Depression Anxiety Stress Scale 21 (DASS 21)

What is stress, anxiety, and depression?

Stress is a feeling that resembles physical or emotional tension. It is our body’s response to external challenges or demands and each individual stress response could be a result of any stressor, event, situation, or thought that makes us feel frustrated, angry, or even nervous. Although it may sound harmful, not all stress is bad. When stress helps us escape danger or push ourselves to meet deadlines, it can actually serve as a positive motivator in our lives. However, when stress lasts for long periods of time, it can adversely affect our physical and mental health. This can eventually develop into something known as chronic stress and may lead to serious health problems.

Anxiety on the other hand is commonly known as stress that continues on even after the stressor is long gone. It is a feeling of uneasiness, such as feeling fearful or feeling worried, or in other words, feeling as if we are under threat even though there is no real danger around. Every one of us would have feelings of anxiety at some point in our lives. For example, we may have anxiety before taking an exam or before attending a job interview. Feeling anxious for these situations are very normal. But for some of us, we may find it hard to control our worries and may find that our anxious feelings are persistent in our everyday lives no matter how much we try to convince ourselves otherwise. This can affect our ability to live fulfilling lives and may hint the presence of an anxiety disorder instead.

While stress and anxiety may cause us to fell as if we’re always on edge, depression may cause us to feel the complete opposite. Depression is considered to be a type of mood disorder where we may experience persistent sadness, sudden loss of interest or pleasure in doing the things we once loved, and even changes in appetite or sleep patterns. It’s important to note that depression is not just about feeling “blue”, instead, our low mood can prolong for an extended period of time and affect our ability to function even when it comes to everyday tasks.

Statistics (Malaysia)
            Almost 500,000 Malaysians experience symptoms of depression (National Health and Morbidity Survey, 2019)
            424,000 Malaysian children experience mental health problems (National Health and Morbidity Survey, 2019)
            Depression accounts to 26 percent of the top contributors to disability in Malaysia whereas Anxiety accounts to 71 (Institute for Health Metrics and Evaluation, 2018)
            Between 76 and 85 percent of people receive no treatment for their disorders (The Lancet Psychiatry, 2017)
            Women are 50 percent more likely to develop depression and anxiety as compared to men
            50 percent of all mental disorders in Malaysia begin by the age of 14

Symptoms

Stress can cause many types of physical and emotional symptoms. Some of the common symptoms include diarrhea or constipation, headaches, frequent body aches and pains, trouble sleeping or sleeping too much, weight changes, and having an upset stomach.

Anxiety symptoms can vary between individuals, but would generally include having an increased heart rate, trembling, difficulty concentrating, rapid breathing or also known as hyperventilation, feeling nervous, restless, or tense, and experiencing some gastrointestinal (GI) problems such as constipation or stomach cramps.

Depression symptoms include having feelings of helplessness or hopelessness, losing interest or pleasure in daily activities, experiencing appetite or sleep changes (e.g., eating too much/too little, sleeping too much/too little), losing energy, feeling more irritable than usual, and experiencing problems in concentration. Some individuals may also experience suicidal thoughts or suicidal ideation as a symptom.

Causes

The cause of stress is different for each individual and there is no one specific cause. This is because what triggers a stress response in one individual may not be the same that triggers a stress response in another individual, and it can greatly vary from forgetting to send an email to a death of a loved one. However, certain life events or certain transitional periods in our lives that can cause stress include:
           Losing a job
           Relationship issues/Breakups/Divorce
           Death in the family
            Financial issues
            Education

            Having a busy schedule

Causes of anxiety may be similar to those of stress where ongoing stressful events may cause us to have anxious feelings, such as work stress or changes in our job, changes in our living environment, pregnancy and the thoughts of labor/giving birth, relationship issues, death or loss of a loved one, and in some individuals who have experienced a traumatic event such as physical or emotional abuse, this could cause them to develop anxiety following that event.

There are a few possible causes of depression and typically ranges from biological causes to situational or social causes:

Family history (we are more likely to develop depression if we have a family member who is diagnosed with this disorder)

Medical conditions/medications (certain medical conditions/medications may put us at a higher risk for depression, such as chronic illnesses)
            Substance use
            Childhood trauma
            Stressful life events
            Low self-esteem