Self-Injection Anxiety: How do I cope with the fear of injecting myself?

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If you have a long-term inflammatory condition such as Inflammatory Bowel Disease or Rheumatoid Arthritis, you may find yourself having to self-administer a biological drug regularly through an injection under the skin.

Self-injections tend to come in the form of a simple-to-use preloaded pen, where all you need to do is select and prep the injection site, click a single button, and wait for the injection to complete.

However, anyone who has ever used one of these knows that it’s just not that simple.

A recent publication highlighted 5 important factors that can affect how well patients manage their self-injections:

Education & Training Around How to Self-Inject

Having adequate training and education around the process of self-injecting can greatly affect whether or not patients experience fear and/or anxiety when they are administering injections themselves. 

Emotional Control

The emotional control surrounding the fear and/or anxiety that may be associated with having to self-inject can affect how well patients manage their self-injections. Some people are naturally better than others at managing their responses to fear.  

Perception Towards Self-Injection

Generally, perceptions towards self-injection are often negative. However, patients often have a better perception of devices that are modern or more technologically advanced.  

Support From Clinical Staff

Having support and education from clinical staff on how one can manage their fear and anxiety around self-injecting is extremely valuable to patients.

Having a Routine

By following a self-injection routine, individuals feel more confident about self-injecting. Having a ritualised and consistent process helps reduce the fear and anxiety associated with self-injecting. 

How our Mental Health Affects our Self-Injections and Medication Adherence

One of the more important things you can do to improve your life with your condition is to take your medication exactly as it is prescribed. Many factors can get in the way of that happening, but there are steps that you can take to reduce your risk of missing a dose.

 Some of us have an unexplainable fear of needles, and as a result, develop fear and anxiety around the action of self-injecting. Sometimes these feelings have developed following a bad experience during an injection in the past. It is very important to address these feelings, because unmanaged fear and anxiety can often result in poor adherence to the medication, which may then lead to worse health outcomes.

It takes time to learn to accept that this may now be your new way of living. Give yourself time to adapt to the idea of self-injecting regularly and know that it’s normal to feel disconnected from your previous disease-free, or injection-free life. It is also normal to experience forms of grief or sadness, but stay alert for symptoms of anxiety or depression, especially ones that last a long time, or become severe around injection times.

A major contributor to feelings of anxiety around self-injection is lack of sufficient instruction or training on how to do it right. If you don’t feel confident in self-injecting correctly, or if you’re nervous about something going wrong, make sure to raise your concerns to your healthcare provider. 

What Self-injection Device you use Matters

There are many self-injection devices available, and although all of them have been through a complex design process and years of rigorous testing, this doesn’t mean that ‘one size fits all’. Having a conversation with your healthcare provider about what devices are available to deliver your medication and making an informed choice about which one is best for you can make a big difference in your life. There is in fact evidence that patients who are given their preferred device over an alternative to self-inject may have a better tolerance and increased adherence to the medication.

  How to get comfortable self-injecting

  • Get your nurse to show you how to self-inject correctly…more than once! Make sure you ask them what can go wrong while taking the different steps.
  • Find reputable resources online to educate yourself on how to troubleshoot when something goes wrong.
  • Search online for medication specific patient support programmes where you can receive additional support to learn more about how to self-inject and boost your confidence in fully adhering to every dose.
  • Set up a routine. Injecting at the same time under the same conditions helps you feel more prepared and in control.

We want to hear from you

Our team is collecting insights from anyone with inflammatory arthritis or inflammatory bowel disease via this survey.

We want to know about your thoughts and experiences self-injecting treatments. You don’t have to be prescribed a self-injection treatment to complete it. In fact, responses from those who are not currently prescribed self-injection treatment can help us gain a better insight into how to support our ‘My IBD Care’ and ‘My Arthritis App’ communities in their treatment journey.


More lifestyle tips and tools to help manage your arthritis or IBD

Learning to live with IBD or arthritis is a process, but there is lots of support and help out there. The My IBD Care and My Arthritis apps can help you with tips, tools and advice for tracking and improving your symptoms.

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Schiff, M., Saunderson, S., Mountian, I. et al. Chronic Disease and Self-Injection: Ethnographic Investigations into the Patient Experience During Treatment. Rheumatol Ther 4, 445–463 (2017).

Bart J. F. van den Bemt, Lynda Gettings, Barbara Domańska, Richard Bruggraber, Irina Mountian & Lars E. Kristensen (2019). A portfolio of biologic self-injection devices in rheumatology: how patient involvement in device design can improve treatment experience, Drug Delivery, 26:1, 384-392, DOI: 10.1080/10717544.2019.1587043

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