Task 4

TRAUMATIC COUNSELING

“Depression and Anxienty”

Lecturer :

Ifdil, S.HI, S.Pd, M.Pd, Ph.D, Kons

Arranged By

Name : Lara Amanda Dwidjo

NIM : 18006081

Department of Guidance and Counseling

Faculty of Education

Universitas Negeri Padang

2021
 Depression and Anxienty

A. Depression
1. Definition of Depression

Depression occurs when an individual cannot control a previous psychological condition.

When an individual who is stressed (depressed) and is not relieved / controlled has the
opportunity to turn into anxiety, meaning that the individual becomes indecisive, the individual
becomes worried about the individual's condition having the opportunity to experience
depression.

Depression itself can be interpreted as "moodiness" the individual becomes moody, the
individual becomes more pensive. this condition is associated with the pressure experienced
followed by guidance and so on to become depressed.

In many references depression is a condition of feeling sad, hopeless, feeling useless,

hopeless, hopeless, regretful, withdrawal, and anxious (Aditomo, 2004; Tegawati, 2009;
Setiowati, 2014) and pleasure in daily activities. , and difficulty in thinking (Gulo, 1986; Rinie,
2004). In handling depression, it requires professional assistance (Amelia, 2015; Supyanti, 2012;
Aufa, 2014; Ajisuksmo, 2014).

Depression can be non-clinical and clinical. in non-clinical depression, feelings of

depression are still proportional to the situation that causes depression, and if the situation has
changed or has passed, depressive behavior usually decreases and gradually disappears (Smith,
1982; Aditomo, 2004). Meanwhile, in clinical depression, individuals show inappropriate
thinking patterns and tend to respond to every incident as a bad thing. This then encourages
individuals to develop depressive ways of thinking, such as seeing themselves as inferiorly,
pessimistic about the future, feeling excessive guilt, and punishing behavior patterns. In severe
depression, it can lead to imagining suicide and attempting suicide (Aditomo, 2004; Smith, 1982;
Yusuf, 2009; Setiowati, 2014).

Depression can occur after someone experiences a disaster (Setiowati, 2014; Rachmat,
2006; Astuti, 2012; Trilistya, 2006). An emerging depressive disorder may be an early clue to a
search for a personality disorder. the disaster against depression is well controlled. Such
knowledge can assist a person in counseling for traumatic disasters due to a disaster.

2. Symptoms of Depression

Depression differs from one individual to another, both in terms of the severity of
depression, its tendency to occur, and the accompanying symptoms (Trilistya, 2006; Setiowati,
2014).

Symptoms of depression that always exist are dysphoric mood (sad, hopeless, worried)
and loss of interest, or pleasure in life (Fitrikasari, 2013). Other symptoms that can also be
encountered:

a. Relationship problems, such as avoiding or withdrawing from the environment and

associations
b. Behavioral problems, namely feelings of irritability and sensitivity to criticism
c. Somatic complaints, for example, frequent headaches, abdominal pain, general
complaints of pain, fatigue, sleep disturbances
d. Anxiety, such as fear of failure, nightmares, feeling very guilty, and difficulty
concentrating (Rostiana, 2009; Smith, 1982; Aditomo, 2004; Setiowati, 2014).

In addition, according to the Diagnostic and Statistical Manual IV-Text Revision or DSM
IV-TR (in Primary, 2012) a person suffers from a depressive disorder if the following five (or
more) depressive symptoms occur over a two week period and are a change from the usual state,
namely :

a. Depressed and depressed emotional state within days, which is characterized by

subjective reports (such as feelings of sadness or emptiness) or observations of
others (e.g., looks like wanting to cry)
b. Loss of interest in activities (characterized by subjective reports or observations
of others)
c. Significant weight loss while not on a diet or significant weight gain (for example,
a change in weight of more than 5% of your previous body weight in one month)
d. Insomnia or hypersomnia almost every day
 e. Anxiety or psychomotor delay most days
f. Feelings of tiredness or loss of strength almost daily
g. Feelings of worthlessness or feelings of excessive or unnatural guilt almost every
day
h. Reduced ability to think, concentrate, difficulty making decisions almost every
day
i. Over and over again there were thoughts of death, not only fear of death but also
thoughts of suicide without a clear plan
3. Factors that cause depression

The factors that cause depression can be studied through depression theories. Theories
related to the causes of depression are biological theory, behavior theory, cognitive theory,
psychodynamic theory, and humanistic theory of existence (Smith, 1982).

a. Biological Theory (Hereditary Factors)

Several studies support a role for hereditary factors in depression. Someone whose family
is known to suffer from major depression has a greater risk of suffering from depressive
disorders than society in general (B.S, 2007; Mahampang, 2010; Nora, 2012; Smith, 1982;
Darmayanti, 2008)

b. Theory of Behavior

A person can become depressed if they don't receive enough reinforcement. The smaller
the strengthening, the more severe the depression experienced (Smith, 182; Pratama, 2012;
Halawa, 2015). For example, for people with HIV / AIDS, strengthening and family support is
needed in an effort to reduce feelings of hopelessness, increase motivation to continue life, the
emergence of a sense of comfort and calm in people with HIV / AIDS that the family does not
stay away from and support in living life related to the illness they suffer ( Primary, 2012). In
addition, depression can also occur because individuals have a negative interpretation of an event
in their life, which is always having a negative view of an event (Smith, 1982).

c. Cognitive Theory
 Different thoughts give rise to different behaviors. A depressed person always thinks
wrong or inexact labeling an event. A depressed person always thinks that the situation is always
bad, sees himself as inadequate, then responds to labels and not to the actual situation. Someone
who feels negative about themselves is prone to depression (Smith, 1982; Aditomo, 2004). For
example, someone is depressed when he retires, moves to work, a lack of economic conditions,
accidents, etc. (Trilistya, 2006).

d. Psychodynamic Theory

Depression can occur because of unplanned events. Based on this theory, depression
appears as a reaction to a very meaningful symbolic event. This relates to the relationship
between the individual and the figure who becomes dependent on them as children, especially
mothers. For example, the loss or death of a parent, where this loss is feared and interpreted as
losing everything (Smith, 1982; Setiowati, 2014). The grief of a parent's death that occurred in
childhood can double or triple the risk of developing depression in adulthood. Sometimes
depression worsens, especially on the anniversary of the death of a parent so it is often referred
to as an anniversary reaction (Astuti, 2012).

e. Humanistic Theory of Existence

This theory focuses more on the relationship between depression and loss of self-esteem.
Individuals who have high self-esteem, see themselves positively and see their strengths as more
important than their weaknesses. Conversely, individuals with low self-esteem tend to view
themselves negatively and focus on their weaknesses. Individuals who view and assess
themselves negatively are more likely to experience depression than individuals who value
themselves positively (Aditomo, 2004).

For example, an event that often triggers depression in men is job loss. Depressed men
feel worthless anymore, even though they can still label themselves as husbands, fathers, wearers
of certain academic degrees, etc. Work is the representation of a man in his own view and that of
others. A woman, even though she has worked, but loses her husband (divorced or dies) not only
feels a loss of love, but also feels depressed with a new status as a widow (Smith, 1982).

4. Post-Disaster Depression
 Disaster is an event or series of events that threatens and disrupts people's lives and
livelihoods caused by natural or human factors resulting in casualties, environmental damage,
property damage and psychological impacts (Setiowati, 2014; Pembriati, 2015; Lestari, 2014;
Pradani, 2013; Sriharini, 2010). After disasters, such as earthquakes, tsunamis, flood victims tend
to experience severe depression which is characterized by suicidal thoughts. In addition, disaster
victims are more sensitive to things around them, such as memories, sounds, smells, and detail
events of natural disasters. Individuals who experience depressive disorders can also lead to
papda, the emergence of grief due to loss, economic problems for the family, feeling of failure
and blaming themselves, withdrawing from the environment, hesitating in making decisions,
having trouble sleeping, easily feeling tired, experiencing eating disorders, etc. (Setiowati, 2014).

B. Anxienty
1. Definition of anxiety

In the language, anxienty is defined as anxiety or in a simpler way it can be interpreted as

"doubt". Unlike stress, anxiety is an emotional condition that arises as a result of an individual's
failure to reduce pressure / stress. If the pressure that occurs in the individual continues, the
emotion of the individual who was depressed has the opportunity to change to become uncertain,
or to feel anxiety or worry. The term "he or she has anxiety" means that the individual is
uncertain or concerned about a certain condition.

Steven Schwartz, S (2000) suggests that anxiety comes from the Latin word anxius,
which means constriction or strangulation. Anxiety is similar to fear but with less specific focus,
whereas fear is usually a response to some immediate threat. Anxiety is characterized by worry
about unforeseen dangers that lie in the future. Anxiety is a negative emotional state
characterized by premonition and somatic tension, such as a racing heart, sweating, and difficulty
breathing.

Gail W. Stuart (2006) defines "anxiety is an unclear and pervasive worry, which is
associated with feelings of uncertainty and helplessness". Anxiety can be defined as feelings of
worry, anxiety, restlessness, and fear that appear simultaneously, which are usually followed by
increased stimulation in the body, such as: heart palpitations, cold sweat. According to Jeffrey S.
Nevid, et al (2005) "anxiety is an emotional state that has the characteristics of physiological
arousal, unpleasant tense feelings, and a comprehensive feeling that something bad will happen".
Anxiety can arise as a reaction to "danger", both real and non-existent (the result of imagination
alone) which is often referred to as "free-floating anxienty" (anxiety that continues to float
without knowing the cause).

Anxiety is a condition characterized by negative effects and is oriented towards the

future. Anxiety makes a person focus on himself for the possibility of a disaster or calamity that
cannot be controlled by himself. There are certain events or in certain circumstances that can
cause anxiety, even so, this anxiety is also important for humans to have. Freud who explained
that anxiety also has a function to inform individuals about the existence of danger as a reaction
to threats, as well as pain or pressure that occurs from outside that are not ready to be overcome.

2. Symptoms of Anxiety

According to Jeffrey S. Nevid et al (2005) there are several characteristics of anxiety,

namely:

a. Physical characteristics of anxiety include:

1) Restlessness
2) Trembling hands or limbs
3) The sensation of the tight band that ties around the forehead
4) sweaty palms
5) Dizziness or fainting
6) The mouth or throat feels dry
7) Difficulty speaking and breathing
8) Heart that is beating hard or beating fast
9) Vibrating sound
10) Fingers or limbs become cold
11) Feeling weak or numb
12) Difficulty swallowing
13) Neck or back feels stiff
14) Stomach pain or nausea
15) Frequent urination
 16) The face feels flushed
17) Feeling sensitive or irritable
b. The behavioral characteristics of anxiety, including: avoidance behavior, clinging
and dependent behavior, and shaken behavior
c. Cognitive characteristics of anxiety, including:
1) Worrying about something, feeling annoying about being afraid of
something that happens in the future
2) The belief that something terrible will happen soon without any clear
explanation
3) Feeling threatened by people or events that normally receive little or no
attention
4) The fear of losing control
5) Fear of inability to solve problems
6) Thinking that everything can no longer be controlled
7) Thinking that everything feels very confusing without being overcome
8) Worry about trivial matters
9) Thinking about the same annoying things over and over
10) The mind feels mixed and confused
11) Worried about being left alone
12) Difficulty concentrating or focusing your mind

Meanwhile, according to Conley (in yuke Wahyu Widosari, 2010) states common
symptoms related to anxiety, including:

1) Somatic symptoms
a. Excessive sweating
b. Tension in the skeletal muscles, such as: headache, contractions in the back of the
neck or chest, shaking voice, back pain.
c. Hyperventilation syndrome such as: shortness of breath, dizziness
d. Gastrointestinal function disorders, such as: abdominal pain, lack of appetite,
nausea, diarrhea
e. Cardiovascular irritability, such as hypertension
 f. Genitourinary dysfunction, such as: frequent urination
2) Psychological symptoms
a. Mood disorders, such as: irritability, irritability and sadness
b. Difficulty sleeping: insomnia, nightmares, recurring dreams
c. Fatigue
d. Loss of motivation and interest
e. Feelings that are not real
f. Very sensitive to sounds, such as: feeling unable to stand sounds that
were previously ordinary
g. Empty minded, unable to concentrate, and easy to forget
h. Awkward
i. Can't make decisions and can't make choices even for the little things.
j. Restless, restless, unable to stay still
k. Loss of self-confidence
l. Tendency to do things over and over again
m. Troubling doubts and fears
n. Constantly check everything that has been done

3. Causes of anxiety
a. Internal factors
1) Experience

According to Horney, anxiety can come from various events in life or it can be located in a
person. For example, someone who has experience in undergoing an action will be more able to
adapt himself or the anxiety that arises will not be too great

2) Age

The older a person is, the more experience he has, so that his knowledge will increase. Because
he has a lot of knowledge, a person will be better prepared to face something.

3) Gender
Regarding anxiety in men and women, Myers said that women are more worried about their
disability than men. Men are more active, explorative, while women are more sensitive.

b. External Factors

With family support, a person is better prepared to face problems. A person's strength in
dealing with problems can be influenced by environmental conditions. If the environmental
conditions are good, it will be stronger in dealing with problems, and vice versa.

In addition, according to Adler and Rodman, there are 2 factors that can cause anxiety,
namely:

1) Negative experiences in the past

Uncomfortable feelings about events that may reoccur in the future. When individuals
face the same situation and it also causes discomfort, such as the experience of failing a test.

2) Irrational thoughts

Irrational thoughts are divided into 4 forms, namely

a) Ketastrophic failure, which is the assumption from the individual that something bad
will happen to him. Individuals experience anxiety and feelings of inadequacy and
inability to cope with the problem.
b) Perfection, that is, individuals expect themselves to behave perfectly and have no
defects. Individuals make the measure of perfection a target and a source of
inspiration.
c) Generalization that is not correct, namely excessive generalization. This occurs in
individuals who have little experience.
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