Comprehensive review of generalized anxiety disorder (GAD), by Dr. Carlo Carandang, MD, anxiety expert and psychiatrist. Brought to you by AnxietyBoss.com.

1. Generalized Anxiety
Disorder
Presented by:
Carlo Carandang, MD
AnxietyBoss.com

2. Introduction
Generalized anxiety disorder (GAD)
is an anxiety disorder where you
have excessive worry about events
and situations, and it disrupts your
life
The audience will benefit from this
presentation by learning more
about GAD, and how they can treat
it

3. Expertise
I am an expert in anxiety and
depression, a psychiatrist with over
15 years of experience treating
patients with anxiety and
depression
In addition, I am the author of the
self-help book, Anxiety Protocol,
the founder of AnxietyBoss.com,
and have many years of research
and teaching experience on the
topics of anxiety and depression

4. GAD- Facts
Lifetime prevalence of GAD in the population is 4.1%
GAD is the most common anxiety disorder in primary care settings
Those at increased risk for developing generalized anxiety disorder include women,
low-income earners, and those who are separated/divorced/widowed
Generalized anxiety disorder also tends to co-occur with other disorders, such as
substance abuse, other anxiety disorders, mood disorders, and personality disorders

5. GAD- Symptoms
Excessive worry about everyday events and situations
Lasts most of the time, for at least 6 months
Physical symptoms from the worry include:
 Restlessness
 Fatigue
 Irritability
 Muscle tension
 Poor concentration
 Sleep problems

6. GAD- Diagnosis
These symptoms of worry and physical problems interfere with your life and disrupt
your functioning
These symptoms are not the result of a substance (caffeine, amphetamines) or the
result of a medical illness (hyperthyroidism)

7. GAD- Clinical Course
Generalized anxiety disorder can start when you are a child, teenager, or adult
Generalized anxiety disorder has a chronic and fluctuating course…in other words, it
can last for a long time, and it can come and go
Usually, stressors will trigger an episode of generalized anxiety disorder

8. GAD- How It Develops

9. GAD- Neurobiology and Family History
In GAD, there is increased activity
in the amygdala
GAD may involve the disruption of
brain circuits which connect the
anterior cingulate cortex (ACC) and
the amygdala, and the dorsomedial
prefrontal cortex (DMPFC) and the
amygdala, which may be involved in
negative emotion regulation
Generalized anxiety disorder runs
in families, and has a significant
genetic component

10. GAD Treatment- Psychotherapy
Psychotherapy is first-line
treatment for generalized anxiety
disorder
Cognitive behavioral therapy (CBT)
and short-term psychodynamic
psychotherapy are both effective
for GAD

11. GAD Treatment- Pharmacotherapy
Prescription drug treatment for
generalized anxiety disorder is a
last-resort treatment; it is for cases
where psychotherapy is not
effective, or for severe cases
Medications effective for GAD
include selective serotonin
reuptake inhibitors (SSRI), serotonin
norepinephrine reuptake inhibitors
(SNRI), benzodiazepines, buspirone,
and pregabalin

12. GAD Treatment- Benzodiazepines
Benzodiazepines are generally not prescribed for GAD, given that this anxiety
disorder has a chronic course and benzodiazepines can have addictive potential
If the anxiety is severe, benzodiazepines can be prescribed on a short-term basis,
until the SSRI or SNRI takes effect a few weeks later
In addition, the SSRI and SNRI may initially cause increased anxiety and agitation, so
the benzodiazepine can address this side effect on a short-term basis, until the SSRI
or SNRI becomes effective for anxiety symptoms weeks later

13. GAD Treatment- Natural Supplements
Multiple studies show several different
natural supplements are effective and
safe for generalized anxiety disorder,
including lavender, passionflower,
galphimia glauca, ginkgo biloba, and
chamomile
Natural supplements generally have
fewer side effects and are generally
less expensive than prescription
medications for anxiety
KalmPro is a natural supplement that
has the research studies showing its
ingredients are both effective and safe
for GAD

14. GAD Treatment: Self-Help
Research has shown that self-help
interventions are effective for
generalized anxiety disorder
Self-help interventions are
convenient, can be done on your
own time, do not require a doctor
visit, do not require a therapist visit,
and are relatively inexpensive
Anxiety Protocol is a self-help book
which uses evidence-based
techniques to help you treat your
GAD

15. Generalized Anxiety Disorder- Summary
GAD is characterized by excessive worry
about events and situations
GAD has effective treatments, which
includes psychotherapy as first-line
treatment, and pharmacotherapy
(prescription medications) as last-resort
treatment
Alternative treatments, which include
natural supplement treatment (KalmPro),
self-help interventions (Anxiety Protocol),
and other alternative treatments such as
meditation and exercise, have preliminary
evidence that they are both effective and
safe for anxiety disorders such as GAD