updated 12/26/2010 1:14:31 PM ET

A new treatment for the feeling of suffocation
that accompanies a panic attack focuses on
getting patients to breathe less.

The treatment, which involves a technique for
altering your breathing, is more effective at
alleviating both short-term panic disorder
symptoms and hyperventilation than
traditional psychological therapy, and it may
make people less prone to panic attacks in the
first place, said study leader Alicia Meuret of
Southern Methodist University in Dallas.

The treatment is called capnometry-assisted
respiratory training, or CART.

In a certain way, CART was superior because it
was changing the psychological symptoms and
the abnormal physiological state," Meuret told

Take a shallow breath
Panic disorder is characterized by sudden,
reoccurring bouts of terror coupled with
physical symptoms such as a racing heartbeat,
sweaty palms and hyperventilation. According
to the National Institute of Mental Health, 6
million American adults have panic disorder.
Panicking people are often told to calm down
and "take a deep breath," Meuret said. But for
someone hyperventilating during a panic
attack, deep breathing is a bad idea. That's
because hyperventilation happens when
people breathe so quickly and deeply that they
expel an unusually high amount of carbon
dioxide, which in turn causes symptoms like
dizziness and numbness. Those symptoms
tend to make people feel like they're
suffocating, so they breathe quicker and
deeper, further exacerbating the problem.
[Read: Brain Cells That Help Us Breathe

"It's not because they have a lack of oxygen,
it's because they're exhaling too much air,"
Meuret said, adding, "'Take a deep breath' is
not a helpful instruction."

Easing hyperventilation
Meuret and her colleagues recruited 41 people with panic disorder and agoraphobia, a condition in which people fear having a panic attack in a place where they couldn't get help. The patients were randomly assigned to either four weeks of twice-daily sessions of CART or cognitive training.

The cognitive-training patients spent 17 minutes twice a day analyzing the catastrophic thoughtsassociated with their panic attacks. The CART patients spent the same amount of time learning to alter their breathing while using a capnometer, a device that measured their carbon dioxide levels, oxygen levels, heart rate and breathing rate. Portable capnometers are normally used by paramedics at emergency scenes, but in this case, the researchers used them to give patients feedback on their breathing.

The cognitive-training patients also had their physiological measurements taken with a capnometer, but they did not see or discuss the results.

In both groups, general panic symptoms (such as heart palpitations and trembling) and panicky thoughts went down, and the participants felt more in control. But only CART sessions reversed hyperventilation and the physical symptoms that accompany it, such as dizziness, shortness of breath and feelings of suffocation. This is the second randomized trial, meaning participants are randomly assigned to one treatment or the other, to show CART's effectiveness, and researchers are now following up to see how the treatment works in the long term.

The treatment works by normalizing the baseline levels of carbon dioxide in the blood, Meuret said, making people less prone to hyperventilation and giving them the tools they need to reverse an attack. (Individuals only need to use the capnometer in the training phase of the treatment.)

"It's very challenging for patients to learn not to breathe deep, because they're feeling sort of breathless," Meuret said. "Patients really need that feedback of carbon dioxide and, ideally, also of oxygen just to confirm to them that the symptoms are not due to suffocation."

Edited by Ken Singer, LCSW (12/27/10 01:59 PM)
Blissfully retired after 35 years treating sexual abuse