How to overcome white coat syndrome
Credit: ©aleutie / Adobe Stock
How to overcome white coat syndrome
Knowing how to calm white coat syndrome begins with knowing you have it. Here is the story of one woman’s white coat syndrome diagnosis and her practical tips to beat 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.’)
White Coat Syndrome and my irrational fear of the blood pressure cuff
Part of my fear of going to the doctor’s office includes my irrational 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.
This 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.
Four CC’s of Smooth Jazz
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.
Facing my fear: how to overcome white coat syndrome
It got to the point where I was required to buy my own blood pressure cuff and create a blood pressure diary, which as a perfectionist made me feel like a complete failure. If I couldn’t even pass a simple blood pressure test, how was I supposed to pass my challenging university courses? (Once again, I was studying how to play pretend in Hollywood so this line of thinking is arguably even more illogical than my fear of the blood pressure cuff.)
How to relax when having blood pressure taken at home
Even worse, the blood pressure cuff I was instructed to buy was automatic. 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. 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.
“I’m not faking it” convincing people I have white coat syndrome
When 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.
Amy Suto is a Los Angeles writer working in Hollywood. She's a coffee connoisseur, former competitive ballroom dancer, and occasionally pretends to be a vegan. She writes scripts about the cost of ambition with her writing partner, a former graffiti artist.