Depression

The most common mental disorders are depression and anxiety. Globally, it is

estimated that 5% of adults suffer from the depression and anxiety. It is characterized

by persistent sadness and a lack of interest or pleasure in previously rewarding or

enjoyable activities. It can also disturb sleep and appetite. Tiredness and poor

concentration are common symptoms (WHO). Despite, there is no certain way to predict

who will become depressed. The difficulties in childhood or a major disaster in later life

can lead to low self-esteem, a sense of rejection, and an inability to feel good about

oneself or one’s life. Yet some people who have no such histories, who appear stable

and well integrated, can nevertheless fall into a depressed state. Likewise, people who

have suffered a childhood trauma or who are subject to significant stresses or life

changes are not unavoidably doomed to a life of depression (Orcard, 2019).  According

to Indonesia's basic health research, the prevalence of mental health disorders in

Indonesia has increased from 6% in 2013 to 9.8% in 2018. The Indonesian Basic Health

Research in 2018 reported that depression could be experienced by all age groups, with

prevalence in the 15–24 age group recorded at 6.2%. The prevalence pattern increases

with age, with the elderly group (>75 years) showing the highest prevalence at 8.9%,

while in the 65–74 age group, the prevalence is 8.0%, and in those aged 55–64 years it

is 6.5% (Riskesdas, 2018). Align with the Riskedas data, a research conducted by

Anisa which taken place in Sumatra, Indonesia, in this study, 33,3% elderly were

depression with the level of depression experience were mild depression 23.3% and

major depression 10% (Anisa, et al., 2019). Another region in Indonesia, a research

with the measuring instruments used were ADL (Activities of Daily Living Scale) and
IADL (Lowton and Brody Instrumental Activities of Daily Living Scale) for physical

activities assessment, APGAR (Adaptability, Participation, Growth, Affection,

Resolution) for family support function assessment, and Geriatric Depression Scale

(GDS) for depression level measurement, with additional questions for psychosocial

assessment. 212 elderlies (46.4%) were found with no depression tendency, 183

elderlies (40%) had a tendency of depression, and 62 elderlies (13.6%) had depression.

These depression issues were significantly linked to retirement and income among

elderly, dependency, fitness and health status, family and social support, and sources of

funds (Kurniawidjaja, 2022). Depression can lead to others mental health problem such

as loneliness, anxiety, social dysfunction, and has relevance with suicide behavior

(Brancho, et al., 2018). In an interview with Kompas.com, a psychologist, Christine

Wibhowo said that depression can cause someone to die either directly or indirectly,

further she explain that direct meaning if the client with depression who do not want to

eat, drink and sleep, those can lead to weakness, sickness and dead. While indirect

meaning is a person experiences depression that indirectly affects his body, not

because he doesn't want to eat or drink, but comes from hurt feelings. He feels gloomy,

sad, and can't stand his heartache. If someone is sick physically, he can bear it, but if

the pain is in his heart, it will be difficult for him to endure it, so he transfers the pain in

his heart to the physical. For example, someone injures himself to the point of killing

himself so that the pain comes out. (Kompas, 2022)

Depression not only burden for the patient but also for family and community. According

to Cherry, depression is a complex condition that affects individuals in a variety of ways,

but people who have the condition aren’t the only ones who hurt. Family members are

also affected when someone they love has depression (Cherry, 2021).

ANXIETY

Anxiety is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel

restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress.

For example, you might feel anxious when faced with a difficult problem at work, before

taking a test, or before making an important decision. It can help you to cope. Anxiety

disorders are conditions in which you have anxiety that does not go away and can get

worse over time. The symptoms can interfere with daily activities such as job

performance, schoolwork, and relationships (Medlineplus, 2020). A research of

predicted anxiety factors in Swiss found that older age, female gender, race, loneliness,

participants’ concern about their own health, and interaction between time and

participants’ concern about their own health (Amendola et al., 2021).  

According to Stuart (2016) predisposing factor and the precipitation of the occurrence of

anxiety consists from biological, psychological and social aspects culture. The

psychoanalytic theory developed by Sigmund Freud explains that anxiety is the result of

an inability to solve problems, an unconscious conflict between aggressive impulses or

libido satisfaction and recognition of the ego from external damage that comes from

satisfaction. The theory was support by the research done by Kandar & Iswanti in

Central Java, Indonesia, the precipitation of anxiety disorder have high relevance with

the social culture and psychological factors (Kandar, Iswanti, 2019). The same finding

by Windarwati in east Java showed the cause of predisposition to elderly mental health
problem is more derived from socio-cultural factors, namely low education, poor

communication patterns, and rarely involved in activities. Adding that, more precipitation

factors were found from psychological and social aspects (Windarwati, 2020).

A study done by Husna and Ariningtyas with the research used descriptive method. The

populations of this study are the elderly active in Integrated Service Post Elderly Mekar

Raharja, Yogyakarta, Indonesia. Total population in this study was 61 elderly. The

results of the study: The number of elderly people with a normal level of anxiety for the

elderly was 67.3%, the mild anxiety for the elderly was 20.0%, the moderate anxiety

level for the elderly was 9.1%, the severe anxiety level for the elderly was 3.6% (Husna,

Ariningtyas, 2022).

Parandangi quote the research of Siti and Dyah in one of his study, he state that
psychosocial factors include patient interactions with family and public, the emergence
of pressure in the interaction of patients with families, for example parenting parents
who put too much pressure on patients, lack of family support in solving problems faced
by patients, patients are not paid enough attention by the family coupled with patients
not being able to interact well in the community making stressors that suppress the
patient's life . When this pressure lasts for a long time so that it reaches a certain level,
it will cause disturbances in the patient's mental balance and one of them is the
emergence of symptoms of schizophrenia (Parandangi, 2021).