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Month: May 2024

Depression Anxiety Stress Scale

Posted on by TYHO Team

66.4% overcome depression & anxiety symptoms after therapy

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  • Updated on 8 July 2024

The depression anxiety and stress scale, known as DASS, is an assessment to identify symptoms of mental health disorders.  

A qualified professional, such as a Malaysian counsellor or psychologist, carries out the test.  

You may receive a comprehensive explanation of your mental wellness based on the DASS results, interpretations, and clinical impressions of your counsellor.  

Read about the components of the depression anxiety stress scale, symptoms of the issues, and DASS diagnosis.  

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Depression Anxiety Stress Scale

The DASS is a tool used to assess the intensity of depression, anxiety, and stress that you may be facing.  

The DASS scale is designed to identify, understand, and accurately measure these feelings. It is used for research purposes and by clinicians to diagnose mental disorders. 

The depression anxiety stress scale has three parts, with 14 questions each. Each part assesses different types of symptoms. 

Part 1: The depression section identifies feelings of sadness, hopelessness, and losing interest in activities previously enjoyed.  

Part 2: The anxiety section identifies signs of fear, overthinking, panic, and feelings of worry.  

Part 3: The stress section measures how stressed or emotional a person is, their mood swings, and the impact of stress on daily life.   

You may be asked to answer the questions based on how you have felt in the past week. Your psychologist may advise you to use a scale of 0 to 3. 0 indicates no distress, and 3 indicates severe distress. 

The shorter version of the DASS is the DASS21, which only has 7 questions in each section.  

The DASS, previously known as the self-analysis questionnaire (SAQ), is reliable and helpful in measuring mental wellness. 

Components of the Scale

The three components of the scale are as follows: 

  1. Depression scale: Measures aspects such as dysphoria (ie dissatisfaction in life), hopelessness, feeling sad for no reason, anhedonia (ie inability to feel joy), and inertia.  
  2. Anxiety scale: Measures hyperarousal, panic, freeze or flight modes, impacts on skeletal muscle, situational anxiety, subjective experience of anxiety, and identifies signs of any other anxiety disorder.  
  3. Stress scale: Measures signs such as difficulty relaxing, burnout, mental exhaustion due to overwork (either in the workplace or personal life), feelings of anger and irritability, impulsiveness, and levels of impatience.  
depression anxiety stress scale

Symptoms of Stress, Anxiety & Depression

The depression anxiety stress scale can help you identify several different symptoms.  

The symptoms of all three disorders can manifest through physical, emotional, and psychological signs.  

For example, sleep is commonly affected if you have stress, anxiety, or depression. Similarly, your mood and control over your emotions may also be affected. 

Some signs, however, are specific to each disorder. Depression could indicate low moods, whereas anxiety could indicate constant mood swings or feeling erratic.  

Note that the symptoms may be different for everyone. Hence, it is important to have an open discussion with your depression counsellor to identify how the symptoms manifest in your life specifically.  

Common signs of stress are: 

  • Headaches and chronic muscle pain  
  • Feeling exhausted and tired 
  • Getting annoyed, upset, or angry easily 
  • Troubles with sleeping too much or not enough 

Symptoms of anxiety include: 

  • Fast heart rate 
  • Sweating and shaking 
  • Feeling worried or emotional all the time 
  • Having gastrointestinal and digestive issues 
  • Negative thought patterns 

Symptoms of depression include: 

  • Lack of joy or enjoyment in life 
  • Lack of appetite 
  • Low moods 
  • Feeling bad and underconfident about oneself 
  • Lack of decision-making skills 
  • Thoughts of self-harm or suicide 

66.4% overcome depression & anxiety symptoms after therapy

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The DASS and Diagnosis

The depression anxiety stress scale helps differentiate the symptoms of depression, anxiety, and stress.  

Although some of the symptoms may appear similar, the core cause, manifestation of signs, and impact on daily life may be quite different.  

For example, on the one hand, people with social anxiety may struggle to make friends and have a fear social interactions and situations.  

On the other hand, people with depression may interact comfortably but may struggle with isolation, fatigue, and sadness.  

Hence, when a professional administers the DASS tool, they can assess the intensity of the emotional distress and offer an effective treatment plan to overcome the issue.  

The scale does not consider several factors. This is where your Malaysian Therapist can help you.  

After assessing your results, your Therapist may look into several other factors contributing to your distress. These factors include: 

  • Your childhood history 
  • Medical history 
  • Interpersonal relationships 
  • Family history 
  • Personality type 
  • Attachment styles 
  • Thought process 
  • Beliefs 
  • Cultural upbringing 

After completely interpreting the results, you may receive a comprehensive insight into your mental health and the steps you can take to improve your wellness.  

The DASS provides a dimensional insight into psychological disorders. In other words, the difference in emotional experiences is seen as a difference in the intensity rather than segregating it into a distinct category of disorders.  

Consequently, while the DASS provides valuable data on the severity of symptoms, it does not directly inform discrete diagnostic categorisations like those found in the DSM or ICD.  

Nonetheless, you can gain more clarity about yourself with the help of a professional.  

If you want to get diagnosed or simply wish to improve your quality of life, TYHO Malaysian counsellors can help you.  

Takeaway

The Depression Anxiety and Stress Scale (DASS) is a tool used for identifying symptoms of depression, anxiety, and stress.

A Malaysian mental health professional may administer the tool to provide a holistic therapeutic plan. The scale has 3 sections, each with 14 questions focusing on different symptoms.

There is also a shorter version, DASS21, with 7 questions per section. The scale helps differentiate the symptoms of each disorder, although they might overlap. The DASS can help you understand the severity of your symptoms and better grasp your emotional distress, but it doesn’t replace formal diagnostic categories.

Talking to a Malaysian Therapist can be helpful for a detailed evaluation and guidance.

Mental Health Services in Malaysia

Posted on by TYHO Team

According to recent community surveys, around 20% of Malaysians in primary care complain of depression and anxiety symptoms.  

A person’s mental fitness (ie how well they handle problems) could determine how they think, act, and feel. 

A mental disorder may be present when a person experiences negative or unhelpful thought patterns that may eventually lead to harmful behaviours.  

However, not everyone who suffers from emotional distress may have a disorder.  

Psychological distress could affect various aspects of life, such as: 

  • Interactions in social settings 
  • Performance at work or school 
  • Learning capabilities expected for one’s age  
  • Interpersonal relationships 
  • Self-image and worth 

Factors such as cultural and family expectations may also contribute to developing a mental health condition such as social anxiety or depression.  

Read about the different types of mental health services in Malaysia that can help you overcome long-term conditions and issues in daily life.  

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Mental Health Services in Malaysia

Getting professional help can be challenging if you are confused about what problem you are facing and which professional to approach.  

For example, if you struggle to control your anger, it may affect your peace of mind and your romantic relationship. Should you then seek individual counselling or couples counselling?  

As for the above example, you can initially consult a Malaysian counsellor to understand and control your anger.  

If you cannot control anger only in your relationship, a couples counsellor can help you better. 

If you are confused about the type of service, you can reach out to us or browse through all TYHO Therapist profiles to find out what the professional can help with. 

We have pulled together basic information in this section about the different types of services you can seek in Malaysia. 

Individual Counselling

Client attending online mental health services in Malaysia

Individual counselling, or psychotherapy, is a process through which you may engage in a structured conversation to assess, explore, understand, and maintain your mental health.  

Your Therapist will provide you with a safe and non-judgmental environment, where they will also avoid clouding or influencing your thoughts.  

You may be encouraged to share extensive details about your thoughts, feelings, beliefs, and habits during this time.  

You may work through negative or challenging memories, set personal goals, and cope with issues such as: 

  • Low self-esteem 
  • Social anxiety 
  • Depression or mood swings 
  • Relationship issues  
  • Lack of self-awareness 
  • Lack of clarity in life 
  • ADHD 
  • Poor self-image 
  • Addictions 

Couples and Marriage Counselling

Couple attending mental health services in Malaysia

Couples and marriage counselling are services that help you improve your relationship with your partner, solve issues that may be contributing to distress, and better understand each other to prevent future conflicts.  

During sessions, you and your partner may learn several essential skills, such as: 

  • Decision making 
  • Communication skills 
  • Interaction skills (eg body language, active listening) 
  • Problem-solving 
  • Conflict resolution 
  • Critical and objective thinking 

These skills can help you view your problem from a fresh perspective and manage your emotions during any arguments.  

Your couples counsellor will avoid taking sides and view your relationship or marriage as the ‘client’. Both of you, along with the professional, will work together to address the ‘client’.  

During couples and marriage counselling, you can solve issues such as: 

  • Financial disagreements 
  • Lack of mutual trust or loyalty in a relationship 
  • Communication issues 
  • Infidelity 
  • Differences in opinions or beliefs 
  • Inferiority complex 
  • Frequent arguments  
  • Hurting or blaming each other  

Family Counselling

Family counselling, or family therapy, is a type of mental health service in Malaysia that can help you improve relationships and affection with your family members and meet your unique emotional needs in the family.  

You can expect to solve issues from various life factors, such as emotional, psychological, developmental, spiritual etc.  

Every family member is unique and may have different personalities. However, a person’s thought process and behaviours may affect everyone else in the family.  

Hence, it becomes important to understand each other and change how we interact to ensure everyone feels valued and loved.  

You can attend family therapy sessions with all family members, with parents, or individually. Your Therapist may advise you on the structure and duration of therapy you may need to overcome any issues.  

Problems you can overcome through family counselling include: 

  • Communication issues 
  • Lack of honesty 
  • Relationship conflicts, such as between siblings or parents 
  • Dealing with grief or separation 

Child Counselling

Child attending mental health services in Malaysia

Children often find it hard to articulate their emotions and thoughts. Since they may either repress their feelings or express them in ways adults may not understand (eg by drawing or throwing a ‘tantrum’), it becomes important for children to seek professional help if they are struggling.  

A child psychologist may use age-appropriate approaches such as art therapy or play therapy to help children understand and express their feelings.  

While talking to a child about emotional distress, it is important to not trigger them further and avoid conversations that may make them feel more uncomfortable.  

This is where Therapists can help. Through tools such as motivational interviewing, a professional can understand and solve issues such as: 

  • Negative thought patterns 
  • Low self-esteem 
  • Negative emotions developed due to bullying or discrimination 
  • Loneliness 
  • Minimal or no social skills 
  • Attention and concentration 
  • Mood swings and impulsiveness 

Contact TYHO Therapists in Malaysia if you or your loved ones need help. Early prevention and intervention could reduce the impact of trauma or distress in the long run! 

5 Anxiety Symptoms to Look Out For

Posted on by TYHO Team

The 5 most common anxiety symptoms to look out for include excessive worrying, fatigue, dissociation, panic attacks, and irrational fears.  

These 5 symptoms can disrupt our daily functioning, influence our social relationships, and affect our academic or work performance.  

Many people may have anxiety at some point in their lives. In fact, the feeling of anxiety is so common that many of us may also experience it regularly.  

However, when anxiety symptoms become larger than the situations that caused them and significantly affect our lives, they could be symptoms of an anxiety disorder.  

In this article, we discuss the 5 most common symptoms of anxiety to look out for and when to seek professional counselling.  

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What Is Anxiety?

Anxiety is an emotion that may include feelings of worry, tension, stress, and physical changes like a pounding heart or high blood pressure.  

Anxiety and fear are usually used interchangeably, although there are differences between them.  

Anxiety is a future-oriented and chronic response that we may give to perceived threats, whereas fear is a present-oriented and appropriate response to specific and real threats.  

Occasional anxiety is a part of life. For example, people may have anxiety about their work, finances, or family issues – but this anxiety is temporary.  

Anxiety disorders do not go away easily and may even worsen over time, especially without the right counselling services.  

When this anxiety worsens, it may lead to other conditions such as generalised anxiety disorder, social anxiety, panic disorder, or phobia-related disorders.  

Person with hands on their head due to anxiety symptoms

What Is an Anxiety Disorder?

An anxiety disorder is a type of psychological condition which may include anxiety symptoms such as dread, fear, and a pounding heart.  

Physical symptoms of anxiety could include sweating, shaking, muscle pain, gastrointestinal issues, headaches, and so on. 

Sometimes, the feeling of anxiety can be helpful as it helps us notice dangerous situations. But when anxiety becomes so intense that we start dreading the future and imagine danger, it could cause us more harm.  

An anxiety disorder usually occurs when: 

  • It interferes with daily functioning 
  • We react intensely to normal situations 
  • We cannot control our emotional responses to any situations 

It can be hard to live with anxiety symptoms. Fortunately, counselling in Singapore can provide effective therapeutic plans to treat and manage anxiety disorders. 

Do I Have Anxiety or Am I Just Anxious?

Being anxious isn’t always unhealthy. Anxiety is a spectrum of sorts, where we can either have normal daily anxiety that helps us protect ourselves or intense anxiety that may interfere with our lives.  

In general, psychologists may diagnose someone with an anxiety disorder if the anxiety: 

  • Is out of proportion to the actual situation 
  • Is not age-appropriate 
  • Impairs the ability to function healthily 

Another way you can identify if you have anxiety or are just feeling anxious is to notice your responses to situations and uncertainty.  

For example, if you have an anxiety disorder, you may have out-of-the-ordinary emotional responses and excessive anticipatory stress to uncertainty.  

On the one hand, with normal feelings of anxiety, a person may quickly move on from the situation.  

On the other hand, an ‘abnormal’ anxiety, or anxiety disorder, is defined by uncontrollable worries that may not go away easily, even when there’s nothing to fear or worry about. 

5 Anxiety Symptoms

The anxiety symptoms depend on the type of anxiety disorder. However, we have listed 5 anxiety symptoms that you can use as a guide to analyse if you struggle with anxiety. 

1. Excessive Worrying

The most common anxiety symptom is worrying excessively and without any control. 

The worry may be completely disproportionate to the current situation. For example, a student who has already finished their exam and scored well may still worry about their performance in the next year’s exam.  

The student might say, “What if I fail next year’s exam? What if I don’t know any answers.” This thought is disproportionate as the student may be studying well and may even be a high scorer.  

Excessive worrying is usually common in generalised anxiety disorder. A psychologist may diagnose someone with GAD if the anxiety symptoms last for at least 6 months and are uncontrollable.  

The worrying may also be intrusive. Intrusive thoughts or worries may include disturbing or negative images, thoughts, and feelings.  

These intrusive thoughts may affect a person’s ability to: 

  • Concentrate 
  • Pay attention 
  • Make decisions 
  • Trust their instincts and thoughts 

Based on recent research, nearly 1.6% of Singaporeans struggle with generalised anxiety disorder.  

2. Fatigue

Fatigue refers to extreme tiredness. People with anxiety disorders may experience severe fatigue that makes it hard to get out of bed, cook for themselves, or even take care of their daily hygiene.  

Common signs of fatigue include: 

  • Tired eyes 
  • Headaches 
  • Muscle aches 
  • Tired legs 
  • Stiff shoulders 
  • Exhaustion 
  • Boredom 
  • Restlessness 
  • Discomfort or unease in the body 

Some people with anxiety symptoms may feel fatigued after an anxiety attack, while others may feel fatigued throughout the day.  

The causes of fatigue can be multiple. For example, a person may have fatigue due to anxiety symptoms, muscle tension, insomnia, or even hormonal effects of chronic anxiety and stress. 

Sometimes, fatigue can also point to other mental health conditions, such as: 

Hence, fatigue cannot be used as the single determinant to diagnose someone with an anxiety disorder. 

However, if you have severe fatigue and one or two of the other anxiety symptoms, you may want to consider seeking professional support to explore further.  

3. Dissociation

Dissociation or derealisation is losing touch with reality and one’s current surroundings. Imagine looking at yourself from a third-person perspective; that could be similar to how dissociation feels. 

Dissociation is an anxiety symptom where a person may be in a dissociative state and cannot identify themselves, their thoughts, memories, and sometimes, even their identity.  

A person can be in a dissociative state during an anxiety attack or may relapse to the state once in a while, especially if they struggle with chronic anxiety.  

When you are in a dissociative state, you may not remember the things that occurred during dissociation. This can last for a few minutes and up to multiple days and weeks, depending on the severity of your anxiety.  

Mild symptoms of dissociation could include daydreaming, becoming immersed in a particular media, or struggling with highway hypnosis (ie zoning out during driving).  

Severe symptoms of dissociation could include identity confusion, feeling like you are not real, memory issues, intense mood swings, memory lapses, and feeling as though the world is fake.  

If you are living with anxiety, you may use dissociation as a coping mechanism during extreme stress or panic.  

A person dissociating due to anxiety symptoms

4. Panic Attacks

Panic attacks are an intense fear response to stressful situations. A person may have a panic attack suddenly, once in a while, or regularly.  

Experiencing regular panic attacks may lead to panic disorder. However, a panic attack is also an anxiety symptom. 

Physical symptoms of panic attacks could include nausea, shortness of breath, racing heartbeat, and intense sweating.  

The DSM-5 indicates that panic attacks can be unexpected or expected.  

Unexpected panic attacks may appear without a clear trigger or cause. Expected panic attacks may occur due to external stressors such as work stress or maladaptive behaviours.  

Usually, people with anxiety disorders may experience expected panic attacks, as the cause is often clear (eg overthinking about the future, uncertainty, dread about an exam). 

5. Irrational Fears

Fear is natural and, most of the time, even important. It is our brain’s way of telling us when we’re in danger physically or emotionally. 

However, this fear may become irrational when it is out of proportion to the situation. Irrational fears are a common anxiety symptom.  

For example, irrational fear may appear before an interview, during flight turbulence, or even after presenting a project.  

The person may become terrified of the possibility of dying during the turbulence, failing an interview even after optimal preparation, and imagining getting fired due to a bad presentation.  

The fear may become problematic and indicate severe anxiety when the person starts avoiding events and people due to their fear.  

For example, they may never take vacations that may require a flight or may avoid attending interviews even if it means that they may stay unemployed for a long time.  

Irrational fears may occur even when there is no threat or danger. The fear can also be related to future events.  

The fear comes with intense and disturbing thoughts and a chaotic emotional reaction (eg panic attacks).  

Another common example is fear in social situations, also known as social anxiety. 

For example, going on dates or socialising with strangers has no real danger. But a person with irrational fear may worry about a fictional situation in extremes, like their date humiliating or shaming them. This thought may cause the person to stop dating altogether.  

Some other common types of phobias include: 

  • Fear of animals 
  • Fear of drowning 
  • Fear of natural calamities like hurricanes 
  • Fear of needles and injections 

When to Seek Professional Help for Anxiety Symptoms

A psychologist assessing anxiety symptoms in a client during psychotherapy

A few important factors can help you identify if you have an anxiety disorder or if you are feeling anxious about a specific and temporary problem.  

These factors include: 

  • Intensity of symptoms 
  • Frequency of symptoms 
  • Duration 
  • Interference 
  • Triggers 
  • Influence on your overall life 

Questions to help you reflect on whether you need professional therapy

  • Does your anxiety feel so intense that you are unable to perform a specific activity? Do you find it hard to manage these symptoms when they occur?  
  • Do you notice that your symptoms occur regularly, perhaps once or twice a day?  
  • Do your anxiety symptoms disappear after you handle the situation? Or do you experience anxiety for a long time? For example, if you have an interview, does your anxiety remain all day and even after you finish giving the interview? Or are you anxious about everything all the time? (ie GAD) 
  • Does your anxiety affect your ability to perform other regular activities like maintaining friendships or engaging in self-care? 
  • Do you have any specific triggers that make you feel anxious? Or do you have so many triggers that you stop doing common things like shopping or travelling?  
  • Try to think about how your anxiety symptoms affect your overall life. Are you struggling to work, form relationships, or feel part of a community? How would you want to live your life if it weren’t for your anxiety?  

Also, consider how your anxiety symptoms affect your life. For example, if you fear snakes, you may find it easy to avoid them.  

However, if you have social anxiety, it may be harder for you to avoid all social situations, and this fear will likely affect your life much more.  

If your anxiety symptoms consistently affect your life or make it hard to function every day, you can consider seeking a Singaporean counsellor.