Fear of blood: why the sight of it makes you faint, and what helps

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Fear of blood is a specific phobia where the sight or thought of blood brings intense fear, often with faintness. Mind lists body-based phobias, such as blood or injuries, among the most common specific phobias, and the NHS names bodily fluids such as blood among the things that can trigger one. You may see it called haemophobia, or grouped with the fear of injections and injuries. The name matters less than what it does to you, which for many people is dread, a lurch in the stomach and the room going grey at the edges.

This guide covers why blood sets off that reaction, why it is the one phobia where the usual advice to relax can backfire, the muscle technique the NHS and Mind describe for stopping the faint, and how to shrink the fear in small steps. It sits in the same family of fears as emetophobia, the guide that opens our phobias series, and the pattern is the same: the things you do to feel safe are the things that keep the fear going. Everything here is drawn from NHS guidance, an NHS trust's needle phobia leaflet and Mind. It is not a diagnostic tool, and it will not tell you whether what you have is a phobia. If you have fainted, or the fear is keeping you from medical care, your GP is the right first conversation.

What is a specific phobia?

A specific phobia is an extreme fear of one particular object or situation, far bigger than the real danger. Mind describes a phobia as a fear that does not match the risk of the thing you are afraid of, and the NHS describes phobias as an anxiety condition usually caused by a particular object or situation. Mind groups specific phobias into animal phobias, body-based phobias such as blood or injuries, medical phobias such as the dentist or anything involving needles, and phobias about your environment, such as heights or enclosed spaces.

Being squeamish is a different thing. Plenty of people look away during a blood test and think nothing more of it. What separates a phobia from that is what the fear makes you do, and how far it reaches into your life. Mind says some people feel the fear only when the trigger is in front of them, while others feel it when they think about it or see pictures of it, and that we can still feel it even when we know the thing is safe. When a nosebleed at work leaves you shaking, when you cannot watch a hospital drama, or when you have put off a blood test for a year, the fear has started making your decisions for you. You do not need to settle which side of the line you are on before you act on it.

Why do I faint at the sight of blood?

Fainting at the sight of blood happens because your blood pressure rises and then drops sharply. Guy's and St Thomas' NHS Foundation Trust explains in its needle phobia guidance that for many people the fear is linked to fainting: when something triggers it, such as seeing blood, heart rate and blood pressure go up and then drop quickly, and that fall in blood pressure can cause fainting. Mind says the same thing from the other side, listing fainting among the physical symptoms of a phobia and noting that it is most common with phobias of blood and needles.

Most phobias do the opposite. A fear of spiders or heights leaves the heart racing and the body ready to run, which is uncomfortable but keeps you upright. The blood response has a second stage, a sudden drop, which is why the NHS lists an intense fear that you may faint, lose control or die among phobia symptoms. The NHS fainting page lists the warning signs: dizziness, sweating, feeling warm or hot, feeling sick, and changes to your vision. If you know that list from the inside, you are not weak, and the response can be worked on.

The rest of the symptoms are the ordinary ones. The NHS lists severe anxiety and worry, feeling dizzy or lightheaded, a noticeable or unusual heartbeat, tightness in the chest, feeling or being sick, and trembling or shaking. Mind adds disgust, which is worth naming, because for a lot of people the feeling around blood is not only fear but a strong physical revulsion, and both are part of the same phobia.

Where the fear comes from

Fear of blood often starts early, and often it is learned. The NHS says it is not always clear why a phobia starts, but that many can be linked to a frightening event or a stressful situation, that phobias usually develop as a child, teenager or young adult, and that you can learn one from family or friends who have it. Mind adds that you can develop a phobia of something without ever having a bad experience of it yourself, and that growing up around people who reacted strongly to something can shape how you react to it.

For blood, the faint itself can be the frightening event. Someone who went grey during a childhood injection, or passed out at a cut knee, learns that blood and collapse go together, and the fear of fainting becomes part of the fear of blood. Each time you look away or leave the room, nothing happens that could correct the fear. Mind is plain that avoiding the trigger can make the phobia worse, and that phobias are unlikely to go away on their own, particularly if you have had one for a long time. Our guide to fear of needles covers the same loop around injections and blood tests, and the two fears very often travel together.

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How do I get over my fear of blood?

Getting over a fear of blood means two separate jobs: stopping the faint, and shrinking the fear. Most general phobia advice covers only the second. The steps below come from the NHS, Guy's and St Thomas' NHS Foundation Trust and Mind, and you can take as few or as many as you need.

Why relaxing can make it worse

Relaxation is the one piece of standard anxiety advice that can backfire with a fear of blood. Mind says that if your phobia makes you faint, relaxation techniques probably will not help, because relaxation slows your heart rate, and you need your heart rate to speed up to avoid fainting. Slow breathing is still useful if your reaction is panic rather than faintness: Guy's and St Thomas' suggests breathing for relaxation if you feel panicky but not faint, and applied tension if you faint or feel faint. Work out which one you are, because the two call for opposite things.

Applied tension: the technique that stops the faint

Applied tension is a muscle exercise that raises your blood pressure so the drop that causes fainting does not happen. Mind describes it as tensing the muscles in your body to increase blood pressure, and Mind and Guy's and St Thomas' both set it out in the same way:

1. Sit somewhere comfortable.
2. Tense the muscles in your arms and legs, and hold the tension for 10 to 15 seconds, or until you feel warmth rising in your face.
3. Release the tension and sit normally.
4. Wait 20 to 30 seconds.
5. Tense again for 10 to 15 seconds, and repeat until you have done it at least 5 times.

Practice is what makes it work on the day. Mind suggests trying it a few times a day in the week before you need to face something that normally makes you faint, and Guy's and St Thomas' suggests practising the sequence 3 times a day for about a week before you face your fear. Both carry the same caution: be careful tensing any part of your body where you have a health problem, and if you get headaches afterwards, stop, or at least avoid tensing your face and head. Guy's and St Thomas' says the exercises are safe in pregnancy and with most medical conditions, and your GP can confirm that for you if you are unsure.

If you feel faint right now

Feeling faint is the moment to get low and get your blood moving. The NHS fainting page says that if you feel like you are about to faint, lie down with your legs raised, or if you cannot, sit with your head lowered between your knees, drink some water, cross your legs while standing or rock up and down on your toes, and clench your fists. Those last three can be done standing in a queue or a waiting room where lying down is not an option. If you have actually fainted, the NHS says it is probably nothing serious but that you should see a GP to find the cause, and it lists when a faint is a 999 call, including if someone cannot be woken within a minute, has chest pain, or has hurt themselves badly.

If you panic rather than faint

Panic around blood is frightening and it passes. The NHS says most panic attacks last between 5 and 20 minutes, that they are not dangerous, and that the thing to do is stay where you are if possible, breathe slowly and deeply, remind yourself that the attack will pass, and remember that it is not life threatening. The NHS breathing exercise for stress, anxiety and panic is to breathe in gently through your nose and out through your mouth, counting steadily from 1 to 5 each way if that helps, for at least 5 minutes. Our guide to what a panic attack feels like goes through the sensations, and how to stop a panic attack covers the steps in more detail.

Building up to it one step at a time

Shrinking the fear itself is done in stages, with applied tension in your pocket for each one. Mind calls this graded exposure: make a list of the things that set the fear off and how they make you feel, then a list of small tasks that slowly build into bigger ones, and repeat each task until it no longer makes you anxious before moving to the next. Guy's and St Thomas' uses a fear ladder for the same idea: list the situations you fear, from thinking about them, to pictures, to seeing it on television, to seeing it in person, to having it happen to you, rate each from 0 to 10, and start at the bottom.

Two things from the sources are worth keeping as you climb. Guy's and St Thomas' says to use the tension or breathing exercise before each step and stay in the situation until your anxiety starts to reduce, because anxiety tends to peak, stay for a while, then fall on its own, and staying long enough shows you that the thing you expected, such as fainting, does not happen. And Mind says that while you do each task, remind yourself that you are safe, be kind to yourself as you go, and reward each step. Mind also suggests asking whether there is any evidence against the frightening thought, whether you are picturing the most likely outcome or the worst one, and what you would tell a friend who thought the same. Some NHS trusts publish graded exposure workbooks you can download, and your GP can point you to one. The same ladder works for dental anxiety and most other specific phobias.

Where Wobble fits

Wobble is the step before a course of therapy, or the check-in alongside one. You describe what is going on in text or voice and a qualified UK therapist records you a personal video, usually within hours, working to the Wobble response framework: what they understood, practical guidance, and one clear next step. Wobble's Clinical Lead is James Penney, NCPS Accredited Psychotherapeutic Counsellor. People use it once in the week before a blood test they have been dreading, or regularly while they work up the ladder above, the way therapy has a rhythm without the appointment. It is not a replacement for a course of therapy if that is what you need, and it is not a crisis service.

When to see your GP

See your GP if the fear of blood is affecting your life, or if you have fainted. The NHS advice is to see a GP if you think you have a phobia and the symptoms are affecting your life, and separately to see a GP after any faint, because it is usually nothing serious but the cause should be checked. Mind suggests support might help if avoiding the trigger makes day-to-day life hard, if you need a lot of preparation or someone with you to face it, if it causes panic attacks, if you use alcohol or drugs to cope, or if it stops you getting support for other health problems, and Mind names a phobia that stops you having a test or treatment that involves a needle as an example. You do not need to be sure it is a phobia before you go.

A GP can assess you and explain your options, which Mind says are usually the same as for other anxiety problems: guided self-help, talking therapies and, in some cases, medication. A GP is the right person to discuss medication with, and Mind notes it should not be the only thing offered because it does not treat the cause. Mind says the therapies most often offered for phobias are cognitive behavioural therapy and exposure therapy, which do the work of the ladder above with a professional alongside you, and Guy's and St Thomas' says CBT is usually recommended for needle phobia. In England you can refer yourself to NHS Talking Therapies at nhs.uk/talk without seeing your GP, phobias are on its list of problems you can self-refer for, and waits vary widely. Elsewhere in the UK your GP can tell you what talking support is available locally. A BACP, UKCP, BABCP, BPS or NCS-registered therapist can help privately.

Tell the people with the needle. Guy's and St Thomas' says to tell the person giving the injection or taking the blood test about your worries, that they can help you cope, for example by chatting to distract you, and that they will not be annoyed or think you are weak. If you have a blood test or a procedure coming up, say the word fainting when you book it and again when you sit down. If you ever feel you cannot keep yourself safe, that is urgent: call 999 or go to A&E, or call NHS 111 and select the mental health option.

Who you can talk to today

Free routes first, then your GP, then Wobble.

• NHS Talking Therapies (England): refer yourself at nhs.uk/talk without seeing your GP. Phobias are on the list. Free. Waits vary widely.
• NHS 111, mental health option: call 111 and select the mental health option, or use 111 online, for urgent help that is not an emergency. Free.
• Samaritans: call 116 123, free from any phone, 24 hours a day, 365 days a year.
• Shout: text 85258, free, confidential, 24/7.
• Mind Infoline: 0300 123 3393, 9am to 6pm Monday to Friday, for information about support and services near you. Mind's Support line is 0300 102 1234, same hours, if you want someone to listen.
• Your GP: if the fear is affecting your life or keeping you from tests or treatment, if you have fainted, or if you want to talk through talking therapies.

Wobble is on-demand mental health support: you choose a topic, then answer six short questions about it, add more in writing or by voice note if you want, and a qualified UK therapist records you a personal video with practical guidance, usually within hours. Use it once, or make it a regular check-in. Your first Wobble is £9.99, usually £14.99. It is not a crisis service.

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Quick summary

Fear of blood is one of the most common specific phobias, and the one most linked with fainting. Blood pressure rises and then drops sharply when the fear kicks in. Avoiding blood keeps the fear alive and can keep you from blood tests and treatment you need. What helps is knowing whether you faint or panic, because the two call for opposite things: applied tension, tensing your arms and legs for 10 to 15 seconds and repeating it, raises blood pressure and stops the faint, while slow breathing suits panic. Lie down with your legs raised if you feel faint, tell the person with the needle, and shrink the fear with a ladder of small steps, with CBT or exposure therapy through NHS Talking Therapies or your GP if it is affecting your life. You do not have to sort this alone.

Sources and further reading

• NHS: Phobias
• NHS: Fainting
• NHS, Guy's and St Thomas' NHS Foundation Trust: Needle phobia and overcoming your fear
• NHS: Panic disorder
• NHS: Breathing exercises for stress
• NHS: NHS Talking Therapies
• NHS: Where to get urgent help for mental health
• Mind: Understanding phobias
• Mind: Coping with phobias
• Mind: Helplines
• Samaritans: Contact a Samaritan
• Shout: text 85258

This article is for information only and does not replace advice from a qualified medical professional. If fear of blood or fainting is affecting your daily life or your health care, please speak to your GP or NHS 111. If you are in crisis, please call 999 or go to A&E.