Have you ever seen a parent or a child not wanting to go visit the hospital or the GP, but they say they would eventually go, yet they don’t? Let’s talk about iatrophobia. What does it entail? Is there even a cure or management for this?
The phobia is not talked about much; it means avoiding going to the hospital to receive treatment for a disease or condition.
Causes of iatrophobia
The term itself describes the fear of doctors and promotes further fears of medical test results. An individual develops a fear of anything that has something to do with seeing a GP, visiting their office, or even not going for a general check-up.
The phobia is a spectrum that begins with a small detail associated with GP, but then it can expand like anxiety building in the waiting room or imagining vaccine needle insertion.
The phobia is triggered when being traumatised in hospital visits and disassociates with the environment where people tend to die or from medical tests’ 50/50 probabilities.
Generally, all phobias are influenced by each other; iatrophobia is one sum of other specific phobias, for instance, carcinophobia, nosophobia, or germophobia-the most common fear of all. These and many other sub-phobias exist within iatrophobia.
Iatrophobia differs in its manifestation between individuals, which is the core reason it’s viewed as unpredictable.
Signs and symptoms of iatrophobia
The symptoms and signs of iatrophobia correlate with the mental health of the person who has developed the phobia.1
Usually, the phobia causes a negative reaction towards an environment where needles, medical results, diagnosis, or prognosis are taking over the anxiety level.
The negative feelings associated with iatrophobia may impact the individual’s relationships and can be alienating. This may cause the individual who is diagnosed with the phobia to set barriers. Iatrophobia symptoms present differently than other diseases and conditions. Delaying seeking medical care is step one of the symptoms that a health expert is looking for in diagnosis evaluation.1 When it comes to specific symptoms that we can look for, like most phobia symptoms, it includes dizziness, dry mouth, and passing out. Yet, hyperhidrosis, described as having excessive sweat, followed by trembling, are specific symptom to look for when diagnosing iatrophobia.
Why is my health anxiety so bad?
There is a connection between having pre-existing anxiety as a result of a traumatic experience that triggers future health anxiety.
Management and treatment for iatrophobia
Since iatrophobia is a mental behaviour issue, the fear needs to be approached by visiting a psychotherapist to localise the trauma and expose less negative stigma towards hospital rooms, doctors or the long wait to get medical results.1 Iatrophobia is not talked about much, and it can be a good fit to talk about it with your GP or other medical expert.
The GP or doctor would need to accommodate their feelings and make them as comfortable as possible by having a policy such as a bedside manner and developing a relationship between the nervous patient showing signs of uncertainty.1 The phobia is diagnosed when the patient is not present to do a follow-up in the treatment and the visits to combat the disease or condition.1 When it comes to treatment, it depends on how severe the iatrophobia is to an individual. The phobia could, depending on the circumstances, not affect their day-to-day life.2
So, the treatments are tailored to each patient according to their medical history and experts' diagnoses. During the treatment sessions, the psychotherapist will go through the symptoms and trauma that trigger the phobia.2
The exercise is to recognise the negative fear and look at the fear in a different way. Exposure therapy is commonly used for other phobias; the purpose of this therapy is to expose all emotions that are attached to the trauma in a controlled environment. Simultaneously, the therapy allows you to divulge relaxation trips.2
Exposure therapy is a safe place to let the fear materialise in front of the psychotherapist. For instance, watching medical treatment videos and being vocal about the fears, starting with the least to the worst, is done in the sessions.2
Clinical hypnotherapy’s purpose, like exposure therapy, is focused more on relaxation tips and locates the traumatic instinct relating to the fear in medical elements. Hypnotherapy reduces the level of stress and anxiety and identifies trigger responses.2
However, if the fear is uncontrolled and there is less progression from both therapies, medication such as beta-blockers can be prescribed; they provide relief from a phobia of intense stress and anxiety. There is zero chance of addiction, but side effects such as insomnia or nightmares might occur.2
Anti-anxiety medications can be prescribed as they reduce anxiety, along with selective serotonin reuptake inhibitors (SSRIs).3
Iatrophobia delays an individual to seek medical attention for the required treatment. Diagnosing iatrophobia is important as we don’t want to further hold up in medical consultation or that the individual might be stressed by keeping their trauma and be overwhelmed.2
Altogether, the GP is the primary expert on preliminary diagnosis. However, it is up to a psychologist by a GP’s recommendation that iatrophobia could be a possible diagnosis.2
The diagnosis process takes a while because the common symptoms associated with iatrophobia are stress, anxiety and having negative thoughts, which are associated with a myriad of other possible conditions.2
The GP will transfer the patient’s medical history to the psychologist for confirmation of an iatrophobia diagnosis. Some phobias have a genetic component; the GP will collect all evidence to share it with the psychologist to avoid misdiagnosis.2
Iatrophobia, in a nutshell, is about delaying going to see a doctor for a health concern or follow-up. Skipping medical examinations will definitely cause more complications to any disease and condition the patient may have.4
Having high blood pressure and high cholesterol could play a hand in stroke or heart attack; these conditions are noted as iatrophobia complications.4
White coat syndrome is diagnosed when a patient has high blood pressure in the presence of white coat experts such as doctors. White coat syndrome can lead to cardiovascular risks; the white coat syndrome differentiates itself from regular hypertension, where white coat syndrome reading is greater than 140/90 mmHg compared to 135/85 mmHg.4
Not being diagnosed with iatrophobia and avoiding going to the doctor amplifies consequences such as having terminal diseases and conditions.2
A traumatic experience demonstrates the patient is not ready to confront their trauma even if their mental and physical health is declining.2
We covered that one main phobia does have subtypes of phobia. Subtypes elevate high blood pressure because iatrophobia patients have no control over amplification of fear.2 The patients’ trauma is the main risk factor to which signs of stress and excessive anxiety shoot up the blood pressure in contrast to regular hypertension.
How can I prevent iatrophobia?
The prevention can be seen as reducing the stress levels that are the major player in developing iatrophobia. Preventive methods like cardiovascular exercising, which is viewed as being resistant to stress levels and training your cardio stamina, too. Endorphins are chemicals that are activated when experiencing pain and stress. The chemical is released to cope with the pain threshold caused by cardiac events.
Working out can condition the mind to focus on the health itself; it is about putting all the stress experiences and using them to fuel a hard workout. By executing any type of workout, hiking, swimming and walking long-distance, you can relieve stress levels.
Other management includes practising yoga to strengthen the mind.
Another preventive method is reducing caffeine intake. The intake accelerates the rate of a person getting more stressed out, further increasing the heart rate.
An individual with iatrophobia is described as having a fight or flight response, which causes panic attacks and promotes worse damage to the heart.
How common is iatrophobia
People who are successfully diagnosed with iatrophobia are not more than 3% of the UK population. The percentage corresponds to the patients who are lucky enough to have been diagnosed, which is a few compared to patients who have no clue this mental phobia exists but are living with it.2
The phobia does present itself as a spectrum of fear. The impact is dependent on how the patient feels about the doctor and the hospital/clinic environment. However, the avoidance behaviour makes it difficult to justify the level of severity that is iatrophobia.2
Iatrophobia is not diagnosed enough nor talked about in the community. The individual that is not yet diagnosed can be harsh on themselves when they do not know that iatrophobia is a legitimate phobia. 2
Covid-19 does raise awareness of iatrophobia being diagnosed. GP appointments have higher cancellations as many communities do not trust hospitals or the GP office.
What can I expect if I have iatrophobia?
People with iatrophobia are going and getting examined by doctors. The phobia begins to develop when it is affecting a patient who imperatively needs to know and be aware of their disease and condition progression.2
Dealing with an unknown traumatic experience is the cause of persistent phobias. The psychology of a patient with iatrophobia not acknowledging their treatment and management plans can result in life-threatening illnesses depending on the severity of the disease and condition.2
The trick is finding the coping mechanism with iatrophobia’s symptoms, such as reducing stress levels to get better.2
For people who are diagnosed with iatrophobia, educating themselves with the support of a GP and psychologist can ameliorate their mental health and begin practising methods that stress, being relieved from trauma and working towards a healthy relationship with medical environments and healthcare professionals.2
To ease the tension and recover from the trauma, meditating and engaging in heavy workouts are recommended to be focused when wanting to control the trauma.2
When should I seek help?
You should contact the GP when experiencing a panic attack and when the anxiety your sleep; that indicates that the trauma is severe enough such that it is not possible to shut the anxiety down.
All researchers' opening statements share that it is imperative for individuals to be exposed to the knowledge of the unwillingness to visit the GP or delay the treatment of a serious disease, and that is iatrophobia.
- Hollander MAG, Greene MG. A conceptual framework for understanding iatrophobia. Patient Education and Counseling [Internet]. 2019 Nov 1 [cited 2023 Jul 9];102(11):2091–6. Available from: https://www.sciencedirect.com/science/article/pii/S0738399118305391
- Murphy N. CPD Online College. 2022 [cited 2023 Jul 9]. What is Iatrophobia | Risk factors, triggers, symptoms, treatment. Available from: https://cpdonline.co.uk/knowledge-base/mental-health/iatrophobia/
- Cassano GB, Rossi NB, Pini S. Psychopharmacology of anxiety disorders. Dialogues Clin Neurosci [Internet]. 2002 Sep [cited 2023 Jul 9];4(3):271–85. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181684/
- Pioli MR, Ritter AM, de Faria AP, Modolo R. White coat syndrome and its variations: differences and clinical impact. Integr Blood Press Control [Internet]. 2018 Nov 8 [cited 2023 Jul 9];11:73–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233698/