Psychological therapy for anxiety disorder and hypertension

When anxiety disorder is combined with hypertension, psychotherapy can be used as an auxiliary intervention. The collaborative management of anxiety disorder and hypertension requires a combination of cognitive-behavioral therapy, relaxation training, mindfulness based stress reduction, biofeedback therapy, and supportive psychotherapy, while emphasizing lifestyle adjustments and medication coordination.

1. Cognitive Behavioral Therapy

Cognitive behavioral therapy reduces anxiety induced blood pressure fluctuations by correcting patients' misconceptions about stressful events. The treatment focuses on identifying automatic negative thinking, such as the tendency to catastrophize work errors, and gradually establishing adaptive coping patterns through behavioral experiments. Typical interventions include recording anxiety diaries and gradual exposure training, suitable for patients with blood pressure fluctuations caused by workplace stress. When accompanied by palpitations, blood pressure changes need to be monitored synchronously.

2. Relaxation Training

Progressive muscle relaxation reduces sympathetic nervous tension by systematically contracting and relaxing muscle groups. Each 20 minute training session can lower systolic blood pressure by 5-10 mmHg. Abdominal breathing training combined with the 4-7-8 breathing technique (inhalation for 4 seconds hold breath for 7 seconds exhale for 8 seconds) can quickly alleviate the elevated blood pressure during acute anxiety attacks. It is recommended to practice once a day in the morning and once in the evening. For those with neck and shoulder pain, warm towels can be used for application before training.

3. Mindfulness based stress reduction

Mindfulness based stress reduction courses cultivate non judgmental awareness of blood pressure changes through body scans and meditation. An 8-week standard course can reduce cortisol levels and improve endothelial function. This is particularly suitable for patients who repeatedly worry about the results of physical examinations leading to hypertension in the consultation room. It is normal for there to be a brief increase in blood pressure during practice, but after continuous practice, blood pressure tends to stabilize.

4. Biofeedback therapy

uses a heart rate variability feedback device to visually regulate autonomic nervous system balance, and trains patients to increase high-frequency heart rate variability components through computer games. 12 courses of treatment can make the circadian rhythm of dynamic blood pressure monitoring more stable, and have a significant effect on anxiety induced hypertension with cold sweat on the hands and feet. In the early stages of treatment, headaches caused by excessive concentration may occur, which usually disappear after 2-3 adaptations.

5. Supportive psychotherapy

alleviates anxiety caused by disease uncertainty by establishing treatment alliances, with a focus on addressing the psychological resistance behind poor adherence to antihypertensive drugs. Using motivational interview techniques to enhance willingness to change, such as analyzing the differences in the effects of benzodiazepines and antihypertensive drugs in patients who are concerned about drug dependence. Family therapy can improve the tension in family relationships caused by excessive attention to blood pressure, and family members need to participate in developing monitoring plans. During psychotherapy, it is recommended to maintain a low sodium and high potassium diet, with daily sodium intake controlled below 2000 milligrams, and to increase potassium rich foods such as bananas and seaweed in moderation. Perform 3-5 30 minute moderate intensity aerobic exercises per week, such as brisk walking, to maintain a heart rate in the range of (220 age) x 60%. Avoid using electronic devices after 8pm, and do a 10 minute guided imagination relaxation before bedtime. Blood pressure fluctuations exceeding 160/100 mmHg or persistent headaches require timely follow-up to adjust the blood pressure lowering plan.