FlourishAnyway is an Industrial/Organizational Psychologist and parent with an interest in DIY and health topics.
How a Phobia Can Jeopardize Your Health
Imagine being so fearful that you'd rather die than get stuck with a needle. No matter how hard you try, panic and a racing heart take control and make you want to bolt.
That is exactly what my brother-in-law faces with his needle phobia. His fear is so intense that it prevents him from getting the medical treatment he needs.
He has a common genetic disorder called hemochromatosis, which causes his body to build up toxic levels of iron.1 Regular blood donations would prevent continued storage of excess iron in his liver, heart, and pancreas. Controlled bloodletting would thus reduce the associated risks of persistent iron overload, significantly decreasing his risks of cancer, heart arrhythmias, and cirrhosis.
Easy choice, right? Ditch the extra iron by toughing it out with the needle. However, his fear of needles outweighs his fear of dying.
That's the irrational part about phobias.
Symptoms of Phobias
A phobia is an irrational fear of an object or situation that poses objectively little danger.
People with phobias experience the following symptoms, according to the American Psychiatric Association (APA):2
- feelings of terror, dread, panic, or horror
- automatic and uncontrollable reactions to a feared object or situation
- recognition that one's fear is disproportionate, considering the actual level of danger
- fast heartbeat
- shortness of breath
- trembling and
- an intense desire to escape the feared situation or object.
How a Phobia Develops
A Blood-Injection-Injury (BII) phobia involves fearing the sight, smells, pain, or even the thoughts connected with injections, injuries, or invasive medical/dental procedures.
This phobia is more prevalent among females, young people, and those in lower income brackets.3 It typically involves a genetic predisposition as well as learned fear.
Learning to Be Afraid
Typically, a person acquires their Blood-Injection-Injury phobia after one of the following occurs:
- a negative experience, such as a blood draw involving repeated needle pricks (i.e., because the phlebotomist could not find a good vein).
- having a panic attack in a specific situation, such as during a dental procedure.
- seeing something traumatic happen to someone else, such as a bloody car accident.
- observing a parent, sibling, or another person who was very scared of needles, or
- learning about something bad happening, such as neighborhood kids playing with contaminated drug syringes.
Read More From Youmemindbody
Early Onset, Long-Term Impacts
Phobias are the most prevalent type of anxiety disorder. The average age of onset for a person with a Blood-Injection-Injury phobia is between eight and nine years old.4
Although this phobia responds well to therapy, people often do not seek help, preferring instead to avoid medical and related settings. Unfortunately, however, if the phobia persists until adulthood, there is only a 20% likelihood that the person will achieve full recovery.5
Medical phobias interfere with normal functioning when individuals avoid activities such as the following because of their medical fears:
- obtaining routine vaccinations, sick care, and surgeries
- planning a family or
- taking a child, parent, significant other, or pet to the doctor.
Students who are training to be nurses and physicians may even struggle with squeamishness in response to needles, blood, and wounds.6 However, with repeated exposure, they are typically able to overcome their fears.
When Should I Seek Help for a Medical Phobia?
Phobias are the most common type of anxiety disorder, and often they do not interfere much with an individual's lifestyle. However, medical phobias are different. You may be able to avoid the annual flu shot, but sooner or later we will all need medical treatment.
Consider seeking treatment for your Blood-Injection-Injury fears if:
- Your level of fear or distress is excessive, unreasonable, and out of proportion to the level of real danger that exists.
- Your level of anxiety creates panic and disabling fear.
- You avoid medical treatment because of your fear (e.g., vaccines, check-ups, blood tests, or treatment for a health problem).
- Your avoidance creates significant distress or interferes with your normal routine.
- You have struggled with your fear-related symptoms for six months or more.
Medical Phobias Are Different From Most Other Types
Medical phobias are different from other phobias in several respects:
Risk to Health
Continuing to avoid the object of one's fears—medical treatment—can potentially lead to one's demise. You cannot necessarily say that about most other fears (e.g., the fear of clowns, heights, or dogs).
Blood-injection-injury phobias are the only type of phobias where fainting can occur. People with medical phobias have typically inherited a tendency to faint in response to fear, something called a vasovagal reflex.7When presented with what scares them, people with medical phobias experience a racing heart, followed by a quick drop in blood pressure. This produces dizziness, nausea, ringing in the ears, and fainting.
Up to half of people with a needle phobia and up to 75% of those with a blood phobia tend to respond by fainting.8 There have been rare documented cases of people dying as a result of vasovagal fainting following needle sticks.
Role of Disgust
Most phobias are considered fear disorders. However, psychological research within the last two decades suggests that both a fear of spiders and a fear of blood-injection-injury may actually be "disgust disorders."
People who experience these phobias are more disgust sensitive than others. These two phobias, particularly blood-injection-injury phobias, are driven at least in part by the emotion of disgust—the desire to escape contamination or infection.9
Medical Phobias: You Are Not Alone
Medical phobias are common, with up to 10% of the general population suffering from needle and injection phobia alone.10 Another 10% of people display a fear of needles/injections that falls short of a full-blown phobia.11
One research study of 1,500 people found that 19.5% of healthy adults and 30.1% of patients with chronic illness reported a fear of blood and/or injury from injections.12
Medical phobias are a special hazard for people who already suffer from chronic illnesses. Unfortunately, self-injections, blood tests, and invasive medical procedures are a normal part of diagnosing and treating many such illnesses. Examples of chronic illnesses include rheumatoid arthritis, multiple sclerosis, diabetes, and chronic renal failure.
When it comes to self-injected medications, pain and fear of needles are the two major reasons for non-compliance with doctor's orders. Up to half of all prescribed medications are not taken as directed, and 20% of prescriptions are not even filled.13
Examples of Blood-Injection-Injury Phobias
Medical phobias include a variety of subtypes:
Hemophobia: Fear of blood.
Trypanophobia: Fear of needles and injections. Approximately 80% of people with a needle phobia report having a first-degree relative with the same phobia.
Tomophobia: Fear of surgery and invasive medical interventions.
Dental Phobia: Fear of the dentist includes fear of extractions, receiving anesthetic injections, and fillings. People with this fear tend to have poorer dental health compared to those without the phobia. They also suffer greater interference with sleep patterns, lower levels of energy, often avoid certain foods and have poorer social relationships.
Iatrophobia: Fear of doctors. People who fear doctors could have some reason to distrust them. In a 2011 survey of 1,900 physicians, doctors admitted to the following behaviors within the previous year:
- 11%—lying to a patient or a patient's guardian
- 20%—not fully disclosing a mistake because of fear of a lawsuit
- 55%—describing a patient’s prognosis in a more positive manner than warranted.14
Leeches and Maggots in Medicine: Don't Try This at Home
If you're afraid of needles, what about an alternative therapy? Say, something that wriggles, squirms and sucks your blood . . . or eats you alive?
Leeches and maggots became approved as medical devices by the US Food and Drug Administration (FDA) in 2004. Under US law, a medical device is any non-pharmacological item that is intended to diagnose, treat, cure, prevent, or alleviate a disease or medical condition.
Hirudotherapy, or the use of medicinal leeches for bloodletting, has been practiced since ancient times.
Leech saliva is comprised of more than 30 various proteins that together numb pain, decrease swelling, and keep blood flowing. Leeches, therefore, are used to alleviate blood clots, relieve pressure on veins, and treat some types of osteoarthritis.
Maggot debridement therapy uses live, sterilized maggots to remove dead tissue and kill bacteria.15 It was a popular form of treatment in the early 1900s before antibiotics became popular in the 1940s with the advent of penicillin.
Depending on the size of the wound, hundreds of maggots are applied for up to three days. The wound is then sealed with a special gauze dressing. Maggot therapy is used to help heal ulcers, gangrene, skin cancer, and burns.
5 Reasons to Donate Blood
Here are some facts from the American Red Cross:
- 1 pint of blood can save up to 3 lives.
- Less than 5% of the population donates blood, although more than 1 in 3 will require blood or blood products at some time in their lives.
- A trauma victim—someone who has been hurt in a fire or car accident, for example—can require as many as 100 pints of blood. That victim could be your friend, neighbor, or family member.
- Blood shortages would not exist if all eligible donors stepped up to donate blood (4 to 6 times per year).
- Blood donation provides men an added benefit because men are at increased risk for hemochromatosis, or iron overload. This is a potentially deadly condition. Simply by donating blood three times a year, they can reduce their iron overload and their risk for heart attack by as much as 50%.
1Mayo Clinic Staff. "Overview - Hemochromatosis - Mayo Clinic." Mayo Clinic. Accessed January 18, 2016. http://www.mayoclinic.org/diseases-conditions/hemochromatosis/home/ovc-20167289.
3Pull, Charles B. "Recent Trends in the Study of Specific Phobias." Curr Opin Psychiatry 21, no. 1 (2008): 43-50. http://www.medscape.com/viewarticle/568313.
4Beidel, Deborah C., and Candice A. Alfano. "Child Anxiety Disorders: A Guide to Research and Treatment, 2nd Edition." Google Books. Accessed September 5, 2013. http://books.google.com/books?id=MWF2TIoYqZwC&dq=average+age+of+onset+BII+phobia.
5Marcdante, Karen. "Nelson Essentials for Pediatrics: Anxiety and Phobias." Inkling for Web. Accessed September 5, 2013. https://www.inkling.com/read/nelsons-essentials-pediatrics-karen-marcdante-6th/chapter-17/anxiety-and-phobias.
6 Neurenbeurg, C. (2011, May 23). Afraid of needles? Why some faint at the very sight. Retrieved from http://bodyodd.nbcnews.com/_news/2011/05/23/6697692-afraid-of-needles-why-some-faint-at-the-very-sight.
7Helpguide.org. "Phobias and Fears: Symptoms, Treatment, and Self-Help." Last modified August, 2013. http://www.helpguide.org/mental/phobia_symptoms_types_treatment.htm.
8Nierengarten , Mary Beth. "Multispecialty." Medscape. Last modified March 17, 2009. http://www.medscape.com/viewarticle/589716.
9Çavuşoğlu, M, and G. Dirik. "Fear or disgust? The role of emotions in spider phobia and blood-injection-injury phobia." National Center for Biotechnology Information. Accessed September 5, 2013. http://www.ncbi.nlm.nih.gov/pubmed/21638233.
10Anxiety UK. "Injection Phobia and Needle Phobia: A Brief Guide." Last modified 2010. http://www.thesf.org.uk/documents/Emotional-Health/Needle-Phobia-web.pdf.
11Healthopedia. (2018). Trypanophobia: Fear of Needles and Injections - Causes, Symptoms and Treatment. Retrieved from https://www.healthtopia.net/disease/mental-health/phobia/trypanophobia-causes-symptoms-treatment.
12Kose, S, and A. Mandiracioglu. "Fear of blood/injection in healthy and unhealthy adults admitted to a teaching hospital." International Journal of Clinical Practice 61, no. 3 (2007): 453-7. Accessed September 3, 2013. http://www.ncbi.nlm.nih.gov/pubmed/17313613.
13 Fung, Brian. "The $289 Billion Cost of Medication Noncompliance, and What to Do About It." The Atlantic. Last modified September 11, 2012. http://www.theatlantic.com/health/archive/2012/09/the-289-billion-cost-of-medication-noncompliance-and-what-to-do-about-it/262222/.
14 LiveScience.com. "1 in 10 Doctors Admit Lying in the Past Year." Last modified February 8, 2012. http://www.livescience.com/18383-doctors-lie-patients.html.
15Youn, Anthony. "Gross, sure -- but maggots have medical benefits." CNN. Last modified September 12, 2012. http://www.cnn.com/2012/09/12/health/youn-maggot-therapy.
Some People Do This for a Living
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 FlourishAnyway
FlourishAnyway (author) from USA on January 01, 2019:
irreverence - My brother-in-law is now my ex-brother in law so I'm thankfully 100 percent divested of him and his decisions. (If it were my brother, we'd have an intense series of discussions.) The ex-brother-in-law still has toxic levels of iron in his blood from his untreated hemochromatosis. Extra iron is stored in the liver, heart, and pancreas and the condition can lead to life-threatening health problems such as liver disease, congestive heart failure or heart arrhythmias, and diabetes. Untreated hemochromatosis can eventually be fatal. Phobias can be addressed through psychotherapy, however. We all make choices. I hope that you have someone who can support and encourage you if you are facing something similar.
irreverence on January 01, 2019:
"Would you rather suffer this invasive, terrifying, exhausting, and painful medical procedure over and over again or die without going through that?" actually sounds like an incredibly difficult choice to make, so I'm on your brother's side. Death isn't always the worst thing in the world for someone with a phobia, because why fear death when there's so much scarier stuff while you're alive?
FlourishAnyway (author) from USA on September 28, 2018:
Subhas Mittra - I understand your perspective. Thanks for commenting.
Subhas Mittra on September 27, 2018:
I do agree with all you points, but still at times it is difficult to manage.
FlourishAnyway (author) from USA on January 07, 2017:
Syed Fahim Uddin - Being so fearful of blood, surgeries, injections, birth, and all, Syed, it's a good thing you are not 1) female and 2) in the medical profession, although there are people in that profession who have the phobia believe it or not. I do hope you seek the help you need if it interferes with your life. I wish you all the best.
Syed Fahim Uddin on January 07, 2017:
I was in normal mood going to bed i just saw a post on facebook which was related to C-Section there was a story about a younger couple i started taking some interest as i already knew i wouldn't be able to read anything about blood operations etc it's really horrible I can't even read, listen and talk about operations i can't see easily injections filled with blood i can't read even anything about surgeries, blood especially talking hearing and reading deeply about pregnancy giving birth I feel anxiety my heart beat gets slower sometimes my body temperature starts colder even in this stage i can't understand a person who talks about them now I have started feeling normal I hope I will read your complete article after reading a bit that post then instantly I just wanted to find my problem with little knowledge of this sort of phobia I got some clue on google while searching about this problem and when i found your article i knew that i wouldn't be able to read I always thought about my problem but i never tried to find anything about it now I'm a bit normal I'm hopeful I'm at right destination :)
FlourishAnyway (author) from USA on May 07, 2016:
rajan - Many people would agree with you. Thanks for stopping by to read.
Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on May 06, 2016:
Though I do not suffer from needle or injection phobia I just cannot stand the sight of blood welling up in a deep wound. Gives me wobbly legs.
FlourishAnyway (author) from USA on May 13, 2015:
Kelsey - Thanks for sharing your perspective on needs and injections. Dentists in particular seem to have it rough as a feared profession. I guess that's one reason to have excellent oral hygiene -- avoiding cavities. What a terrible feeling.
Kelsey Elise Farrell from Orange County, CA on May 13, 2015:
Very interesting hub--I'm terrified of shots and have been ever since I was little. To this day I cry at the mere thought of a needle plunging into my arm. Likewise, I am totally panicky over the dentist--too many noises and sharp objects for my liking. Voted up--thanks for posting!
FlourishAnyway (author) from USA on September 10, 2014:
VioletteRose - Very interesting! Thanks for sharing that.
VioletteRose from Atlanta on September 10, 2014:
Actually, I never cried while getting vaccinations even when I was so small and my mother was quite surprised. And now I see this in my toddler too, he doesn't cry for injections anymore. The interesting thing is that I am very sensitive to most of the things and I have phobias for blood, fire and also heights.
FlourishAnyway (author) from USA on September 10, 2014:
VioletteRose - Interesting that you prefer injections!
VioletteRose from Atlanta on September 10, 2014:
Interesting, I have hemophobia I think. But I am not at all concerned about injections and needles, in fact I prefer injections than taking other medicines.
FlourishAnyway (author) from USA on August 12, 2014:
ologsinquito - It certainly would. Maybe if we just didn't have to look at what was releasing the blood. Yuck. Thanks as always for reading, pinning, sharing.
ologsinquito from USA on August 12, 2014:
The fact that blood letting is making sort of a comeback, in some circles, is very interesting. Donating blood is probably a healthy thing to do, and it would be so much easier without those darn needles.
Pinned and shared.
FlourishAnyway (author) from USA on March 01, 2014:
Everyday Miracles - Bless your heart!
Becki Rizzuti from Indiana, USA on February 28, 2014:
I've actually tried that and been told that they don't have time to deal with me. Most of the time the nurses just give up on getting the blood, even though I'm consenting, just panicked. It seems that in the area where we're living right now they just /are not/ well trained.
FlourishAnyway (author) from USA on February 28, 2014:
Everyday Miracles - Oh I shuddered as I read your account! I feel a bit weak now. One thing I have learned is that the nurses in the pediatric department are good with problem veins. If things don't seem to be going well, remember you are a customer not just a patient. Demand that they stop their shaming and go get you someone who can work effectively on you and treat you respectfully. You're just a challenging case like some other folks (me).
Becki Rizzuti from Indiana, USA on February 28, 2014:
I am absolutely terrified of needles. Ordinarily I can handle injections, but anything that goes into the vein (blood draws and IVs) are terrible for me because my veins are difficult to stick and they tend to roll. This is made worse by the fact that very often the nurse will attempt to flush an IV line that hasn't been properly inserted (when I've already been stuck two or three times) and then insist on sticking me /again/. Most nurses refuse any sort of topical anesthetic to make me more comfortable, but it gets worse.
It gets MUCH worse.
In an incident a few years ago, when I was pregnant with my daughter, a nurse told me that "even a six year old could do it better" and "you've been through natural child birth, this is nothing!" She made fun of me and pointed out that they'd done several young children that day who weren't putting up as much of a fuss as I have.
This experience is, unfortunately, typical for me. I panic, cry, squirm, want to bolt, cannot seem to behave in a manner that is befitting of my age when it comes to needles, and the nurses typically badger or make fun of me. This badgering doesn't help my situation at all, and has contributed greatly to my fear.
FlourishAnyway (author) from USA on February 06, 2014:
Brian - Thanks for the kind compliments!
I certainly know what you're talking about having a hunch that fears came from somewhere deeper, more remote and removed. There's new research about some types of phobias being passed down from ancestors via DNA, thus not requiring descendants to have direct experience with the object to fear it. Needles are not my thing either. I once told a nurse who was having trouble with drawing my blood that on the third stick I start to cry. (She kept on commenting on my allegedly hard-to-find veins, and it felt like she was probing for them under the skin.) I think she doubted me, but when she did it a third time, I cried like a little girl who had her candy taken away -- LOUD. I was scaring other patients apparently. Must've been some real bad stuff somewhere in the way way back.
Eww, and I have stepped on a needle and it was completely lodged between two of my toes, going almost to the bone. Other than pain, there was no external evidence of a foreign object until after a week I couldn't wear a shoe. I had gone on a business trip and walked around downtown NYC in heels thinking nothing was wrong. Just recalling this makes me want to wear shoes while indoors.
Brian Prickril from Savannah, GA on February 06, 2014:
I find the crippling power of phobias to be quite fascinating. I have the worst fear of needles and injections and I can't explain it. I often wonder if it's a "past life" thing, if you believe in that. Even teeny-tiny little needles make my heart race and the blood drain from my head. I'm old enough now that I just tell the nurse about my phobia in advance. I like to think that if I knew where the fear originated from then I could overcome it. But I remains a mystery. Great hub. You're so thorough with your footnotes and additional reading. It's very professional.
FlourishAnyway (author) from USA on December 01, 2013:
Moonlake - Glad you got over that phobia. Sounds like you had no choice with all the hands-on assistance there was. Thanks for reading, commenting, and sharing.
moonlake from America on December 01, 2013:
Blood doesn't bother me to much. Shots I hated and one time I ran right out of the room and right outside. My mother and the doctor had to catch me. That was in the days when doctors were part of your family.
I'm ok with needles now. Voted up and pinned
FlourishAnyway (author) from USA on November 10, 2013:
Suzanne - Thanks again! I wish there were a way to let authors know you read it without having to comment. I read every new hub of every Hubber I follow.
FlourishAnyway (author) from USA on November 08, 2013:
Suzanne - Thanks for reading and commenting. The maggots really gave me the willies, too.
Suzanne Day from Melbourne, Victoria, Australia on November 08, 2013:
PS - Voted up of course! I vote on all your hubs that I read, I just don't write about it much....
Suzanne Day from Melbo