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Depression is a significant common mental health problem. It affects 300 million people
worldwide ranking depression second to heart disease in terms of impact on disability-adjusted
life years. According to Department of Health more than 3.29 million people in the Philippines
are living with depression.

It can cause the affected person to suffer greatly and function poorly at work, at school
and in the family. At its worst, depression can lead to suicide. Depression in the senior
population is a reality. It is well documented among frail older adults and those confined to their
homes due to medical illness and disability. However it is sometimes remain undiagnosed,
because sadness in the elderly is not often the main symptom. There may be other, less obvious
symptoms of depression such as anger, irritability or forgetfulness. According to the US National
Institute on Mental Health (NIMH), depression has many symptoms, including physical signs.
Several of the following symptoms are persistent sad, anxious or “empty” mood, Loss of interest
or pleasure in hobbies and activities, feelings of hopelessness, pessimism, feelings of guilt,
worthlessness, helplessness and decreased energy, fatigue, More importantly, old-age depression
contributes to an exacerbation of medical conditions and deterioration in functioning.

Controlling depressive symptoms is considered the first step to slowing or preventing the
development of depression. Today, one approach that is gaining currency is horticultural therapy
(HT) and the related practice of therapeutic horticulture.

Horticultural therapy is defined as “a formal practice that uses plants, horticultural

activities and the garden landscape to promote well-being for its participants


This study aims to determine the effects of Horticulture therapy to the depression of geriatric
patients three (3) times a week for two months in homecare facilities in Metro Manila

The study sought to answer the following questions:
1. What is the level of depression in the control and experimental before Tai Chi?
2. What is the level of depression in the control and experimental after Tai Chi?
3. Is there a significance difference in the depression before and after Tai Chi?


This section of the research provides the reader on the subject being studied. The researcher
pored over the different literatures and studies that aided the researcher to come up this kind of
endeavor. This part of the study was vital in supporting findings.

Depression Defined

Depression (major depressive disorder) is a common and serious medical illness that negatively
affects how you feel, the way you think and how you act. Depression causes feelings of sadness
and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and
physical problems and can decrease a person’s ability to function at work and at home.
Depression symptoms can vary from mild to severe and can include: feeling sad or having a
depressed mood, loss of interest or pleasure in activities once enjoyed, changes in appetite —
weight loss or gain unrelated to dieting, trouble sleeping or sleeping too much, loss of energy or
increased fatigue, increase in purposeless physical activity (e.g., hand-wringing or pacing) or
slowed movements and speech (actions observable by others), feeling worthless or guilty,
Difficulty thinking, concentrating or making decisions, thoughts of death or suicide. (American
Psychiatric Association 2017)

According to American Psychiatric Association (2017), depression affects an estimated one in 15

adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at
some time in their life. Depression can strike at any time, but on average, first appears during the
late teens to mid-20s. Women are more likely than men to experience depression. Some studies
show that one-third of women will experience a major depressive episode in their lifetime.

Depression and Elderly Patients

According to the Centers for Disease Control and Prevention (CDC), depression affects about
1%-5% of the general elderly population, 13.5% in elderly who require home healthcare, and
11.5% in older hospital patients.Older adults are at risk of misdiagnosis and lack of treatment
because some of their symptoms can mimic normal age-related issues. Symptoms can also be
mistakenly attributed to other illnesses, medications, or life changes. Elderly patients might also
be reluctant to talk about their feelings or fail to understand that physical symptoms can be a sign
of depression. For elderly people living independently, isolation can make it difficult to reach out
for help.

Tai Chi Defined

Tai chi is a centuries-old Chinese martial art that descends from qigong, an ancient Chinese
discipline that has its roots in traditional Chinese medicine. (The people that you see moving
gracefully with flowing motions in parks throughout China, and increasingly throughout much of
the modern world, are practicing tai chi.) According to some records, tai chi dates back as far as
2,500 years! It involves a series of slow, meditative body movements that were originally
designed for self-defense and to promote inner peace and calm. Its movements use internal
energy and movements too subtle for most people. (

Effects of Tai chi to mental and psychosocial aspect

According to Medical News Today (2018), the benefits of tai chi are said to include the reduction
of stress, anxiety, and depression, and the enhancement of mood, both in both healthy people and
in those with chronic conditions. Some of the benefits claimed for tai chi include: better mood,
with lower levels of depression, stress, and anxiety, greater aerobic capacity and muscle strength,
more energy and stamina, enhanced flexibility, balance, and agility, lower blood pressure and
improved heart health, reduced Inflammation, and fewer falls. Other benefits are said to include
better sleep quality and an enhanced immune system. (Medical News Today, 2018)

Tai Chi may be associated with improvements in psychological well-being including reduced
stress, anxiety, depression and mood disturbance, and increased self-esteem. Tai chi counteracts
erratic movements and thoughts by increasing awareness of and eventually releasing muscle
holding patterns and their associated emotions caused by stress. A study conducted by Wang et al
(2013) demonstrated that mind–body interventions such as tai chi have beneficial effects for

various populations on a range of psychological wellbeing measures, including depression,
anxiety, general stress management, and exercise self-efficacy. Another research study was
conducted by Walther (2017) indicated that Tai chi is beneficially associated with steroid
secretion patterns and mental health in aging men, when training is performed with a frequency
of 4 or more trainings per week,

Studies has shown beneficial effects of a Tai Chi program on depression symptoms, as well as
anxiety, stress, and leg strength in centrally obese participants with depression symptoms. Tai
Chi appears to be a beneficial strategy to augment usual medical care in improving mental health
and leg strength for these patients.