Health monitoring without the anxiety
December 13, 2024 2:47 AM   Subscribe

I'm having a health thing, and as part of that I need to do regular monitoring, as directed by my doctor. Unfortunately, this is playing absolute havoc with my anxiety and quality of life. How can I monitor health markers without letting it affect my anxiety?

The particulars of my situation are so banal as to be embarrassing.

So, a month ago I was diagnosed with soaring blood pressure and had to go to the ER, it was pretty scary.

I am now on a cocktail of meds and have been strictly directed by my doctor to monitor my blood pressure daily on a home monitor.

Unfortunately, this is playing absolute havoc with my state of mind. I have posted previously on AskMe about my health anxiety, and honestly the coping mechanism I've developed over a lifetime of HA has been to avoid monitoring anything. Probably not healthy, but it's helped me.

I started getting annual health checks a few years ago, which was hard for me, but manageable because I obviously can't run blood tests on myself, and it can only happen in a clinic. For my own peace of mind, I have always avoided self-monitoring. But because of my recent blood pressure episode, I now have to do it everyday.

Monitoring my blood pressure at home is very stressful for me. Today I was super anxious while doing it and the reading went up 30 points higher than yesterday. Every so often I get the irregular heartbeat symbol while doing it and I am terrified to the point of having palpitations the entire day. I'm also fairly sure that panicking all day is not good FOR my blood pressure. The general trend has been downward, which is good, but a bad day can send me spiralling; and then the spiralling sends my numbers up; which makes me spiral further, etc.

I honestly would feel so much better if I didn't have to do this. But I understand why my doctor has told me to do it; it's the only way they can assess whether the medications are working, whether I need my dosage changed etc.

To pre-empt: I'm in discussion about this topic with my therapist; I am going to speak to my doctor about the anxiety. I'm open to discussing medication.

I'm looking for advice from AskMe on coping when a key coping mechanism (avoidance) has been taken away from you. I'm also, absolutely NOT looking for medical advice.
posted by unicorn chaser to Health & Fitness (19 answers total) 4 users marked this as a favorite
 
Do you have a local pharmacy where you could go to have a blood pressure reading? That might help as at least you would not be the person conducting the whole affair yourself.

Also, have you told your doctor about your BP anxiety? They might be able to help, maybe just by reducing the number of readings they expect you do in a week. Like, maybe you could do it once a week, at a familiar pharmacy?

ps: Great to hear the BP is trending down - the meds are working their magic!!
posted by lulu68 at 2:58 AM on December 13, 2024 [1 favorite]


Any chance there’s a tool you could use to get this info directly into your medical record so you never have to look at the numbers? Maybe the pharmacy suggestion above is one path to this. Maybe some home blood pressure device has similar options.

This isn’t about your question directly, but Mr. eirias had to do this for a week and for the first few days his readings also looked super high, but he was actually doing it wrong, sitting with his arm too low. Once he fixed his positioning his measurements dropped immediately.
posted by eirias at 3:12 AM on December 13, 2024 [2 favorites]


I hope this doesn't count as medical advice, but from personal experience and from seeing the before and after in my grandma (who has very severe anxiety), anti-anxiety meds are a great option to try. I'm glad you'll be discussing them with your doctor because I think they're likely to help more than anything else.

I found it very difficult to talk myself out of anxiety and the meds just didn't let me get into spiraling mode. It's like the latch that caught me into that mode was gone. I'm no longer on them, but being forced to realize that trying to control everything didn't actually need to be done was life changing.

My grandma is still on hers and even from the outside I can tell she's feeling a lot better. She has high blood pressure and the anxiety meds help a bit with that too (not replacing blood pressure meds of course, but more like helping with the scenerio where your blood pressure went up 30 points due to stress). And if this is a worry for you, like it was for me, I was relieved to find that we were still both ourselves after getting on the meds, just less stressed out.
posted by Eyelash at 3:21 AM on December 13, 2024 [2 favorites]


Similar to the pharmacy suggestion, if you live with someone you might ask them to do the monitoring and not tell you what the numbers are, just note it down for the records with your doc.

You might also try intentionally setting up some little rituals around the monitoring that you find soothing, for before and after the numbers are recorded. Maybe a guided meditation that does a body scan before.

You might see this period of needing to self-monitor as exposure therapy. Extending that idea, you try to accept that this will be sort of terrible and work on normalizing the instruments and process. Kind of the opposite approach to the ritual idea, but not mutually exclusive. You do what you can to self-soothe and try to integrate the whole experience more rather that the avoidance, which has served you until now but can't help anymore.
posted by Summers at 3:57 AM on December 13, 2024 [1 favorite]


Best answer: I'm looking for advice from AskMe on coping when a key coping mechanism (avoidance) has been taken away from you.

Could be well past time to take a cold hard look at avoidance as a coping mechanism. I don't believe it is one. I believe it's the opposite of a coping mechanism. Avoiding activities that call for coping is not coping, any more than avoiding activities that call for exercise is exercise.

The single most useful remark I've ever heard made by a counsellor specializing in social anxiety is this: "We're not avoiders, we're confronters."

A great deal of suffering is rooted in being untrained to meet the challenges that life inevitably throws at us, and emotional stress shares a great deal with physical stress in this respect. The more regular aerobic exercise we do, the less suffering is involved in walking ten miles holding an empty gas can, and the same applies to coping. The more of it we regularly choose to take on, the less suffering is involved in being forced to.

But just as a well designed strength training program does not begin with deadlifting 300kg on day 1, a well designed emotional resilience training program does not begin with tackling issues that currently leave us spiralling. This is why it's kind of unfortunate that the most common path people take toward becoming better at coping, whether we intended that as an outcome or not, is trying to raise kids. It works really well when it does work, but it also regularly breaks people and it's horrible when little kids get tangled in the wreckage.

I hope you find a way through the current crisis, but I would also strongly urge you to take it as a signal to take a slightly wider view of the habitual methods you currently employ and begin regularly choosing to put yourself in situations that make you slightly uncomfortable until you've dealt with them properly. Over time, I expect you'll find yourself becoming able to breeze through stuff that would seem completely off the table for you from where you sit right now.
posted by flabdablet at 4:07 AM on December 13, 2024 [7 favorites]


How often do you have to take the readings? I would set those times in stone so you aren’t spending any energy on deciding when. If it’s once a day, do it first thing in the morning so it’s off your plate, like have the monitor right in the bathroom.

Another thing you can do is chain it to something you really want to do. I reserve a few favourite shows to get through things like gross cleaning tasks (podcasts in that case). So get a mug of favourite tea, blanket, pop open Netflix, slap on that cuff, press play.

The other approaches are more physiological and you might want to check with your doctor if they would impact your BP reading but if you can spend some of that anxiety - go for a very brisk walk or a run, do some jumping jacks, dance vigorously, lift some weights, etc. and then let your heart rate come down, do the reading, and then do a bit more exercise, you’ll interrupt that stress cycle. (Remember our anxiety is like, saw a tiger! Run or freeze!)

You’ve got this.
posted by warriorqueen at 4:33 AM on December 13, 2024 [2 favorites]


Take your blood pressure every half hour for five days, never bothering to write it down, or if you do tossing it immediately afterwards. Desensitization. Take your blood pressure so often your reaction to do it is "Oh god, this is boring. How quickly can I get this over with?"

The next time you take your blood pressure go on and take it every two minutes for the next few hours, switching arms until you get fed up with the exercise instead of anxious about it. Figure out how to become fast and efficient at it and not at all anxious about the result because of course it's going to be pretty darn close to the last time you took it, two minutes ago.
posted by Jane the Brown at 4:44 AM on December 13, 2024 [13 favorites]


My blood pressure is always, ALWAYS high on the first reading. Which always makes me more anxious.

So I always do it twice. First, sit quietly for a few minutes. Make sure you’re correctly positioned. Take the reading. Then chill for a bit, have some water, play a relaxing (non-timed) puzzle on my phone. Let 10-15 minutes pass. Take it again. The second reading is often better.

Also, your bp reading can change depending on activity, time of day, whether you’ve eaten recently, whether you’re dehydrated. When you take it often, these patterns emerge.

I have bloodwork due this week and I’ve been putting it off because I haven’t been eating well and I’m positive the numbers will be weird. But I’m heading out to do this now — what the doctors really want is a range of readings over time so they can get an idea of how things are going, and what we might need to change.

Two thoughts:
1. Can you get an accountability buddy?
2. Things often get easier the more you do them.
posted by mochapickle at 4:45 AM on December 13, 2024 [5 favorites]


This situation is exactly why my doctor told me that daily BP readings are unhelpful to the point of being useless. She recommended three times a week at most, which can still give a good overview. Hopefully your doctor will concur.

I'd also like to recommend getting an Omron BP machine if you can (upper arm, make sure the cuff is an appropriate size for you). The benefit of Omron is that the machines come with an app that automatically takes the reading from the machine via Bluetooth, so you don't actually have to look at the reading at any point. You can just sit there, press the button, get the reading (do at least 3 readings per session, with 5/10 minutes of sitting quietly between them) and let it communicate with the app and log it, then you're done. You don't have to actually look at any of the numbers and you can just give your doctor the app results which will be plotted on a graph for you.
posted by fight or flight at 5:13 AM on December 13, 2024 [13 favorites]


Very similar thing happened with me; my high BP just got higher and higher on my little spreadsheet. I tried a bunch of things like posture and timing and all the things people suggest for getting accurate BP readings - my brain was just like NOPE and it kept blipping higher. I do have a family history of high blood pressure and also GAD plus an extra helping of medical anxiety and avoidance, so readings at the doctor are also very alarming.

After a month of terrifying myself multiple times a day I went to my follow up appointment nearly in tears. My GP at the time told me immediately to stop taking my blood pressure. It was just stressing me out more. She knew my BP was high, knew my family history and my other health markers, and prescribed me a beta blocker. Wow I love beta blockers! They are amazing and really do a one-two punch on physical anxiety symptoms. When medicated with the beta blocker and my SSRI, I managed to get multiple slightly elevated but still okay BP readings, both at home and in the clinic. Also, calming my racing thoughts was so much easier, exercising was easier, and so-on.

Unfortunately, a few years later, my blood tests showed very high triglycerides, which can be a side effect of beta blockers. Boooo! We then embarked on trying a few different blood pressure meds - the first one gave me such a terrible cough it really freaked me out until my mom mentioned having the same issue with the same (very common, often first thing to be prescribed) drug. Luckily we found one that works okay for me, although I suspect I’ll need to up the dose or add another this year, and my blood tests came back a lot better with a few months off the beta blocker.

To make sure the BP drug was working though, they had me do readings at home again. They knew my history with it and said to only do it once every other day, or less. They also had me bring in my cuff to the follow up appointment. There, I got spectacularly high reading, which coincided with the high reading the nurse also got. And then they tried again at the end of the appointment, saying I seemed more calm (I’m always quite calm, that doesn’t stop the anxiety from wracking my body!) and my cuff from home again perfectly matched the doctor’s and the nurse’s readings. But! My numbers at home were again in the under control high but not concerning range, and they had proof that my cuff at home was accurate so they trusted me that the meds were working, despite the readings at the appointment being scary by other metrics.

Anyway. Long story short, it’s good to be able to provide data from home to your doctors, especially when you have physical anxiety when you’re in doctors offices. But high blood pressure is such a hugely common issue and there are so many different ways to treat it that there’s very little reason not to try some drugs that are likely to work for you, given your medical history and doctor’s medical opinion. Then, you will be able to get some readings at home that are less terrifying, and begin to feel a bit more in control, but also a competent and communicative doctor should be able to treat you for high blood pressure without reams of home testing. If you can’t get good readings at home you will still get your health looked after.
posted by Mizu at 5:40 AM on December 13, 2024 [5 favorites]


Take comfort in the fact that you’ve had the irregular heartbeat sign and high readings and that nothing bad has happened. The reading from the machine isn’t an oracle, it’s just a pile of electronics doing its best and a fair amount of variation is normal. Use the evidence of high reading -> no crisis to counter your anxious thoughts. I also like the idea of just hanging out with the cuff on, reading or watching TV, and starting to desensitize from there.

That said, if you’re in this much distress and/or none of these suggestions sound helpful, tell your doctor. You probably aren’t getting useful data, don’t suffer for no reason.
posted by momus_window at 7:58 AM on December 13, 2024


I’m a data person, so I find it helpful to think about health measurements as data points. An individual data point is meaningless; what matters is the trend over time. I agree with posters above to take multiple measurements per day. It will help desensitize you to the process, but it also gives you more data points, which means any individual measurement is less meaningful.
posted by bluloo at 10:23 AM on December 13, 2024


The thing that helped me was when my doctor set me up with a wearable monitor for 24 hours. I didn't have to do anything, didn't have to set up it up, there was no prep that let my anxiety start before it took the reading. It just did it's thing my average was perfectly normal.
I still get high readings in the office, but at least we know it's white coat/anxiety issues.
posted by platypus of the universe at 10:56 AM on December 13, 2024 [1 favorite]


I will second bluloo. Your doctor would tell you that any individual reading cannot be taken to mean something about your overall health without the pattern. A pattern may mean something, but you are not a doctor and not responsible for that decision. Can you possibly change the way you think about the readings to be non-meaningful information that is not your business? You could even create a Google form or something (private) where you enter in the reading but don't intentionally look at the overall pattern.
posted by lookoutbelow at 4:00 PM on December 13, 2024 [1 favorite]


I really know how you feel! I had some weird blood pressure issues during pregnancy and had to track it carefully at home. I got so anxious about it, which I’m sure made my blood pressure worse, which made me more anxious, and so on.

Some little things that helped me were checking it while I was doing something super cozy and relaxing (like watching a 90s romcom on the couch under a blanket), taking it without looking at the display, and getting the doctor to let me take it a bit less often. I also like the idea of a wearable monitor. One time at the hospital, they hooked me up to a blood pressure monitor that went off on its own maybe every 15 minutes, and that was a lot better because I didn’t have a chance to get nervous!

Sorry you’re dealing with this—it is really not fun. But it sounds like the medicine is helping, and hopefully this will be behind you soon!
posted by bijoubijou at 5:59 PM on December 13, 2024


Best answer: How can I monitor health markers without letting it affect my anxiety?

The real answer here is: You can't. Your anxiety isn't under your control. You can't make it better or worse in this particular situation. Not saying anxiety can't be alleviated overall--of course it's treatable!--but, rather, this is one of those 'only way out is through' things where you feel the fear and do it anyway. There is a good chance the anxiety will lessen with the dull repetition of having to put the thing on your arm and squeeze and then write down the numbers and all that; there's a better chance that by repeatedly doing this you'll learn some other nonavoidant anxiety skill, some sort of bodily ritual around it where at least you're controlling something about the process. For me, it's timed breathing--inhale to the count of four, hold, exhale to the count of four--I'm sure you're familiar with the tactic. It gives me something to do, something to concentrate on.

There's plenty of tips in this thread, and I guess I didn't want to give a tip, I wanted to say it's actually okay to be anxious about this. You're not doing something weird and unusual. Your body is activating a reflex because it thinks it's in danger, and of course your BP might go up during that process. Why wouldn't it? Perfectly normal. You basically have white-coat syndrome in your own home.

I just used an EKG app and it scared the hell out of me, because what if it showed something terribly wrong? It didn't, but I was shaky enough during it that there were a lot of scary motion artifacts on the screen. And for a minute there I was convinced the app didn't have the ability to really read the jagged artifacts, that it was trying to give me false hope because something was really going wrong with my heart. (Unlike with the BP monitor, I don't have the dull repetition skill down with this, so literally forgot to breathe like a normal person during it.)

And that's...okay. I can have that fear. I don't have to fight it. Fighting it, trying to be less anxious, is just going to make it worse.

So anyway, you have to kind of trust yourself on two counts, first that you'll just do this and write down your numbers and be done with the daily task, and second that your body will get used to the task, and get used to seeing numbers that are sometimes good and sometimes bad, and will stop reacting with the same fervor. Because it really will; familiarity is the enemy of anxiety.
posted by mittens at 6:50 PM on December 13, 2024 [3 favorites]


Over the last two years, I've had to monitor a lot of my health data. I've had a lot of blood work, first monthly, then bi-weekly, then weekly, then daily, then twice daily. There were a lot of times when this testing made me very anxious. I did most of my blood work through a lab that I could then access my own results, which I found far less nerve=wracking than waiting to see if a doctor was going to call and say something was wrong. How I coped was by thinking consciously that there was nothing I could do to change the results and to focus on them as data points. The lab service had analytics available (I was tracking a lot of things) and I could track individual results on an historical graph. This made it a lot less scary for me (I like tracking data in general) as it became a collection of data rather than OMG THINGS IN MY BLOOD ARE WRONG. Perhaps you could graph your results or put them in a spread sheet and this might depersonalize it somewhat?

That being said, when I was in hospital I had my blood pressure taken several times a day and the results were sometimes all over the place, even with hospital-quality equipment. If a reading seemed too high or low, I would ask them to do it again. I still do this at check-ups because you can get vastly different results even ten minutes apart. In fact, when I was in chemotherapy daycare, my nurse told me not to fret over home machine results unless they were really crazy high on two or three subsequent attempts, as home blood pressure machines are notoriously unreliable. So, as people suggested up-thread, maybe try the pharmacy blood pressure machines instead if it's not too inconvenient. I've found them to be generally pretty good, and don't be afraid to consciously relax and try again if you get a high reading. Stress can really affect your readings. At many appointments, I've had the nurse put a high initial reading down to 'white coat syndrome' and let me relax and repeat the test.

Dealing with health stuff can be extremely stress-inducing and really affect your blood pressure. I hope you're able to overcome some of your anxiety and I'm sure if you can do this through breathing exercises, visualization or some other coping strategy, that you will find you have fewer alarmingly high blood pressure readings. All the best to you.
posted by alltomorrowsparties at 11:14 PM on December 13, 2024


My blood pressure is always higher in the doctor's office. My doctor asked me to measure it at home and record it. That filled me with dread. I hated taking my blood pressure until I heard a friend say that they felt like the blood pressure cuff was 'giving them a hug' and helping them out. They found the experience reassuring. The friend had a weirdly positive attitude toward the whole process which I must say was totally unlike them.

So I practiced following a certain procedure which was as follows: using the toilet first, sitting quietly for a few minutes at a table with my feet flat on the floor while doing something soothing on my phone or reading something amusing. Then I took the reading while breathing calmly and supporting my arm so it was in front of my chest. I would imagine being hugged by a loved one.

I like the idea of using an app to give the data to the doctor! Best of luck!
posted by goodsearch at 1:52 PM on December 14, 2024


Response by poster: Thanks for all the answers - I best answered a couple, but all your insights were helpful and I appreciate it. My doctor is changing up my medication as my recent blood tests showed that my potassium levels were too high; she has warned that my readings might go up again for a few days so I'm kind of glad I asked this question when I did, as the answers will (I hope) give me some arsenal to deal with the anxiety associated with increased numbers.
posted by unicorn chaser at 3:27 AM on December 19, 2024 [1 favorite]


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