Learn How to Cope with the Fear of Needles

By Lisa Fritscher, Medically reviewed by Steven Gans, MD, Updated on May 23, 2023 (Published in verywell)

Modified by Dr M Krishna, Consultant Pain Medicine

Trypanophobia is the extreme fear of medical procedures involving injections or hypodermic needles. It tends to be more common in children and may lessen as people grow older and gain more experience having medical procedures and injections involving needles. For some people, however, this fear can remain extreme and distressing during adulthood.

Despite the fact that an estimated 10% of Americans struggle with this phobia, it was not recognised as a specific phobia in the Diagnostic and Statistical Manual (DSM) until 1994. Though specific to medical needles, this disorder is commonly referred to as “needle phobia” by the general public.

Symptoms of Trypanophobia

If you have trypanophobia, you may dread receiving medical care, particularly injections. When you are required to undergo a medical procedure, you are likely to experience high blood pressure and an elevated heart rate in the hours and days leading up to your procedure. At the time of the event, your blood pressure may rapidly drop and you may even faint.

Other common symptoms of this phobia include:

• Anxiety
• Dizziness
• Insomnia
• Nausea
• Racing heartbeat
• Rapid breathing
• Sweating
• Trembling

People will also engage in avoidance behaviours, which can affect medical care if they refuse to get treatment due to their fear of needles. In some cases, these feelings of anxiety can become so severe that a person experiences a panic attack.

How Is Trypanophobia Diagnosed?

In order to diagnose your condition, a doctor will perform a physical exam to rule out any potential physical conditions that might be contributing to your symptoms. They will also ask questions about your symptoms including information about the severity, duration, and nature of what you have been experiencing.

In order to be diagnosed with a specific phobia such as trypanophobia, your symptoms must:

• Be unreasonable and excessive
• Occur immediately in response to the feared object
• Lead to avoidance and extreme distress
• Be life-limiting and affect your ability to function normally

Additionally, your symptoms must be present for a minimum of six months and not be due to another disorder or illness.

What Causes Someone to Be Afraid of Needles?

Scientists are still unsure precisely what causes needle phobia. Like other specific phobias, a number of different factors may play a role. Some factors that may contribute to trypanophobia include:

Experience: Negative experiences involving needles or medical procedures may play a role in the onset of a needle phobia. Research has found that needle phobias tend to be common in people who have chronic conditions that require injections.

Genetics and family history: It seems to be inherited, as an estimated 80% of adults who have the condition reported having a first-degree relative who suffers from the same phobia. However, it’s possible that the fear is learned rather than biologically inherited.

Evolutionary influences: Some evolutionary psychologists believe that fear may be rooted in an ancient survival technique. Puncture wounds could be deadly, particularly in the days before modern antibiotics. It’s possible that a fear of puncturing the skin was an evolutionary adaptation.

Vasovagal reflex: In some cases, people may experience a vasovagal response to the sight of needles or to having their skin pierced by a needle. This response triggers a sudden drop in blood pressure that leads to dizziness and fainting. This fear reflex also tends to run in families.

What Is the Impact of Trypanophobia?

Aside from the physical symptoms that usually accompany this condition, trypanophobia has the added danger of potentially altering behaviour. People may avoid visiting the doctor or dentist so they don’t have to have any injections.

Although the actual phobia is of needles, it can lead to a more generalised fear of medical and dental healthcare providers. In extreme cases, a person with this phobia may refuse to receive even routine checkups.

How Is the Fear of Needles Treated?

Treatments for specific phobias usually involve psychotherapy, but medications may sometimes be prescribed to help people cope with symptoms of anxiety caused by the condition.

Psychotherapy

Exposure therapy is the treatment that is often recommended for treating specific phobias such as needle phobia. Through techniques such as systematic desensitisation, you can gradually learn to tolerate needles.

The goal of systematic desensitisation is to gradually expose you to needles in a controlled, safe setting, beginning with seeing a syringe without a needle, then a syringe with a needle, and eventually allowing you to handle the needle.

Cognitive behavioural therapy (CBT) can also be highly effective in treating trypanophobia. Some experts have also found success using hypnotherapy with their patients.

Medication

Selective-serotonin reuptake inhibitors (SSRIs) and other related medications may sometimes be prescribed to help decrease anxiety. Benzodiazepines can be in the short term to relieve acute anxiety symptoms.

How to Cope With a Fear of Needles?

One thing that may help you cope with a fear of needles and injections is finding ways to get treatment without needle injections. With new routes of medication distribution being developed all the time, a person with trypanophobia may be able to receive important treatment without being exposed to needles at all.

For instance, jet injection forces medication through the skin using high pressure. Jet injectors not only reduce the pain and fear associated with needles but also eliminate some of the risks of accidental needle sticks.

There are ways of testing blood sugar and performing other needed medical tests without needles. However, some medications and tests still require injections or blood draws, making the use of a needle sometimes unavoidable.

When you do have to have some type of injection, distraction can also be a helpful technique. Try distracting yourself by listening to music or talking to another person during the procedure.

Takeaway:

In the UK, if you’re struggling with trypanophobia (fear of needles), several resources can offer help. You can self-refer to the NHS talking therapies for free counselling, including cognitive behavioural therapy (CBT), which is often recommended for phobias like needle phobia. Additionally, organisations like Anxiety UK provide resources and information on needle phobia. Your GP can also refer you to specialist therapies or provide guidance.

• NHS Talking Therapies:

  The NHS offers free talking therapies, including CBT, which can be particularly helpful for managing phobias like trypanophobia. You can self-refer to these services. 
• Cognitive Behavioural Therapy (CBT):

  CBT is a highly effective therapy for phobias. It helps you change your thought patterns and behaviours related to your fear, making it easier to cope with needles and injections. 
• Anxiety UK:

  This organisation provides information, resources, and support for individuals with anxiety disorders, including needle phobia. They also offer a booklet specifically for needle phobia, including self-help strategies and details on available treatments. 
• Your GP:

  Your general practitioner can provide a formal diagnosis and recommend appropriate treatment options, including specialist referrals or therapies. 
• Counselling and Psychotherapy:

  If you’re looking for alternative therapies, you can explore counselling or psychotherapy. The British Association of Counsellors and Psychotherapists can help you find members in your area. 
• Hypnotherapy:

  Hypnotherapy can also be an effective way to manage and reduce the anxiety associated with needle phobia. 
• Distraction Techniques:

  While you’re waiting for an injection, try distracting yourself with activities like listening to music, reading, or focusing on something else in the room. 
• Breathing Techniques:

  Deep breathing exercises can help to calm your nerves before and during a needle procedure. 
• Relaxation Techniques:

  Tensing and relaxing muscles can help to reduce anxiety and make you feel more comfortable during an injection. 

References: 

Raghvendra TP, Yadav P, Saxena S, Dodia RA, Patel TD. Trypanophobia-an extreme and irrational fear of medical procedures: An overview. Int J Pharm Sci Rev Res. 2010;4:18-21.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC; 2013. doi:10.1176/appi.books.9780890425596

Jenkins K. II. Needle phobia: A psychological perspective. Br J Anaesth. 2014;113(1):4-6. doi:10.1093/bja/aeu013

McLenon J, Rogers MAM. The fear of needles: A systematic review and meta-analysis. J Adv Nurs. 2019;75(1):30-42. doi: 10.1111/jan.13818

Orenius T, LicPsych, Säilä H, Mikola K, Ristolainen L. Fear of injections and needle phobia among children and adolescents: An overview of psychological, behavioral, and contextual factors. SAGE Open Nursing. 2018;4:2377960818759442. doi:10.1177/2377960818759442

Ritz T, Meuret AE, Ayala ES. The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm. Int J Psychophysiol. 2010;78(1):50-67. doi:10.1016/j.ijpsycho.2010.05.007

Barolet D, Benohanian A. Current trends in needle-free jet injection: an update. Clin Cosmet Investig Dermatol. 2018;11:231-238. doi:10.2147/CCID.S162724