Your palms are sweaty, your heart is racing and your stomach is in knots: You’re about to get your blood drawn.
If the mere thought of needles has you feeling queasy, you’re not alone.
“These are not uncommon fears, a lot of people have them,” says Dr. Michele Bedard-Gilligan, a clinical psychologist at the UW Medical Center – Roosevelt Psychiatry Clinic and an associate professor in the Department of Psychiatry and Behavioral Sciences at UW School of Medicine.
While this fear is real, it doesn’t change the fact that you will need to get shots and your blood drawn in the future — whether it’s because of a vaccination, a health condition, a blood donation or a pregnancy.
The good news? It’s possible to overcome your fear of needles.
What causes the fear of needles?
Although your physical reaction to needles may be intense, it can be hard to put a finger on exactly why you get nervous about getting a shot or giving blood.
Logically, you know that you will be okay, but somehow that knowledge doesn’t stop you from breaking into a cold sweat in your doctor’s office.
“We are preprogrammed to see something that pierces our skin as threatening,” Bedard-Gilligan explains. “Sometimes this response is helpful, but it depends on the context. With a shot or a blood test, this fear is happening in the wrong place.”
Bedard-Gilligan likens your fear response to an alarm system. When your palms sweat or your heart rate picks up, a subconscious alarm is going off to warn you about danger. This is why it can be hard to say exactly why you are afraid — the physical response is an innate reaction to anything that is sharp or could cause you to bleed.
While this fear response helps keep you safe by discouraging you from plunging your bare arm into a thorny bush while gardening or provoking an animal while hiking, it isn’t helpful when you need to get a shot or have your blood drawn.
In these cases, the fear or anxiety you are feeling is a false alarm because you aren’t in any danger.
What can you do to prepare for a blood draw or donation?
There are some simple ways you can prepare to help the process go smoothly, and at the top of the list is hydration.
While staying hydrated is a helpful and healthy practice at any time, it’s especially important to drink lots of water the day before and morning of your appointment.
Fill up — and make sure to refill — a water bottle that you can sip on the day before your appointment, then bring it with you so you can stay hydrated afterward as well.
If you’re donating blood, you should also eat a hearty meal with some protein.
“We encourage eating a substantial meal a couple hours prior to donation as well as some salty snacks to help boost electrolytes,” says Sasha Seiden, regional donation manager at BloodWorks Northwest, a blood bank and medical research institute headquartered in Seattle.
Once you’re there, let the staff know you are feeling nervous so they can help by chatting with you, covering the puncture site and situating you so that you are as comfortable as possible.
What can you expect when you have a blood test?
One way to help ease your nerves is to know what to expect before you have a blood test. This will help you focus on the actual process instead of letting your imagination conjure up scenes from a horror movie.
For example, at UW Medicine hospitals, you will be asked to provide an ID and confirm your name, date of birth and the reason for your visit. You will then be seen by a phlebotomist, who is a trained expert in collecting blood samples.
The process itself can be fairly simple, says LaToyce Lindsey, a phlebotomy manager with UW Department of Laboratory Medicine.
Your phlebotomist will use a tourniquet to help find your vein and will clean the draw site with alcohol. They will then insert the needle and collect the sample. Afterward, they will remove the needle, put pressure on the puncture site and cover it with gauze and a bandage.
“The tourniquet may be a little tight and uncomfortable,” Lindsey says. “However, it will be released once we’ve determined a good blood flow is entering the collection tubes.”
You will feel an initial prick when the needle goes in your arm, similar to a scratch or pinch, but after that you shouldn’t feel any pain or discomfort, Lindsey explains.
Though circumstances can vary from person to person, the entire blood test process takes on average 10 minutes, and the collection itself takes roughly under a minute. This means the needle will be out before you can even listen to your favorite song. (And for some, the collection is closer to 30 seconds, which means one time through the alphabet and you’re all set to go.)
What about if you go to donate blood?
If shots or blood tests are overwhelming, then donating blood may feel like an insurmountable feat — but it doesn’t have to be.
At BloodWorks Northwest, a donation only takes seven to 15 minutes, and the entire process is over in about an hour.
Upon arrival, you’ll provide contact info and answer some health questions. You’ll then be given some educational materials on the donation process and will go through a mini physical where staff check your blood pressure, pulse and temperature.
They will also check for hemoglobin in your blood by pricking your finger with a small needle, called a lancet, that is similar to the devices that people with diabetes use to check their blood sugar. The phlebotomist may need to pinch your finger hard to draw a couple drops of blood, but luckily the test is over quickly.
Once the screening is completed and your eligibility has been confirmed, the donation process is fairly similar to a blood test.
A phlebotomist will put a blood pressure cuff on your arm and have you squeeze a small ball to help them find a viable vein in the crook of your elbow. They will sanitize the draw site, set up a collection bag on a scale that will weigh the donation and then insert the needle. Once you’ve donated one pint of blood, the phlebotomist will remove the needle, put pressure on the draw site and then wrap it or put on a bandage.
“Keep the Band-Aid or wrap on your arm for four hours and refrain from heavy lifting or strenuous exercise for 12 hours,” Seiden says.
Post donation, you will stay on-site to grab some snacks (cookies, chips, juice, oh my!) and to make sure you are feeling well.
There is a chance that you could experience some side effects after donation, like bruising, which can cause some soreness, or feeling faint, Seiden notes. If this happens, let the on-site staff know and they’ll make sure you are healthy and safe before you leave.
“Most donations are uneventful, and our staff is there to keep you safe,” Seiden says. “For most people, they feel the same as normal after donation.”
What are some ways to cope?
You’ve prepared for your appointment and you know what to expect. What can you do if you start to feel panicky?
“How you cope will depend on the extent of your fear,” Bedard-Gilligan explains.
Here are some tips for making the whole ordeal a little more bearable.
It may sound obvious, but remember to breathe.
Lindsey recommends taking deep breaths in through your nose and out through your mouth.
You can also practice box breathing, a mindfulness breathing exercise where you breathe in for four seconds, hold for four, breathe out for four, hold for another four and repeat.
Picturing your breath tracing the outside of a box, along with deep breathing, can help you stay calm.
Work on interpreting the situation as safe even though you feel afraid, Bedard-Gilligan says.
You can reassure yourself by thinking of how you’ve successfully and safely gotten a shot or blood test in the past.
Try not to get frustrated if your thoughts start to spiral into what-ifs or unrealistic worst-case scenarios. Instead, take a breath and then direct your thoughts back on what you know: you have done this before, it’s never as bad as you think it is going to be, you are doing this for your health and you are going to be OK.
Practice tolerating your anxiety
Self-talk is a great place to start, but it often needs to be paired with learning how to tolerate and cope with some of your anxiety.
“You can be afraid of something and choose to do it anyway,” Bedard-Gilligan says. “Fear is just one way to choose to do something or not. You don’t have to listen to your fear.”
Facing your fears is easier said than done, so start by giving yourself credit for going to get a shot or having your blood drawn in the first place.
When you start to feel panicked, acknowledge that what you are feeling is anxiety and take a moment to remind yourself that it is a false alarm.
The more you are able to sit with your anxiety and still get an injection anyway, the more your body will learn that there is nothing to fear.
While distracting yourself won’t help you get over your fear, it can help you cope in the moment.
There are a lot of ways you can do this, from talking with your phlebotomist to looking away from the needle to bringing a friend along — anything that will keep your mind off what is happening.
Bedard-Gilligan does caution that by looking away from the injection or distracting yourself, you can subtly reinforce the idea that needles are dangerous.
So, should you distract yourself to feel better in the moment?
It’s up to you whether or not you want to try this coping mechanism, but a good rule of thumb is that it can be helpful if you only need to get an injection or blood test once a year, but it probably isn’t the best solution if you need to get injections more frequently.
Seek out professional help
If your fear is preventing you from getting necessary medical care, you might be experiencing trypanophobia, the extreme fear of needles. This can include a vasovagal response, which is when your blood pressure drops, causing you to faint.
In this case, it may be helpful to reach out to a medical professional for a formal treatment approach, like exposure therapy. Your doctor will help you become more comfortable with needles by exposing you to them in different ways, from showing you images of needles to eventually having you prick your finger.
Though the thought of confronting more needles may sound unappealing, this treatment teaches your body that you aren’t in any real danger and it can help you overcome your fear.
“The success rate of treatment is extremely high,” Bedard-Gilligan says. “Basically, there is a proven method for people who want to get over their fear.”