Trypanophobia (Fear of Needles): Symptoms, Treatments, & How to Cope

What Is Trypanophobia?

Trypanophobia is a specific phobia, which means it is an anxiety disorder that is triggered by specific objects or situations—in this case, needles. 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 from hemophobia, which is the 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

Normal Fear of Needles Vs. Trypanophobia

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.

Trypanophobia Vs. Aichmophobia

Aichmophobia is a fear of sharp objects such as needles, knives and blades. Trypanophobia is a fear of injections done with needles. Given that there is overlap here and that needles are also considered a sharp object, asking more questions about the fear and type of objects which trigger this fear will help a mental health provider determine whether someone is dealing with trypanophobia or aichmophobia.

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, higher pain levels. Some people might have more than one type.

Starting with the most common types, the four kinds of trypanophobia are:⁵

1. 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.
2. 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.
3. 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.
4. 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.

How Common Is Trypanophobia?

Trypanophobia is very common. Women are more likely to have this phobia, and it impacts 20-50% of youth and 20–30% of adults.²

Symptoms of Trypanophobia

The symptoms of trypanophobia 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.

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

How Do I Know If I Have Trypanophobia?

It can be hard to know if you have trypanophobia but some common questions to ask yourself to help you consider your phobias include:

• Do I avoid situations where I may get hurt by (or even be around) needles?
• Do I avoid dangerous places that may have sharp edges?
• Do I avoid the doctor’s office?
• Do I get nervous and dizzy when I am around needles?

What Causes a Fear of Needles?

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 they developed vicarious trauma from 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.

Does Having Other Mental Health Disorders Heighten the Risk for Trypanophobia?

Phobias can co-occur with other mental health conditions such as depression, OCD, and other forms of anxiety. It is important to understand how other conditions can fuel the fear related to a needle phobia, and understanding how that works can help you learn how you may need to manage your phobia along with your other concerns.

Long-Term Effects of Having a Needle Phobia

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.

Trypanophobia may impact someone in any of the following ways:

• 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

How to Get Over Fear of Needles

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 tips for overcoming the fear of needles:^2,4,7

1. 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
2. Consider asking your doctor not to give you advance notice when you need bloodwork or shots (to reduce your chances of canceling appointments)
3. Use relaxation and grounding techniques to avoid fainting and reduce anxiety; focus on things you can hear, see, or smell instead of the needle
4. 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
5. Bring a support person to your appointment to help you calm down and hold you accountable for following through
6. Ask the provider to apply numbing gel to reduce your sensitivity or pain
7. 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
8. Tensing up muscles in the body can help prevent dizziness and fainting during an injection or blood draw
9. Focus on the benefits or health reasons for getting the injection or blood draw to remind yourself why it’s important

When to Seek Help for Trypanophobia

If you are avoiding standard and important medical treatment because of this phobia, it is important to consider mental health treatment. This phobia can keep you from getting the care that your body needs, so it should be taken very seriously and you shouldn’t hesitate to get help if you find yourself avoiding important care.

How Is Trypanophobia Diagnosed?

The phobia is diagnosed by a mental health professional and can take time to understand where the fear comes from to understand the depth of the phobia. The official diagnosis of trypanophobia is determined when someone reports the symptoms listed above, plus the additional criteria that it cannot be better explained by another medical or psychological condition or the effects of a drug or medication.

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

Exposure 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

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.