Breathing therapy beats anxiety, panic

A new treatment programme teaches people who suffer from panic disorder how to reduce the terrorising symptoms by normalising their breathing.

The method has proved better than traditional cognitive therapy at reducing both symptoms of panic and hyperventilation, according to a new study.

The biological-behavioural treatment programme is called Capnometry-Assisted Respiratory Training, or CART, said psychologist and panic disorder expert Alicia E. Meuret at Southern Methodist University in Dallas, US.

Reverse hyperventilation

CART helps patients learn to breathe in such a way as to reverse hyperventilation, a highly uncomfortable state where the blood stream operates with abnormally low levels of carbon dioxide, said Meuret, one of the researchers conducting the study.

Hyperventilation, a state of excessive breathing, results from deep or rapid breathing and is common in patients with panic disorders.

"We found that with CART it's the therapeutic change in carbon dioxide that changes the panic symptoms - and not vice versa," Meuret said.

CART: Breathing exercises twice a day

During the treatment, patients undergo simple breathing exercises twice a day. A portable capnometer device supplies feedback during the exercises on a patient's CO2 levels. The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly. Contrary to lay belief, taking deep breaths actually worsens hyperventilation and symptoms.

"Most panic-disorder patients report they are terrified of physical symptoms such as shortness of breath or dizziness," Meuret said. "In our study, cognitive therapy didn't change respiratory physiology, but CART did effectively reduce hyperventilation. CART was proved an effective and powerful treatment that reduces the panic by means of normalising respiratory physiology."

The findings appeared in the Journal of Consulting and Clinical Psychology. Meuret, who developed CART, is an assistant professor in the Department of Psychology at SMU and co-directs the department's Stress, Anxiety and Chronic Disease Research Programme. - (EurekAlert!, December 2010)