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INCIDENCE OF DEPRESSION, ANXIETY AND STRESS

AMONG SENIOR HIGH SCHOOL STUDENTS

AMYLYN F. LABASANO, PhD

Email: amylyn.labasano@deped.gov.ph

ABSTRACT

Significant literature reviews revealed that depression, anxiety and stress are among the
prevalent problems of teen-agers today. This study aimed to determine the incidence of
depression, anxiety, and stress among senior high school students using survey research. Non-
experimental descriptive research design was used in the study. Simple random sampling was
utilized to generate the sample size of 499 Grade 11 students across track and strand. An
adopted survey questionnaire, Depression, Anxiety and Stress Scale (DASS-21) with 21
questions developed by Lovibond & Lovibond (1995) was used to gather data. Frequency and
percentage distribution were the statistical tools used to analyze the prevalence of depression,
anxiety and stress among senior high school students. It was clear from the findings that there
was an incidence of depression, anxiety and stress among senior high school students.
Depression topped the problem, followed by anxiety, then stress. Thus, the guidance office of
the school may conduct programs and activities that would uplift the morale and psychological
aspects of the students, establish a stronger parents-teachers’ partnership, and boost students’
spiritual life so they can manage their emotions and feelings. A qualitative study exploring the
factors causing students’ emotional distress leading to depression, anxiety and stress may also
be conducted to deepen the analysis of the problem.
Keywords: Depression, anxiety, stress, non-experimental, descriptive research

INTRODUCTION

Adolescent depression is a serious problem affecting 10.7% of all teens and 29.9% of
high school students; 17% of high school students have contemplated suicide. Yet, depression
in teens is often unrecognized (Kroning & Kroning, 2016). It was supported by the paper of
Thapar, Collishaw, Pine & Thapar (2012) which revealed that unipolar depressive disorder is
common worldwide but often unrecognized. The incidence, notably in girls, rises sharply after
puberty and, by the end of adolescence, the 1-year prevalence rate exceeds 4%. Depression is
associated with substantial present and future morbidity, and heightens suicide risks. The
strongest factors for depression in adolescents are a family history of depression and exposure
to psychological stress. Inherited risks, developmental factors, sex hormones, and
psychological adversity interact to increase risk through hormonal factors and associated
perturbed neural pathways. MacLeod (2015) also discussed that depression is a mood disorder
which prevents individuals from leading a normal life, at work socially or within their family.
On the other hand, anxiety disorders are some of the most commonly occurring
psychological disorders, and risk for the development of these conditions greatly increases
during adolescence. Despite this, the literature examining these conditions among adolescents
is still relatively sparse (Grant, 2013). Similarly, the paper of Madasu, Malhotra, Kant, Sagar,
Mishra, Misra, & Ahamed (2019) stated that anxiety disorders are the most frequent mental
disorders encountered in childhood and adolescent years. Social anxiety was the most common
type of anxiety disorder. Female sex, lower middle socioeconomic class, and stressful event in
the past 1-year were found to be significantly associated with anxiety disorders in adolescents.

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Moreover, the study of Krapic, Hudek-Knezevic, & Kardum (2015) pointed out that
adolescents frequently have to cope with various stressors that could be potential threats to
their healthy development and well-being. Most important mental health consequences of
stress in adolescence were depression, anxiety, suicide, substance use, and antisocial behavior.
Physiological mechanisms were also described through which stress exerts its effects on health,
as well as some physical health outcomes, such as somatic symptoms, immune changes, and
illnesses. Correspondingly, the paper of Damodaran (2016) found out that majority of
adolescents (63%) experienced moderate stress specifically in the interpersonal domain.
Psychological manifestations were more and depression (70%) was the most common
manifestation experienced. majority of adolescents (63%) experienced moderate stress
specifically in the interpersonal domain. Psychological manifestations were more and
depression (70%) was the most common manifestation experienced. Of all life-stages
adolescence is the potentially tumultuous transition period. Chronic stress in childhood and
adolescence can lead to lasting changes in the structure and function of the brain because it
occurs during sensitive periods of brain growth and development. There is empirical evidence
that stressful life experiences predict increases in psychological problems over time.
Unresolved stress in childhood and adolescence leads to physical and psychological problems
and risk taking behaviour and poor coping skills in adulthood.
A lot of psychological theories explained about the occurrence of depression. Two of
them are behaviorist theory and operant conditioning. Behaviorism emphasizes the importance
of the environment in shaping behavior. The focus is on observable behavior and the conditions
through which individuals' learn behavior, namely classical conditioning, operant conditioning
and social learning theory. Therefore, depression is the result of a person's interaction with their
environment. Operant conditioning states that depression is caused by the removal of positive
reinforcement from the environment (Lewinsohn, 1974 as cited in MacLeod (2015). Certain
events, such as losing your job, induce depression because they reduce positive reinforcement
from others (e.g. being around people who like you.Depressed people usually become much
less socially active. In addition, depression can also be caused through inadvertent
reinforcement of depressed behavior by others.
Similarly, in the article of Jacofsky, M.D., Santos, M.T., Khemlani-Patel, S. &
Neziroglu, F. (n.d.), both anxiety and depression can be explained by similar theories. Both of
these theories resulted in effective forms of cognitive therapy. These therapies continue to be
widely practiced today. While behavioral learning theory emphasizes the role of the
environment, cognitive theory emphasizes the key role of the mind's cognitions in determining
behavior. These cognitions include a person's thoughts, feelings, beliefs, and perceptions.
According to cognitive theory, our dysfunctional thoughts lead to extreme emotions. These
extreme emotions in turn, lead to maladaptive behaviors.
Further, the article of Sincero (n.d.) on psychological theories of stress explained that
because stress is one of the most interesting and mysterious subjects we have since the
beginning of time, its study is not only limited to what happens to the body during a stressful
situation, but also to what occurs in the psyche of an individual. The psychological theories of
stress gradually evolved from the Theory of Emotion (James-Lange), The Emergency Theory
(Cannon-Bard), and to the Theory of Emotion (Schachter-Singer). According to James and
Lange, the feeling of fear or any other emotion only begins after you experience these bodily
changes. This means that the emotional behavior is not possible to occur unless it is connected
to one’s brain. According to theorist Walter Cannon, emotion in response to stress can actually
occur even when the bodily changes are not present. Cannon said that the visceral or internal
physiologic response of one’s body is more slowly recognized by the brain as compared with

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its function to release emotional response. Theorists Stanley Schachter and Jerome Singer
argued that the appropriate identification of the emotion requires both cognitive activity and
emotional arousal in order to experience an emotion. Attribution, or the process wherein the
brain can identify the stress stimulus producing an emotion is also proposed by Schachter and
Singer. The theory explains that we become aware of the reason behind the emotional response,
and when the reason is not obvious, we start to look for environmental clues for the proper
interpretation of the emotion to occur.
Moreover, in the study of Dy, Espiritu-Santo, Ferido, & Ria (2015) among the
undergraduate students of the University of the Philippines Los Banos, they found out that the
top five overall stressors of the respondents were academic difficulty of subject matter,
workload due to subjects, time management because of subjects, responsibilities due to being
on one’s own, and time management because of both subjects and organizations. The most
frequently occurring stress responses were affective stress responses followed by cognitive
responses. For both male and female respondents, the top stressors were academics, workload
due to subjects, and time management concerns. Overall, the males reacted to stress through
affective responses and females through cognitive responses. Students enrolled in the hard and
soft sciences both considered academics, workload due to subjects, and time management
concerns as their top stressors. Those in the soft sciences reacted with cognitive stress responses
while those in the hard sciences reacted with affective stress responses. Generally, all students,
regardless of their academic classification pointed out that academics, workload due to
subjects, and time management were their main stressors. They all reacted to stress with
affective stress responses.

This study aimed to determine the incidence of depression, anxiety, and stress among
senior high school students of one school in Davao City. It was anchored on the scenario that
the school has been besotted by this problem for the previous years. Many of the high school
students committed suicide in their homes or somewhere they frequented with. Reasons were
not totally revealed and had not been given due attention by the community. Thus, this study
was conducted with the aim of helping to solve this phenomenon among the high school
students.
METHOD

Non-experimental descriptive research design was used in this study. Descriptive

method provided a complete picture of the current status of the problem being studied. The
respondents of the study were the 499 Grade 11 Senior High School students of a chosen high
school in Davao City for the school year 2019 - 2020. The initial plan was to use a total
enumeration, however, not all students really responded to the survey, thus, simple random
sampling technique was used instead.
Profile Distribution of the Respondents According to Sex
___________________________________________________________________________
Profile Frequency Percentage
___________________________________________________________________________
Male 205 40.9
Female 295 59.0
TOTAL 499 100.0

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The study utilized an adopted questionnaire named as Depression Anxiety Stress Scale
(DASS) developed by Lovibond & Lovibond (1995). DASS was originally 42-item
questionnaire but for under time pressure respondents, the 21-item questionnaire can be used.
The DASS-21 scores are multiplied by two so that you can compare the DASS-21 score with the
normal DASS. This was a three self-reporting scales designed to measure the negative
emotional states of depression, anxiety, and stress. Each of the three scales consisted of seven
items. Items 3, 5, 10, 13, 16, 17 & 21 were items for depression; items 2, 4, 7, 9, 15, 19, & 20
were items for anxiety; and, items 1, 6, 8, 11, 12, 14 & 18 were items for stress. Respondents
were asked to use the 4-point severity/frequency scales to rate the extent to which they had
experienced each state over the past week. Further, since the DASS permits cutoffs into
different categories (normal, mild, moderate, severe, and extremely severe) based on the scores,
the incidence will be generated accordingly. Below is the interpretation of the DASS scores.

Category Depression Anxiety Stress

Normal 0-9 0-7 0-14
Mild 10-13 8-9 15-18
Moderate 14-20 10-14 19-25
Severe 21-27 15-19 26-33
Extremely Severe 28+ 20+ 34+

The questionnaires were distributed to the students in the classroom with the permission
of the subject teachers/advisers. Filled-up questionnaires were collected right away and were
checked for completeness. The data gathered were analyzed using Excel. Descriptive statistics
such as frequency and percentage distribution were used in the analysis.

RESULTS AND DISCUSSION

This section discusses the findings of the study based on the prevalence of
depression, anxiety and stress among Grade 11 senior high school students. The discussion was
focused on the severe and extremely severe cases of depression, anxiety and stress by which
the problem can be traced with.

DEPRESSION
Table 1. Frequency and Percentage Distribution of Depressed Students According to Track
Category Frequency Percentage
ACADEMIC TRACK
STEM
Normal 14 53.8
Mild 5 19.2
Moderate 3 11.5
Severe 0 0

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Extremely Severe 4 15.5

TOTAL 26 100
ABM
Normal 17 25
Mild 8 11.7
Moderate 28 41.2
Severe 14 20.6
Extremely Severe 1 1.5
TOTAL 68 100
HUMSS
Normal 71 21.7
Mild 36 11
Moderate 119 36.4
Severe 55 16.8
Extremely Severe 46 14.1
TOTAL 327 100
TVL TRACK
Normal 13 16.7
Mild 13 16.7
Moderate 24 30.7
Severe 22 28.2
Extremely Severe 6 7.7
TOTAL 78 100

Table 1 highlighted the number of respondents with severe and extremely severe cases
of depression. It was found out that the greatest number of depressed students were coming
from HUMSS with 55 (16.8%) severe cases and 46 (14.1%) extremely severe which brought
to the total of 101 students which is 30.9 percent of their population. TVL followed HUMSS
in terms of most prevalent cases. TVL had 22 (28.2%) severe cases and 6 (7.7%) extremely
severe which was totaled to 28 (35.9%) cases However, if we based it on the percentage
distribution comparing the number of cases relative to the total population, TVL was higher
(35.9%) compared to HUMSS (30.9%). This was followed by ABM with 14 (20.6%) severe
cases and 1 (1.5%) extremely severe, a total of 15 cases or 22.1% of the entire ABM population.
The least case was coming from STEM with 0 severe cases and 4 (15.5%) extremely severe
cases. Though, STEM had the lowest but it should be noted that they still had 4 severe cases
which is still a great number to be alarmed with. In total there were 91 severe cases (18.2%)
of the entire population and 57 (11.4%) for extremely severe cases experiencing depression.

ANXIETY
Table 2. Frequency and Percentage Distribution of Anxious Students According to Track
Category Frequency Percentage
ACADEMIC TRACK
STEM
Normal 8 30.8
Mild 2 7.7

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Moderate 1 3.8
Severe 7 26.9
Extremely Severe 8 30.8
TOTAL 26 100.0
ABM
Normal 4 5.9
Mild 3 4.4
Moderate 17 25.0
Severe 8 11.8
Extremely Severe 36 52.9
TOTAL 68 100.0
HUMSS
Normal 21 6.4
Mild 16 4.9
Moderate 59 18.0
Severe 61 18.7
Extremely Severe 170 52.0
TOTAL 327 100.0
TVL TRACK
Normal 5 6.4
Mild 8 10.3
Moderate 13 16.6
Severe 11 14.1
Extremely Severe 41 52.6
TOTAL 78 100.0

Table 2 revealed the distribution of respondents with anxiety still focusing on severe
and extremely severe cases. The findings disclosed that HUMSS still had the highest case with
61 (18.7%) severe and 170 (52%) extremely severe cases of anxiety which was 70.7 % of the
entire population. It was followed by TVL with 11 (14.1%) severe and 41 (52.6%) extremely
severe) or a total of 51 cases which was 66.7% of the total population. ABM was the next with
8 severe (11.8%) and 36 (52.9) extremely severe cases. The last was still STEM with 7 (26.9%)
severe cases and 8 (30.8%) extremely severe cases. In total, there were 87 (17.4%) severe cases
and 255 (51.1%) extremely severe cases of anxiety were experienced by Grade 11 students.

STRESS

Table 3. Frequency and Percentage Distribution of Stressed Students According to Track

Category Frequency Percentage
ACADEMIC TRACK
STEM
Normal 19 73.1
Mild 2 7.7
Moderate 1 3.8
Severe 4 15.4
Extremely Severe 0 0
TOTAL 26 100
ABM
Normal 28 41.2
Mild 22 32.3
Moderate 14 20.6

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Severe 3 4.4
Extremely Severe 1 1.5
TOTAL 68 100
HUMSS
Normal 115 35.2
Mild 65 19.9
Moderate 83 25.4
Severe 48 14.7
Extremely Severe 16 4.8
TOTAL 327 100
TVL TRACK
Normal 31 39.7
Mild 18 23.1
Moderate 17 21.8
Severe 11 14.1
Extremely Severe 1 1.3
TOTAL 78 100

Table 3 unfolded the distribution of respondents who were experiencing stress. It was
found out that HUMSS still got the highest number with 48 (14.7%) severe cases and 16 (4.8%)
extremely severe cases. TVL was the next with 11 (14.1%) severe cases and 1(1.3% extremely
severe cases). It was followed by STEM with 4 (15.4%) severe cases and 0 extremely severe
cases. The last was ABM with 3 (4.4%) severe cases and 1 (1.5%) extremely severe cases. In
total, there were 66 (13.2%) severe cases and 18 (3.6%) extremely severe cases relative to the
total population.

Based on the data presented, a total of 148 students or 29.7% of the total number of
respondents were experiencing the symptoms of depression. 91 were on severe cases and 57
extremely severe cases. Further, a total of 342 students or 68.5 % of the total number of students
were showing symptoms of anxiety. 87 of them were on severe cases and 255 extremely severe
cases. Moreover, there were a total of 84 or 16.8% of the total number of students expressed
that they were experiencing stress. 66 were of severe cases and 18 extremely severe.

CONCLUSION AND RECOMMENDATIONS

Based on the findings, it was clear that there was an incidence of depression, anxiety
and stress among senior high school students. Depression topped the problem, followed by
anxiety, then stress. Nowadays, senior high school students are vulnerable to this kind of
problems. If this problem will not be arrested earlier, it could lead to a more serious one or
even death. Doing this kind of research opens the mind of the public to the seriousness of the
problem which has not been given due attention but pose an irreversible damage to the life of
our children. Shall we allow these problems to persist?
Thus, the guidance office of the school may conduct programs and activities that would
uplift the morale and psychological aspects of the students, establish a stronger parents-
teachers’ partnership, and boost students’ spiritual life so they can manage their emotions and
feelings. With that, we could expect a more emotionally and psychologically stable student life
and lesser incidence of depression, anxiety and stress among senior high school students. A

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qualitative study exploring the factors causing students’ emotional distress leading to
depression, anxiety and stress may also be conducted to deepen the analysis of the problem.

REFERENCES

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