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  • Q&A with Australian Health Practitioners

    How can I overcome white coat hypertension?

    I have what I think is white coat hypertension, how can I overcome this?

    I use self talk and tell myself to relax, and that its ‘only another person’ but it does not seem to help, I am still nervous inside the surgery.

    Sometimes I feel my heart racing inside, but when I walk out of the room I am fine.

    Any ideas?
  • Find a professional to answer your question

  • 1

    Thanks

    Ralph Graham

    Counsellor

    Ralph Graham, Counsellor, Psychotherapist, helping those who are affected by:grief, loss, anxiety, phobias, panic attack.And those who have been traumatised by:crime, assault, sexual abuse and … View Profile

    There will be different approaches to this. My approach is to use my training to find an experience one has had where the fear might have begun. If the experience first dealt with does not turn out to be the earliest one then this will eventually show up and after dealing with that one the anxiety can stop. Facing surgery may cause a little anxiety in almost anyone but the stronger, pervasive style of anxiety you describe will no longer be present. That is how it happens with the way I do it but others will use other approaches. Whatever works, works.

    The beauty of the above it is usually takes only one session. Having said that, once I spend some time and assess the situation there may be other things that after discussion the client realises they want to handle first so the surgery anxiety may be put off till a later session. But do get some help because it is not the kind of thing that normally goes away on its own and telling oneself to relax can be frustrating if we are dealing with something that just sits there festering in the past and we can’t quite see it or know how to get to it.

    It is a bit like saying “relax” as the growling dog walks toward us when instead the owner could just close the gate or call out “sit.”
    That is remove the problem rather than trying to grin and bear it. Go well

  • 1

    Thanks

    Dr Carolyn Ee

    Acupuncturist, GP (General Practitioner)

    I'm a Sydney GP with a special interest in women's health especially menopause and TTC ( trying to conceive). I specialise in acupuncture, and am … View Profile

    White coat hypertension is a very real syndrome. I have several patients with a marked case of it! I cannot add much to the excellent answer above, except from a GP's point of view we are very sympathetic, and usually the best way around knowing what your BP actually is is to get you to check it at home; alternatively, conclusive proof can be obtained by doing a test called a 24 hour ambulatory BP monitor. You wear a special monitor for 24 hrs and it records fairly continuously, and then gives an average BP reading.

    I often turn away while the monitor is recording as well (I have an automatic monitor for my patients) in the hope that this helps the sense of being watched!

  • Dr. John Mahony

    Cosmetic Physician

    Dr John Mahony studied Medicine at Sydney University 1980-1984 graduating early 1985. Internship and residency years followed in the Illawarra, covering general medical and surgical … View Profile

    Firstly a semantic point.

    When doctors use the term “hypertension”, they aren't talking about “feeling really really tense”. The medical term “hypertension” relates wholly and solely to blood pressure, regardless of any sense of anxiety.

    So, if you are sound asleep but with high blood pressure, you have hypertension.

    If your heart is pounding and your knees are shaking and you are sweating and about to scream with anxiety, but your blood pressure is 110/70, you *don't* have hypertension, white-coat or otherwise.

    …..

    Thus, “white-coat hypertension” is really something your doctor has to consider in determining whether you have actual high blood pressure, and Carolyn has addressed this well.

    Feelings of anxiety on seeing a doctor is not “white coat hypertension” as such. It's more “iatrophobia”, which, strictly, is what Ralph has discussed, and is the correct term for the condition described in the question.

    Of course, iatrophobia can cause or contribute to white-coat hypertension!

    Hope this helps

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