you have failed to cope, but because something treatable may be going on.
To be accurate about where that number comes from: two weeks is the period the standard questionnaires ask you about, and for depression it is also the duration doctors use when making a diagnosis. For anxiety conditions the formal diagnosis usually needs a much longer history, closer to six months. But you should never wait six months to ask for help. Two weeks of most days is the sensible moment to raise it.
Before two weeks, in a genuinely hard patch, watchful waiting with sleep, movement and company is reasonable. After two weeks, waiting longer rarely helps.
Why anxiety in Indian women often shows up in the body first
Many women who come to me do not say they are anxious. They say their chest feels tight, their head aches every evening, their stomach is upset, or their heart races at night. The distress arrives as a body complaint.
There are good reasons for this. Speaking about mood is not part of how most Indian families talk, while a body symptom is acceptable to mention. Anxiety also genuinely produces physical effects, so the sensations are real, not imagined.
The trouble is that this path leads to test after test coming back normal, and a woman being told nothing is wrong. Nothing is wrong with your heart is not the same as nothing is wrong. If your investigations are clear and the symptoms continue, asking about anxiety is the next sensible step, not a dismissal.
Some symptoms follow the menstrual cycle closely, appearing in the week before the period and lifting when it starts. That pattern has its own name and its own treatment, and I cover it in my guide to PMDD.
The two questionnaires your doctor uses
Doctors do not diagnose these conditions by intuition. Two short questionnaires are used worldwide, and you can look at them yourself.
PHQ-9 asks nine questions about mood over the last two weeks. GAD-7 asks seven about worry. Each answer scores 0 to 3, and the total falls into a band.
Score band
PHQ-9 (mood)
GAD-7 (worry)
Minimal
0 to 4
0 to 4
Mild
5 to 9
5 to 9
Moderate
10 to 14
10 to 14
Moderately severe
15 to 19
Not used
Severe
20 to 27
15 to 21
A total of 10 or more on either is the usual point at which doctors take it seriously and look further. But please read this next line carefully, because it is the part people get wrong. These scores measure how heavy your symptoms have been over two weeks. They are not a diagnosis. A high score means have a proper conversation, not that you now have an illness.
How common is this, really?
Common enough that you are almost certainly not the only woman on your street going through it.
India's most recent national mental health survey, carried out in 2015 and 2016, found that about one in ten adults had a mental health condition at the time of the survey. Women had higher rates than men for both depression and anxiety.
The number that troubles me most is a different one. For anxiety disorders, the survey found a treatment gap of nearly 83%. That means more than four in five people with a diagnosable anxiety condition were getting no treatment at all. Not because treatment does not exist, but because people do not reach it.
About Dr. Geeta S. K.
Dr. Geeta S K, MBBS, DGO, FRM, DRM (Germany), is a gynecologist and fertility specialist. She provides clear, compassionate guidance on PCOS, pregnancy, fertility and women's health.
Dr. Geeta S. K.