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Medicineworld.org: New breathing therapy reduces panic and anxiety

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New breathing therapy reduces panic and anxiety




A new therapy program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing.

The method has proved better than traditional cognitive treatment at reducing both symptoms of panic and hyperventilation, as per a newly released study.

The biological-behavioral therapy program is called Capnometry-Assisted Respiratory Training, or CART, said psychology expert and panic disorder expert Alicia E. Meuret at Southern Methodist University in Dallas.

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 scientists conducting the study.



New breathing therapy reduces panic and anxiety
A new treatment that helps people with panic disorder normalize their breathing works better to reduce panic symptoms and hyperventilation than traditional cognitive therapy, says SMU psychologist Alicia Meuret.

Credit: Hillsman Jackson, SMU


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

"We observed 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 therapy, 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 treatment didn't change respiratory physiology, but CART did effectively reduce hyperventilation. CART was proved an effective and powerful therapy that reduces the panic by means of normalizing respiratory physiology".

The findings, "Respiratory and cognitive mediators of therapy change in panic disorder: Evidence for intervention specificity," 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 Program. The Beth & Russell Siegelman Foundation funded the research.

See www.smuresearch for related links and a video about CART. Get the video html from youtube at http://www.youtube.com/watch?v=AcQsJnLBWpE.


CART breathing a proven biological treatment

The study pitted CART against a conventional cognitive treatment therapy, or CT. Traditional CT teaches patients techniques aimed at helping them change and reverse catastrophic thoughts in order to reduce fear and panic.

In the CART-CT study, 41 patients were assigned to complete either a CART or CT therapy program for panic disorder and agoraphobia, a fear of being trapped with no means of escape or help.

Both therapy programs were equally effective in reducing symptoms, said Meuret. But CART was the only therapy to physiologically alter panic symptoms by actively reversing hyperventilation in the patients. Cognitive treatment didn't change the respiratory physiology, said Meuret.


Treatment helps patients address terror linked to panic

The study is the second randomized control trial to measure CART's effectiveness. By reversing hyperventilation, patients reported a new ability to reduce panic symptoms by means of changing their respiration.

With CT, Meuret said, if a patient reports shortness of breath, the therapist challenges the assumption by asking how often the person actually has suffocated during a panic attack, then hopes that will reverse the patient's thinking.

"I observed that process very challenging for some of my patients because it acknowledges the symptom but says it's not a problem," Meuret said.

"CART, however, tells us a patient's CO2 is very low and is causing a number of of the symptoms feared, but it can also show how to change these symptoms through correct breathing. There has been an assumption that if people worry less about symptoms it will also normalize their physiology, but this study shows that this is not the case," she said. "Hyperventilation remains unchanged, which could be a risk factor for relapse down the road. Apart from hyperventilation being a symptom generator, it is an unhealthy biological state linked to negative health outcomes".


Broader study planned to measure CART

The scientists plan to branch out with their studies on CART by taking the program into the community, especially to ethnic minorities. They believe CART is a more universally understood therapy due to its physical exercises � as opposed to cognitive treatment's more intellectual methods � and therefore more accessible to a broader range of people with varying levels of education and different cultural backgrounds. Ongoing studies will test the efficacy of CART in patients with asthma and fear of blood.


Posted by: JoAnn    Source




Did you know?
A new therapy program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing. The method has proved better than traditional cognitive treatment at reducing both symptoms of panic and hyperventilation, as per a newly released study.

Medicineworld.org: New breathing therapy reduces panic and anxiety

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