Bed bugs can be psychologically harmful, even triggering PTSD symptoms

‘You don’t feel safe in your own home:’ Bed bugs’ biggest health threats are psychological, triggering flashbacks, extreme anxiety, and other symptoms of PTSD

Rebecca Ross had been living in her new Minneapolis apartment for only a week when she started noticing the bugs. Having grown up in the rural Midwest, the 25-year-old wasn’t afraid of insects. But these were unfamiliar.

First, there were only a few. Then, she started noticing them in clumps. Dozens of the bugs were crowded in corners, between cracks in furniture, and most of all near the bed.

She sent a picture to maintenance, who replied with a damning diagnosis: Ross’s new place was infested with bed bugs. The insects, which resemble of apple seeds and feed on human blood, «i nfest virtually anywhere humans congregate» and are on the rise, according to the National Pest Management Association .

Still, Ross’s landlord said he needed confirmation before he could send an exterminator, so Ross began collecting the critters in clear plastic bags.

A month later, the bugs had laid and hatched eggs inside the bags, filling them with swarms of tiny, hungry baby bed bugs called nymphs. And still no exterminator came.

Since her move-in day more than four months ago, Ross has gotten rid of all her big furniture, including her bed. She’s stored her clothes and other items in garbage bags, and invested in an expensive heat-treatment system to kill the bed bugs.

Ross is looking for a new apartment, but the psychological scars remain.

She’s constantly roused by her two cats’ slightest movement or touch, and rarely sleeps more than three hours a night. She’s missed work, and the depression and anxiety she already lived with have gotten worse. Friends have refused to visit and she’s begun startling at odd marks on the floor or furniture, seeing bugs where there aren’t any.

«I know for awhile I’m going to be on edge,» she told INSIDER.

Ross’s experience isn’t unique. While bed bugs are a practical nightmare and a physical discomfort — their bites can leave behind itchy red welts — their real damage is more than skin deep.

Multiple researchers have documented the connection between bed bugs, emotional trauma, and lingering mental health issues. In some cases, side effects like severe anxiety, sleeplessness, difficulty concentrating, obsessiveness, and hypervigilance are severe enough mimic posttraumatic stress disorder .

«People are really emotionally affected by these things,» Jerome Goddard, a medical entomologist at Mississippi State University, who’s studied bed bugs’ physical and psychological effects, told INSIDER. «It just drives people crazy.»

Most people who have bed bugs experience mental health consequences

A majority of people who experience bed bugs suffer psychological harm as a result, according to Goddard’s research , which looked at the critters’ psychological effects based on 135 victims’ online accounts. His work found that 81% of bed bug victims reported negative mental health side effects, including paranoia, trouble sleeping, nightmares, and an extreme level of vigilance to prevent the bugs from returning.

Other symptoms include obsessive or intrusive thoughts and heightened anxiety. «There can even be flashbacks, where a person sees a speck of something [that looks like a bug] and that triggers them to re-experience the event,» said Alexis Hansen, a trauma-oriented psychotherapist.

These symptoms are all characteristics of PTSD, according to the Mayo Clinic. O ne person in Goddard’s study scored high enough on a checklist that he or she could have been diagnosed with the condition using the American Psychiatric Association’s diagnostic criteria .

Goddard said his research doesn’t account for people’s mental and emotional state before the bed bugs, so it’s possible some of the symptoms were pre-existing. And, because the study was based on internet posts, it is only representative of people who chose to share their experiences online, potentially leaving out a larger population with less severe symptoms.

Still, other research has suggested bed bugs could cause mental health symptoms in psychologically healthy individuals, and they certainly can exacerbate symptoms for people with previous illness.

Bed bugs have the power to make people feel helpless and trapped

Hansen said the psychological toll of bed bugs is related to two factors — first, the bugs invade the intimate space of your home and bed and second, they typically attack when you’re sleeping and at your most vulnerable. «It’s your safe space and something invading that is really terrifying,» she said.

Goddard came to a similar conclusion in his research. «If you’re outside and get bit by mosquitoes, you can go inside,» he said. » But if bedbugs are in your house, where are you gonna go? You can’t just get away from the world and go to bed, because that’s where they are.»

This creates a perception of being helpless and unable to escape, he explained, prompting people to take protection measures that seem irrational to those who haven’t experienced an infestation. Goddard has heard from people who have changed clothes five or more times a day, put all the legs of furniture in cans of kerosene, and soaked themselves in bleach, all in an effort to not let the bed bugs bite.

Gavin Stern, a former bed bug victim, gets it. He experienced a bed bug infestation while he was a grad student in Stony Brook, New York, in 2011. He still thinks about it eight years later.

«It was a nightmare,» Stern said. «You basically have to uproot everything. It’s a major calamity out of nowhere. You don’t feel safe in your own house.»

The six-month ordeal permanently changed the way he views the world, Stern said. He now looks closely at every bug, particularly since he’s a homeowner now and has to worry about the potential financial damage of an infestation, which can cost upwards of 5,000 to exterminate. Thoughts of bed bugs are now a routine concern alongside everyday worries like whether he turned off the stove or locked the door, Stern said.

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«There’s not many events from that long ago I still think about,» he said. » There is life pre-bedbugs and post-bedbugs.»

Bed bugs’ mental health harms are a ‘social justice issue’

Dr. Stéphane Perron, a public health physician and professor of the University of Montreal, has also studied the psychology of bed bug-related trauma. He said that some anxiety about the pests is natural.

«It’s normal to be stressed by bed bugs in your house; it’s adaptive to do something about it,» he said. «If you had bed bugs and did not react, you’d probably have a mental health issue.»

As Hansen put it, «during the infestation, it makes sense to feel anxious and obsessive about it, and it’s almost the energy you need to deal with it.» In psychologically healthy people, the anxiety typically passes soon after the problem is resolved, she said.

But for people who already live with mental illness, are isolated, older, or live in poverty, the risk of lingering or severe trauma from bed bugs is higher.

One case study in Perron’s research describes an elderly woman who committed suicide after repeat infestations of bed bugs in her apartment. She had previously struggled with mental illness and could not afford to move out of the infested building.

Other r esearch has also linked bed bugs and suicidality in multiple cases, particularly in people with a history of mental illness.

A strong stigma associated with bed bugs can also isolate vulnerable people from their support networks, Hansen added. «There’s a lot of shame attached to people having bed bugs,» she said. This can make it difficult for people to talk about their experiences, even with mental health professionals, who can be guilty of perpetuating the stigma themselves.

During Hansen’s work as an in-home therapist for at-risk youth, for instance, some clinicians were wary of meeting with clients who had bed bugs. «There’s an ethical issue there because we have to deliver the service, and how do you do it when the staff is afraid to enter the home?» she said.

The worst cases occur when people are living in unfit housing, Perron added, where landlords are unresponsive and residents lack the resources to solve the problem themselves. A few months of neglect can cause a full-blown infestation, and a severe infestation can make it hard to fully eliminate the bugs.

And, Perron’s found, the longer you deal with bed bugs, the greater the mental health consequences. It’s a «social justice issue,» Goddard said.

Understanding how to get rid of bed bugs can help alleviate fears

Part of the psychological burden of bed bugs is that their terrifying traits are exaggerated in mythological proportions — people believe they can fly, hide anywhere, and are impossible to kill.

None of this is true, Goddard said, and the key to psychological resilience in the face of bed bugs is a hefty dose of reality.

«You can kill them. They actually die pretty easy,» Goddard said. «They’re not magic.»

They’re also easy to spot, once you know the signs. Although they are small, particularly the eggs and nymphs, bed bugs are in no way a subtle species.

Other myths are that they multiply quickly, travel on your body or in your hair, and will relentlessly pursue you and your neighbors in search of a meal. In fact, bed bugs can’t sense humans outside of about a 3-foot radius, Goddard said. He added that although it’s true they can sneak into clothes and luggage to hitch a ride, they’re definitely not going to chase you down the street or come running down the hall into other rooms of your house.

Bed bug infestations, especially when caught early, can be very manageable. It can take months before an infestation really gets out of control, according to Goddard. But, he added, people should never try to tackle it alone or waste money on DIY products — always contact an exterminator.

And, if your mental and emotional symptoms linger after the bugs are long gone, consider another kind of professional help: that of a therapist.

«Don’t just live in a world of fear and suspicion and paranoia. Don’t withdraw from society,» Goddard said. «Talk to someone.»

Bed bugs

If you’re waking up feeling itchy, bed bugs may be the problem.


Bed bugs are small insects that feed on the blood of sleeping people and animals at night. During the day, they hide in dry, dark places.

The bites of bed bugs aren’t usually a health hazard, but they can be irritating. Scratching at them can cause infection.

If you’ve got bed bugs, you’ll need to find the infestation, then treat it with pesticide.

Many people pick up bed bugs in their luggage when they’re travelling. You can also bring them into your home in second-hand furniture, bedding or clothing.


Bed bug bites affect everyone differently.

  • Some people have no reaction and don’t even develop bite marks.
  • Most people get a series of itchy bites, similar to mosquito or sandfly bites. These may not show up until a few days after you’ve been bitten.
  • Some people are allergic to bed bugs’ saliva. This means they may get painful swelling or enlarged bite marks.
  • In very rare cases, people can have a severe allergic reaction called anaphylaxis. This is a medical emergency and you should dial 111 immediately.


The bites of bed bugs aren’t usually dangerous.

  • As with mosquito bites, the best thing to do is avoid scratching.
  • If you have a mild allergic reaction, use an antihistamine.
  • In the rare event of an anaphylactic reaction, dial 111 immediately.

Getting rid of bed bugs

You can kill bed bugs by washing and drying bedding and clothing at high temperatures. However, it’s important to figure out where the actual infestation is, as they often hide in furniture and walls.

If you think you may have bed bugs, have a look in and around your bed. Bed bugs hide in dry, dark places, such as mattresses, headboards and bed frames, furniture, drapes, and cracks in walls and floors.

  • Adult bed bugs are a reddish brown colour. They have a flat oval body around 4–7 mm long.
  • Young bed bugs look the same, but are smaller.
  • Bed bug eggs are around 1 mm long and are white.

You may find live bugs, cast-off skins, eggs or faecal stains (small dark brown or black marks).

Check other bedrooms in the house, too: bed bugs can’t fly, but they can crawl short distances.

Once you’ve found the infestation, you should use a pesticide to kill the bed bugs: ask at your hardware store or supermarket. Alternatively, you could hire a pest control expert. (If concerned about pesticides, ask about eco-friendly products.)

Bed Bugs in the Workplace

What are bed bugs?

Bed bugs are small, oval shaped, wingless insects. The bugs are about the size of apple seeds. The eggs are white, and are found in clusters. The eggs are about the size of a pin head. The flattened bodies of bed bugs allow them to hide in very small places such as seams of mattresses, cracks, crevices, electrical outlets, box springs, bed frames, headboards, behind wallpaper, or in any other objects around a bed or on the floor. Bed bugs cannot climb metal or polished surfaces and are not able to fly or jump.

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Bed bugs typically feed on a diet consisting solely of blood once a week, but they can live months without feeding. They have about a one-year life span during which time females can lay up to 200-400 eggs which hatch in about 10 days. The bugs usually come out at night to feed on the blood of people and animals, biting their victims as they sleep.

How can infestation occur?

Bed bugs move very quickly and can travel through hallways, plumbing, and electrical lines. They can climb into bags or on clothing. They usually feed at night and hide during the day. These insects prefer darkness and tend to hide near the bed. They travel up to 20 feet in search of a human host.

Who is at risk?

Bed bugs can be found anywhere that humans live or visit. Bed bugs can be unknowingly brought into the workplace by employees, custodial staff, visitors, customers, vendors, clients, and others.

Workers potentially at higher risk are those who handle bedding, clothing, or furniture where bed bugs could be hiding. These occupations include fire fighters, health care professionals, housing management staff, housekeeping and custodial staff, police, and social workers who work in or visit hospitals, long-term care facilities, shelters, rooming houses, hotels, motels and residences.

What are the symptoms?

Bed bugs are not known to spread diseases and the bites do not usually require any medical treatment. One way to identify a bed bug infestation is by the bite marks on the face, neck, arms, hands, or any other body parts while sleeping. However, a bed bug bite can take as long as 14 days to appear, depending on the person.

When bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing they are being bitten. Some people do not react at all to the bites, while others may have small skin reactions. The bite marks are similar to that of a mosquito or a flea; slightly swollen and red area that may itch and be irritating. In rare cases, some people may have severe allergic reactions.

To avoid infection, try not to scratch the bites and keep the bite sites clean. Using antiseptic creams or lotions, as well as antihistamines, may help. Talk to your health care provider for advice.

How do I find bed bugs?

Some workplaces are susceptible to bed bugs, or perhaps you will find them while working in a client’s home or when travelling for work.

Seeing bed bugs can be difficult, but you can try to inspect both hard and soft furniture (such as the head board, night stand, mattresses and box springs) or around electrical outlets and light switches. Look at the seams, between cushions, in the folds of blankets or curtains, etc. for bugs, eggs, or blood stains/droppings. One option is to run an object with a sharp edge (such as a credit card) past these areas to disturb any bugs that may be present.

If you suspect bed bugs are present in the workplace, report this to your supervisor. If your concerns are not addressed in a timely manner, you can report the concern to your joint health and safety committee or health and safety representative. You may also be able to confirm if you have bed bugs by consulting with your local public health unit or pest control operator.

How do you prevent bed bug infestation?

The best way to prevent bed bugs is regular inspection for the signs of an infestation.

  • Be careful when buying used furniture. Inspect each item carefully and wash/clean before use.
  • Reduce clutter, as it serves as an ideal habitat for bed bugs whether at home, school, or at work. This housekeeping measure will reduce the number of places for the bed bugs to hide and fewer opportunities for them to travel home with you.
  • Keep your belongings stored separately from those of other people. If there is a known problem with bed bugs in the workplace or at school, consider storing your belongings in a separate plastic bin.
  • Be vigilant in areas where bed bugs are most likely to be found – including break rooms, storage areas, offices or lounges with upholstered furniture, or areas where people may rest.
  • Consider changing into work clothes and shoes when arriving at work and removing them before going home (when there is a risk of infestation).

What are the employer’s responsibilities?

Employers have duties under the occupational health and safety Acts and its applicable Regulations to take every reasonable precaution to protect the health and safety of the worker.

The following precautionary measures can be taken to prevent bed bug infestations and to protect the worker based on a risk assessment conducted of the workplace:

  • Develop policies and procedures for reporting bed bug infestations (on-site and off-site workplaces).
  • Keep records of infestations, including details of where and when infestations were encountered and the extent of infestations.
  • Provide education to all workers regarding bed bugs, including information on bed bug identification, signs of infestation, and prevention awareness.
  • Implement integrated pest management activities through a licensed pest management service provider.
  • Provide coveralls, shoe covers, or gloves to workers if appropriate. Provide sealable plastic containers to protect workers’ equipment or belongings.

How can bed bugs be removed?

Bed bug infestations are commonly treated by chemical spraying. An integrated pest management system which combines a variety of techniques and products is usually the best option. Information on the safety data sheet should be read and used as directed. To reduce exposure to the chemicals being used for treatment/spraying, it should not occur while employees are in the area. Always follow safe work procedures when working with or near pesticides. See the series of documents about pesticides for more information.

Other physical methods of controlling bedbugs include steam cleaning, vacuuming, heating, freezing, washing, or throwing out items. Steam cleaning should be done before vacuuming, as the steam will flush any bedbugs out of hiding. Heat treatments should be done by professionals.

Whichever treatment is used, it will only be effective if physical control methods and preventative measures are used together.

If you suspect bed bugs have entered your suitcase or clothing, prevention steps include to unpack outdoors, wash clothes using hot water, dry everything in the dryer at the highest temperature for at least 30 minutes, and vacuum your luggage thoroughly.

Add a badge to your website or intranet so your workers can quickly find answers to their health and safety questions.

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What’s New

Check out our What’s New listing to see what has been added or revised.

Pets in Bed: More Dangerous Than Bedbugs?

Sleeping With Dogs, Cats Linked to Disease, Infections, Parasites

Jan. 14, 2011 — We’re all having nightmares about bedbugs, but your bed pets may be the real danger.

In the U.S, surveys indicate that up to 56% of dog owners and 62% of cat fanciers regularly fall asleep with their pets in their bed. Reports from the U.K., Netherlands, France, and Japan suggest that this isn’t a peculiarly American quirk.

But those cuddly pets harbor some icky germs, worms, and cooties, note Bruno B. Chomel, DVM, PhD, of the University of California, Davis, and Ben Sun, DVM, of the California Department of Health.

«Sharing our resting hours with our pets may be a source of psychological comfort, but . sharing is also associated with risks,» they write in the current issue of the CDC journal Emerging Infectious Diseases.

It’s not just small animals. Chomel and Sun note that a survey recently reported by WebMD showed that 62% of small dogs, 41% of medium-sized dogs, and 32% of large dogs sleep in their humans’ beds.

So what do these bed pets bring to our beds?

Bubonic Plague

Humans get bubonic plague from fleas. Chomel and Sun recount various cases of plague linked to sleeping with cats. These include a 9-year-old boy from Arizona who slept with his sick cat.

And a 2008 study of plague survivors found that 44% of them slept with their pet dog, while only 10% of matched comparison subjects slept with their pets. This dog-in-bed plague risk remained significant even after the study authors took into account a large number of other factors.

This last factoid is troubling because dogs — unlike cats — can carry plague fleas without showing symptoms of the disease.

Chagas Disease

Chagas disease is a potentially fatal illness caused by a protozoan parasite. It’s usually spread by the «kissing bugs» and other blood-sucking bugs.

But one study from Argentina suggests that people who own dogs and cats are at increased risk of the dread disease — and that infection rates are significantly higher for those who sleep with their pets.

While Chagas disease is uncommon in the U.S., some experts worry that it is working its way northward through Mexico.


Cat-Scratch Disease

As the name implies, cat scratch disease is transmitted by being scratched by cats that harbor fleas infected with disease-causing bacteria. But being licked by a cat can also spread the disease.

In a Connecticut study of risk factors for cat scratch disease, patients were more likely than matched comparison subjects to have been scratched or licked by a kitten — or to have slept with one.

The multidrug-resistant strain of strep known as MRSA rapidly is becoming widespread in the U.S. Humans can carry the bug in their noses — and so can dogs.

Chomel and Sun recount the case of a couple that kept getting MRSA infections over and over again. Finally, doctors learned that their dog slept in their bed and licked their faces. Tests of the dog were positive for MRSA. And once the dog was rid of the germ, the couple stopped getting MRSA infections.

Other Bacterial Infections

Contrary to popular belief, the mouths of dogs and cats are not sterile. There are several bacteria that live in the mouths of carnivorous animals. Humans, particularly those with impaired or immature immune systems, can become infected.

Chomel and Sun describe one case of meningitis linked to a pet dog that often licked a baby’s face.


Dogs often carry hookworms and roundworms. They can also carry protozoan parasites. These parasites, or their eggs, can sometimes be found on a pet’s fur.

What You Should Do

It’s relatively rare to get any of these infections from sleeping with a pet. But as Chomel and Sun show, it does happen.

They recommend that pets get regular veterinary examinations and vaccinations.

Because young children are at higher risk than adults, they recommend that small kids and adults with compromised immune systems avoid sleeping with, kissing, or even being licked by pets.

And they recommend that any area licked by a pet should immediately be washed with soap and water, especially if the pet licks an open wound.

«Our review suggests that persons, especially young children or immunocompromised persons, should be discouraged from sharing their bed with their pets or regularly kissing their pets,» Chomel and Sun suggest.

Can You Get Bed Bugs by Being in a Person’s House Who Has Them?

About the Author:

Lillian Downey

A Jill-of-all-trades, Lillian Downey is a certified Responsible Sexuality Educator, certified clinical phlebotomist and a certified non-profit administrator. She’s also written extensively on gardening and cooking. She also authors blogs on nail art blog and women’s self esteem.

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Bed bugs are back in epic numbers after having once been nearly eradicated by dangerous pesticides. Since the pesticide that nearly wiped them out isn’t used in the U.S. anymore, the bugs have made their way back into the mainstream. Part of why they travel so fast is because they’re small and sneaky, and easy to pick up from someone’s house or an infested hotel. If you know the signs of infestation and take proper precautions when you travel or visit friends, you can avoid inviting the pests into your bedroom.

Where Bed Bugs Live

Bed bugs typically live in bedrooms because they feed at night on human blood. Still, staying away from an infested bedroom won’t eliminate the chances that you’ll bring them home. Bed bugs like to be near people and if people spend a lot of time on couches or lounging next to book cases, bed bugs can live near those areas as well. Because they’re so small, you friend might not even know she has them until the infestation gets big enough to become more obvious.

How They Travel

Bed bugs travel when we travel. In fact, traveling is one of the most common ways the bugs spread. Bed bugs come out at night and don’t like to be disturbed, so they don’t live on people. They prefer dark places, like under your mattress. Still, if bed bugs are hungry enough, they will come out in the daytime. If they do, it’s possible to carry them home on your clothes. What’s more common is to carry them home in your bags or luggage. If you climb into bed or plop down on a couch, you could disturb bed bugs and they may scatter into your baggage.

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