The Blood Pressure Cuff - My Unhealthy Obsession

A lot of these types of posts come from people who have fully overcome their OCD or unhealthy habits, such as checking their heart rate or Googling symptoms. However, I am still right in the depths of it.

I thought, why not share my experiences and insights around the “safety behaviour” of checking my blood pressure while I’m learning to put it down? I have a whole toolkit of strategies, thought processes, and actions that I can use to eventually stop relying on a blood pressure number to feel safe, but I thought it could be more relatable to talk about it while I’m still learning myself.

A big health fear of mine is fainting, and that stems from a fear of losing control. Ever since being diagnosed with POTS and experiencing vasovagal presyncope episodes, my OCD and anxiety have completely latched onto those traumatic experiences, and I spend every waking minute, especially when upright, thinking I’m going to faint.

Here’s the funny thing: I have not once fainted in my life. Sure, I’ve experienced vasovagal presyncope when getting my blood drawn and during a tilt table test after being given GTN (a drug that relaxes your blood vessels), but I have never actually fully lost consciousness.

So why does my brain convince me that I’m about to lose consciousness any second?

My anxiety and OCD remember and hold onto those exact feelings I experienced during those scary times, and they are trying to protect me from it happening again. Every sensation I feel, whether it’s a slight wave of dizziness, heat, nausea, a heart palpitation, or a chest flutter, my brain immediately tells me I’m going to faint. That fear then sets off a whole cascade of physical sensations that can feel very similar to what I imagine fainting would feel like, even when I’m not actually in danger of fainting.

My rational brain knows this, but my anxiety and OCD cannot rationalise it. Instead, I seek constant reassurance from my blood pressure cuff.

I got myself to a point where, if I felt any slight symptom or even had a thought about fainting, I had to check my blood pressure to make sure it wasn’t dropping. Now, the logic behind this doesn’t make sense because you cannot stop a faint by catching a low blood pressure reading on a cuff. Again, I know this, but my OCD tells me otherwise, and it is such a hard loop to break.

I am a teacher, and I would go to the bathroom in the middle of class to check my blood pressure. I would check it in the bathroom when I was out, check it as soon as I got back to my car, and check it again before getting out of the car. I would check it first thing in the morning, and it would be the last thing I did before falling asleep. I took it with me everywhere (and I still do).

To this day, I can recognise and rationalise that the thousands of times I checked my blood pressure, I didn’t need to. Nothing happened. I didn’t faint. My body was doing what it needed to do by itself. However, my mind says, “But what about next time?” “What if I don’t check this time and I miss a really bad reading that I should know about?”

All I have been doing this entire time is showing my brain that it needs a blood pressure reading in order to feel safe.

The thing about reassurance is that the feeling of “safety” it provides only lasts for a short while, sometimes just seconds. My blood pressure tends to run on the lower side of normal, and that has always been normal for me. But if I get a reading in the 90/60s, I immediately panic because my brain tells me that’s “too low”. I then feel the need to keep checking over and over again to make sure it isn’t dropping, or until I get a reading that my brain deems “normal”.

But even then, the rumination continues. My brain says, “Well, it was normal five minutes ago, but you’ve been upright for five minutes now, so maybe it’s dropping. Better check again!”

I am truly stuck in a never-ending loop of feeling a symptom or compulsion, checking my blood pressure, experiencing temporary relief, feeling another surge of adrenaline, becoming more symptomatic and repeating the cycle all over again.

So, how do I plan on putting a halt to this?

Well, a lot of people in my life tell me to just throw it out. And yes, I could do that. However, my current obsession with checking my blood pressure is too strong, and I know that I would simply go and buy another one.

Something I have been doing to slowly move away from the cuff is delaying the urge, even if it’s just for five minutes. If I feel the urge to check my blood pressure, I tell myself, “Okay, you can check, but only in five minutes.” Sometimes, once those five minutes are up, the urge isn’t as strong, and I’m able to stop myself from checking. Most of the time, though, the urge and the “what if” thoughts are still there, so I do check. But I have just proved to my brain that I was safe for those five minutes without checking my blood pressure. Then, you can slowly increase the delay to 10 minutes, then 15 minutes, and each time you are showing your brain that you are safe without checking.

Another strategy that I use is putting the cuff somewhere inconvenient, like packed away in its box at the back of the cupboard. The goal of this is that when you have the urge to check, you have to go through a bit of extra effort to actually get the cuff, which can create a moment to think, “Do I really need to check?”

Now, I have to be honest and say I haven’t gone as far as packing it away in its box and putting it at the back of the cupboard. However, what I have started to do is, if I am in my bedroom, I will leave it in another room so that it is out of arm’s reach. Because if it is sitting right there, I will 100% check it. I have also had a few attempts at leaving it in my car so that when I get the urge, I would have to go and get it. And yes, sometimes I have been so panicked and desperate that I have gone to get it. But other times, I have been able to pause and think, “Hmm, maybe I don’t need to check right now.”

My anxiety and OCD have convinced me that my body cannot be upright for long periods of time, which then feeds into my safety behaviour of checking my blood pressure. My psychologist and I have decided that a priority is rebuilding trust and confidence in my body being upright again. In turn, this will help alleviate the urge to check my blood pressure.

I have started by doing small exposures at home, like pottering around the house, watching a TV show while being upright for a little while, and practising sitting back down before the panic, urge to check, or rumination takes over. This way, I am slowly showing my body that it can be upright, that I am safe, and that I don’t need to seek reassurance from my blood pressure cuff or my heart rate on my Apple Watch (that is a whole other story, which I will also do a blog post on).

There are definitely days that are better than others. I have had some great symptom days where I have only checked once or not at all! But I’m writing this during a stage of my life where I’m really struggling and relying on checking far too much.

However, I know that together we can make it through this and learn to feel safe in our bodies again.

If reading this blog post made you think about checking your vitals, Googling a symptom, or seeking reassurance of any kind, first of all… sorry lol. But second - DON’T!!!! Or at least try delaying the urge by five minutes. Distract yourself with something else, and you might just find that the symptom and the urge begin to ease.

Anyway, my blood pressure right now is 112/74, so I’m pretty happy with that (oops).