- Trypanophobia is a type of specific phobia characterized by an intense fear of needles.
- In some cases of trypanophobia, there can be a decrease in heart rate and even fainting.
- There are a few therapeutic interventions that are effective for treating trypanophobia.
Trypanophobia is a condition characterized by an extreme fear of needles, blood, and even injury. Among clinicians, it is often referred to as blood-injection-injury phobia.
Understandably, most individuals do not enjoy visiting a health practitioner for an annual flu shot or getting a blood test done.
However, there is a subsection of individuals who experience intense fear that is out of proportion to the said source of threat.
People with a phobia of needles tend to fear medical procedures that entail injections or hypodermic needles.
Sometimes, this fear extends and becomes associated with medical professionals. This culminates in avoidance of receiving even recommended treatment.
If you are interested in knowing more about this rather common type of phobia, keep reading.
What Is the Phobia of Needles?
The phobia of needles is known as trypanophobia. It is an intense, irrational, and overwhelming fear of blood or needles.
Although the intensity and experience vary for each individual, the fear of needles can affect one’s life gravely.
It is important to bring to light the difference between fear of needles and needle phobia.
A fear of needles is a natural response and experienced by 20-30% of young adults. It is normal to experience feelings of minor anxiety, particularly when large needles are involved.
On the other hand, a phobia of needles or trypanophobia is an intense and overwhelming feeling surrounding blood or needles.
An individual suffering from a phobia might experience anxiety or even panic attacks merely from thinking about a needle.
Trypanophobia: Fear of Needles
Trypanophobia is a rather common condition characterized by an intense fear of blood, needles, and injury. It can lead many individuals to avoid important vaccinations and accessing medical care.
Trypanophobia is a combination of two words of Greek origin, namely trypano and phobos. While the former means puncturing or piercing, the latter refers to extreme fear. Therefore, an overwhelming fear of blood, needles, and injury characterizes this condition.
The fear of needles, or trypanophobia, affects 3-4% of the general population. Although so many people struggle with this condition, it was not categorized as a specific phobia in the Diagnostic and Statistical Manual (DSM) until 1994.
Moreover, this condition possibly drives 16% of people in the US to avoid influenza vaccinations.
Also, these individuals may avoid doctor visits and medical care. So, these figures are likely skewed in that the problem is underestimated or under-reported.
Like many other mental health conditions, the symptoms of trypanophobia may be experienced to varying intensities by each individual. These symptoms can disrupt a person’s quality of life.
In extreme cases, they can be debilitating, as even the thought or sight of a needle can invoke anxiety. Undergoing procedures also become a major problem for these individuals.
The commonly experienced symptoms related to anxiety include the following.
- Trembling or shaking
- Muscle tension
- Difficulty concentrating
- High blood pressure
- Increased heart rate
- Dizziness, lightheadedness
- Fainting or syncope
- Panic attacks
- Hyperventilation, shortness of breath
- Worrying about worst-case scenarios
- Emotional or physical violence
The more specific symptoms of trypanophobia include the following.
- Excessive and intense fear of needles
- Experiencing fear out of proportion to the actual threat
- Avoidance of situations involving needles or enduring the same with great distress
- Impairment in other areas of life
- Avoidance of medical care
In terms of blood pressure and heart rate, these elements are likely to remain increased until the procedure.
Right before the procedure, blood pressure and heart rate are likely to drop, resulting in vasovagal syncope.
Types of Trypanophobia
You would have understood by now that trypanophobia is an overwhelming fear of needles, blood, and injury. However, did you know that there are different types of this phobia?
Each type is dependent on specific factors, like the way the symptoms manifest or with what the fear is associated. Following is an outline of the various types of trypanophobia.
1. Associative Trypanophobia
This type of trypanophobia is associated with traumatic experiences. Individuals with this fear are likely to have undergone an excruciatingly painful medical procedure.
Otherwise, there is a chance that they experienced a serious reaction to an injection.
The odds are low for associative trypanophobia to develop from observing someone. In other words, it is unlikely to develop from witnessing another person experiencing a painful procedure.
Irrespective of the details, this type of trypanophobia boils down to an association between needles and an unpleasant event.
2. Hyperalgesic Trypanophobia
Hyperalgesic trypanophobia is characterized by heightened sensitivity to physical pain. An individual with this type of trypanophobia experiences an increased feeling of pain.
Children are likely to experience pain from needles more acutely than older individuals.
This heightened sensitivity to pain from injections and resulting fear may develop as a consequence of several factors. Some of these include injury, chronic diseases, inflammation, stress, and even autoimmune diseases.
Overall, hyperalgesic trypanophobia is more closely associated with the physical experience of pain over the actual needle.
3. Resistive Trypanophobia
As the name suggests, a fear of being restrained or controlled characterizes resistive trypanophobia. It is most common in children when they are likely to feel controlled during flu shots or blood draws.
Additionally, individuals with this trypanophobia can become aggressive in situations that involve injections.
Consequently, they may have to be restrained so they do not risk harming themselves or those around them.
The bottom line is that resistive trypanophobia involves a fear of needles as well as control or restraint.
4. Vasovagal Trypanophobia
This trypanophobia is characterized by a vasovagal response. Such a response occurs when the individual undergoes a sharp increase followed by a drop in heart rate and blood pressure. These extreme changes can lead to losing consciousness.
Other physiological responses include lightheadedness, sweating, nausea, panic attacks, and tinnitus.
Moreover, there is a lack of clarity whether the vasovagal response causes this type of trypanophobia or vice-versa.
One study published in the journal Circulation explored this. In many individuals with this type, an initial vasovagal syncope during a procedure is thought to be the preliminary cause of trypanophobia.
This finding went against the commonly held belief that this condition stems from a basic fear of needles.
Further, there also seems to be a genetic component to this fainting response. Consequently, it leads to a phobia of needles owing to associations with the unpleasant event of fainting.
5. Vicarious Trypanophobia
As the name suggests, this type of trypanophobia is vicariously learned. It entails an intense fear of needles merely from witnessing someone else’s encounter with injections.
Further, they experience symptoms as described for other types, including a vasovagal response.
It can develop from a traumatic experience from observing another individual undergo a painful procedure involving needles.
Causes of Trypanophobia
Similar to other specific phobias, such as zoophobia and claustrophobia, researchers are yet to find a specific cause for trypanophobia.
They believe multiple factors play a role in an individual developing a fear of needles. Some of these elements are outlined below.
1. Negative Experience
A negative experience in the past entailing needs or medical procedures is likely to lead to this phobia. A study in 2018 identified that trypanophobia was most prevalent among people with long-standing conditions that require injections.
Besides this, a traumatic experience can involve witnessing someone close to the individual undergo a medical procedure.
Consequently, they begin associating everything entailing the use of needles with this original experience.
Such associative fear of needs predominantly results in psychological symptoms. These symptoms may include unexplained anxiety, panic attacks, and extreme preoccupation with an upcoming procedure.
2. Limited Exposure and Avoidance
Individuals are likely to fear what they do not know. Unfamiliar territory can be daunting. Therefore, people with limited exposure to getting shots or blood tests tend to be more afraid than those with prior experience.
Similarly, the more people avoid doing something, the more likely they are to develop a fear. This avoidance pattern can also worsen one’s fear.
For instance, individuals who have canceled appointments multiple times end up worsening their anxiety around needles.
3. Genetic Predisposition
Researchers seem to believe that there is a genetic component to the development of this phobia. One study found that around 80% of adults with trypanophobia stated that a first-degree relative displays the same fear.
Moreover, a systematic review in 2013 explored heritability estimates of subtypes of fear as well as a specific phobia. It found that, among the specific phobia subtypes, the highest heritability was seen for blood-injury-injection phobia (33%).
More research on genetic factors stem from studies on vasovagal response. In some cases of trypanophobia, individuals may experience a vasovagal reflex from seeing a syringe with a needle or having oneself injected.
Such reflexive responses lead to an increase in heart rate and blood pressure followed by an immediate drop in the same.
This phenomenon may even result in dizziness or fainting. This response is known to have a heritable factor.
4. Evolutionary Factors
It is possible that the cause of being intensely afraid of needles could be rooted in survival instincts. Further to the above-mentioned point, some believe that a genetic predisposition to trypanophobia may be based on evolution.
This assumption stems from the fact that human beings who evaded stab wounds successfully were more likely to survive. Before modern antibiotics, puncture wounds were known to be deadly.
Therefore, certain evolutionary psychologists believe that a fear of needs is an evolutionary adaptation.
5. Observational Learning
People can develop phobias through vicarious experiences. witnessing another individual undergo a painful procedure can cause phobia.
Also, hearing about an unpleasant or traumatic experience with needles from someone else can have the same impact.
For instance, getting to know that an individual contracted an infection owing to an unsterilized needle can lead to a fear of needles.
6. Nervous System Response
When an individual is experiencing feelings of anxiety, their nervous system responds with fight or flight. Stress hormones are released along with a rush of adrenaline.
These bodily changes cause an increase in heart rate and other symptoms associated with anxiety.
Further, these physiological symptoms or panic attacks scare many individuals as they believe they are experiencing a heart attack.
Also, they may focus too much on these bodily experiences, leading them to panic even more.
7. Hypersensitivity to Pain
It is postulated that another cause of needle phobia is a hypersensitivity to pain. A few individuals suffering from this phobia are likely to have inherited heightened sensitivity to needles.
This makes them experience needle sticks as more painful than individuals without this genetic component.
When to Seek Help
You may be wondering when you need to seek professional help. Typically, most people reach out to medical professionals when one of the following things happens.
1. Diminished quality of life
If you find yourself living a lessened quality of life, it is time to evaluate visiting a mental health professional.
For instance, if you spend a long amount of time preoccupied with thoughts regarding needles, it is a sign to get yourself checked.
Similarly, dreading or worrying excessively about a doctor’s appointment can show that your symptoms are rather intense.
2. Holding back on routine check-ups
If your fear of needles is forbidding you from visiting the physician for a routine check-up, it is detrimental to your wellbeing.
Specifically, you are putting your physical health as well at risk. Your phobia is increasing the likelihood of a potentially serious condition going undetected.
3. Avoidance of required treatment
Avoiding recommended medical care to avoid needles can cause unfavorable consequences. For instance, it can lead to missed diagnoses, improper regulation of conditions, and prevention of obtaining the required help.
Many individuals choose not to take their flu shot owing to their fear. Sadly, this group also includes individuals who have an increased risk of complications if they get exposed.
An example of this involves people refraining from getting the COVID-19 vaccine for a fear of needles. This behavior leads to an increased risk of contracting the disease. Consequently, it poses a threat not only to the individual, but to their community as well.
Moreover, drug advertisers are also likely to play on people’s fear of needles while marketing. They might try concealing the fact that a specific medication requires to be injected.
Impact of Trypanophobia
As has been well-established so far, individuals with trypanophobia are likely to avoid situations that entail needles.
This avoidance can extend to not seeking appropriate and necessary treatment. Consequently, such behaviors can result in health problems.
Here is a list of the ways in which trypanophobia has an impact on individuals.
- Avoidance of vaccines, annual flu shots, blood draws, or even preventative medication. This can lead to an increased risk of developing infections.
- Avoidance of tests required to understand and regulate their health and the functioning of various organs.
- Increased possibility of having diseases and infections go undetected.
- Denying oneself the medication to treat serious health conditions, such as insulin injection for diabetes.
- Rejecting medical care even while sick owing to a fear of receiving an injection or being requested to take a blood test.
There is no specific or standardized test that one can take to know whether they have trypanophobia. To achieve a clinical diagnosis, it is best to consult a mental health professional.
Specifically, they will take into consideration several factors before arriving at a diagnosis.
Some of these factors may include your symptoms, the diagnostic criteria, and their clinical judgment.
Moreover, instead of trying to diagnose yourself or browsing the internet to gain insights, it is recommended that you seek professional help.
Diagnosis of Trypanophobia
Most people with specific phobias, including trypanophobia, use avoidance as their coping strategy.
Such avoidance can entail hefty consequences, such as denying oneself much-needed treatment, shots, or blood draws.
Therefore, it is better not to wait for the symptoms to become intense to get yourself checked out by a medical professional.
Before providing you with any diagnosis, your doctor will perform a physical exam to eliminate any underlying physical condition that explains your symptoms.
Additionally, they will question your symptoms regarding their intensity, duration, and nature.
They are also likely to use the Diagnostic and Statistic Manual 5th Ed (DSM-5) to aid in their diagnosis. A summary of the diagnostic criteria for specific phobia, according to the DSM-5, is outlined below.
- The fear of needles or blood is excessive, persistent, unreasonable, and intense.
- There is an immediate response of anxiety. Moreover, the fear is out of proportion to the actual threat the object (needles, injury, or blood) poses.
- The individual exhibits avoidance of the object or situation, and/or handles it with extreme distress.
- The phobia is pervasive and affects various areas of functioning.
- The individual has experienced the symptoms for at least six months.
- Any other mental condition does not explain the symptoms, like agoraphobia, obsessive-compulsive disorder (OCD), or separation anxiety disorder.
In previous editions of the DSM, adults with specific phobias needed to consider their fears as out of proportion to reality. This was not the case for children. The recent edition does not mandate the recognition of irrationality of behavior to receive a diagnosis.
How to Get Over Fear of Needles: Treatment Options
The primary choice of treatment for specific phobias is exposure therapy. Apart from this mode of intervention, professionals also use cognitive behavioral therapy (CBT) and medication. Outlined below is a brief account of each of these treatment options.
1. Exposure Therapy
This form of therapy aims to change the individual’s psychological and physiological response to blood, needle injection, and injury. The mental health professional will gradually expose the individual to needles.
Along with the exposure, they will help in managing the thoughts and feelings that crop up. This procedure is carried out in a safe and controlled environment.
The therapist also ensures the comfort of the individual before progressing to the next level of exposure.
Moreover, systematic desensitization is a type of exposure therapy in which the individual learns relaxation techniques. As the individual is gradually exposed to the feared object, they practice these relaxation skills.
Specifically, exposure therapists who practice exposure therapy may also teach clients relaxation techniques or mindfulness skills.
These abilities help individuals cope with and manage their symptoms better while being exposed to the feared object.
With that said, in some cases, relaxation techniques may be contraindicated for treating trypanophobia. This is because these skills encourage a decrease in heart rate and blood pressure, which intensifies the vasovagal response.
Therefore, graded exposure approaches can entail a coping technique that is dependent on applied tension. Doing so can help in the avoidance of a vasovagal response to the stimuli.
Further, exposure therapy through virtual reality is gaining traction and proving to be a cost-effective method. It is specifically helpful in cases where the therapist or client cannot access the feared object in person.
The impetus of in vivo exposure therapy is to aid clients in overcoming their avoidance of the feared object. Additionally, the therapist helps the individual build competence surrounding the object.
Typically, avoidance takes place because the needle is perceived as dangerous or if it triggers traumatic memories. Exposure therapy helps develop a sense of mastery over needles.
A 2007 review found that 80 to 90% of individuals with specific phobias experience an improvement in symptoms after in vivo exposure therapy.
2. Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy involves an exploration of the fear of needles in therapy sessions. Along with this, the individual is taught techniques that help them cope with this fear better.
The therapist will help in the recognition of maladaptive patterns of thinking, feeling, and behaving.
Such awareness will aid in managing and replacing these patterns with more adaptive ones. By the end of the sessions, there is a sense of confidence and mastery.
3. Energy Psychology or Emotional Freedom Techniques (EFT)
Emotional Freedom Technique is fast-growing and has proven to be effective in the treatment of anxiety disorders, including specific phobias.
It is brief, safe, and long-lasting. EFT shares its foundations with acupuncture, except in the former there are no needles involved.
A 2011 study found that EFT could reduce the anxiety related to specific phobias comparable to diaphragmatic breathing. The researchers noticed positive results in just 10 minutes after an EFT intervention.
An advantage of EFT is it can be self-administered following the initial treatment. It is also possible to administer in group settings. Overall, it is an effective, rapidly-working, and long-lasting intervention that changes thought and behavioral patterns.
This treatment option involves reprogramming an individual’s subconsciousness, which may play a role in their fear. Such resetting minimizes the intensity of the symptoms.
With that said, many individuals are wary of losing control that accompanies hypnotherapy. It is a safe method, but many researchers question its efficacy.
Sometimes, medication may be deemed necessary by your medical professional based on the severity of the anxiety. It is also possible that the individual is not responsive to psychotherapy. Anti-anxiety and sedative medications help relax your body.
Typically, the professional prescribes selective serotonin reuptake inhibitors (SSRIs) and related medications for depression and anxiety. Additionally, benzodiazepines are known to relieve acute anxiety symptoms.
It is true that medications can offer some relief, especially in the immediate duration. However, it does entail the long-term benefits that therapeutic interventions, such as exposure therapy, provide.
Specifically, individuals who use medication as the standalone mode of treatment suffer more.
They do not develop adaptive skills to cope with their situations. Additionally, they do not feel equipped or confident to face their fear on their own.
Overall, these are the reasons medication is not solely recommended while treating specific phobias and other anxiety disorders.
6. Miscellaneous Treatments
There are certain other treatment options that one can consider upon consultation with their health provider. Outlined below is a list of treatments that may be effective in some cases.
- Ethyl Chloride Spray – Freezing agents like the ethyl chloride spray can be administered with ease on the area to be injected. It provides superficial protection from pain.
- Iontophoresis – This procedure involves the use of a mild electrical current to administer anesthetics. However, it is difficult to use and is not available on the commercial market.
- Jet injectors – Jet injectors can replace a needle in some cases. It uses high pressure gas to administer medication. Their usage is mostly limited to situations that involve administering insulin and some vaccines.
- Eutectic Mixture of Local Anaesthetic (EMLA) – EMLA is an anesthetic cream applied topically. It is a eutectic mixture of lidocaine and prilocaine. Although in some countries, it is an over-the-counter drug, in the United States, you need to obtain a prescription. EMLA is easier to administer than iontophoresis, but is not as effective for some individuals, and does not penetrate as deeply. With that said, it permeates the skin more than other topical anesthetic creams.
- Nitrous Oxide or Laughing Gas – Nitrous Oxide provides sedation and decreases feelings of anxiety. It also offers some pain relief.
- Inhalation General Anesthesia – This method is an extreme one as it leaves the individual with no memory of the procedure. Indeed, it eliminates all pain. However, insurance does not cover it and most physicians will not recommend it. It is also risky, expensive, and might involve a hospital stay.
How to Get Over Trypanophobia: Self-Help Tips
Seeking therapy from a trained professional is the recommended approach to treating trypanophobia. Most individuals who seek professional help respond positively and show improvements rather quickly.
Although individuals can overcome their fear of needles, they may continue to feel afraid of needles.
Nonetheless, they can learn more adaptive ways to cope with and regulate their feelings of anxiety. Similarly, it may be difficult for people to gain access to the more intensive interventions.
In such cases, people can cultivate certain coping mechanisms on their own. There are a few self-help strategies that one can employ to help manage their symptoms, at least temporarily.
Following is a list of ways to cope with the phobia.
These are merely coping strategies and do not replace professional help in any way. To truly overcome a fear of needles, it is best to visit a medical professional.
1. Practice mindfulness and grounding techniques
Practicing a few minutes of mindfulness and escalating the amount of time spent meditating can be helpful.
Further, thinking of and listing out things you are grateful for can also help and so can imagining some of your goals being accomplished.
Additionally, you can lie down and do a quick body scan to calm your nerves. This can be particularly useful if you have had instances of feeling faint when needles were involved.
Further, grounding techniques can decrease the chances of fainting, while reducing feelings of anxiety. The simplest way one can ground themselves is by focusing on sensory information.
Specifically, pay attention to things you can see, hear, taste, or smell. Doing so can also help you not focus on the needle.
2. Deep breathing exercises
Relaxation practices can also include deep or abdominal breathing exercises. You can visualize yourself in a peaceful or comfortable space of your choice.
While practicing deep breathing, you can attempt to befriend and face your fear.
Instead, you can view the injection as something that will help in your betterment. In the end, the medication will make you feel more comfortable. So, focusing on this aspect can be beneficial.
3. Prepare the area to be injected
It is recommended that preparing the area to be injected with medication can help. As mentioned earlier, using an ethyl chloride spray or a topical anesthetic cream like lidocaine can be beneficial.
This is because it reduces pain caused by needle sticks, at least superficially.
Moreover, jet injectors are known to decrease pain. A jet injector works by injecting medication through a high-pressure stream of liquid instead of needle.
This injector merely penetrates the outermost layer of your skin for the medication to permeate.
4. Distract yourself
Distraction can be a useful coping strategy, at least in the short term. For instance, you can imagine sitting in a relaxing place while you are being injected.
Similarly, listening to music, watching a video, or talking to someone during the procedure can help.
Focusing on anything but the needle will help. Stare at a spot on the wall. Recall the benefits of getting the shot or even a holiday you would rather be on.
Also, remember not to look at the needle. Watching yourself getting injected can make things worse.
5. Show and tell with children
As a healthcare provider, using the show and tell approach with children can be wildly beneficial.
First, explain the procedure to the child and demonstrate how it will be done. Take your time to explain each move that you will make as the child watches you.
Then, try to show the same by injecting a needle into a fruit. Allow the child to play with the fruit until the child is comfortable injecting the fruit herself.
This will allow them to brave their fears and go through the procedure at ease.
6. Inform the healthcare provider
Inform the person who is giving you the shot or drawing blood about your struggle. You can tell them what works best for you and what does not.
Sometimes, it helps to know what exactly is going on. So, you could request the healthcare provider to tell you every step of the procedure as it is happening. Alternatively, ask if they have tricks of the trade to ease the process for you.
Similarly, you can talk to your physician about not giving prior notice when blood tests or shots are needed. This practice can decrease the possibility of canceling appointments.
The unique factor about trypanophobia is that it is characterized by a vasovagal reaction. There are two phases of response, also referred to as diphasic response.
In the first phase, there is an increase in heart rate or tachycardia, along with increased blood pressure. This fight-flight response is seen in other phobias as well.
In the second phase, there is a unique response of a sharp drop in blood pressure and heart rate, also known as bradycardia.
This is accompanied by decreased blood pressure, resulting in reduced cerebral blood flow. These reactions can culminate in fainting.
Concluding Thoughts from ThePleasantMind
For a long time, trypanophobia was not given the recognition and seriousness that it deserves. It was dismissed even by the medical fraternity as merely an emotional response to a fear that originated in one’s childhood.
However, nowadays, it is deemed a significant condition that can have important repercussions if left untreated.
Regardless of the cause of this phobia, it poses a problem worth tackling for medical professionals and the public alike.
With medical advancement, there are alternative ways of providing people with medication.
Besides that, effective therapeutic interventions, such as exposure therapy, have developed to treat specific phobias.
Keep in mind that you do not have to wait for the fear to intensify before seeking help. If you or someone you know is dealing with this phobia, reach out to a professional.
Are you interested to know more about ‘Technophobia’ then click here?
Ananya Ramesh is a mental health professional with a master’s degree in clinical psychology. She has a profound interest in producing and refining content, specifically ones related to mental health and psychology. What began as casually penning down her musings back in school has grown into a successful freelance venture. Outside of work, Ananya is constantly looking to live a more sustainable lifestyle and minimize her carbon footprint. She also enjoys reading fiction and autobiographies, cooking, exercising, and sketching portraits.