Bonus Day: Question on Medical Anxiety Answered
Nov 28, 2023
EmToday is a bonus because I wanted to answer a listener's question, but I knew that this week was going to be focused more on thankfulness and those benefits, spiritually and mental health wise. Since this didn't really have a place to fit in over the last couple of weeks, I thought I'd throw in a bonus because I'm thankful that she reached out and asked this question. This is around how to handle white coat syndrome and anxiety that comes from knowing that you're going to get your blood pressure taken.
I personally have struggled with this one. In fact, it's been the kind of unhelpful thing that I've been dealing with as I've gone to different appointments this year. Oh, my goodness, I'm about to get my blood pressure taken, and instantly, I could feel my blood pressure rise. The reason being is I have a history of having high blood pressure and preeclampsia in my pregnancies, so whenever they would take my blood pressure, it could mean delivery or not and my health or the baby's health or not, depending on the readings and what they determine to do with those readings. In my history, I know that blood pressure readings can be nerve wracking because I've experienced something that was scary and unknown that I didn't have control over, and my babies depended on me, and I couldn't do much about it. You can only do so much about blood pressure, so I took my prescribed medication and had my blood pressure checked, and everything turned out great for me and my babies, who are now grown young adults and doing great.
At the same time, I was still left with a hesitancy to ever want to have my blood pressure taken again. Every time that I get to a place where I need to have it taken, I can feel the increase in the tension inside me and I can also feel the experience of, oh, my goodness, am I about to be trapped? So, are they going to put me in the hospital? Is something really wrong? Is this dire? Is someone going to die? It's kind of like really intense, really fast, and I feel it all at once.
As a mental health professional and somebody who knows how to deal with my own anxiety, I have done a few things to manage this. It does not mean that I don't have this. Now, I might do some EMDR (eye movement desensitization reprocessing) on it at some point, but it really didn't seem to be a problem until this past year, so I haven't given it that much thought. Recently, I've thought this might be something to do EMDR on to process some of that disturbance and the trauma still stored in my system from those preeclamptic times when I was pregnant.
Whether you have had a negative experience before as far as blood pressure or whether you're anticipating fear of a negative outcome. White coat syndrome can be a real phenomenon where you go, and your numbers can go higher because you're nervous. Having it taken by a medical professional, the white coat comes in and, oh, here goes my blood pressure, right? For some, this doesn't happen, but for those that have medical anxiety, it is very unpleasant and very uncomfortable.
Things I've Found to Help Medical Anxiety
To answer this listener's question, there are a few things that I have found help, and I also did a little bit of research online to kind of see if there was anything else that could be helpful.
- Just Tell People: Tell the people you come in contact with, I get scared when I have to have my blood pressure taken. And I would like to be able to relax first before you rush me in, sit me down, slap a cuff on me, and expect me to be able to give you an accurate reading. Okay? You don't necessarily need to say it that way, but you could say, hey, my blood pressure tends to run high. I'd like a few moments to just really calm down so you can get a more accurate reading. That's one way to do it and just own it. Another can be, I get anxious. For some reason, my nervous system just gets really anxious and it's hard to get a good reading. Would you mind if I talked softly with you while you take my pressure? Another could be, I'd like to do some deep breathing before you take that, because I'd like to transition to being calmer before you take it because I have a tendency to get really uptight whenever blood pressure is about to happen. But definitely speaking up for yourself is the first thing I recommend. When people know that you're dealing with an anxiety issue and they know that this is a tendency for you, they can often work with you. I've had people bring me water so that I could calm down and relax. I've had them wait and hold off some time to take it until they took it later in the visit, rather than when I'm just rushing in after traffic and parking and waiting room and being shuttled into the room.
- Numbers are only an indicator of the numbers. Numbers don't necessarily mean anything, even mid-range or high blood pressure. They're not an indicator necessarily. Now, they can be, but not necessarily of your overall health. There are other things that go into being healthy. There are other risk factors or preventative measures or things that you have going for you, such as if you have a higher blood pressure but you're a younger, healthy, regular weight, not in a dangerous weight category type person, those numbers may not be as threatening as somebody who has heart disease, who's in their 70s, who is overweight and smokes all the time, right? It doesn't necessarily mean something catastrophic. It's just an indicator of the numbers. If you realize that the numbers aren't the whole picture and that getting it checked is a way that you can be helped so that the numbers can be treated either by lifestyle changes or medications to prevent problems. This is a way to find out if you need to prevent problems. Just like if you go to an eye doctor and they make you look at a chart and you can't read the stuff. Well, it's going to prevent problems as far as eye strain or being able to drive safely and not running into things that you wouldn't prevent if you went without glasses, right? So you go, you get checked, you see how bad it is, and then you fix it. And so that's something that can be done with blood pressure. You figure out how to best fix it just like with your eyes. Okay? Do you want contacts? Do you want glasses? Do you want LASIK surgery? How are we going to help you fix this so that you don't have these problems? That's another way to look at this as preventative care, to prevent negative outcomes as best as possible.
- Reduce Caffeine: Caffeine has been known to kind of tighten the blood vessels, shrink them, and you want to be able to have enough flow for blood as possible, but not do it all at once or that's going to probably send you into a tailspin. If you need to get off of caffeine, I recommend doing it in a very methodical way so that you can say, okay, I'll reduce it by this much this week and then a little bit more next week until you're finally down to being off of it.
- Stretching: There are certain poses of stretches that can help. There are ways to reset your nervous system, and here's one of them. Hold your head straight, look in front of you. Don't move your head and move your eyes only to the right. As your head's still facing forward and your eyes move to the right, hold that for 30 to 60 seconds until you feel a release of some sort which may feel like an extra breath or a sigh, something that allows you to know, oh, something shifted here. Once that's happened, keep your head still facing straight, bring your eyes back to center, and then keep your head straight again and move your eyes to the left. Do the same thing for 30 to 60 seconds until you feel that shift into either a sigh or a deeper breath. Something that indicates a letdown of the tension and a release I believe this is because there is more blood going to the brainstem, which allows you to get back into a regulated body. And you can do that as needed to reset your nervous system.
- Drink more water and limit salt. Drinking more water can help, and limiting salt can help.
- Self-Talk & Self-Care at Home: It's an overall plan of self-care. So many things in life are about adopting small changes in the healthy direction over a period of time. Consistently implementing small beneficial changes that can help you instead of telling yourself, oh my gosh, this is going to be awful, you can also change your mindset and say, this is going to help me take control of my health in a good way. Let's problem solve here. There's nothing to be afraid of. They'll help me if I get this checked out and then go from there. So those are some tips. Those are ways that I kind of do some self-talk and some personal work. Also, do some deep breathing while I'm in the office and then release. I also track my blood pressure at home so that it's not in the office where it makes me as nervous.
- Talk with a Therapist: If you just feel like you cannot get your blood pressure taken and it's really, really scary, I suggest working with a therapist who can help you with exposure therapy. Basically, maybe you just start with thinking about getting your blood pressure taken and you just do that for a week or two. And once you're able to be comfortable thinking about it, then maybe you test it once a week and then maybe you test it every day. Once a day, right and exposing yourself to the thing you fear and realizing you can be okay, or that there's help available, or that it gives you options, those are other things that can help.
I am really, really sorry to anybody who is dealing with this stressor. It is not a fun stressor, and no matter how many tools you have, if your nervous system is saying under alert, under alert, things seem scary, and your blood pressure kind of goes high, it's something that all bets are off sometimes. Like, okay, what do I need to do to survive this right now? That's why it's important to have a toolkit that you can rely on, a toolkit that you can go back to and that you can say, okay, let's try this technique. Okay, let's try this one. Oh, that works great. Or maybe this could work this time. And just case by case finding the right management tool for the type of anxiety you're dealing with. I hope that was helpful to you.
If you would like more information on anxiety, I have a new anxiety management course that is going to be released relatively soon. Right now, we are taking sign-ups for beta testers. You go to Mental Health for Christian Women and click on the button for beta testers for the anxiety management course, and you can save substantially. It's only $97, and it gives you so many tips and tricks and so much information right there. The first 10 people will be my beta testers. This opened up on Monday. I'm not sure if we still have spots, but go check it out, and if not, just for going over there. If the spots are already out, you can get on the waiting list and if you're on the waiting list when the finalized product comes out, you'll be given a coupon for 10%. So, you'll also save money there if you'd like to get it. Go take on the day.
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