Overcoming Anxiety and Fear Related to Blood Pressure Monitoring - Psychiatry

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Fear and anxiety issues?


Hello Doctor: I previously had unstable blood pressure and was diagnosed with hypertension.
I took a beta-blocker (the lowest dose, half a pill) daily for six months, but my blood pressure kept dropping to 88/60.
The doctor said I do not have hypertension but rather sympathetic nervous system overactivity, and I could stop the medication.
My blood pressure remained normal for half a month, but once I measured it at 220/80, later realizing the blood pressure monitor was faulty.
Since then, I have been very afraid of measuring my blood pressure...
Now, every time I see a blood pressure monitor, I experience palpitations and anxiety, causing my blood pressure to spike.
It only normalizes after my heart rate calms down.
I keep telling myself that I do not have hypertension and that the elevated blood pressure is due to psychological factors, but there has been no improvement, and my anxiety is increasing.
Doctor, what mindset can help me stop this fear? Would seeing a psychiatrist and using medication help improve or cure this? Would it involve anti-anxiety medication? How long does it typically take to be effective? Thank you for your response!

Mei, 40~49 year old female. Ask Date: 2018/10/26

Dr. Huang Jiabin reply Psychiatry


Hello: You have taken the first step in overcoming fear: "self-awareness," by beginning to recognize your irrational anxiety.
The next step is to address the physiological responses that fear brings.
You can search for "relaxation training" on YouTube, where you will find many tutorial videos, including "diaphragmatic breathing" and "muscle relaxation." Choose a video that suits you for practice.
As soon as you notice irrational worries about your blood pressure, begin your relaxation training.
By addressing anxiety and fear responses cognitively and physiologically, your condition will naturally improve.
One benefit of visiting a psychosomatic medicine clinic is the opportunity to discuss your practice with a physician, which can enhance the effectiveness of your improvement.
Additionally, the physician can assess whether there are other underlying issues that need to be addressed.
Medication will not be the first option considered.
Even if medication is necessary, the aforementioned practices remain essential.

Reply Date: 2018/10/26

More Info


Overcoming anxiety and fear related to blood pressure monitoring is a common challenge, especially for individuals who have experienced fluctuations in their blood pressure readings or have a history of anxiety disorders. Your situation, where a faulty blood pressure monitor led to an alarming reading, has understandably heightened your fear and anxiety surrounding blood pressure checks.
First, it’s important to recognize that anxiety can significantly influence physiological responses, including heart rate and blood pressure. When you feel anxious about measuring your blood pressure, your body may react with a "fight or flight" response, leading to increased heart rate and elevated blood pressure readings. This is a normal physiological reaction, but it can create a vicious cycle where the fear of high blood pressure leads to anxiety, which in turn causes high blood pressure.

Here are several strategies that may help you manage your anxiety related to blood pressure monitoring:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety disorders. CBT helps you identify and challenge negative thought patterns and beliefs about blood pressure monitoring. By reframing your thoughts, you can reduce the fear associated with measuring your blood pressure. A therapist can guide you through this process.

2. Mindfulness and Relaxation Techniques: Practicing mindfulness, deep breathing exercises, or progressive muscle relaxation can help calm your mind and body before measuring your blood pressure. Techniques such as visualization—imagining a peaceful scene—can also help reduce anxiety.

3. Desensitization: Gradually exposing yourself to the source of your fear in a controlled manner can help reduce anxiety over time. Start by simply being in the same room as the blood pressure monitor without using it. Once you feel comfortable, progress to touching the monitor, and eventually to taking your blood pressure while practicing relaxation techniques.

4. Regular Monitoring in a Comfortable Environment: Try measuring your blood pressure at home when you feel relaxed. This can help you associate the process with a more positive experience. Choose a time when you are calm, perhaps after a few minutes of deep breathing.

5. Education and Understanding: Understanding how blood pressure works and the factors that can influence it may help alleviate some of your fears. For instance, knowing that anxiety can temporarily raise blood pressure can help you contextualize your readings.

6. Medication: If your anxiety is significantly impacting your quality of life, discussing medication options with a psychiatrist or primary care physician may be beneficial. Anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, can help manage symptoms. The duration of treatment varies by individual, and your doctor can help determine the best approach for you.

7. Support Groups: Connecting with others who share similar experiences can provide comfort and strategies for coping with anxiety related to health monitoring.

8. Positive Affirmations: Remind yourself that your previous high readings were due to a faulty device and that your blood pressure has been normal since then. Positive self-talk can help counteract anxious thoughts.

In conclusion, overcoming anxiety related to blood pressure monitoring is a process that may require a combination of therapeutic techniques, lifestyle adjustments, and possibly medication. It’s essential to work closely with your healthcare provider to develop a personalized plan that addresses both your anxiety and blood pressure management. Remember, you are not alone in this experience, and with the right support and strategies, you can learn to manage your anxiety effectively.

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