A common mistake is underestimating the impact of the psyche in cases of high blood pressure. Those who take blood pressure medications, despite being physically healthy, and where only an anxiety disorder is responsible for the high values, often risk further problems. Blood pressure medications can cause a range of unpleasant side effects, such as dizziness, drowsiness, skin problems, or gastrointestinal issues. This blog article from the Institute for Modern Psychotherapy in Berlin discusses what you should pay attention to and what you can do if your high blood pressure is likely caused by anxiety.
Overview of Topics
Blood pressure-lowering medication is only recommended if blood pressure is permanently high
Blood pressure-lowering medications are only recommended for persistently high blood pressure. We always advise our patients to undergo a 24-hour ambulatory blood pressure monitoring before starting to take blood pressure medications. If the measurement results are predominantly in the normal range, you should seriously discuss with your general practitioner whether these medications are truly necessary. Taking blood pressure medications unnecessarily for years, due to a misdiagnosis of hypertension based on inaccurate measurements, can cause serious long-term harm to your body.
Isolated episodes of high blood pressure throughout the day are definitely not a reason to immediately start medication.
High blood pressure is sometimes important and helpful
Short-term high blood pressure is usually a normal and healthy response of your body. Under stress, including anxiety, your body uses more energy. The cellular turnover increases, meaning that oxygen and nutrients need to be transported to the cells more quickly. Your body accomplishes this faster transport by temporarily raising blood pressure, allowing the blood to flow more quickly. Once the stress subsides, the high blood pressure will naturally disappear as normal blood pressure is sufficient to handle all other tasks. Therefore, it is essential to critically question if blood pressure medications are prescribed too quickly without first asking about your current life stressors.
By the way, asking if you have been experiencing increased anxiety lately can be a good indicator of whether your treating doctor has considered all possible causes of presumed hypertension.
If not, you should definitely bring it to their attention, as it is a matter of your health.
High blood pressure as an Indication of an Anxiety Disorder
If high blood pressure is caused by excessive fears or phobias, it makes much more sense to address the anxiety disorder with psychotherapy rather than merely suppressing the symptoms with blood pressure medications. According to a study by Clevelandclinic, about one in three people suffer from the previously mentioned white coat syndrome (white coat hypertension). In addition to suddenly elevated blood pressure, primarily triggered by the fear of possibly receiving a poor reading, affected individuals often also suffer from additional symptoms such as:
- Panic
- Dizziness
- Shortness of breath
- Sweating
If one or more of these symptoms apply to you, we advise you to consider whether your high blood pressure might be the result of an undiagnosed anxiety disorder.
It is no coincidence that all four mentioned symptoms are among the main symptoms of most anxiety disorders.
Older People Surprisingly Often Suffer from White Coat Syndrome
Several clinical studies (e.g., the IDACO and HYVET studies) have examined in recent years to what extent older patients suffer from white coat hypertension. The proportion of affected individuals was usually far higher than anticipated, sometimes even exceeding 50% of participants. Patients over 80 years old represent the highest risk group. Therefore, treating physicians should take extra time with these individuals. After an initial (too high) reading, a few calming words followed by a second blood pressure measurement a few minutes later often show a significantly lower result.
Since older people often already take too many different medications, which can interact with each other, every pill avoided thanks to a second measurement is a real gain.
What is the Connection Between High Blood Pressure and Anxiety Disorders?
The connection between anxiety disorders and high blood pressure is now well-researched. Our experiences at the Institute for Modern Psychotherapy in Berlin also confirm that anxiety patients are diagnosed with high blood pressure more frequently than average. However, we have also observed that many people with generalized anxiety disorder, agoraphobia, or cardiophobia were able to completely taper off their blood pressure medications after successful anxiety therapy.
With the individually appropriate form of psychotherapy, not only was the anxiety disorder overcome, but blood pressure also normalized in many cases.
Medications for Hypertension in Anxiety Disorders Often unnecessary
In most cases where anxiety is the actual trigger of high blood pressure (hypertension), treatment with blood pressure-lowering medications is unnecessary. However, the risk of developing chronic hypertension is significantly increased if anxiety disorders are left untreated for too long, especially when additional risk factors are present, such as:
- Smoking
- Lack of exercise
- Overweight
- High stress levels
- Frequent consumption of heavily salted foods
- Regular alcohol consumption
Therefore, in addition to a suitable form of psychotherapy, you should also avoid these risk factors as much as possible.
Overcoming Not Only Anxiety Disorders but Also High Blood Pressure with Psychotherapy
Not every form of psychotherapy is suitable for everyone. Especially, people who have had negative experiences in this regard are often hesitant to try new approaches. This is more than understandable, especially since many therapies offered here are now outdated.
Looking at the latest findings in brain research, it becomes clear that even long-standing anxiety disorders could typically be overcome in just a few weeks if the neuroplasticity of the brain were appropriately considered. Neuroplasticity refers to the brain’s ability to rewire itself well into old age, effectively shutting down the neural pathways to anxiety. However, this cannot be achieved through long psychotherapeutic group sessions or the often extremely unpleasant exposure therapy. The use of psychotropic drugs is also increasingly viewed critically and rejected by many psychotherapists, as is the prolonged digging into childhood memories.
Therefore, at the Institute for Modern Psychotherapy in Berlin, the structural rewiring of the brain is at the heart of therapeutic work. Using surprisingly simple techniques that anyone can apply at home, the brain’s neuroplasticity is specifically utilized to reduce anxiety and the resulting high blood pressure within a few weeks, so that medications can frequently be permanently avoided. If you want to learn more about the Institute’s work, I recommend my book “How to calm Anxiety: Live a Life Free From Panic in Just a Few Weeks” or our new online therapy “Finally Free from Anxiety!”. With the help of the techniques described therein, many former anxiety patients have managed to lead lives full of joy and lightness on their own.
Troy A.
Tampa, Florida