ANXIETY DISORDERS: A CASE STUDY ON ABNORMAL BEHAVIOR

INTRODUCTION

Abnormal behavior is a psychological term for actions that fall

outside of the realm of what is considered normative in a

particular society or culture. Abnormal behavior can be

difficult to define, but it is often easy to notice when it

happens. Abnormal behavior also refers to dysfunctional and

socially deviant behaviors that cause personal distress and can

be potentially harmful to the self or others. It is define as

well as something or someone deviant from the ideal norms of the

society. The definition of the term abnormal behavior can be

subjective and heavily depend on cultural influences. Something

that is abnormal behavior in one culture may not be abnormal in

others. Society is also ever-changing. A type of behavior may

have been perfectly acceptable hundreds of years ago that is not

acceptable today. There are four major criteria for identifying

abnormal behavior in individuals, according to the Diagnostic and

Statistical Manual of Mental Disorders, Fifth Edition (DSM-V.

These four criteria are; violation of social norms, statistical

rarity, personal distress, and maladaptive behaviors. None of

these criteria is sufficient on its own; abnormal behavior is

usually identified when it falls into several of these

categories.

Anxiety disorder and trauma-stressor related disorders are few

of the examples of an abnormal behavior. They are quite common

in general population and often experienced by young adults whom

are very susceptible to stressful environment. An anxiety

disorder is a type of mental health condition that goes beyond

the regular nervousness and slight fear you may feel from time to

time. Instead, someone with an anxiety disorder experiences

extreme feelings of worry and anxiety. There are high levels of

fear as well. Often, anxiety disorders involve repeated episodes

of sudden feelings of intense anxiety and fear or terror that

reach a peak within minutes, also called as panic attacks.

Examples of anxiety disorders include generalized anxiety

disorder, social anxiety disorder (social phobia), specific

phobias and separation anxiety disorder. Anxiety disorders can

cause people to try to avoid situations that trigger or worsen

their symptoms. Job performance, school work and personal

relationships can be affected. On the other hand, trauma-

stressor related disorders are a group of emotional and

behavioral problems that may result from childhood traumatic and

stressful experiences. These traumatic and stressful experiences

can include exposure to physical or emotional violence or pain,

including abuse, neglect or family conflict. Two of the trauma-

related disorders are acute stress disorder and posttraumatic

stress disorder (PTSD). Acute stress disorder and PTSD are

similar except that acute stress disorder typically begins

immediately after the trauma and lasts from 3 days to 1 month,

whereas PTSD lasts for more than 1 month, either as a

continuation of acute stress disorder or as a separate occurrence

that begins up to 6 months after the trauma. Although, trauma-

stressor related disorders and anxiety disorders are two distinct

abnormal behaviors, the former were previously considered as an

anxiety disorder. Both disorders are abnormal behaviors that can

even severely affect the person’s daily routine.

DISCUSSION

This case study discussed four different cases of anxiety

disorders and trauma-stressor related disorders. This study also

outline the factors that cause such behaviors and the effect of

these disorders to the quality of life of those persons involved.

A variety of factors can cause and elevate a person’s risk for

developing anxiety disorders. It includes genetic, chemical

imbalance, health problems, and environmental factors. You can

have more than one anxiety disorder. Symptoms include feelings

of nervousness, panic and fear as well as sweating and a rapid

heartbeat. Sometimes anxiety results from a medical condition

that needs treatment. Anxiety disorders most often begin in

childhood, adolescence or early adulthood. Whereas, trauma-

stressor related disorders involve exposure to a traumatic or

stressful event. Stressors such as parental separation or

divorce or even more severe stressors such as emotional or

physical neglect can cause problems when they are prolonged or

not addressed by caring adults.

Case 1. Grace, a 20 years old nursing student displays social

anxiety disorder, where she felt anxious and nervous while

speaking or presenting in front of a crowd. She is currently in

her third year as a nursing student at Central Philippines

University Visayas. She’s the oldest in their family of five and

is experiencing the pressure of being a bread winner. With her

chosen career, it requires interaction with countless of people,

and having a social anxiety is a big challenge for her. Social

anxiety disorder is an example of anxiety disorders that

describes a situation in which a person experiences significant

anxiety about being humiliated, rejected, or embarrassed in

social situations. According to Grace, this anxiety behavior was

caused by a traumatic incident that had happened when she was

young. Grace was once an active pupil, but then lost her self

confidence due to the incident and to the bullying she

experienced afterwards. “Nag start sang grade 3 when gin pabasa

ako sang paragraph sa blackboard sang amon teacher, then indi ko

mabasa because may ara ko gli nga nearsightedness or myopia nga

wala lang na diagnose.” (It started in grade 3 when my teacher

asked me to read a paragraph on the blackboard, but then I

couldn't read it because I have nearsightedness or myopia that

wasn’t diagnosed yet.) ”Then kay indi ko mabasa ang paragraph sa

blackboard ginkadlawan ko sang akon klasmeyts even if kabalo man

ko magbasa syempre. Tapos ang amon nga teacher, ginpapapalapit ya

ko sa blackboard kg ginapabasa liwat. Then nabasa ko na ang sa

blackboard nga paragraph. Minor ma lang to nga incident pero na

hurt ko kay first time ko nahuy an.” (Then, because I couldn't

read the paragraph on the blackboard, my classmates laughed at me

even if I know how to read, of course. Then our teacher, brought

me near the blackboard and let me read it again. Then I

successfully read the paragraph on the blackboard. It's only a

minor incident, but it hurt me for it’s the first time I was

embarrassed.) She also mentioned that another incident added her

already collapsing self esteem. “One time,sa school ang akon nga

teacher gin criticize ya ang akon sleeveless nga bayo habang

gaklase,nahurt pa gid ko to hay sa tubangan sang mga klasmeyt ko

ngaa kuno gasuksok ko sang sleeveless nga bayo, nga grade 6 nako

gasuksok pa gyapon sang mga informal nga clothes. Because of it,

daw afraid ako kag gakaconscious nga basi may makita naman ang

iban nga tawo nga wrong saakon.” (One time, at school, my teacher

criticized my sleeveless dress while we’re in class, I was really

hurt by it because it was in front of my classmates, he asked why

I was still wearing a sleeveless dress, when I’m already in grade

6 and still wore informal clothes. Because of it, I seem to be

afraid and conscious that other people might see something wrong

with me.) Grace said it was so hard for her growing through it

with that kind of mindset inflicted by those people who are

supposed to help her develop her self-esteem. Until now, she

still feels that anxiousness and fear in public like when she’s

reporting in front of the class or performing demonstration. In

those situations, Grace experienced having cold sweat, heart

palpitations, and shaking of her hands and knees. In result, she

prefers to be alone and tries to avoid being call out or become

the center of attention in class. Grace also tries to avoid

being in stage, but when it’s unavoidable, she limits her

presence which affects her whole performance in class.

Case 2. Jemay, 20 years old and a second year accounting

student appears to also have anxiety and irritation when out in

public since the Covid 19 Pandemic. Jemay lived with her younger

sister under the roof of her grandmother for most of her life.
But recently she moved to a boarding house together with her

cousins near the college where they’re studying. Before the

Covid 19 Pandemic, she had an outgoing personality and usually

have good relationship with other people. According to her, it

might have been a result of too much isolation due to the long

home quarantine she experienced during the pandemic. “Dali lang

ko mairita pag damo tawo tas biskan 5 minutes pa lang ko sa gwa

gusto ko na dayon magpuli. Natak an ko kung damo tawo kay magahod

mo. Siguro sa sobra man ka quarantine? Daw di na ko anad sa

guwa. Tas pag nasa gwa ko feel ko daw ginatulok ako sang iban

nga tawo kag ginajudge.” (I got easily irritated when there’s a

lot of people and even though I’ve been out for just like 5

minutes, I really want to go back home. It’s noisy when there’s a

lot of people and I hate it. Maybe because of too much

quarantine? I’m not used going out. Then when I’m outside, I

feel like other people’s eyes are at me and judging me.) Jemay

said it was also caused by an embarrassing experience at that

time. “Nag umpisa lang ni tong nagpabanwa ko sang quarantine pa

tas nagbakal ko tinapay sa Reymaries. Ti gainulan tas nakadanlog

ako kay kadanlog sang tiles. Naglumpiga gid takon kag puno ka

lutak ang leggings ko tas nagkadlaw pa si kuya.” (This started

when I went to town and bought bread at Reymaries during

quarantine period. It rained and I slipped from the tiles. I did

sat there with my leggings full of dirt, while kuya laughed at

me.) Jemay was very embarrassed at that time where since then

she sometimes avoided going out except for more important

matters. When asked if she had overcome or trying to overcome

this behavior, she jokingly answered, “Wala ko kabalo. Di ko man

gusto dyapon makipagsocialize sa mga classmate ko. Wala na ko

gani nag attend acquaintance tas di pa gid ko mag attend OH Day

bwas. Hahaha.” (I don’t know. I still don’t like socializing with

my classmates. I didn’t even attended our acquaintance and I’m

also not going to attend tomorrow’s OH Day. Hahaha.) Jemay said

that she’s trying to avoid interactions with other people as much

as possible to also avoid being in embarrassing situations. She

also hates going to social gatherings and much prefer to stay at

home playing mobile games or playing with her dogs. This

behavior that Jemay exhibits had a huge impact on her

relationship with other people and some of her everyday routine.

Case 3. Julla, a third year accounting student is currently

experiencing panic disorder. She became a working student since

the start of her second year in college due to lack of financial

stability. Panic disorder involves recurring panic attacks.

These attacks are severe and involve both psychological and

physical distress. Julla has experienced panic attacks during

very stressful and depressive situations, and when asked what

kind of situation it was, she responded, “Sa ubra kis-a kag kung

may makasabay ako nga tawo sa jeep nga hubog or makaexperience

sang di manami nga situation.” (Sometimes at work, when I’m

riding on jeep with a drunk person, or when I experience

unpleasant situations.) “Magsakay sa jeep may hubog ako nga

ingod gasala na akon heart tapus damo na ko napanumdom. Arang

ang utok ko damo na napanumdum nga malain, na try ko man

punggan,” she added. (When I’m riding in a jeep and there’s a

drunk person beside me, my heart pounds and then I overthink.

Like my mind thinks a lot of horrible things, I tried to stop

it.) Julla often experienced heart palpitations, dizziness,

sweating, shortness of breath, and nausea when these recurring

attacks happened. Panic attacks also occurs when she’s at fearful

situations like witnessing a fight. “Kag kung may akig pa gid sa

atubang ko or ga inaway amo pa gid na tapus kis-a malala daw

mahibi ako. Basta arang di man akig pay daw gakakita ko nga akig

na or daw mainaway.”. (And also when someone’s angry in front of

me or when there’s a fight. Or when I see that someone’s getting

angry or getting into a fight.) Julla said that these severe

panic attacks just started recently where she almost pass out

cold. “Subong man lang gid ni ya nagturobo sila. Masubrahan ko ya

kahibi daw gina convulsion ko. First nga grabi grabi mayad ara si

Angel nabal an ko nga damo damo ko bagsak. Last feb pa to ata

ginkurog ako tapus ko hibi nga yami yami kag tugnaw tugnaw sa

pamatyagan ko nga daw di ko ginhawa daw malipong ako.” (This

started recently. When I cried too much I feel like having

convulsions. The first severe one was when I found out I have a

lot of failing grades, good thing Angel was with me that time.

It’s last Feb I think, I shivered after crying, I felt so cold

and I’m hyperventilating, like I’m gonna pass out.) As a working

student and a bread winner of their, Julla absolutely needs to

keep her job while balancing it with her studies, and her panic

disorder adds up to the things that burdens or affects her

everyday living.

Case 4. Jopay, an English major student from Silay, Negros

Occidental exhibits a trauma-stressor disorder. When asked what

behavior of her that she find as an abnormal she answered, “There

are times when I wanted to cry but I can’t. Like my eyes burn and

my chest clenched in pain but I can’t shed a tear. So in order

for me to let those emotions out, I often watched sad movies and

read sad stories with tragic endings, alone. And watching and

reading those would make me cry because it hurts me and pains me.

That’s when I finally let myself drown in tears. And I think I

considered that kind of behavior abnormal.” Jopay also had an

outgoing and bubbly personality, so you can’t easily tell when

something’s bothering her. According to Jopay, the cause of this

bizarre behavior is related to the family problems she have and

had experienced when she's younger. She’s living far from her

parents and is currently residing with her grandmother and other

relatives while she’s studying. She didn’t add further details

about the cause as it is very personal for her. This situations

mostly happened when she’s in too much stress or when in a

familiar problematic situations. Those stressors often triggered

her disorder. “It also became my coping mechanism. It’s

imprinted in my mind that if I cry, I would be seen as someone

weak. Despite experiencing family related problems and despite

having to lose everything at a young age, I don’t want people to

pick and see me as someone who’s weak, rather I want to hide my

pain, show them a version of me that’s strong and invincible,”

she added. Jopay find it hard to trust fully and show her

vulnerable side on most people even on those she’s close with.

It may also be the result of depression and the trauma she

experienced. This behavior affected her in many ways, but it

does not directly affect her everyday activities.

CONCLUSION AND RECOMMENDATION

Abnormal behaviors such as anxiety disorders and trauma-

stressor related disorder are complex disorders related to mental

and emotional health that has huge impact to a person’s life. In

conclusion, all four cases discussed above shows various examples

of anxiety disorders and trauma-stressor related disorders as a

result of various factors that causes and triggered those

abnormal behaviors. These disorders can affect anyone, anytime

may it be children, teenagers and adults. But it often seen

within young adults which also affects their academic and

personal life. Some abnormal behaviors mentioned above are not

as extreme as other disorders, but it still have an impact the

person who exhibits it. Those behaviors results to personal

distress which sometimes lead to self-harm, and can potentially

affects not just other people but also their relationship with

them. It can also lead to some more serious mental health issues

like depression, that needed therapy or medication. It is very

important to know the main reason of the behaviors to have a

better understanding on the person with disorders.

All cases presents anxiety disorders and trauma-stressor

disorder, where they’d been in situations experiencing

embarrassment, isolation, fear and trauma that led them to feel

afraid, anxious, and stressed when out in public. Treatment

depends on how much social anxiety disorder affects your ability

to function in daily life. The most common treatment for social

anxiety disorder includes psychotherapy (also called

psychological counseling or talk therapy) or medications or both.

Cognitive behavioral therapy (CBT) is the most effective type of

psychotherapy for anxiety, and it can be equally effective when

conducted individually or in groups. In addition, being involved

in a more active and meaningful interaction with people you trust

can also be a huge help to overcome the feeling of being isolated

and anxious. Leaning on loved ones for support or opening to

them can also be a step to recover. It’s normal to want to avoid

thinking about a stressful or traumatic event, but facing you’re

your feelings and fears can be a brave thing to do. One can also

take actions as avoiding caffeine, alcohol and smoking, for these

can make anxiety and panic attacks worse. Exercising regularly

to help manage stress, relieve tension and boost one’s mood.

Eating a healthy and balance diet is also important, as well as

managing stress in healthy ways. Prioritizing, accepting your

flaws, and loving yourself the way you are is another powerful

way to treat anxiety disorders.

DOCUMENTATION

Interview with Grace, Jemay, Julla and Jopay.

REFERENCES

https://www.onlinepsychologydegree.info/lists/5-examples-of-

abnormal-psychology/

https://study.com/learn/lesson/abnormal-behavior-examples-

criteria.html

https://my.clevelandclinic.org/health/diseases/9536-anxiety-

disorders

https://www.psychiatry.org/patients-families/anxiety-disorders/

what-are-anxiety-disorders#:~:text=Anxiety%20disorders%20are

%20the%20most,people%20lead%20normal%20productive%20lives.

https://www.msdmanuals.com/professional/psychiatric-disorders/

anxiety-and-stressor-related-disorders/overview-of-trauma-and-

stressor-related-disorders
https://www.mayoclinic.org/diseases-conditions/social-anxiety-

disorder/diagnosis-treatment/drc-20353567

https://www.nimh.nih.gov/health/publications/panic-disorder-when-

fear-overwhelms