When the fear of needles paralyzes medical care

When I was a kid, my pediatrician was a friend of my parents who practiced out of a first floor office in his home across the street from ours. He was a wonderful man and doctor, I’m sure, but I was terrified of him because I associated him with the injections he gave me periodically. Even when he and his wife came to our house for dinner I hid–just in case he was carrying a hypodermic needle in his jacket pocket.

As an adult, I don’t love needles but they don’t bother me much. For 10% or more of people, though, fear of needles or trypanophobia is so severe it may interfere with their ability to receive appropriate or any medical and dental care. This phobia has been formally categorized in the DSM, the widely used manual of psychiatric disorders, since 1994.

In my practice, I have several patients who have this phobia. Often the fear is quite specific. Some people, for example, don’t find blood drawing nearly as difficult as getting a vaccine. Some don’t mind dental injections but can’t stand a shot in the arm.

Interestingly, I’ve been told that it’s not the pain of the needle, but the idea of the needle that’s petrifying. As with other phobias, people who have trypanophobia aren’t necessarily afraid of other things and may, in fact, be dare devils.

If you’re afraid of snakes or spiders or heights or elevators, you can avoid these things safely, though it might be inconvenient to do so. But it’s not healthy to avoid recommended vaccines to prevent infectious diseases or blood tests to screen for high cholesterol, diabetes, thyroid disease, anemia, and other conditions when medically indicated.

And even when people with severe fear of needles do agree to vaccines and blood tests, they may faint, vomit, or even have seizures during these procedures.

So how do you get proper medical care when you have this phobia? First, tell your doctor, nurse, or phlebotomist. In our office we frequently make special accommodations for trypanophobics: having them lie down, using extra-small needles, offering juice and snacks, bringing in a family member, and talking them through what can be a traumatic experience.

For some people, though, even those measures aren’t enough. Cognitive behavioral therapy, hypnosis, use of anesthetic cream such as EMLA may be helpful.

But the most important thing is not to avoid medical or dental care altogether because of fear of needles. It’s common, it’s nothing to be embarrassed about–and it’s treatable.

Suzanne Koven is an internal medicine physician who blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50

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