When Maryam Bami, 29, was in college, she was hospitalized with a bad case of the flu. Bami has been afraid of needles for as long as she can remember, so when the doctors said they had to give her an injection, she was terrified. “I called an ex-boyfriend I wasn’t speaking with, and asked him to come to the hospital to hold my hand as they administered a shot in my butt,” Bami says. Not one of her finer moments, she admits, but she didn’t know what else to do.
Throughout her 20s, Bami continued to avoid needles at all costs. She couldn’t bring herself to finish the Gardasil vaccine, which is administered in a series of three separate shots to help prevent HPV infection. “I got one, and then would just blow off the appointments because I wouldn’t want to do it,” Bami says.
Bami’s contentious relationship with needles is all too common. A recent review published in the Journal of Advanced Nursing found that the majority of children are afraid of needles, and an estimated 20-50 percent of adolescents and 20-30 percent of young adults also exhibit this fear. Fear typically decreases with age, and that’s likely a result of exposure, says Amanda M. Spray, PhD, clinical assistant professor in the department of psychiatry at NYU Langone Health in New York. Over time, as we get vaccines and have blood drawn and see that nothing bad happens, we chip away at that fear a little more, she says.
Let’s be honest: Most people don’t enjoy needles, says Ashley Brown, clinical fellow in psychology at UNC Health Care. “But there’s a pretty wide continuum, from getting a little anxious, all the way up to avoiding the care you need because you’re so fearful,” Brown says. As Bami knows firsthand, being afraid of needles can keep people from giving blood, getting vaccinated, and undergoing important medical procedures they need.
What causes fear of needles, anyway?
There are a lot of theories, says Dr. Spray. “Sometimes, there’s a negative event early in life and that can lead to intense far.” There also may be an adaptive component—it’s probably good to be fearful of a sharp object coming your way from a stranger, she says. “The goal is that over time, as you go to get shots or blood drawn, you learn it’s not something you have to be fearful of. But sometimes that doesn’t happen,” says Dr. Spray. A particularly traumatic experience or messages from family members and the media that tell us needles are scary can exacerbate that fear.
For some, it’s about loss of control
Bami can’t pinpoint when or how her fear of needles started—”I’d have to do a lot of therapy to think back on that,” she says—but she guesses that at its essence, it’s a fear of loss of control. “I have a lot of anxiety over everything, and I feel like I have to control every situation. But I can’t control what’s being injected into me or how my body reacts,” she says. Brown notes that loss of control is generally an underlying explanation for many anxieties and fears, including fear of needles.
Being restrained can make things worse
Speaking of loss of control: Brown says that being held down for shots or blood work as a kid increases the risk that person will develop a needle phobia. “Restraining of children is definitely not good, I do not recommended that,” she says. “It’s a complete loss of control, and then something kind of painful happens.” For kids, this may feel traumatic enough for them to develop a deep-seated fear with real staying power.
There’s a difference between moderate fear and a phobia
“A phobia is diagnosed when you actively avoid injections or blood draws because it’s so anxiety-provoking for you, or you endure it with intense fear or anxiety,” says Dr. Spray. Mental health professionals typically diagnose a phobia if it’s causing significant distress is someone’s life, she adds. “For example, if someone is anxious for days beforehand, can’t sleep the night before, or if they’re avoiding the doctor.” These behaviors go beyond a little anxiety or nervousness, and can have serious health implications. “The biggest consequence of these fears, especially when they rise to the level of a phobia, is avoidance of the doctor and avoidance of vaccinations,” says Dr. Spray. (An extreme fear of medical procedures involving injections or the drawing of blood is known as trypanophobia, while a fear of sharp objects in general is called aichmophobia.)
In 2016, Bami was forced to face her fears
In August of 2016, Bami says she felt a numbing sensation in her legs after an indoor cycling class. Over the next few months, she was in and out of the hospital, taking a battery of tests—including a spinal tap, which she says she lost sleep over anticipating—ultimately leading to a multiple sclerosis diagnosis in November 2016. Being afraid of needles was no longer an option. “At this point, I couldn’t walk, I couldn’t use my hands, and it felt like someone was choking me at all times,” she says. “I knew I couldn’t live the rest of my life like that, and I needed to get over my fear and power through.”
She also got her doctors on board and credits her care team for helping her manage her fear. When she had her spinal tap, for example, her doctors knew she wouldn’t be able to handle it so they sedated her beforehand.
For many people, therapy is effective for overcoming needle phobia
Exposure therapy, a form of cognitive behavioral therapy, is effective in helping people overcome phobias, Dr. Spray says. “This can be accomplished in as little as six to eight sessions, but it is usually closer to 12,” she says. Your therapist will help you establish a hierarchy of fear-inducing activities—everything from walking by a blood bank, to watching a video of someone getting a vaccine, to actually giving blood or getting a shot yourself. Then, they’ll help you work on gradually exposing yourself to those feared situations, starting with the mildly to moderately scary, and working up, Dr. Spray explains. “Sometimes this starts with the therapist joining, but most of this happens between sessions,” she says.
There’s a breathing technique you can learn if needles make you woozy
Fear of needles can cause a physiological reaction in some people that makes them feel lightheaded, dizzy, and in some cases, causes them to actually faint. This response, called vasovagal syncope, occurs when your body overreacts to certain triggers and your blood pressure and heart rate drop suddenly. “This leads to reduced blood flow in the brain, and fainting can occur,” says Dr. Spray. If this happens to you, your therapist can also teach you something called applied tension, “a physical technique where you tense up the muscles, which raises one’s blood pressure, to combat the vasovagal response,” Dr. Spray explains. By using it when you start to feel faint, you can stop full-fledged vasovagal syncope from happening.
Finding a way to make the experience positive can help
When Bami had to start facing her fear head-on to figure out her diagnosis, she turned to one thing in particular to calm her down before a needle encounter: watching her favorite music video by her idol, Reba McIntyre. “The Fancy music video is very long and drawn out, very cinematic. I’d watch it whenever they did an IV or blood draw when they were trying to diagnose me,” she says. While she was still freaked out, she says it helped to keep her mind occupied by something that brought her joy.
Dr. Spray says that instead of thinking about distracting yourself, think more about finding something positive you can associate with the experience. Basically, find your own Reba, and do it before and/or during. Adding a positive element to the situation can help soften it and make you realize there’s nothing to be afraid of, says Dr. Spray.
You can also reward yourself for facing your fear
“We are more likely to engage in a behavior when there’s a clear reward,” says Dr. Spray. “There’s no instant gratification from getting one flu shot or having your lipids tested for high cholesterol.” By establishing a clear, immediate reward, you may be able to willingly face your source of anxiety and fear. Everybody’s rewards are going to be different, so pick something that’s enticing to you. Maybe it’s treating yourself to your favorite latte afterward, or meeting a friend for lunch. Whatever it is, telling yourself you’ll get X reward after can be motivation to face those uncomfortable feelings.
Before heading into a shot or blood draw, practice deep breathing
For people who just get really nervous or anxious around needles, employing relaxation techniques like deep breathing can help, says Brown. (The exception: If you experience dizziness or lightheadedness with needles, then the applied tension technique is better, she adds.) “Doing what you can to relax your body physiologically can make a difference in how you experience fear.” Specifically, it calms you down and minimizes the risk of hyperventilation, which is not only uncomfortable but also signals to your body that there is something to be afraid of, Brown says. “Breaths should be slow, and your abdomen should expand with each one.” Here’s more information on exactly how to breathe deeply to best calm anxiety.
If fear is keeping you from vaccines and other medical procedures, seek help
If you get anxious or moderately afraid around needles, deep breathing, positive associations, and rewards can help. But these tactics may not be so effective for someone who has a true phobia. Not everyone is going to be forced into exposure the way Bami was, but there are ways to expose yourself in a controlled way to effectively overcome your fear.
Both Dr. Spray and Brown encourage people who having a debilitating fear of needles to see a therapist. Treatments for phobias are extremely effective, and the process can be relatively quick, Dr. Spray says. Look for a therapist who specializes in cognitive behavioral therapy. And don’t forget to remind yourself that this fear is common, Brown says. You’re certainly not alone, but you also don’t have to live in fear forever.
As for Bami, she now gets her blood tested every month, and receives an IV treatment every 6 months to control her MS. “The progression from where I was in college to where I am now is like night and day,” she says, adding, incredulously, “I don’t even need Reba anymore.”