Overview
Trypanophobia is an extreme fear or phobia of needles.1 Although most people won’t come across needles on a day-to-day basis, it does have a significant impact on those affected. This phobia affects medical treatments the most. This includes vaccinations, injected medicines and blood tests.1
Extreme fears often lead to avoidance behaviours, and this could be problematic as people would end up avoiding medical treatment that they may need. Most recently, a fear of needles may have impacted people's decision whether to have the COVID-19 vaccine or not.1
Symptoms and causes
Usually, people experiencing trypanophobia experience anxiety, panic attacks, dizziness, heart palpitations and feeling faint when needles are involved.1 These symptoms can arise in different situations, most commonly when a medical procedure with a needle is required. However, it can also be caused by seeing, thinking or talking about needles.1
Trypanophobia can affect anyone. However, statistics show that it is more common in those assigned females at birth (AFAB) and even medical students.1 Also, people are more likely to develop this phobia if someone else in their family has it. This is why it is especially important to look at how to prevent this phobia in children if it can be avoided.1
Often, phobias are a result of a traumatic event that involves the fear object, in this case, needles. There are two main ways to deal with trypanophobia. During an experience involving a needle, relaxation techniques such as deep breathing have been somewhat effective.1 The second is different types of cognitive therapy, which can be accompanied by anti-anxiety medication.1
Understanding trypanophobia
There are a few factors that contribute to the cause of trypanophobia. Firstly, statistics show that some people are more likely to have trypanophobia. This includes AFABs, medical students, people with traumatic childhood experiences, and those who have family members with trypanophobia.1 People who have repeated contact with needles may also be more likely to develop an extreme fear of them; however, this is not always the case.1 There are also different aspects of this phobia, such as the pain of an injection, the sight of it, a previously bad experience or even a fear of being restrained.3
To understand trypanophobia, it is important to look at how a fear becomes a phobia. Fear is often associated with a previous unpleasant event. In this case, a medical procedure where an injection was uncomfortable or painful.2 In children, this can be quite scary, and a normal feeling of anxiety may arise. However, this fear can continue into adulthood and increase in its severity. Once a fear becomes more severe, stronger feelings of anxiety and panic attacks may arise in situations involving needles.2 This fear has now transitioned into a phobia, and commonly, people try to avoid any triggers of their phobia. Therefore, people may opt out of vital medical procedures that require a needle.2
Impact on individuals
The main concern of trypanophobia is that some individuals may avoid necessary medical procedures because needles are involved.1 This includes people choosing not to have a vaccination or avoid seeing a doctor as it may require a blood test.1
Furthermore, there might also be social implications. Phobias can sometimes feel embarrassing but it is important to remember that a phobia is a very real fear that causes an emotional and physical response that can often be quite traumatic itself. A phobia isn’t a choice and can impact individuals differently.2
Identifying trypanophobia
Phobias are classified as mental health disorders and, therefore, follow the DSM criteria. This criteria is a list of features that a professional will use to determine whether you have this type of phobia.3 If you think you may have trypanophobia and it is negatively impacting you, it is best to seek professional advice. In order to identify trypanophobia you may ask some questions to determine the severity of this fear. This includes how long it has been going on, what the symptoms are like and how it impacts your life.3
Coping with trypanophobia
Phobias are difficult to treat by yourself so normally it is recommended to see a therapist who will be able to provide a variety of therapies to help treat this phobia.5 The most common method used to deal with trypanophobia is different types of talking therapies. However, medications can be used alongside therapy. The main two types of talking therapy are exposure therapy and cognitive behavioural therapy (CBT).6 There are also other types, including ego-state therapy.5
- Exposure therapy: This is where you are gradually exposed to an increasing severity of the stimuli. In this case, it may start off with a video of an injection. Then, see it in real life and end with an injection to yourself. The number of steps will depend on your specific needs and the severity of the phobia6
- Cognitive behavioural therapy (CBT): CBT also uses gradual exposure to needles. However, they use other methods like relaxation techniques and ways to challenge your worries as well. During this process, you should eventually become desensitised to needles6
- Medications: Although medications don’t treat the underlying cause of phobias, they can be used to reduce the symptoms associated with trypanophobia
- Feelings of anxiety and panic can be treated using beta blockers.6 Beta-blockers rescue the physiological effects that anxiety and panic cause, such as heart palpitations and shaking
- Sedatives like benzodiazepines could be used to reduce anxiety.6 Alternatively, short-term medication like numbing creams could be used if the underlying cause of the phobia is the pain aspect.6 Using distractions may help, too.8
- Procedual mitigations: Certain methods can be done during a procedure with a needle. For example, using numbing cream to reduce any pain or using psychological distractions to deliver your attention away from the needle, with the aim to reduce your anxiety about it.
The most important thing you can do to help your phobia is talk about it and get help so that you're not dealing with it alone. This includes medical professionals but also your family and friends.4
Preventing trypanophobia in children
Research indicates that children are more likely to develop trypanophobia if someone else in their family has it or if they have a traumatic experience.1 To reduce the likelihood of this fear, developing new technology solutions could be used to make medical procedures with needles less scary.7 Easier ways to do this include understanding the fear behind the needle and the pain and managing these things up front to try and prevent any worry coming from unknown questions, especially for children.2 It is also important, as a parent, to reassure your child and try to be calm so that your child can learn from you that needles don't have to be a scary thing.8
Summary
Trypanophobia is the fear of needles that has escalated into a phobia. People can be afraid of different aspects of needles. For example, the pain of an injection, the sight of it or the fear of being controlled. Usually, this phobia is a result of a traumatic experience in childhood, either personally or by observing someone else. Anyone could be affected by trypanophobia; however, some people are more likely than others.
The most common treatments are talking therapies such as exposure therapy and CBT. This involves gradually exposing you to needles whilst learning relaxation techniques to help you manage your emotions and behaviour. Anti-anxiety medication may be prescribed to help deal with the physiological effects caused by anxiety and panic, as well as procedural mitigations to lower the stress of a situation involving a needle. A healthcare professional will be able to recommend the best treatment according to your specific circumstances and the severity of your phobia. It is also important to prevent trypanophobia at a young age because if it develops, it may result in people missing vital medical procedures. f your child is having a procedure with a needle, it is best to create a calm environment with lots of reassurance to help them understand that needles don't need to be scary.
References
- Jha A, Holla R, Satish KP, Kundolil FS, Goel P, Jaiswal S, et al. Trypanophobia among medical students - An overlooked concern. Clinical Epidemiology and Global Health [Internet]. 2023 Mar 1 [cited 2023 Aug 8];20:101257. Available from: https://www.sciencedirect.com/science/article/pii/S2213398423000441
- CDC. Centers for Disease Control and Prevention. 2023 [cited 2023 Aug 8]. Needle fears and phobia. Available from: https://www.cdc.gov/childrensmentalhealth/features/needle-fears-and-phobia.html
- Cleveland Clinic [Internet]. [cited 2023 Aug 8]. Trypanophobia (Fear of needles): symptoms & treatment. Available from: https://my.clevelandclinic.org/health/diseases/22731-trypanophobia-fear-of-needles
- Andrews GJ. ‘I had to go to the hospital and it was freaking me out’: Needle phobic encounter space. Health & Place [Internet]. 2011 Jul 1 [cited 2023 Aug 8];17(4):875–84. Available from: https://www.sciencedirect.com/science/article/pii/S1353829211000773
- Daharnis D, Ifdil I, Amalianita B, Zola N, Putri YE. The effectiveness of ego-state therapy in reducing trypanophobia. Addictive Disorders & Their Treatment [Internet]. 2021 Mar [cited 2023 Aug 10];20(1):61. Available from: https://journals.lww.com/addictiondisorders/Abstract/2021/03000/The_Effectiveness_of_Ego_state_Therapy_in_Reducing.8.aspx
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders [Internet]. DSM-5-TR. American Psychiatric Association Publishing; 2022 [cited 2023 Aug 10]. Available from: https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
- Sajid MI, Ahmed AS, Baig MA, Nasir N, Mian AI. A low-cost low-tech solution to lessen the fear of needles in children. Pediatr Res [Internet]. 2021 Feb [cited 2023 Aug 10];89(3):394–5. Available from: https://www.nature.com/articles/s41390-020-01178-8
- 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 Nurs [Internet]. 2018 Mar 14 [cited 2023 Aug 11];4:2377960818759442. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774419/