Hemophobia

Hemophobia is an intense fear of blood. It is typically classified as a specific phobia and is often considered part of blood-injection-injury (BII) phobia. People with hemophobia experience marked anxiety or distress when they encounter blood or blood-related situations, which can lead to avoidance of such stimuli.

Triggers include seeing blood, imagining blood, or undergoing medical procedures that involve blood. Symptoms commonly include rapid heartbeat, sweating, trembling, dizziness, nausea, and panic. In many cases, exposure to blood can provoke a vasovagal response, resulting in fainting or near-fainting. This reaction can reinforce avoidance behaviors and complicate medical care.

Causes and risk factors are thought to involve a combination of genetic predisposition, learned experiences, and conditioning. Some individuals show heightened amygdala reactivity or autonomic nervous system sensitivity. Onset typically occurs in childhood or adolescence, and some studies report a higher prevalence in females in certain populations.

Diagnosis and differential: In DSM-5-TR, hemophobia is understood within the broader category of specific phobias, with BII phobia encompassing fears of blood, injections, and injuries. A clinical assessment relies on patient history and observed distress or impairment lasting at least six months, rather than on laboratory tests. Differential diagnosis includes general medical anxiety or other specific phobias.

Treatment and prognosis: Cognitive-behavioral therapy with exposure is the primary evidence-based approach, often using graded exposure to blood or blood-related stimuli. In BII phobia, applied tension techniques to prevent fainting may be taught. Virtual reality exposure can be an adjunct. Medications are not first-line but may be considered for comorbid conditions. With appropriate treatment, many individuals reduce fear and avoidance and improve functioning.