National Anxiety Foundation



Something New for Nervousness Suffering -- The  Bcalm Device.  A totally new European approach based on medical science and 30 years of research. An article by Stephen Cox MD

To do a good job in educating readers about anxiety I have to review the latest things and to report to our readers. I must state for the record that I have a financial interest in this one. So, I just lay the fact out there that I, personally, get a sliver of one percent (0.2-0.3%) of net profits of the European company that the inventors (I am one of the two) gave the patent rights to. That being understood, I will report on this device as unbiasedly as I can.

Besides medicines and psychotherapy to help assist sufferers of panic attacks of panic disorder, there now a third means of help. This is a device that may prove beneficial for nervousness in closed-in situations so bothersome to Panic Disorder sufferers and persons who are bothered by anxiety stemming from claustrophobia. Time will tell. In the United Kingdom, and on the European internet market, the new Bcalm device is available for purchase in Europe.  For more information see the website: Be aware. This device is not approved by the USA FDA. These are portable, hand held air filters that promise to remove much of the excessive CO2 in claustrophobic situations like elevators, MRI scanners, airplanes, crowded rooms, vehicles and so on.

Presumably persons who are triggered to be compelled to “escape” the CO2 rich air in these situations can take this out of their pocket (or ask the flight attendant for one) and breathe air that, so far as CO2 is concerned, is like breathing very nearly outdoor fresh air. Studies have shown that fresh air with as little as 5% CO2 added will trigger panic attacks in 80% of panic disorder sufferers within 20 minutes. A 50/50 mixture will trigger attacks after just two breaths. One study demonstrated that actually CO2 levels as low as 600 ppm (0.0006%) will trigger panic attacks in those susceptible to having panic attacks. I have observed for years that often patients with panic attacks are choked slightly and briefly by inhaling the invisible vapor over a freshly poured carbonated beverage or a freshly popped can of cola. That little whiff is about 80% CO2.

It is clinical observation of psychiatrists and a frequent experience of panicking claustrophobics that these sufferers are sometimes frantic to get out of the place in which they are confined and go “outside”. Within a minute or two of getting out they usually begin to recover significantly. Why is that? That rapid recovery process has heretofore been thought to be purely, psychological, due to removal of the person from a “phobic” psychological situation about which they were “catastrophizing” cognitively (thinking scary thoughts). And it may be that plenty of suffering people do that. However, this new view of the data, details research that supports the fact that such persons are hypersensitive to carbon dioxide levels that do not bother ‘normal’ people. And that their recovery experienced by leaving and going “outside” is more often simply due to breathing good air that has no untoward polluted elevation of CO2. Studies have shown the indoor and vehicular elevation of CO2 in indoor (e.g., classrooms) and vehicular air (e.g., elevators, airline cabins, MRI scanners) to be not just 2% or 3% higher than fresh air, but almost always 100-200% higher at a minimum, and, not rarely, as high as 650% higher than outdoor air. One study showed that this interference with a feeling of wellness extends to office workers in most commercial office buildings. The study showed interference with a commonly experienced CO2 level of 1000 ppm caused measureable interference in executive brain function the sum of memory, focus, concentration, solution finding and creativity.

Two clinical trials have been done that show benefit of clinical panic disorder pathology with prototypes of the bcalm device, one in the US and one in Finland. The Finnish study was not published due to imperfect (partially active) placebos but the researcher told me in personal communication that the trend was useful nonetheless, The more active units performed better than the partially active units. bcalm is not FDA approved for any disorder. 

One might well assume, that the bcalm device which removes CO2 from the CO2 -polluted air would help persons who are known to be overly sensitive to CO2 -polluted air in these close-in situations. For now, the maker is simply stating that the bcalm is guarantees to filter CO2 pollution out of air with the typical CO2 elevations known to exist in elevators and planes and forth on down to levels close to or equal to outdoor air.

CO2 is not the only trigger for panic attacks. It is known to researchers in the field that the following things are all triggers for panic attacks: CO2, adrenalin, medicines which similarly increase brain norepinephrine levels such as some buproprion, decongestant cold pills, caffeine in large doses, surges in cycles of progesterone, cholecystokinin, I.V. Na lactate infusions, and β-Carboline alkaloids. Interestingly, none of these provokers of panic attacks in persons who suffer from panic disorder, will provoke panic attacks in “normal” persons… except for β-Carboline. β-Carboline will cause any person to have a severe panic attack.

It may give panic attack sufferers a sense of relief to know that at least part, if not all, of their suffering is increasingly thought to be medically based in cause. The bcalm device a completely new approach, a third alternative, to help people who suffer from CO2 nervousness and sense of smothering by removing the invisible, odorless and tasteless CO2 excesses everyone is talking about these days. Who’s not against air pollution anyway?

Stephen M. Cox, M.D.
National Anxiety Foundation
President and Founder

Volunteer faculty at the University of Kentucky College of Medicine and Cumberland University

This information (except for the name of the device, bcalm) was reviewed and agreed upon by Dr. David Sinclair of Finland who did the second clinical trial.