Vol. 16, No.

2 (1-7), ISSN: 1823-884x

DEPRESSION, ANXIETY AND STRESS AMONG UNDERGRADUATE
STUDENTS

Ranita Manap, Sohana Abdul Hamid, Marhaini Abdul Ghani

ABSTRACT

The demands of living nowadays causing a rising number people being diagnosed with
depression, anxiety or other mental health problems. A survey done by National Health and
Morbidity 2015 finds that the prevalence of mental health problems among adults in Malaysia
has increased from 10.7% in 1996, to 11.2% in 2006, to 29.2% in 2015. One in 10 individuals
in 2011 to one in five in 2016 cases reported are among Malaysian students. This results reveal
a worsening state of mental health problems especially among students in Malaysia that must
be addressed. Therefore a preliminary study was conducted among students in one of the
private college. The Depression, Anxiety and Stress Scale 21 (DASS-21) inventory was used
to measure the students’ mental health based on three elements which are depression, anxiety
and stress. The results showed that there are students having moderate to very severe level of
depression, anxiety and moderate to severe level of stress. This finding is alarming in terms of
increased risk for psychiatric morbidity because it indicates the amount of burden students have
to bear in the current situation. Therefore, initiation of stress management programs such as
expanding counselling activities, providing adequate facilities and resources should be highly
prioritized by authorities. Interview sessions are suggested to explore in depth on these issues.

Keywords: depression, anxiety, stress, academic factors, learning environment

INTRODUCTION

Many people perceive health as being physically well and free of any diseases, and thus they
have neglected the importance of mental health. However according to World Health
Organization (WHO) 2013, Health is defined as a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity. Thus, mental health is part of
health and it is an irreplaceable aspect of health.
Identifying depression, anxiety and stress levels are considered as important indicators
for mental health. These three emotional disorders can lead to negative outcomes, such as
impaired normal functioning, burnout, and health problems. Failure to detect and address it
will unfortunately lead to increased psychological morbidity with undesirable impacts all
through their professions and lives.
A survey done by National Health and Morbidity (2015) finds that the prevalence of
mental health problems among adults in Malaysia has increased from 10.7% in 1996,
to 11.2% in 2006, to 29.2% in 2015. It is also reported 1 in 10 individuals in 2011 to 1 in 5
individuals in 2016 cases reported are among Malaysian students. University students are a
special group of people that are enduring a critical transition period. At this age are moving
from adolescence stage to adulthood whereby it can be one of the most stressful times in a
person’s life. A research conducted in Malaysia among undergraduate students showed that the
prevalence of moderate to extremely severe level of depression (13.9% to 29.3%), anxiety
(51.5% to 55.0%) and stress (12.9% to 21.6%) (Gan, Mohd Nasir, Shariff & Azizi,2013; Al-
Ani, Radeef & Ghazi, 2015). Therefore, addressing this issues is vital to improve the mental
health status among undergraduate students.

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LITERATURE REVIEW

Every one of us experiences stress and it is a response to a threat in a situation. Stress can be
divided into three types which are eustress, acute stress and chronic stress. Good stress is
known as eustress which occurs when we feel excited, no threat or fear. Eustress keeps an
individual feeling alive and excited about life. Next is acute stress which it comes from quick
surprises that need a response and not always happy and exciting. Once the stressor has been
dealt with, our body will return back to its pre-stress state, to be healthy and happy. Lastly is
chronic stress which we must pay more attention on this type of stress. This type of stress
comes when an individual repeatedly face stressors that take a heavy toll and feel inescapable.
If our body exposed to a long term of chronic stress it can negatively affect our physical, mental
and emotional health.
In today’s situation, the process of education is a very stressful experience (Manpreet
& Maheshwari, 2015 and university students encounter a great deal of academic, personal and
social stress during their academic activities (Kuruppuarachchi et al., 2012). Stress can occur
because of variety of factors like social adjustment to the environment, assignments, peer
relationship, peer pressure to secure a high marks in exams. Perceived stress among university
students is often related to their course assignments, and studies have shown a positive
relationship between perceived stress and academic workload (Kausar, 2010). Although some
degree of stress is essential to stimulate and motivate individuals to achieve their goals
(Ellawela & Fonseka, 2011), stress can be a barrier for concentrating, problem solving, decision
making, and other necessary abilities for students’ learning (Yazdani et al., 2010). The ability
to adapt to stress depends on the individual coping strategies.
Anxiety is a reaction of human body to threat, danger or stress. Therefore, feel anxious
occasionally is normal emotion that everyone faced. However, constant anxiety will cause
overwhelming worry and fear which can interferes with our daily activities. Someone can be
diagnosed having anxiety disorder if external or internal stimulus produces a disproportionate
anxiety that lead to intense distress or significant impairment of functioning (Maina Mauri &
Rossi, 2016). Anxiety disorder refers to specific psychiatric disorders that involve extreme fear
or worry which frequently occurs for no reason. Due to the intense and pervasive, they perceive
everyday life as unmanageable. Statistics by WHO (2013), 1 in 13 globally suffers from anxiety
and it is the most common mental disorders worldwide. Anxiety derives from complex origins
and among the most important influences are genetic disposition, environmental impact upon
individual and acute stressors that result in adaptational changes (Wiedemann, 2015).
According to the Diagnostic and Statistical Manual of Mental Disorders (2013) or known as
DSM-5 panic attacks and panic disorder, phobias, social phobia, and generalized anxiety
disorder are summarized in anxiety disorders.
A lot of university students experience significant amount of stress in university which
interrupt students’ performance (Brockelman & Scheyett, 2015; Brook & Willoughby, 2016).
They seem to experience psychological consequences of stress, such as anxiety, hopelessness,
worry and tension (Majumdar & Ray, 2010). According to previous research, the prevalence
rate of anxiety among university students differ between studies, but it appears that most studies
show the prevalence to be high (Bayram & Bilgel, 2008;Bernhardsdóttir & Vilhjálmsson,
2013). High level of anxiety will interferes with concentration and memory therefore, lead to
misapprehension of information or blocking of memory and recall, thus effect the academic
performance (Prima,V., Muhammad Nubli, A.W.& Ahmad.O.,2010).
Depression and anxiety are common, serious and debilitating mental health problems
and are afflicting adolescents and student population to a large extent (Andrews &
Wilding,2004; Emslie, Mayes & Ruberu;2005).Depressive disorder is one the disposition
issues and is becoming more frequent day by day. It comes with symptoms of anxiety and at

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its worst can lead to suicide. High level of demands in academics and psychosocial pressure
exposed university students at risk of depression. Study done by Klomek et al.,(2008) found
that youth and college students between aged 18 to 24 years are found to have susceptibility
for depression possibly due to the load faced by them.

METHODOLOGY

This preliminary study was done among undergraduate students in Faculty of Management and
Muamalah (FPM) and FPPI in Kolej Universiti Islam Antarabangsa Selangor. The Depression,
Anxiety and Stress Scale 21 (DASS-21) inventory was used to measure the students’ mental
health based on three elements which are depression, anxiety and stress.Self-administered
questionnaires consisted of 2 sections: Demographic data, and DASS 21 questions.
Demographic data consists of 5 questions based on personal details: gender, age, study course,
semester and previous school before joining the private educational institution. The DASS 21
is a 21 item self-report questionnaire devised to measure and assesses the severity of a range
of symptoms common to depression, anxiety and stress. DASS-21 was used because it is well-
established, easy to use and reliable, based on Cronbach’s alpha scores (0.91 for depression,
0.84 for anxiety and 0.90 for stress) in the normative sample

FINDINGS

Table 1 shows the respondents’ demographic data. A total of 91 undergraduate students were
involved in this study 61.5% were female respondents and 38.5 male respondents. The
participants’ age was between 18 to 21 years old (30.7%) and 22 to 25 years old (69.3%).
Based on the descriptive statistics, majority of the respondents were students from Ijazah
Sarjana Muda Pengurusan Sumber Insan (Kepujian) (70.3%) followed by Ijazah Sarjana
Muda Dakwah dengan Pengurusan Sumber Insan (Kepujian) (19.8%) and Diploma
Pengurusan Sumber Manusia (9.9%).
Most of the respondents’ are from semester 6 (63.7%), next by semester 3 (30.8%) and
semester 5 (5.5%). Majority are from Sekolah Harian (67%), Sekolah Menengah Agama (88%)
and Matriculation (7.7%). All respondents were from private university college in Kajang,
Selangor.
Table 1.0: Frequency and percentage of respondents’ demographic data (N = 91)

Demographic Frequency Percentage

Gender
Male 35 38.5
Female 56 61.5
Age
18 - 21 years old 28 30.7
22 – 25 years old 63 69.3
Study course
Diploma Pengurusan Sumber Manusia 9 9.9
Ijazah Sarjana Muda Pengurusan Sumber
64 70.3
Insan (Kepujian)
Ijazah Sarjana Muda Dakwah dengan
18 19.8
Pengurusan Sumber Insan (Kepujian)
Semester
3 28 30.8
5 5 5.5
6 58 63.7
Previous school/institution

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Sekolah Harian 61 67.0
Sekolah Menengah Agama 8 8.8
Sekolah Agama Menengah 4 4.4
Matriculation 7 7.7
Sekolah Menengah Kebangsaan Agama
5 5.5
Maahad
College 2 2.2
Other institutions 4 4.4

Table 2 below shows the rating and score used to identify the level of depression, anxiety and
stress among respondents which can be divided to normal, mild, moderate, severe and
extremely severe.

Table 2: Severity of depression, anxiety and stress on DASS-21

Rating 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 Severely 28+ 20+ 37+

Table 3 shows the respondents’ level of depression, anxiety and stress. Majority of
respondents’ (54.9%) having normal level depression level, followed by moderate (19.8%),
mild (14.3%), severe (8.8%) and extremely severe (2.2%).
Next, anxiety level most of the respondents are moderate (29.7%), next is mild (25.3%),
normal (23.1%), and followed by severe and extremely severe (11.0%).
Lastly is the stress level. Majority of the respondents’ having normal stress level (65.9%), mild
(19.8%), moderate (11.0%) and severe (3.3%).

Table 3: Level of depression, anxiety and stress among undergraduate students.

Emotional instability Depression Anxiety Stress

Frequency % Frequency % Frequency %

Normal 50 54.9 21 23.1 60 65.9
Mild 13 14.3 23 25.3 18 19.8
Level Moderate 18 19.8 27 29.7 10 11.0
Severe 8 8.8 10 11.0 3 3.3
Extremely 2 2.2 10 11.0 0 0
severe
Total 91 100.0 91 100.0 91 100.0

DISCUSSION

This study investigated the level depression, anxiety and stress among undergraduate students
in one of the private educational institution in Malaysia. The results showed that there are
students having moderate to very severe level of depression, anxiety and moderate to severe
level of stress. This finding is alarming in terms of increased risk for psychiatric morbidity
because it indicates the amount of burden students have to bear in the current scenario. It is
necessary for students to be in their better psychological health so as to achieve success and for
a brighter future. Early interventions are necessary to improve the quality of life and reduce the
level of depression, anxiety and stress among undergraduate students. Multiple factors such as

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feeling of incompetence, lack of motivation to learn and difficulty of class work might act as
sources of the stressors that may precipitate depression, anxiety and stress. Therefore, initiation
of stress management programs such as expanding counselling activities, providing adequate
facilities and resources should be highly prioritized by authorities. Sharing session on study
techniques and coping skills workshop should be planned for the targeted groups. Lecturer may
help the students to overcome their difficulties in their academic life by enhancing the
mentor/mentee programs. Discussion in detail with the student who are having problems will
help them to release the tension applied on them so as to motivate them to give a better effort
in their study. Overburdened on the student may cause emotional disturbances and exhaust
them physically and mentally.

CONCLUSION

These results might help to better understand the phenomenon of emotional instability among
undergraduates. Early recognition of depression, anxiety and stress level and problems are
essential as to offer treatment to those who are affected. Interview sessions are suggested to
explore in depth on these issues.

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ABOUT THE AUTHORS

RANITA MANAP
Kolej Universiti Islam Antarabangsa Selangor (KUIS)
[email protected]

SOHANA ABDUL HAMID

Kolej Universiti Islam Antarabangsa Selangor (KUIS)
[email protected]

MARHAINI ABDUL GHANI

Kolej Universiti Islam Antarabangsa Selangor (KUIS)
[email protected]