Bed bugs and mental health: suicide, depression, anxiety, PTSD, & more

by nobugsonme on July 12, 2013 · 15 comments

in anxiety, bed bugs, dr. jerome goddard, mental health, mental illness

The psychological effects of bed bugs have been the recent focus of a number of articles.  It’s pretty clear that bed bugs can exacerbate or cause psychological problems in many individuals.  And an article published at the end of May (“Suicide following an infestation of bed bugs”) suggests bed bugs can now be linked to at least one suicide.  

In their 2012 study, Psychiatric consequences of actual versus feared and perceived bed bug infestations: a case series examining a current epidemicEvan Rieder et. al. examined the psychiatric consequences of either having bed bugs — or even simply fearing one has bed bugs.  Looking at various case studies, the authors found that

In response to real bed bug infestations, patients may suffer major depressive episodes and anxiety-spectrum disorders, including acute stress disorders, adjustment disorders, and specific phobias. Disorders may be new-onset or the result of worsening of pre-existing conditions. Patients may suffer significant social isolation as a result of stigma, as well as from self-imposed social withdrawal. Depressive episodes may be severe enough to cause suicidality, warrant inpatient hospitalization, and result in lost occupational or educational productivity (88-89).

They also found that

In response to perceived bed bug infestations, patients with a psychotic diathesis may suffer from brief psychotic and delusional disorders (89).

(For others who had trouble with this one, Dictionary.com defines “diathesis”, in terms of pathology, as “a constitutional predisposition or tendency, as to a particular disease or affection”.)

Rieder et. al. suggested that physicians need to anticipate these potential issues and try and identify them in patients:

While mental health providers are the most likely to treat psychological disturbances, the epidemic necessitates that all physicians gain familiarity with bed bug-related psychopathology, screen for psychiatric illness, and make appropriate referrals. We believe that this information is particularly salient for dermatologists, general practitioners, infectious disease specialists, internists, and primary care providers (86).

The authors argue for implementation of the following to lessen the psychological effects of bed bugs (and fear of bed bugs) and support sufferers:

  • social support (especially since people fearing or suffering from bed bugs tend to self-isolate),
  • public education about bed bugs (which helps with identifying problems and how to treat them), and
  • having health care practitioners scree for mental health issues and monitor existing ones, when patients are known to have bed bugs (90).

And they suggest that bed bugs should “be viewed as a serious psychosocial stressor, which may lead to patient decompensation or uncovering of psychiatric illness” (90).

(Incidentally, this article lists the Bedbugger forum entitled “Psychological and Health Problems Caused by Bed Bugs (Besides Bites)” as a reference [3].)

Jerome Goddard and Richard deShazo have also recently explored the psychological effects of bed bugs, in their 2012 article, “Psychological Effects of Bed Bug Attacks (Cimex lectularius L.)” (link to full text).

Goddard and deShazo examined user forum posts on BedbuggerThe Bed Bug Resource and Insectgeeks.com over a one-month period from May 15, 2011, and rated them for signs of PTSD.

The authors concluded that,

Bed bug infestations and associated bites produce a variety of emotional and psychological reactions, some of which may meet criteria for PTSD, although further research is needed to determine to what extent PTSD may occur after attacks by bed bugs. Our findings suggest that all individuals who experience bites should be queried for symptoms of emotional trauma and be offered psychological counseling where indicated. More accurate and available public health information on the biology, ecology, and health effects of these insects could decrease the level of anxiety associated with bed bug bites.

Again, here, public health education and physician screening are recommended.

Finally, a May 2013 article in the American Journal of Case Reports (“Suicide following an infestation of bed bugs”) reports on the first case of suicide known by doctors to be linked to the victim’s battle with bed bugs in her home.

Authors Stephanie Burrows et. al. describe the woman in this case as follows:

Ms. A was a 62 year old woman, diagnosed with bipolar disorder (treated with mood stabilizer), borderline personality, chronic alcoholism and an addiction to gambling. She had suicidal thoughts intermittently since age 25 years and had made three suicide attempts in the past. There had been long periods of abstinence from alcohol and gambling.

Ms. A lived in an apartment in a social housing complex. Six weeks before her death, Ms. A discovered bed bugs in her apartment. An exterminator was called, but four weeks later there was another infestation. During the second visit, the exterminator recommended that all her clothes be placed in plastic bags for three weeks, before a third fumigation of the apartment. Having developed a phobia of the bed bugs, Ms. A requested help to be relocated but could not be accommodated. Ms A resumed her gambling, losing a considerable sum of money. She also resumed her consumption of alcohol, which increased following her losses at the casino.

On the night of her death, she awoke at 3 am and found a drop of blood on her dressing gown.

What happens next, according to Burrows et. al., is chilling.

The woman took the blood on her nightgown to be a sign bed bugs had returned, and wrote a suicide note which made it clear that she had been “depressed since their arrival”; she then took 200 pills, drank a bottle of wine and called her boss to let him know she’d be missing work. He recognized her distress, and called 911, but when emergency services arrived, they were unable to dissuade the woman from jumping off her 17th floor balcony.

Though the woman’s name isn’t mentioned, the case was reported on in the local media in 2011 (almost two years after the woman died) (here’s a Google translation of that article from French into English).

Burrows et. al. conclude that

In addition to a systematic approach to the control and eradication of bed bugs, management of the psychological consequences is also needed. Clinicians should be alert to psychological distress that often accompanies an infestation of bed bugs and should ask targeted questions to determine whether an anxiety-depressive pathology is present in order to respond appropriately. In addition, adequate social support to prevent isolation and cope with the psychological symptoms needs to be provided.

Again, Burrows et. al. echo the other authors in calling for clinicians to actively screen patients for psychological distress, and for more social support for bed bug sufferers.  Burrows et. al. also mention the need for “a systematic approach to the control and eradication of bed bugs” — notable since, in this case, the problem seemed to recur a month after the first treatment (which suggests it’s possible more could have been done in terms of treatment and monitoring).

Although Burrows et. al. note that they “know of no other reports in the literature of a suicide explicitly linked to a bed bug infestation,” we have heard anecdotally of at least two other possible cases of bed bug-related suicides in Canada in our Bedbugger Forums and on the Bed Bug Registry.

In September 2008, a Canadian woman who actively participated on our Bedbugger forums for over two years reported that her neighbor committed suicide after being treated for bed bugs for two months.

She noted that while speaking to the multi-unit building’s pest management professional about apartments which had bed bugs, they

… mentioned that Apt. 702 was “showing signs of activity again”. Apt 702??!! That apartment is currently vacant, as the tenant committed suicide on June 30th. One morning, at around 6:00 a.m., she threw herself off the balcony. It was horrible. I remember at the time thinking that it was strange that it occurred early in the morning, and that perhaps she just couldn’t face one more day. I felt so terrible for her.

So I asked the PCO “How long have you been treating the apartment?”

And they replied “Four months”.

Which means the woman battled bedbugs for 2 months and then killed herself.

Of course, there’s no way to know whether or how much bed bugs affected the woman’s mental state in this case, or what pre-existing conditions were present.  Nevetheless, it seems quite possible that there was a link.

Then, in February 2009, a poster on the Bed Bug Registry wrote on the page for 4175 Lawrence Avenue East, claiming that the poster’s building has bed bugs “on every floor”, that apartments were sprayed weekly for bed bugs, and that s/he had had bed bugs in his/her unit for at least a year.

And, chillingly, the poster claimed that

In January 2009, the man that lived in unit #1306 KILLED HIMSELF because he couldn’t handle the mental stress of getting CHEWED UP by bed bugs anymore.

He wrote several letters to the building INSISTING that they “once and for all” rid his unit of its bedbug problem OR MOVE HIM TO ANOTHER UNIT, OR HE WOULD TAKE HIS OWN LIFE.

The poster goes on to claim to have been “told ‘secretly’ by staff” that there had been three suicides in the building in the past year “because of bed bugs.”

Obviously, we have no way of verifying the accuracy of this anecdote.

However, we do routinely hear from people in the Bedbugger Forums who are suffering from depression, anxiety or other mental health conditions (also including phobias, obsessive-compulsive disorder, bipolar disorder, acute stress disorder) which they report as being exacerbated by bed bugs, or in some cases even triggered by their bed bug situation.

This site has a policy on posts mentioning suicide (the policy is explained further here: “Forum Rules”). We aren’t qualified to offer counseling, so we close these threads down and direct the writer to seek help immediately from a medical or mental health professional and refer them to additional resources online (see “If you are feeling suicidal, or anxious“).

For anyone who’s reading this and suffering from depression, anxiety or other mental health issues, whether new or ongoing, and whether due to bed bugs, or from fear you may have bed bugs, please seek immediate assistance from a medical or mental health professional. If necessary, go to an Emergency Room. There is help available for these conditions. Please do not harm yourself.

Ultimately, articles such as the three described here may be very helpful in helping medical and mental health professionals understand the need for psychological screening for patients who have or suspect bed bugs.

I agree with these authors’ various calls forsuch screening, for more public health education about bed bugs, and more social support for sufferers who often isolate themselves out of a fear of spreading bed bugs.  These studies remind us that having bed bugs — or even not knowing if one has them — can be much more than a “nuisance” to those affected.

 

References:

Burrows S, Perron S, Susser S. Suicide following an infestation of bed bugs (link to full article) Am J Case Rep. 2013; 14: 176–178. Published online 2013 May 29. doi: 10.12659/AJCR.883926

Goddard J, de Shazo R. Psychological effects of bed bug attacks (Cimex lectularius L.) (full-text). Am J Med. 2012;125(1):101–3. doi: 10.1016/j.amjmed.2011.08.010.

Rieder E, Hamalian G, Maloy K, et al. Psychiatric consequences of actual versus feared and perceived bed bug infestations: a case series examining a current epidemic. Psychosomatics. 2012;53(1):85–91. doi: 10.1016/j.psym.2011.08.001.

facebooktwittergoogle_plusredditpinterestlinkedintumblrmail
1 Heather Hunter July 13, 2013 at 5:39 pm

I have been bitten by bedbugs since Sept of last year. I share an apartment with my boyfriend`s mother who is embarrassed by the issue and does not actually believe the bed bugs are biting me. A dermatologist confirmed my suspicions. The building owner is in denial as well as he stated that “until your roommate reports it, we will do nothing”. I am not on the lease as I am only here to help out financially. Today I spoke to the superintendent who told me he would get an exterminator in to treat the bed bugs. I do not suffer from a mental illness but the bed bugs affected my already tested sleeping habits. I am bone-tired from the lack of sleep due to my fear of actually going to sleep. Time will tell if these bed bugs are killed forever.

I wanted to share a little tip. If you are bitten, apply the 3 antibiotic Polysporin to the bites as it helps with the itch and does assist with healing. It does not prevent bed bug bites. Your investment in Polysporin will go a long way towards some peace of mind.

2 nobugsonme July 13, 2013 at 11:16 pm

Hi Heather,

Thanks for the Polysporin suggestion!

Here’s a question for you: did you get a visual confirmation on bed bugs? Because they can’t be confirmed by a dermatologist (unless the doctor was looking at a bug). You need to find bed bugs, cast skins, fecal stains or eggs to confirm bed bugs are the source of the skin reaction — and if you post a photo on our active user forums, an expert will be able to confirm the ID.

The forum is here: http://bedbugger.com/forum

I also suggest you consider using an anonymous username. People often don’t like their real names turning up a bed bug website in Google searches, unless they’re in the industry.

3 AshamedandScratching July 27, 2013 at 11:12 am

I certainly can attest to the suicide ideation.

Even today, I’m not sure I wouldn’t say fuck all and walk away of I discovered them again.

4 TiTi Garcia September 25, 2013 at 12:01 am

I have been dealing with this bed bug problem for almost a month. When I first realizedthat I had bed bugs I immediately threw out my futon that I used to sleep on the floor with. I then reported it to the management and waited for them to come and fumigate. During this time, I was sleeping in my bath tub. I have a REAL PHOBIA of bugs! I googled alot of information on these things. I couldn’t sleep! I didn’t and still don’t want to be or live here anymore. And I’ve only lived here a little over a year. So, ALL my furniture was new. After they fumigated, I threw EVERYTHING out, and washed EVERYTHING! Since there is no longer anything in my single unit, I thought I wad rid of them BUT still can’t sleep at night. I leave ALL the lights on and I’mstill totally freaked out! I’m now sleeping on the floor, with only blankets. Today I found them in the seams of my curtains. I’m going insane and I don’t know what to do. I’m looking to move. But, going nuts for the time being!

5 Richard November 6, 2013 at 6:56 am

Interesting: Before the “bed bug” issue a bite was just a bite….spider or? Post bed bugs, almost every bite is a bed bug bite according to the Dr.’s.

…and yes, you need to find evidence.

6 nobugsonme November 7, 2013 at 3:24 am

Titi,
So sorry I missed your comment. It sounds like there are two issues there: bed bugs, which need treatment (and this usually does not require throwing out all your stuff), and phobia/anxiety, which can also be treated. I really hope you’ve gotten some good professional help, preferably in both cases.

7 Christina November 8, 2013 at 10:16 pm

Professional help was needed , could you imagine not buying a bed in 3yrs ? PTSD< ANXIETY and OCD…… My situation occurred in public housing ( moving into a unit with the devil hiding in the walls) So of course the low income is dismissed as the culprit… Not true at all. im sorry (NOBUGSNOME) I trashed every thing for 3 yrs straight,, .. The thought of this multiplying devil hiding anywhere, will scare the crap out of anybody. Only the strong survive bedbug attacks… *****Suicide is not the answer to get a good SLEEP*****

8 Christina November 8, 2013 at 10:24 pm

cleaning and cleaning for 3yrs in and out, total isolation, I too slept in the tub, but it was with my kid, she had the tub I had the floor, or vice verso what every mad her comfortable.. And this was my second relocation,, yes the floor is real…. now im on my third relocation, still on the floor, but I got curtains now :) yeah I know it sounds in sane, but that’s what bedbugs do 2 u…..

9 announcer November 12, 2013 at 9:58 pm

I just found this site. My ex boyfriend and I are both dealing with these little m#$^$^%fck6536ers. For months now. It all goes back to us living in Hollywood and our neighbor got the bugs. They sprayed his apartment..and all the bugs came over to ours. They were biting him, but not me. I was not all that sympathetic. We ended up breaking up and moving out. And I guess I either took some with me, or they were already in the building I moved to. Not sure which because they pro that treated my apartment told me he treats lots of units in the building for this. Which makes me wonder if these things CAN be gotten rid of.
In the new place, I’m getting bitten. The pro actually took photos of me to show people because I am so badly bitten/scarred from this. It is really embarrassing and I cannot bring myself to talk to people about it much. Anyway, he came about two weeks ago. I threw out a love seat that was badly infested. For a little while there I had some peace. However, I have been itchy the last few days, and just now I discovered one of the little varmints in my clothing. Actually ON my clothing. Possibly I only noticed it because I wore white slacks today.
Now I’m headed to Home Depot for another bug bomb which I will use tomorrow just in case I don’t find something on this site that gives me hope. If anyone can point me to a place for newbies (ha ha..I wrote newbites, first)..I’d appreciate it. Just don’t know where to start and it looks like people are at wit’s end with this..like it’s impossible to get rid of them. The stories I’m seeing and the comments indicate months and months and sometimes years of attempts to deal with them. Not very encouraging to say the least. Can we bring back the DDT since it wasn’t killing the birds after all?

10 nobugsonme November 13, 2013 at 3:20 am

Hi announcer,
Please, please do not use a bug bomb. They do not work on bed bugs but can make the problem worse by driving them deeper into your home.

Please read our FAQs (we have one on bug bombs!) and then come to our user forums to connect with others (people who’ve had bed bugs AND experts) and ask questions.

FAQS: http://bedbugger.com/faqs

FORUMS: http://bedbugger.com/forum

Or just use the navigation menu at the top of the page.

Oh, and bed bugs started to show resistance to DDT in 1948, so it is not the silver bullet you might think.

Bed bugs CAN be thoroughly eliminated in your building, but if the landlord has not addressed the problem thoroughly, they will likely persist.

In the absence of an ongoing source of exposure (like infested attached neighbors), and with knowledgeable, experienced professional treatment, nobody should be living with bed bugs for months or years. Actually, even a non-pro can beat this problem, if absolutely necessary, with a certain level of basic skills, basic research and self-education.

Sometimes landlords who are slacking can get pressured to take action with some media attention. Since your PCO found your case to be quite obvious and serious, it might make a good story for the local news, especially if neighbors will also speak about their problems to the press. There are pluses and minuses to this sort of exposure, but if the situation is desperate, it might help make things happen.

11 Frustrated November 15, 2013 at 5:07 am

It is 2:03 in the morning and im sitting here crying out of frustration…. i have been dealing with bed bugs for 8 months… I got some releaf when my lanlord finally sent an exterminator out to spray, but he failed to have the other units treated… So now theyre BACK :’( im going crazy i juat got bit three nights ago and about half hour ago i got four new bites!!! This is a nightmare!!!! any suggestions?

12 Tori November 19, 2013 at 10:58 pm

I have had bed bugs for about a month, thinking the mosquito looking bites were just hives or something…I kept getting them especially in the morning after I woke up. I investigated my bed skirt and saw one of the bugs and knew I was in trouble. My super didn’t believe me at first he thought bed bug bites were supposed to be all over and bloody but mine were just red welts on my arms and very itchy! I have had major anxiety, stress, basically PTSD like the article states. The clean up and bagging process was grueling and i decided to stay somewhere else with only some clean items. I have not been sleeping well, I already take something and now have to take extra to get through this difficult time. I haven’t had time to clean all my things so a lot of it is still in garbage bags which bothers me. Insurance doesn’t cover anything and I feel like the future of this is unknown so I am staying somewhere else until the second treatment is done. Is there any hope in getting rid of these suckers if I followed all the pest controls instructions ? I am really down this isn’t the first time I’ve had apt troubles….:-/

13 nobugsonme November 20, 2013 at 2:22 am

Hi Frustrated,

So sorry you’re having a rough time.

If attached neighbors have bed bugs, they may keep coming back. Please come to our active user forums for more feedback and support. There may be things you can do, and if you post in the forums, myself and others will try and give some suggestions.

You may also need more than one treatment — as most spray/dust treatments take more than one visit.

Hi Tori,

First, take care of your mental and emotional health. Seek professional support if necessary. You really will do better with the bed bug situation if you’re taking care of yourself first. Depression and anxiety don’t make dealing with bed bugs (or whatever you need to do in response to bed bugs) any easier.

Bed bugs can be thoroughly eliminated — it happens all the time. It may even take three treatments or so.

However, bed bugs become very difficult to eliminate if attached neighbors have them and aren’t getting treatment, or there’s some other continued “exposure”, so be sure and ask your landlord about whether attached neighbors are being inspected. See our FAQs for precautions to take when you sleep somewhere else (see the section on travel).

And as I said to the previous poster, please come to our active user forums for more feedback and support.

14 AptDwellerInPortland January 5, 2014 at 2:20 pm

5 months since I bagged and boxed everything for a total cost of almost $3000, and they are back. I found ONE on Friday night, and reported it to the manager of my building on Saturday. The inspectors will likely come at the end of this week (today in Sunday). I am physically and mentally unable to do this 6-week in hell preparation again. I had a small nervous breakdown and had to see my psychiatrist in July. My question is this: I believe that bedbugs in the United States (and probably worldwide) are a fact of life. We need to find out how to live with A FEW of them in our home, and how to MAINTAIN only a few. Nobody can live with doing 6 weeks of pack-up, washing/drying sheets on hot 2x-3x a week, changing clothes to visit friends, not ever having friends come to one’s home or apartment. Does anybody know how to maintain a bedbug free home, and how not to spread them, without doing all that? I live in a 172 unit building which has a lot of apartments with bedbugs. I can’t afford another prep, and can’t do it on my own, and have nobody to help me. Portland Legal Aid says I could be evicted if I refuse to do the preps required.

15 nobugsonme January 5, 2014 at 10:46 pm

Hi Portland,
Sorry you’re dealing with bed bugs again.

I don’t know any way to have and maintain a few bed bugs in your home.

If you have bed bugs again after six weeks, one of these things is likely true: either you got them from a neighbor who has bed bugs, or you brought them in from outside (or a visitor to your home did).

I would make sure of your ID before you panic (you can post a photo in our forums for an expert to confirm).

As for treatment, there are actually some PCOs who do not require you to do any prep for treatment. I think this is the minority right now, but they do exist. And some of them are very highly thought of. If your landlord is responsible for treatment, then the problem becomes getting him/her to hire one of these PCOs if available.

Also, heat treatment is an option which usually has markedly less prep. The downside is it may cost more than spray/dust treatment, and unless residual sprays or dusts are put down afterwards, you have nothing to protect against stragglers (which sometimes occur) or new introductions.

The bottom line is if there is continued exposure then it isn’t about the treatment so much as about preventing reintroduction, since it does sound like your treatment initially worked.

I hope you can find support for the anxiety this situation brings with it. And I hope you’ll come to our forums if you need further support or suggestions.

Comments on this entry are closed.

Previous post:

Next post: