Posted on: February 10, 2009 Posted by: Nicole Harding Comments: 8

Not everyone would admit it, but a visit to the doctor is anything but a happy experience. Oftentimes, you remind yourself that a visit to the doctor is beneficial to you, so you try to push your fears out of your mind. Unfortunately, your blood pressure doesn’t lie. When your blood pressure suddenly shoots up when you walk into a clinic or hospital, you’re likely experiencing white coat syndrome.

What is White Coat Syndrome?

White coat syndrome, also known as white coat hypertension and white coat effect, occurs when a patient’s blood pressure surges only when he’s in a medical or clinical environment. The “white coat” refers to the white coat that doctors wear. The condition affects everyone, male or female, young and old.

Hypertension is different from white coat syndrome because hypertension means that the patient has consistently high readings regardless whether he’s in a clinical setting or not. A patient with white coat syndrome however, has normal readings outside the clinic but his blood pressure shoots up when he enters a clinical environment.

It’s quite difficult to diagnose white coat syndrome because a lot of people aren’t even aware that they have it. Some doctors also confuse white coat syndrome with hypertension, resulting in unnecessary or wrong treatment. The patient must have records of his blood pressure readings at home and at a clinical setting, so that the doctor can come up with a proper diagnosis.

What Causes White Coat Syndrome?

Some experts define white coat syndrome as high readings of 140/90 mmHg or above when the patient is in a clinical setting, and normal readings when he’s somewhere else. The condition results from the patient’s anxiety, as his instincts tell him to either resist or flee from the doctor and the clinic. A lot of people are aware that they’re experiencing this kind of anxiety, while others aren’t even aware that their blood pressure is already rising. The following factors have been identified by experts as contributing to white coat syndrome:

  • Your fear instincts: Evolution equipped humans with fear, so they can quickly avoid situations where they are exposed to physical threat. While hospitals and clinics aren’t lion dens, people still perceive them as places where nasty things happen. You get this belief through years of hearing stories of people sick in clinics, or even dying in hospitals. Your mind then associates those places to danger, and your body promptly reacts to it by telling you to resist or flee.
  • Intrusive medical procedures: It’s not only physical harm that you fear when you go inside the doctor’s office when you want a checkup. You’re also anticipating that the doctor will touch you, perhaps in a very uncomfortable way. A lot of people are also afraid of being naked in front of their doctors, because this makes them feel vulnerable and not in control of the situation. There are also people who are very worried that their doctors will criticize them for their unhealthy lifestyle or behavior. All of these thoughts and emotions combine to push the blood pressure of some patients through the roof.
  • Lack of trust in the health care system: Today’s health care is system is vastly different from years past. Doctors are very busy, so it’s difficult for a lot of them to build strong, long-term relationships with their patients. The media is also responsible for broadcasting medical errors and other bad news about the state of health care. As a result, many people don’t fully trust doctors and hospitals, and some of them even choose not go to hospitals altogether.
  • Too much preventive care: As scientists discover more and more diseases and new ways of treating them, the focus of health care has also greatly shifted from cure to prevention. People are encouraged to undergo screenings such as cholesterol checks, mammograms, rectal exams, and many others, which make them more conscious of their health. Many of these tests are done through uncomfortable procedures, and it’s also frightening to think that you are in danger of so many diseases. While preventive care is done for the patient’s benefit, it does make him overly critical and sometimes anxious of his health.

How to Deal with White Coat Syndrome

The best way to get rid of white coat syndrome is to train yourself to face your fear of medical environments. This process could take a long time, because you have to go against your instincts. The following tips can help you get rid of your fear as soon as possible:

  • Admit your fear: The most important thing to do is to admit that there’s fear in the first place. Doing something about your fear is easier once you’ve accepted the reality that you are afraid. Don’t push the fear out of your mind because this will not solve the problem. Admit that you’re fearful, and then focus your attention on how to get rid of that fear.
  • Identify your fears: It’s often hard to see what really worries you because fear is diffused. You are anxious, but you don’t know what specifically worries you. Try to meditate or think through what goes on in your mind during a visit to the doctor. It will be easier to deal with your anxiety once you identify its exact causes.
  • Consider cognitive behavioral therapy: This form of therapy works by teaching the patient coping techniques and reframing his mind. Patients can get rid of their anxiety in just two or three sessions of this therapy.
  • Ask for anesthetics and sedatives: Pain is one of the biggest causes of white coat syndrome. Some people just equate going to the doctor with feeling a lot of pain. Give yourself some peace of mind by asking your doctor for anesthetics and sedatives whenever possible. People with needle phobia can benefit greatly from these drugs as they get rid of pain.
  • Remind yourself of the benefits of tests: It’s easy to forget why you’re undergoing intrusive tests when you feel too anxious. Sit back and remind yourself of the benefits of the tests to reduce some of the fear in your mind; for example, rectal exams are important to detect prostate cancer early, while colorectal exams are needed to catch colorectal cancers in their early stages. A lot of men avoid such tests because they feel that they compromise their sexuality. You can reduce that fear of intrusive tests by being rational and reminding yourself that they are all done for your benefit.
  • Go to another doctor: Don’t go to a doctor who you’re not at ease with. Find another one who evokes a more positive reaction from you, so the procedure will be more tolerable.
  • Don’t go to the doctor alone: Taking someone with you to the clinic or hospital helps to relieve anxiety. That someone should care deeply for you, so you know you’re not alone no matter what happens during the procedure. He could be your friend, relative, or spouse; and he should stay with you throughout the entire procedure unless the doctor recommends otherwise.
  • Ask your doctor what to expect: Another technique to reduce anxiety is to ask your doctor what to expect during the procedure. Many patients are overly worried about medical procedures because they don’t know what will happen to them. Ask your doctor what kind of pain you are going to experience, if any, and how long it will last. Also, inquire about what other sensations you might feel during the procedure, so you don’t get surprised or traumatized.

Don’t let white coat syndrome rule your life, because it can lead to hypertension, which is even more dangerous. Talk to your doctor immediately if you notice any signs of white coat syndrome so you can begin treatment early.

 Click here for more information on how to get rid of white coat syndrome.

8 People reacted on this

  1. Have white coat hypertenion. Having a biopsy, very upset. I am afraid they will not do the test because I know my reading will be high. Please help me.

  2. Take a small dose of Xanax of some other such drug HOURS before you go. Helps me. I get great readings in contrast with bad ones if I don’t.

  3. I keep a log of my Blood pressure I got from It lets me record my BP at home or at a store away from the doctor.
    Then when I go in to the office I know its okay and it is only high because I and at the doctor’s office. Over time just by writing in the log I relaxed more and don’t have the white coat hypertension plus just agreeing to keep a running record that the doctor could see of my blood pressure keep me off meds.

  4. I keep a Blood pressure log that I bought off amazon to prove to my doctot it is only high at the office and normal at home of at a store.

  5. I have had a phobia and severe anxiety sice I was little I have been on the birthcontrol pill but just found out I’m pregnant and in my situatiom I have 2 have an abortion I’m so scared I hope I will be ok I’m goin in tom. And thankfully they have been really supportive at the clinic so after getting so anxious n havin 2 leave 2x I hope I can make it through this tom.

  6. Shannon, I hope you can get some help for anxiety. Have you tried a prescription medication from your Dr?
    Please reconsider abortion. The outcome can cause more emotional and physical problems. What about visiting a crisis pregnancy center, maybe consider adoption? Best wishes Shannon.

  7. Another tip to add to this is to use image exposure. Lie down and visualize yourself having your blood pressure taken. Make sure the images are very vivid to the point you are using all 5 senses. Hear, smell, and touch the environment. Feel your heart beat rising. Keep doing this for a week… for 5 minutes a day. Then test it at a Pharmacy where the Pharmacist takes your blood pressure. Walgreens is a good place to start.

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