Overcoming Injection Anxiety
Worried about your shot? Here’s how to handle it like a pro
Whether it’s for a vaccine or a blood test, getting stuck with a needle is never fun. But for some, the mere idea of a shot in the arm can cause serious anxiety, making the process nearly impossible to get through.
Immunizations, and the injections that come with them, are important tools for keeping us healthy. And with the prospect of a dangerous COVID-19 surge over the next several months, they’re now more critical than ever — and so is overcoming injection anxiety.
While most children have needle anxiety, they tend to grow out of it; by young adulthood, only 20 to 30 percent are still afraid. Still, needle fear — which can run the gamut from a vague sense of unease to a full-blown panic attack — remains a deterrent for many. Some 16 percent of adults avoid their yearly flu vaccine because of it.
“Often, needle phobias are accompanied by procedural phobias,” says Beth Salcedo, M.D., a psychiatrist and medical director of the Ross Center in Washington, DC. “That can lead to people not getting treatment for very serious conditions, or avoiding preventive measures, like immunizations, because they’re so afraid.”
Pain, or fear of pain, is often the main motive behind people’s dread of needles. Perhaps a bad experience with vaccinations in childhood left a negative impression. But whatever the underlying cause, fear and anxiety can intensify pain, reinforcing that negative view.
People with a needle phobia, known as trypanophobia, worry about having panic symptoms, such as dizziness and fainting. “It makes a lot of people feel like they’re either going to faint or die or something horrible is going to happen,” says Dr. Salcedo. “It’s not so much just the needle they want to avoid, it’s everything around it.”
Luckily, there are ways to cope. Whether needles cause you minor jitters or high anxiety, these tips can help you get through the process.
Before a Shot
Before you even set foot in the doctor’s office or pharmacy for a shot, you can prepare yourself to have a positive experience.
- Numb the injection area. An over-the-counter topical anesthetic, such as an ointment containing lidocaine, can block pain signals to your skin. These pain-relieving creams take time to work, so ask your doctor or pharmacist how long before a shot you should rub it on. Another option is a cooling spray, or vapocoolant, which can reduce the sensitivity of nerve endings. Apply it to the injection site immediately before your shot.
- Practice mindfulness meditation. When you’re worried about something, the tendency is to hyperfocus on it, says Dr. Salcedo. And that can intensify negative feelings. Mindfulness meditation helps redirect your attention to the here and now — and away from that future shot. “For someone who has a significant fear of needles, practicing mindful meditation is good for a lot of different reasons,” says Dr. Salcedo. Many hospital systems offer Mindfulness-Based Stress Reduction, or MBSR. This eight-week course has been shown to reduce anxiety, depression, and chronic pain. Ask your doctor if such a program might be available to you. Or get started now by downloading a free mindfulness meditation app, such as Insight Timer or Smiling Mind. Whichever method you choose, understand that for mindfulness meditation to be effective, you should practice it on a regular basis.
- Tell your health care professional. Letting the doctor, nurse or pharmacist know helps them help you. They can use a smaller needle or a numbing agent, for example.
During the Shot
The shot itself takes only a few seconds, but setting it up may take longer. And that’s when your fears can get the best of you.
- Distract yourself. There are lots of ways to keep your mind occupied while you wait. Listen to your favorite music. (Classical can be soothing.) Cue up an engaging podcast or a funny video on your smartphone. Look through a kaleidoscope. Or play mind games — count backward from 100, recite the alphabet in reverse, think of a fruit or vegetable that starts with each letter of the alphabet.
- Don’t look at the needle. For some, it helps to not know when the shot goes in.
- Take deep, slow breaths. “Diaphragmatic breathing can be both anxiety reducing and help redirect your attention,” says Dr. Salcedo.
- Relax your muscles. This can make the shot less painful.
- Squeeze and release your muscles. Have you ever fainted before or during your shot? One technique to prevent that is to tense your muscles in sequence or squeeze a ball until the procedure is finished.
After the Shot
It’s not uncommon to have mild side effects from vaccinations. Here are some post-procedure recommendations from the Centers for Disease Control and Prevention:
- Move your arm around gently. This can help reduce any pain or swelling in the vaccine arm.
- Put a cool, wet washcloth on the injection site. This can help reduce soreness from the injection.
- Take an over-the-counter non-aspirin pain reliever. Some vaccines may cause soreness at the injection site, or general muscle aches. Ask your doctor or pharmacist if it’s okay to take a nonprescription pain reliever, such as acetaminophen (Tylenol).
If you have a true needle phobia, you may need professional help, says Dr. Salcedo, a board member of the Anxiety and Depression Association of America. A trained mental health professional can develop a plan to help you overcome your fear.
“How you think affects how you feel and how you act,” says Dr. Salcedo. That’s why treatment for any phobia often includes cognitive behavioral therapy (CBT), aimed at helping you challenge and reset your negative thinking.
CBT typically lasts over several weeks. A trained professional will identify your negative beliefs, teach you relaxation techniques, and then gradually expose you to your fear. “It’s a structured hierarchy, where we take the least fearful things and you desensitize the anxiety around those. Then you go up the hierarchy as you master each level,” Dr. Salcedo explains.
For needle anxiety, a CBT exposure challenge might include these steps:
- Thinking about getting an injection.
- Listening to someone else talk about getting an injection.
- Watching someone you know get an injection (or a YouTube video of the process).
- Holding and touching a needle.
- Giving an injection to an orange.
- Practicing giving yourself an injection.
During each of these increasingly stressful challenges, you’ll manage your anxiety by using the relaxation techniques you learned. In this manner, Dr. Salcedo says, you slowly become desensitized to the anxiety of what’s about to happen.
Vaccines themselves don’t safeguard your health; vaccinations do. comfortable getting the shots you need.
The information in this story is accurate as of press time and posting. To limit the spread of the coronavirus, it’s important to continue practicing social distancing (keeping at least 6 feet away from people outside your household) and washing your hands frequently. You should also be appropriately masked any time you’ll be in public. According to the CDC’s latest guidance means layering a disposable surgical mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDC, WHO, and their local public health department.