If you experience heightened anxiety and nervousness when going to doctors’ appointments, you’re not alone. But did you know that this anxiety can actually have an impact on your blood pressure? Many people with migraine experience what is called white coat syndrome, also known as white coat hypertension, which happens when someone develops higher blood pressure in the presence of a physician or other healthcare professional than is normal for them. It can be experienced by anyone, even those who typically have normal or even low blood pressure. It is quite common and is believed to be brought on by the stress of being in a doctor’s office.
White Coat Syndrome
White coat syndrome can happen to anyone, but for those with migraine, a trip to the doctor’s office can be especially anxiety-producing. As a result, in addition to higher blood pressure patients can experience increased anxiety, palpitations, fear, tightness in the chest, and more. What is most sad is that for some people the experience is so severe that it impacts their willingness to see a doctor, and access the care they need for disease management.
It’s not uncommon for people with migraine to wait weeks or months to get appointments with a headache specialist. The anticipation of the upcoming visit can cause stress to build. Patients may have many questions running through their minds for weeks leading up to the visit—will I have enough time with the doctor? Will I remember to tell him/her everything I think they need to know? Will this provider be able to help me? Will they even believe me?!
In addition to worrying about the upcoming visit, many people with migraine may be nervous for doctors’ visits due to previous negative experiences with healthcare providers. Having your pain dismissed or not believed is incredibly frustrating and upsetting. People with migraine may be accused of not working hard enough on healthy lifestyle habits or exhibiting signs of drug-seeking behavior. This type of judgment on the part of healthcare providers is very anxiety-producing for patients and greatly impacts their willingness to seek appropriate medical care, or to tell their doctor about all their symptoms and the impact on their life.
Another potential reason for increased stress upon going to a doctor’s appointment is that intense, chronic pain creates trauma on both our bodies and minds. When we go to the doctor and have to relive that pain by talking about it, it can enhance our anxiety and make us very nervous. That anxiety is amplified, again, by concern about reliving the pain in front of a doctor who may not take it seriously. The question may be asked: Why should I go through that for nothing?
Sad man talking to doctor wearing white coat
What can you do if you experience white coat syndrome?
White coat syndrome is typically not a cause for concern, but if you’ve ever experienced it before, it’s a good idea to tell your doctor’s office at the beginning of each visit. If your blood pressure is elevated, your doctor will likely continue to monitor the situation. He/she may take your blood pressure readings several times throughout the visit. If it does not normalize, they may ask you to continue to monitor your pressure at home for several days or weeks to make sure there is not an underlying blood pressure issue. Hypertension and migraine are comorbid conditions, and some migraine medications can increase blood pressure, so it is important not to dismiss the possibility of an actual problem. Some doctors believe that if you experience white coat hypertension you may be at future risk of developing high blood pressure, even if your pressure normalizes at home. In addition, anxiety spikes may be a warning sign of generalized anxiety disorders or PTSD. If your symptoms are severe, you may benefit from mental health support such as therapy, or anti-anxiety medications. Some of the newer telehealth options for people with migraine, such as Neura Health, even offer life coaching specifically for people with migraine to help with this type of experience.
There are some other things you can try to ease your doctor’s office stress:
- Make a list of the things you want to discuss with your doctor before your visit. Put them in order so you can get to the most important ones first and bring it with you to your appointment so you can be sure you won’t forget anything.
- Low blood sugar and dehydration can impact your blood pressure levels so make sure to eat something and drink plenty of water before your visit.
- Use a meditation app or bring a book with you to keep your mind busy while you wait.
- Take deep calming breaths.
- Read more about what to expect and how to plan for doctor’s appointments here.
- Don’t be afraid to change doctors if necessary—sometimes seeing a new doctor who partners better with you can reduce the white coat syndrome experience.
Tell us! Have you ever experienced white coat syndrome? Do you have any tips for dealing with doctor-visit stress? Have you ever had to change a doctor because of the stress experienced in doctor visits?
Note: For more information on Neura Health, which offers access to educated headache specialists as well as migraine life coaching, all via telehealth, please visit www.NeuraHealth.co and use discount code “MIGRAINEM15” to get $15 off.
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