Tips to beat white coat hypertension forever

"Want to know how to calm white coat syndrome? Looking for tips to beat white coat hypertension? Step one, stop thinking doctors are really evil." | Photo ©aleutie / Adobe Stock

The first step to overcoming white coat syndrome begins with knowing you have it. Only then can you find a cure. Here is the true story of one woman’s white coat syndrome diagnosis and her practical tips that finally allowed her to overcome white coat hypertension.

Is recessed lighting and bubbling fountains too much to ask for hospital waiting rooms?

Probably, but that won’t stop me from asking for a Queer Eye-style makeover in every sterile medical setting, particularly because I’m one of those people who have panic attacks at the sight of a white coat or hospital interior.

While it sounds like an episode of Black Mirror, white coat syndrome is a fancy name for the high blood pressure reading and anxiety those of us encounter when in the presence of doctors, which probably includes Dr. Dre. (Not because I’m afraid. I just dislike all music that doesn’t include folksy mandolins made by bands that seem to be named by randomly selecting words from the dictionary, like ‘Unproductive Camels.’)

Part of my fear of going to the doctor’s office includes my fear of blood pressure cuffs. It started when I was a kid. My doctor would have to use the manual blood pressure cuff because as soon as they switched to the kind that automatically amputates your arm — er, automatically inflates — I was done. Game over. Panic attack: initiated. I know my fear of blood pressure cuffs is irrational, but it doesn't make it less real.

This fear of blood pressure cuffs also played into my decision to not become a CIA agent, which was legitimately on the table before I decided to switch over to my current, more practical career path: playing pretend in Hollywood. I knew that if I couldn’t withstand an inflatable band, I probably shouldn’t be trusted with government secrets. 

During my first appointment at an unfamiliar health center on my college campus, I was too embarrassed to admit that as a Grown-Up Adult, I trembled in my boots around blood pressure cuffs and medical staff with clipboards. So when the nurse took my blood pressure, I did my best to contain my panic attack by attempting to take measured breaths that ended up sounding like I had just finished a marathon. The nurse took one look at my readings and relegated me to a hospital bed, telling me to listen to smooth jazz until I calmed down.

Now, there’s a unique pressure in being told to calm yourself down. Especially because, as I mentioned previously, I can’t stand any music that doesn’t sound like it’s currently being played by musicians surrounded by llamas in the alps. But I tried my best to take to the smooth jazz and the intentional meditative-style breath that probably sounded more like I was about to go into labor than finding my inner zen.

This ritual continued in one form or another every time I came back to the medical center, my palms clammy, and my high blood pressure readings not helped by the four lattes and longboard ride preceding every visit. 

Eventually my doctor insisted I buy a blood pressure monitor and test myself at home. They were alarmed at my blood pressure readings and wanted track my readings over a month to try and identify a pattern.

What was even worse than being told to buy a blood pressure, was that the blood pressure cuff I was instructed to buy was automatic. How was I ever going to relax when having blood pressure taken at home?

It took me a week to even get it out of its packaging, just envisioning it inflating until it exploded like a kind of rubber grenade. When my roommate left for class one day, I decided to just bite the bullet and take my first reading. I put the thing on, took deep breaths, pressed the start button… and it started to inflate. While my inner monologue was just a serious of unintelligible screams, I felt calmer than usual.

Then, the device beeped. I looked at the result. My blood pressure… was super low. Not like the higher than normal numbers I sometimes got at the doctor’s office. I sighed in complete relief, grateful not to have a nurse staring at me as if worried I was about to go into cardiac arrest before her lunch break. Just to be sure, I took my blood pressure again. And again. Day after day after day. I even compared the readings to the blood pressure cuff at my doctor’s to make sure my device was accurate. 

When I saw my doctor a few weeks later, the verdict was in: I wasn’t scared of the blood pressure cuff, I was terrified of the doctor’s office. I had white coat syndrome. And that was okay! Because if I wanted to lower my blood pressure, I needed to know what was causing the high blood pressure readings. 

My doctor then explained that for some people, the knowledge their blood pressure might climb higher when they visit the doctor’s office might be a self-fulfilling prophecy. To put this another way: if a person is worried they might have high blood pressure, their anxiety about a high reading will be enough to give rise to a high blood pressure reading. And this is what was happening to me

. 
And like all good doctors, he gave me some resources and told me that I needed to learn how to relax when having my blood pressure taken. And only then would I know how to overcome white coat syndrome.

If you want to know how to overcome white coat syndrome, try these tips to beat white coat hypertension. And remember, it is just about overcoming the syndrome, knowing how to relax when having your blood pressure taken has obvious health benefits.

As I mentioned earlier there’s a unique pressure in being told to calm yourself down and relax. I know that relaxing is easier said than done, but it is true, you need to relax. If you’re feeling worried or anxious before having your blood pressure test, let the person taking the test know you experience white coat syndrome. Ask them if they can wait a few moments so can relax and chill. 

Being open with the medical staff about being nervous before blood pressure tests helped them help me. Trust me, you and I are not alone here. 

Try taking the blood pressure test in a different location. This is a proven way to calm and overcome white coat syndrome. If you are at a medical clinic ask if you can move to a quiet area for the test. If you take the test in a busy clinic or in a hospital emergency room, the surrounding noise can definitely increase your stress levels triggering your white coat syndrome. 

To beat white coat syndrome, identify a stress relief technique that enables you to calm down when you’re anxious or stressed. One method is to close your eyes, breathe deeply and exhale slowly. Do a few of these breaths before your blood pressure reading. This really does work.

For some people, having a conversation while getting their blood pressure taken can help distract them from the test, which can lower stress levels and improve the result. For other people, simply sitting quietly without talking may be more relaxing. 

Obviously try and avoid topics that will make you annoyed or tense!

“I’m not faking it” convincing people I have white coat syndromeWhen I explained my feeling of being the verge of panic attacks and ensuing blood pressure readings every time I entered the threshold of the medical center to a doctor at my next visit, he just nodded and said:“You’ve got white coat syndrome.”And with that, everything clicked into place, like I was an analyst in a spy movie staring at streams of data for hours on end until I found a pattern that leads me to the lair of some bad guy we were after. All of these numbers — they’re not just numbers. There’s a pattern.

That pattern was that medical settings freak me out. I’m not alone, either. Around 15-30% of people who present with high blood pressure in medical settings have white coat syndrome – a form of anxiety – but don’t have hypertension. It’s all in our heads.

If I were to play being a psychiatrist with myself, I would probably point to childhood memories of being with my grandfather in his final days in the hospital when I was a kid, realizing cancer was killing him and grappling with the reality that people could die like that. 

After his funeral, I developed a fear that every hospital or doctor’s office visit was just a formality and that I, too, would be diagnosed with cancer. It was just a matter of time.That fear sticks with me today. But when I heard those words from the doctor who understood what I was going through, it was like a vote of confidence. 

I wasn’t just a silly irrational girl, but somebody who was experiencing a syndrome that others did, too.

When my fear was given a name – white coat syndrome – it gave me a kind of power over my anxiety and the know-how to overcome white coat syndrome, and most importantly, how to relax when having blood pressure taken by a doctor.

Knowing how to stop white coat syndrome has helped me have much less stressful visits to the doctors. Knowing how to relax when having blood pressure taken has had obvious health benefits for me, including reduced anxiety. And even better than reduced anxiety, I no longer have to endure four cc’s of smooth jazz.