CART for Panic Disorder

Cognitive therapy has been a common treatment for panic disorder and agoraphobia for a long time. However, a new study indicates breathing exercises might actually be a more effective and accessible treatment for these psychological disorders.

The study examined the effectiveness of a program known as Capnometry-Assisted Respiratory Training or CART on the symptoms of panic disorder, including hyperventilation, which is defined as excessive breathing. Dr. Alicia E. Meuret, who is a panic disorder expert and psychologist at Southern Methodist University and her colleagues conducted this study with 41 participants who suffered from agoraphobia or panic disorder.

Each participant was assigned to either go through cognitive therapy or CART. Participants in the CART group learned simple breathing exercises and performed them twice a day. The exercises were aimed at reducing acute and chronic hyperventilation and its associated symptoms. The breathing exercises helped participants learn to breathe more slowly and shallowly. Feedback on participants' CO2 (carbon dioxide) levels was provided with a portable capnometer device.

Participants who received cognitive therapy learned how to identify and challenge catastrophic thoughts. Reducing catastrophic thoughts, in turn, reduces panic and fear.

The researchers discovered both cognitive therapy and CART were effective at reducing symptoms of panic. However, CART physiologically reduced symptoms of panic by reversing hyperventilation in the participants whereas cognitive therapy did not alter respiratory physiology.

According to Psych Central, this is the second randomized, controlled study to show the effectiveness of CART. Participants reported an ability to alter symptoms of panic by changing their breathing. On the other hand, cognitive therapy addresses panic symptoms through changing how an individual thinks about them. Hyperventilation remains unchanged when utilizing this type of treatment.

The researchers assert CART may be a more accessible treatment to individuals of different educational levels and cultural backgrounds due to its physical nature - breathing exercises - as opposed to cognitive therapy, which utilizes the intellect. They plan to do further studies with individuals in communities, especially individuals of different ethnic backgrounds to test CART's effectiveness with different groups of people.

Panic Disorder is defined by a set of criteria described in the Diagnostic and Statistical Manual of Mental Disorder IV-TR published by the American Psychiatric Association. Someone who suffers from Panic Disorder experiences unexpected, recurrent panic attacks. Additionally, an individual with panic disorder will also have significant behavior changes related to the panic attacks, be concerned about having future panic attacks, and/or worry about the consequences or implications a panic attack may have, such as "going crazy," or losing control.

A person who is having a panic attack will experience fear or discomfort as well as at least four other symptoms. These symptoms include: feeling as if you are choking, having heart palpitations, increased heartbeat, or pounding heart, hot flashes or chills, nausea or abdominal discomfort, feeling as if you are being smothered or being short of breath, feeling lightheaded, faint, dizzy, or unsteady, being afraid of dying, being afraid of going crazy or losing control, sweating, tingling or numbness sensations, chest discomfort or pain, experiencing a feeling of unreality or detachment from your body, and shaking or trembling. Additionally, when someone experiences a panic attack, these symptoms come on suddenly and reach their peak in approximately 10 minutes.

An individual who experiences panic disorder does not experience panic attacks due to a substance (such as a drug or medication) or as a result of a general medical condition.

A new study indicates Capnometry-Assisted Respiratory Training (CART) may be more effective for panic disorder than cognitive therapy. Perhaps in the future, CART will be an option of treatment for those who suffer from panic disorder.

Source:

Psych Central: Panic Treatment Targets Breathing Symptoms:
http://psychcentral.com/news/2010/12/21/panic-treatment-targets-breathing-symptoms/22015.html

Medical Criteria: DSM-IV Diagnostic Criteria for Panic Disorder With or Without Agoraphobia:
http://www.medicalcriteria.com/criteria/panic_disorder.htm

Behavior Net: DSM-IV-TR: Panic Attack:
http://www.behavenet.com/capsules/disorders/panicattk.htm