Your question: Why do I get anxious when I go to take my blood pressure?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy.

As a universal experience, anxiety can manifest itself in multiple forms. In small doses, anxiety is necessary and does not represent a problem. However, when it becomes very recurrent and intense, it can trigger physical and emotional problems that affect the quality of life.

Studies have shown that anxiety is related to many medical problems, including cardiovascular problems. Surely if you read this you are wondering how normal it is to experience an increase in your blood pressure when you go to get your blood pressure checked.

The answer is that it is a relatively common phenomenon. First, research has found a link between anxiety and hypertension. Anxiety attacks can increase blood pressure sporadically and momentarily, but they cannot cause a hypertension problem as such. On the other hand, having hypertension and being constantly checked to regulate blood pressure can generate health anxiety (1).

Secondly, the phenomenon of experiencing a rise in blood pressure just when you go to have your blood pressure checked by a physician has been studied. This problem is known as White Coat Syndrome or white coat hypertension (2).

White Coat Syndrome is a cause for concern because people may feel their blood pressure is stable when they take it at home, but once they arrive at a doctor’s office or a medical facility in general, their blood pressure rises.

There are several factors that can cause this, the most common being health anxiety. Although it is a problem that can generate fear and worry, I would like to tell you that it is a phenomenon that has been studied and that you are not alone in this. Moreover, it is something that has a solution, through coping strategies for anxiety and regular medical check-ups.

It is important that you first understand why White Coat Syndrome occurs, as well as the medical and psychological implications related to it. At the end of this blog, I will introduce you to some strategies for coping with anxiety and preventing increased blood pressure both inside and outside of a doctor’s office.

Why does White Coat Syndrome occur?

The people most prone to suffer from White Coat Syndrome are people over 50 years old, however, it is not a problem that is exempt from any person with hypertension. This phenomenon occurs specifically within medical and hospital environments. The person notices a mismatch between the blood pressure levels they had at home and those they have when they see a physician.

The most common cause of White Coat Syndrome is health anxiety, an intense worry and fear of getting sick or having health problems of any kind, as well as of hospitals, doctors and health care institutions in general. Health anxiety causes the person to suffer nervousness, worry and intense anxiety when in the presence of something related to the world of health, since they associate these elements with illness and death.

The worry begins as soon as the person arrives at a clinic or hospital to have their blood pressure checked. Their anxiety skyrockets, their heart rate accelerates, and when the doctor takes their blood pressure, it is elevated. While at home the levels were normal, when you were in a healthcare facility your blood pressure increased because of anxiety. People with this type of anxiety feel intense worry about their medical problems, and in general, they tend to exaggerate their symptoms.

If you are going through this situation, it is not your fault you feel this way. No one chooses to have health anxiety or White Coat Syndrome. Although others may question them, these symptoms are real for you because your anxiety tells you they are. Therefore, to address this problem you need to learn how to regulate your blood pressure regularly and deal with the anxious symptoms that medical spaces create for you.

How to prevent increased blood pressure?

In the long term, anxiety can aggravate cardiovascular problems, so it is necessary that if you have a previous diagnosis of hypertension, you maintain constant supervision with your doctor. In general, it is recommended that you avoid smoking and drinking alcohol in excess. Likewise, you should work on maintaining healthy sleeping and eating habits. This not only helps to keep your blood pressure stable but also to prevent the onset of anxiety episodes that increase it abruptly.

How to deal with your anxiety?

Dealing with health anxiety is complicated, but not impossible. You need to be in constant communication with a physician and psychologist, allowing you to rule out that the sudden onset of increased tension is related to another medical problem. Through some coping strategies, you will be able to deal with the characteristic symptoms of anxiety.

Breathing and relaxation

Inhale through your nose for three seconds, exhale through your mouth for another three seconds. This while you close your eyes and feel how slowly the tension in your body decreases. You can apply this exercise for at least 10 minutes a day at different times, and just after experiencing an episode of anxiety.

Keep a diary about your anxiety

Recording in a notebook the facts related to your anxiety has several functions. On the one hand, it allows you to express yourself honestly about your emotional problems in a private place; on the other hand, it allows you to identify patterns that trigger your anxious symptoms. Write down in your diary the episodes of anxiety you experience during the day, as well as the related facts: who you were with at the time, what was happening, where you were, and what you felt.

By describing these details, specifying whether you suffered a rise in blood pressure at that time, you will be able to observe which scenarios and people are associated with your anxiety episodes, allowing you to start making changes in your life to prevent anxiety in the future.

5, 4, 3, 2, 1

This technique consists of using your senses to dissuade emotional discomfort at a given moment. It is useful when you experience a lot of physical agitation or when you feel you have a lot of unpleasant thoughts, and you find it difficult to control your emotions. Wherever you are, you will focus on identifying 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. This will allow you to focus your attention on specific things during the period of anxiety, and slowly, the feeling of intense worry will diminish.

In my experience…

Both White Coat Syndrome and health anxiety are little-discussed but more common problems than you might think. They represent discomfort because they can make you doubt yourself, as you question whether your blood pressure problem is psychological or real. With the necessary professional support and the right coping strategies to combat anxiety, you can reduce the levels of anxiety in your life and stabilize your blood pressure both at home and in healthcare settings, confronting your fears and worries.

I believe you have the ability to improve and heal these feelings of discomfort you are experiencing now. The fact that you are seeking professional help through this medium proves it to me, and I applaud you for making that decision and being on track to improve your mental health and overall, your physical health.

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