Coping with “White Coat Syndrome”

Anxiety disorders should never be trivialized or dismissed out-of-hand. This is true even for disorders that aren’t well-recognized by the general public or are triggered in only one particular setting. These sorts of anxiety disorders can still have a profound effect on the quality of life of people who suffer from them.

“White coat syndrome” (also sometimes referred to more narrowly as “white coat hypertension”) occurs when a person experiences heightened anxiety as a result of being in or around a medical environment. In some cases, this anxiety may even be triggered simply by visualizing a medical setting. Symptoms typically include elevated blood pressure and rapid respiration, but they may also include the body’s full range of “fight or flight” responses.

While very few people truly enjoy a visit to the doctor, people who suffer from white coat syndrome have an irrational fear that is out-of-proportion with the risks involved in going to see a physician.  There are, of course, actual risks involved—hospital-acquired infections, medical errors, unwanted diagnoses, and bad news—but this type of anxiety tends to be very general and diffuse.  People with white coat syndrome often have difficulty describing exactly what it is that they’re afraid of.  But the fear itself is real.

The real danger is that people who are afraid of the doctor will become victims of delay and avoidance—that they will wait too long to get help when they need it or that they will avoid healthcare altogether, even preventive care.  There are a number of things your chiropractor can do for you if anxiety is standing between you and the healthcare you need, but he or she needs to know about your fears first.

• Many chiropractic physicians practice in environments that feel less “clinical” and more inviting than conventional doctors’ offices.  For many patients, this kind of setting may help dial down the level of anxiety they experience during visits.
• Modern chiropractic care includes a variety of low-force techniques that don’t cause the “snap, crackle, pop” associated with traditional spinal adjustments.
• Some chiropractic physicians have been specially trained to provide manipulation under anesthesia (MUA) for particular conditions.

Good communication is the key to helping your healthcare team help you. At the same time, there are several important things you can do on your own that may help open the door to a more effective relationship between you and your chiropractic physician.

• “Name” your worries. Some psychologists and psychiatrists call this “deconstructing your fears”.  Whatever phraseology you prefer, this bit of advice means to identify the cause of your fears in a specific way.  This is critical to understanding your fears and developing targeted ways to cope with them.
• List the pros and cons of seeking (or avoiding) care, and evaluate them rationally.  Once you do the research and can actually visualize your choices, it’s usually much easier to make decisions that are based on facts rather than general apprehension.
• Ask your doctor to describe whatever pain or discomfort you might feel as the result of a particular diagnostic test or treatment.
• Choose a new doctor.  If something about your physician makes you nervous, or if he or she seems unwilling or unable to respond to your anxiety (even after you’ve discussed it), then it may be a good idea to find a new healthcare provider.
• Bring a family member or friend with you.  Remember—the role of this person is to understand your fear but to help you get beyond it.  Their first priority should be to ensure you get the healthcare you need, not to validate the underlying anxiety or to be an enabler of delay and avoidance.

If general fear and uncertainty are preventing your from seeking appropriate care, we encourage you to call or visit our office.  We’ll be happy to describe our approach, explain our treatment methods and work with you to find solutions.