Trypanophobia, or fear of needles, is a common problem that affects between 10-20% of adults.1,2 Nausea, fainting, increased heart rate, and panic attacks are commonly reported when people with trypanophobia have an injection or need to get blood drawn.3 Needle phobias can be treated with medication, therapy, or a combination of the two.
What Is Trypanophobia?
Trypanophobia is a specific phobia, which means it is an anxiety disorder that is triggered by specific objects or situations. Unlike people with generalized anxiety disorder, anxiety related to specific phobias is more predictable because it only occurs in certain situations. In these situations, people with specific phobias tend to become highly anxious.
Sometimes, this anxiety intensifies into a panic attack, which some people confuse for a heart attack or other medical emergency. For people with trypanophobia, their anxiety is triggered by the thought, sight, or feel of needles (different than hemophobia, a fear of blood). People with a phobia of needles may go to great lengths to avoid needles by not getting flu shots or optional vaccines or even canceling routine appointments where they suspect they will be given a shot or asked to give blood.1,2,4
The difference between a normal, rational needle fear and trypanophobia is the level of anxiety caused by needles and the extent to which this fear gets in the way of a person’s ability to function. If a person’s needle phobia causes them to avoid routine medical care or not take medicine they need to manage an illness, it often is a sign of a phobia, rather than a normal fear.
4 Types of Trypanophobia
There are four different types of trypanophobia, which may present with slightly different symptoms and complaints like lightheadedness, aggression during blood draw or injection, and, in some cases, pain. Some people might have more than one type.
Starting with the most common types, the four kinds of trypanophobia are:5
- Vasovagal trypanophobia: 50% of people with a needle phobia have vasovagal trypanophobia, which means they become dizzy, lightheaded, and may even faint at the sight, thought, or feeling of a needle.
- Associative trypanophobia: 30% of people with a needle phobia have had a negative past experience with needles and because of this, they associate any and all medical procedures with needles as being negative and traumatic.
- Resistive trypanophobia: 20% of people with needle phobias will become resistant or aggressive during a blood draw or injection. More common in children, this kind of phobia often results from forced injections or blood draws where people need to be restrained or held down.
- Hyperalgesic trypanophobia: 10% of people with trypanophobia are believed to have an inherited hypersensitivity that causes injections or blood draws to be much more painful for them.
Symptoms of Trypanophobia
The symptoms of trypanophobia are the same as those for other specific phobias like agoraphobia or claustrophobia, and involve intense anxiety and fear when exposed to needles. The anxiety can be triggered by the sight of needles, the feeling of a needle prick, or even by thinking about needles, injections, or IVs.
Common symptoms of anxiety include:3
- Trembling or shaking
- Feeling sweaty, hot, or cold
- Feeling nauseous or ill
- Muscle tension and headaches
- Trouble eating or sleeping
- Inability to focus or concentrate
- Worried, racing thoughts about worst-case scenarios
- Dizziness and feeling lightheaded or fainting (syncopia)
- Hyperventilating and choking feeling or inability to breathe
- Feeling a rush or surge of nervous energy and restlessness
- Panic attacks involving sudden and intense onset of symptoms (any listed above)
Specific symptoms of trypanophobia include:3
- An excessive fear or concern of needles
- Needles consistently provoke excessive fear responses
- Fear that is disproportionate to the actual risk/danger
- Situations involving needles are avoided or endured with a lot of distress
- Persistent fear for six months or more
- Fear that is severe enough to cause distress or impairment
The official diagnosis of trypanophobia is made with the above symptoms, plus the additional criteria that it cannot be better explained by another medical or psychological condition or the effects of a drug or medication.
What Causes Trypanophobia?
Survival instincts cause people to fear objects and situations that could result in serious injury or death, including heights, weapons, and needles. People with trypanophobia experience intense fear or anxiety about needles, which exceeds the “normal” and expected level of anxiety. Most children are trypanophobic but outgrow their fear as they get older.2 Some people are unable to figure out the cause of their needle phobia, while others can pinpoint the exact cause of their phobia.
Causes of trypanophobia include:5
Negative Past Experiences
Having a scary, painful, or difficult experience with needles in the past can cause trypanophobia. Examples include having a nurse or doctor make an error during a blood draw, multiple needle sticks to draw blood, or pain or bruising at the site of the injection. Others develop a negative association with needles because of a health problem or disease. For example, a person who gets chemo might begin to associate IVs with feeling sick or having cancer.
Limited Exposure & Experience
People tend to have more fear of things that are unknown or unfamiliar. People who have had limited experiences with getting injections or having blood drawn may be more scared of needles than someone who has had multiple experiences.
Avoidance
Sometimes, phobias can develop and worsen after a person has developed a pattern of avoidance. For example, a person who has canceled multiple appointments where they needed to get a shot may actually worsen their anxiety about needles.
Vicarious Trauma
Some people are afraid of needles because of hearing about a bad or traumatic needle experience from another person, or seeing a show or movie involving a bad needle experience. For example, hearing someone who contracted an infection from a dirty needle or other uncommon scenarios may lead people to develop a phobia.
Nervous System Response
When a person is anxious, their nervous system’s “fight or flight” response kicks in, pumping stress hormones and adrenaline into the blood. This is what causes people’s hearts to race and other physical symptoms of anxiety. Some people become scared when this happens because they either confuse anxiety with a heart attack or focus too much on their heart rate or breathing and become more panicked.
Hypersensitivity to Pain
Being overly sensitive to pain is another cause of needle phobias. A small percentage of people with trypanophobia are believed to have an inherited hypersensitivity to needles that causes needle sticks to be more painful for them than for an ordinary person.
Impact of Trypanophobia
People with a severe needle phobia may go to great lengths to avoid any situation involving needles, even when it means not getting medical care they need.6,7 Over time, this can lead to serious health problems.
The impacts of trypanophobia are:
- They may avoid vaccines, flu shots, or other preventative drugs, increasing the likelihood of infections
- They may avoid blood work needed to monitor their health, organ functioning, and may not detect diseases or infections in a timely manner
- They may not get the medication they need to treat a chronic or serious health problem (i.e. insulin injections for diabetes)
- They may avoid seeking medical care when sick for fear of getting an injection or the doctor requesting blood work
Fear of Needles & the Pandemic
Each year, a large portion of the population chooses not to receive a flu shot because of their fear of needles.7 Unfortunately, this includes some people who are at higher risk of complications or death if they contract the flu. A fear of needles may also cause people to avoid other vaccines and preventative medicine, including the COVID-19 vaccine.
Needle Phobia Treatment
Anxiety disorders and phobias are highly treatable. Most phobias respond well to therapy alone, although some people may choose to also take medication for their anxiety on either a regular or PRN (as-needed) basis.6
Therapy for Trypanophobia
The most effective form of therapy for phobias is a specific kind of cognitive behavioral therapy (CBT) called exposure therapy.4,6 Exposure therapy works to desensitize fear responses by gradually exposing a person to the object or situation they are afraid of. Research shows that 80-90% of people with specific phobias see improvements after exposure therapy.6
For example, a person may start out just thinking or talking about needles, then work up to imagining themselves getting a shot or seeing a video of an injection. Eventually, the goal would be for them to get to a point where they are able to go and get an injection themselves.
Exposure therapists also work with clients to teach them relaxation and mindfulness skills to better manage their anxiety through these exposures.
Medications for Trypanophobia
Some people benefit from medications to help them manage anxiety related to their phobia. Usually, this kind of medication is taken on an as-needed basis when a person knows they will be exposed to needles. Medications like benzodiazepines and also certain beta-blockers are sometimes prescribed.
While these medications can provide some immediate relief, they are not as effective in the long term as exposure therapy.6 When people only take medication to manage their symptoms, they are not able to develop their coping skills and do not develop the ability or confidence to face the fear on their own. This is why medication alone is not recommended for anxiety disorders, including specific phobias.6
How to Get Over Fear of Needles
If you have a needle phobia, seeking out a licensed therapist who is trained in cognitive behavioral therapy or exposure therapy is recommended. Most people with phobias respond well and quickly to therapy, so this is the best course of action for someone with trypanophobia.6 While people who overcome their phobia may still be scared of shots, they can often learn new, better ways to cope with their anxiety. In addition to seeking therapy, there are some other things you can do on your own to get over a fear of needles.
Here are nine ways to deal with the fear of needles:2,4,7
- Tell your doctor or primary care provider that you are afraid of needles and ask for your doctor to arrange any injections at a lab or with providers who are most skilled at drawing blood or giving injections
- Consider asking your doctor not to give you advance notice when you need bloodwork or shots (to reduce your chances of canceling appointments)
- Use relaxation and grounding techniques to avoid fainting and reduce anxiety; focus on things you can hear, see, or smell instead of the needle
- Look away (instead of watching) when you get a shot, IV, or blood draw and consider distracting yourself with music, a video, or something in the room
- Bring a support person to your appointment to help you calm down and hold you accountable for following through (i.e. talk you out of leaving)
- Ask the provider to apply numbing gel to reduce your sensitivity or pain
- Don’t avoid or cancel an appointment when you feel nervous about a shot or blood draw. Instead, show up and take it one moment at a time
- Tensing up muscles in the body can help prevent dizziness and fainting during an injection or blood draw
- Focus on the benefits or health reasons for getting the injection or blood draw to remind yourself why it’s important
Final Thoughts on Fear of Needles
There are few people who really enjoy needles, shots, or getting blood drawn. Most people don’t like the experience, but find ways to get through it when it is necessary for their health. If your fear of needles is severe, intense, and keeps you from getting medical and preventative care, you may need to seek professional help from a counselor. Often, with just a few sessions of exposure therapy, people are able to get to a point where they can withstand routine blood work and injections.
For Further Reading
Trypanophobia Infographics
