There you are, walking through the mall on your way to the food court.  Just a normal, ordinary Saturday afternoon.  Then suddenly, without warning or explanation, your heart starts racing, pounding in your chest.  Sweat instantly covers your body, and your hands and arms begin to tremble.  Then the real terror begins… You can’t catch your breath.  You’re growing dizzy.  You feel…you feel that you are going to die!

No, you’re not a character in the latest Steven Spielberg movie.  You are, in fact, one of the millions of Americans who suffer from panic attacks.  According to the National Institutes of Health, just under three million of us will suffer at least one panic attack in the next 12 months, of which 45% are categorized as “severe.”  For many, such terror episodes occur only once or twice in their lifetime.  Yet for an unfortunate population, panic attacks are recurrent, striking whenever and wherever.  And sentencing the sufferers to a life of fear, social isolation, erratic work, and depression.  This nightmare condition, called panic disorder, affects approximately six million of us.

Just what causes these incapacitating, frightening episodes?  There are lots of credible theories, including genetic predisposition, a history of a major stress event earlier in life, and mental illness.  Indeed psychotherapy and medications (including anti-depressants and benzodiazepines) do help some people cope with panic attacks and even panic disorder.  And simply attributing panic attacks to "mental illness" is simple for those of us who do not suffer from the condition.

But in calling something a “mental illness,” many people don’t appreciate that such disorders are no less “real” or “physiologic” than, say, diabetes; they are just not yet completely figured out.  Thus there is something comforting in recognizing that there is an apparent relationship between panic attacks and… breathing.  That perhaps panic attacks and panic disorder may be (at least in part) a respiratory illness

It turns out that panic and breathing are quite closely intertwined.  Remember when that truck blew through that stop sign and almost hit you?  Your respiratory rate (the number of breaths you take per minute) shot up.  Because “panic” is not always a bad thing.  In fact, “panic” is at the heart of our primitive “fight or flight” response, an automatic system that alerts us to danger, driving up our respiratory and heart rates, igniting our muscles to flee or battle.  We all are set at a moment’s notice to trigger such an evolutionarily favorable “panic attack” aimed at survival.

But for those suffering from dysfunctional panic attacks and panic disorder, the unwanted, unanticipated, and entirely inappropriate triggering of the “fight or flight” response is disastrous, not only for the patient, but for their family, friends, and work colleagues.  Because sufferers are not only terrified during the episodes themselves, but many develop an overwhelming, disabling fear of “when will the next attack occur?”  This can lead to a growing “shut in” lifestyle in which social interactions and ventures outside of the home are dramatically reduced, and in which more and more work days become “sick days.”  In the end, not only the attacks, but fears of the next attack, dominate the sufferer, leading to a horrible decrease in the enjoyment of life.

So, back to breathing.

Research now strongly suggests that people who experience panic attacks or suffer from panic disorder don’t breathe normally.  Among the many abnormal aspects of their breathing, many panic sufferers hyperventilate.  And unlike when most of acutely hyperventilate (from running or climbing quickly, for example), where we are told to “breath into a paper bag” until the tingling and dizziness go away, those with panic attacks demonstrate chronic (ongoing, continuous) hyperventilation.  In other words, these folks are always breathing too much, the physiological result of which is a continuously low level of carbon dioxide (CO2) in their blood.  (An acute drop in CO2 leads to the tingling and dizziness everyone has experienced; thus, re-breathing exhaled CO2 from a paper bag is meant to rapidly return the level of the gas to normal, relieving the symptoms.)  And not only do panic attack sufferers have an inappropriately low level of CO2 circulating in their bloodstream, they also may be abnormally sensitive to sudden additional CO2 decreases, triggering the terrifying attacks.

Now, all this might not sound like enjoyable dinner conversation, but if you’re passionate about patient empowerment and a student of human physiology (both of which I am), and if an old and dear friend is out from Silicon Valley and free for the evening, and if she is now the CEO of a company with a highly effective, safe, breathing treatment for panic attack and panic disorder sufferers…well, then, this is exactly what you talk about over salad and entrees.

Using the new FDA-cleared treatment for panic attack and disorder, patients re-train themselves to breathe normally.  At home, work, wherever, the patient slips the small, clear plastic tubing over the ears and places the two short extensions into the nostrils (the same set-up used by folks who need extra oxygen).  This tubing is hooked to system which analyzes the exhaled CO2 (when they breathe out).  The complex computer program then instructs them when to breathe in and when to breathe out based on their level of exhaled CO2.  The treatment empowers patients to retrain their bodies to no longer hyperventilate, returning their blood CO2 levels to normal.  Patients practice the 17 minute exercise twice daily for four weeks.  And then they’re done.

It’s safe.  It’s simple.  It’s FDA cleared.  But is it effective?  Clinical trials of the treatment from respected research institutions (including Stanford University School of Medicine) demonstrated that at 12 months following treatment, 68% of patients remained panic attack free.  And 96% of all treated patients reported a reduction in panic symptoms over the same time period.

So it’s safe, simple, FDA cleared, and effective.  Just the profile that physicians and patient alike look for in all treatments.

So now you’re likely saying to yourself, “How much of this company’s stock does Dr. Edelstein own?”

None.  No stock.  No payments.  No investments.  All that my friend’s company has given me is excitement about a new, safe, simple, and effective treatment for a horrific, paralyzing condition.  And for those who suffer from panic attacks and panic disorder, the Palo Alto-based company has given new hope.

Now that’s something that gets my heart racing!

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