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Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Panic Attacks [Read/Print full article]
Overview
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A panic attack is a sudden, overwhelming feeling of terror or fear accompanied by physical symptoms such as sweating, heart palpitations, or dizziness. Panic attacks happen suddenly and usually peak in 10 minutes or less, although it may take much longer for all the symptoms to go away, anywhere from 30 minutes to several hours. A panic attack can occur at anytime (day or night) and anywhere (at home, at work, while driving, or even while sleeping).
Panic attacks have been experienced by 15 to 30 percent of adults. Some people only have one or two panic attacks during their lifetime. People who have more frequent panic attacks may also have a panic disorder.
Panic attacks can be successfully treated with a combination of counseling, self-care techniques, and, in some cases, medication.
Causes
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Our bodies naturally react to danger with an increase in heart rate and faster breathing, which provide the energy to react quickly to a threatening or fearful situation. This is called the "fight-or-flight response." Some people respond this way even if there is no imminent danger, but we are not sure why. It may be that a combination of factors plays a part in triggering panic attacks, including the following:
Genetic. You are more likely to have panic attacks if you have a family member who suffers from them or if you have a parent with depression.
Life stress. Chronic and long-term life stress can trigger panic attacks.
Other factors that might also trigger or increase your risk for developing a panic attack are:
- Drinking excessive amounts of alcohol or caffeinated drinks
- Smoking, which creates high levels of nicotine in the blood
- Using drugs such as cocaine or marijuana
- Undergoing surgery or having general anesthesia
Risk Factors
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You may be a higher risk for panic attacks if any of the following apply to you:
- Other family members with an anxiety disorder or a family history of panic attacks
- A history of childhood physical abuse
- A history of childhood sexual abuse
- Experiencing or witnessing a traumatic event like rape, natural disaster, or a violent act
- Serious and stressful illness or death of a loved one
- Major life changes like a new baby, marriage, or job
Symptoms
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A panic attack is a sudden, intense feeling of fear or discomfort accompanied by physical symptoms. A number of different symptoms may occur during a panic attack. You may experience some or all of the following:
- Pounding heart, heart palpitations, or a racing heart
- Sweating
- Dizziness, nausea, or feeling faint
- Tingling or numb hands
- Chest pain or a feeling that you can't breathe
- A choking feeling
- Feeling of unreality or a sense of doom
- Feeling of losing control
- Fear of dying
- Chills or hot flashes
These symptoms can be so severe that some people mistake their panic attack for a heart attack.
Diagnosis
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In order to determine whether you have had a panic attack, we may conduct a physical examination including checking your heart rate and blood pressure. We may also ask you to take a blood test to determine if your symptoms might be the result of a physical condition.
We can discuss your symptoms, what happens during the panic attack, and how often you get them. We can also talk about any stress, concerns, or fears you may have, as well as any relationship, substance abuse, or other problems in your life.
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Treatments
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Panic attacks can be successfully treated with both therapy and medication.
Therapy
Therapy can help you understand panic attacks and learn to manage your symptoms. There are different types of therapy that are helpful in treating panic attacks, including:
- Cognitive-behavioral therapy (CBT) helps you recognize and change your negative thought patterns into healthy thought patterns. If you have discouraging or irrational thoughts that come to you automatically, these thoughts can cause you to feel bad. When you replace negative thoughts with healthy positive ones, you become calmer and you may be better able to react to situations that cause anxiety.
- Relaxation techniques help you become aware of tension in your body. You learn how to relax, which reduces your feelings of anxiety. Techniques, such as those used in yoga or other relaxation practices, include deep breathing exercises and methods to relax specific muscles.
- Guided imagery is a technique in which you learn how to use your imagination to produce positive, calming images that can help to reduce anxiety and stress.
Medications
There are different types of medication that help control the symptoms of panic attacks. We will work with you to see if the following types of medications may be appropriate for you:
- SSRIs: We may prescribe antidepressants called selective serotonin reuptake inhibitors (SSRIs). This type of medication is used for depression but also helps reduce the symptoms of panic attacks. Examples of these medications include Prozac (fluoxetine), Paxil (paroxetine), or Zoloft (sertraline).
- Other antidepressants sometimes used are Effexor (venlafaxine) or one of the trycyclic antidepressants (Tofranil, Norpramin, or Anafranil).
Your Care with Me
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If you have symptoms of panic or have other behavioral health concerns, you can contact the Psychiatry or Health Education Departments directly, without a referral from me. They will be able to help you find the resources that best fit your needs. The Health Education Department can help connect you with a wide variety of related classes. You can also find classes in the Health Tools and Classes section on this site.
You can also contact me. Depending on the situation and what is most convenient for you at the time, you can connect with me in a variety of ways. I am available online, by telephone, or in person.
- For nonurgent questions or concerns, you can e-mail me using this site. You can also book an appointment online to see me in person.
- If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment with me or one of my colleagues, if I am not available.
You may also contact the Chemical Dependency Recovery Program if you have concerns about your use of alcohol or other substances.
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How We Coordinate Your Care
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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
If you come to an office visit
- At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need.
- At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
- To help you prepare for your visit, please see additional details under Office Visit.
If I prescribe medications
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
- Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
- Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If I refer you to a specialist
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
If you are due for preventive screenings or tests
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
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Convenient Resources for You
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My goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions and schedule appointments.
- View your past visits and test results.
- View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
- Read about causes, symptoms, treatments and procedures.
- Find interactive health tools, videos, and podcasts to help you manage your condition.
- View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
- Locate health education classes and support groups offered at our medical center.
- Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
- View your Preventive Services to see whether you are due for a routine screening or updated immunization.
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Related Health Tools:
Podcasts
- Panic Attacks and Anxiety Panic Attacks and Anxiety
- Stress Management Stress Management
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.