For some, just seeing a needle is more than they can bear. Needle phobia, or trypanophobia, can elicit in certain patients what’s described as a vasovagal response when they spy that (sometimes) long, thin, metal, pinpoint — well, you get the idea — needle: The person’s heart rate and blood pressure spike, then both vitals fall rapidly, which may cause a patient to lose consciousness.
In some cases, “people faint when they see a needle or syringe,” says Martha Barnard, a behavioral psychologist and a professor of pediatrics at the University of Kansas School of Medicine.
Though most experts say that some mild level of fear or aversion to needles is common — who, after all, actually wants to get stuck? — there’s debate about the prevalence of full-blown needle phobia, and little research on the subject. One still-referenced pioneering clinical review on the fear of needles published in The Journal of Family Pratice, however, estimated that needle phobia affects at least 10 percent of the population; the phobia was first added to the American Psychiatric Association’s Diagnostic and Statistical Manual in 1994. As the review posited then, some experts say it’s still an under-diagnosed condition, because many who fear needles avoid getting medical treatment.
[Read: Living With a Food Phobia.]
Whether a person simply has a strong aversion, anxiety-provoking fear or diagnosed phobia of needles, health professionals today say that point remains: Many, from parents not taking children in to get vaccines, to kids and adults with diabetes refusing to check blood-sugar or inject insulin needed to prevent serious complications, and others bypassing routine medical appointments, potentially miss out on needed care as a result. Barnard, who sees mainly children up to young adults, says she recently worked with a child with Type 2 diabetes who had a fear of needles. “He needed to be taking insulin, and he was avoiding it like the plague.” She says that’s indicative of the larger issue, as patients who have a fear of needles “avoid a lot of good health care.”
Both kids and adults can be fearful of needles, and there are ways to address the issue, including therapy to treat needle phobia. To come to that diagnosis, the fear must rise to the level of getting in the way of important activities in a person’s life, or cause “functional impairment,” and be accompanied by avoidance, like that person who just won’t go to the doctor or inject insulin, no matter the cost to his or her health, to avoid needles, says Addie Fortmann, a clinical health psychologist and manager of Diabetes Care Line Research at Scripps Whittier Diabetes Institute in San Diego. “So they don’t go near it.” She adds that needles must elicit a physiological arousal in that person akin to a fight-or-flight response: “racing heartbeat, blood pressure might be going up, you might feel flush, you might feel tingly, have shortness of breath or rapid breathing [and] muscle tension — those sorts of things,” Fortmann says.
There’s much misconception surrounding a fear of needles, though, she says, with some who simply have the exceedingly common aversion to getting pricked, erroneously thinking that constitutes a phobia. In other cases, people may be more concerned about what they learn as a result of a needle prick — like if they expect a blood glucose reading to be high, and would rather avoid taking the reading — instead of the actual needle itself, she says.
[See: Got Diabetes? Why You Must Protect Your Feet.]
But for those with a diagnosed needle phobia — which Fortmann describes as rare, while some other experts describe it as common — psychological treatment may help. She says the most evidenced-based phobia treatment is exposure therapy. “You expose the person to the feared stimulus over and over and over again, until they kind of become desensitized to it, and it doesn’t evoke quite the fear response as it initially did,” Fortmann says. “So you would treat a needle phobia no differently than any other phobia — if it truly is a diagnosable needle phobia.”
A fear of needles is believed to be both genetic and learned. “Parents might have their own needle phobia, and when they know their child’s getting stuck, they might get anxious for their child,” explains Stacey Berry, a psychologist at St. Louis Children’s Hospital. So it’s important parents understand their own state of mind and check their own fears and reactions — with help if needed — so as not to pass on fears that could make a child more reluctant to go back to the doctor’s office; that, in turn, can make it less likely some parents will comply with recommended care, including immunizations, she says.
Those who do go through desensitization therapy are encouraged to take things at their own pace. “They come in and they’ve got to learn that they can trust me, No. 1. I’m not going to let them get hurt,” Barnard says of patients she treats for needle phobia. That might start with the patient holding a syringe; Barnard holds it, at first, if that’s too much to handle. Then they move on to being exposed to a larger syringe, then small needles — like an insulin needle — then larger needles. “Eventually, I will have them maybe even give an injection to something else,” she says, such as a stuffed animal or an orange. “With kids it may take up to six sessions” for patients to overcome their fear of needles, Barnard says; adults typically progress faster than children, she adds, though sometimes it may take them longer.
Experts say even with milder fears, it’s important that providers and parents offer empathy and are patient, and that each person comes to grips with a needle fear on his or her own terms and timetable. That might mean a mother breast-feeding or holding an infant, while the child gets an injection to sooth the baby and feel more in control as a parent, too, Berry says.
[See: How to Find the Best Mental Health Professional for You.]
It could be as simple as talking to a doctor about applying numbing topical cream first to diminish the discomfort of an injection; or, Fortmann says, taking advantage of technology that lessens the need for needle pricks, like continuous glucose monitoring for patients. For a patient with diabetes, or another condition that may require becoming more comfortable with needle sticks, joining a patient education or support group can also help. “We as providers can tell them all these stories, but if they talk to somebody who’s been through it, and has succeeded, that’s the most powerful force,” Fortmann says.
Even very basic, simple techniques, like momentary distraction — such as for a child getting an immunization — can help lessen the fearful response. Rubbing the skin a little before, during and after around the injection site (though not right on it after the injection) can create a competing sensation, Berry says, that may help reduce the perceived discomfort. Whatever works best, experts say, patients, parents and providers should be thoughtful in their approach, rather than rushing to simply get an injection done, so as to prevent a traumatizing experience that could cause a child — or adult — to be fearful of getting stuck later.
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Stuck: Is a Fear of Needles Causing You to Avoid Needed Care? originally appeared on usnews.com
