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Bed bugs: ‘Until you go through an infestation, you have no idea just how horrifying it really is’

Dr Muiris Houston: These home invaders bite psychologically as much as physically

Are you someone who struggles with a fear of insects? Has this autumn’s noticeable increase in spider activity affected you? And did the recent media focus on the explosion of bed bug numbers in France make your skin crawl?

If so, you may be one of the estimated 5 per cent of the population who suffer with entomophobia, aka insect phobia. Those with the condition experience extreme anxiety or fear when encountering or thinking about certain insects. If your fear is of spiders, then you have arachnophobia; katsaridaphobia is the medical term for a fear of cockroaches; and if you fear ants then you are a myrmecophobe.

Insects can evoke a sense of distress and anxiety in some of us. For example, head lice infestations in children have been shown to cause feelings of low self-esteem and high levels of anxiety for both children and their parents. Bed bug infestations may similarly lead to mental health consequences, such as nervousness and insomnia.

The common bed bug, Cimex lectularius, has been a parasite of humans for thousands of years. Historically, these tiny bloodsuckers were common in human dwellings worldwide. They disappeared in developing countries for about 70 years, until the mid-1990s, when they began making a comeback. This coincided with restricted use of pesticides such as DDT and increased international travel.


While there is little evidence that bed bugs transmit infectious disease, they bite us in order to feed, leading to itching and skin inflammation in the form of itchy red spots. But it is bed bugs’ psychological impact that stands out: they can trigger nervousness and insomnia. A Canadian who experienced a bed bug invasion described it like this:

“To be honest, until you go through [an infestation], you have no idea just how horrifying it really is. It is just natural for you to become paranoid; you lose sleep, you end up dreaming and thinking about bed bugs – they just consume every fibre of your being.”

Prof Jerome Goddard and colleagues from Mississippi State University analysed some 135 internet posts concerning bed bug infestations. In some 80 per cent of the posts, victims reported reactions like a re-experiencing of the event through intrusive memories and nightmares. In addition they developed startle responses and hyper-vigilance after the event which was reminiscent of a post-traumatic distress reaction. And five of the posters reported persistent avoidance of people and places that might lead to transmission of insects or trigger memories of the original encounter.

Although there is no scientific explanation for why people are afraid of insects, it is likely to be influenced by childhood experiences and cultural influences.

Keeping bed bugs out of houses and apartments can be difficult, especially if you travel a lot, says Goddard. “After travelling, unpack luggage in the garage, and wash all clothing from the luggage in hot water and dry on high heat, if possible,” he advises. “Bed bugs can also hitch a ride into your home on used furniture or items purchased at second-hand stores or garage sales. Be sure to disinfect – more precisely ‘dis-insect’ – those kinds of items.”

Not every hotel room has bed bugs, but some do. Indeed, the recent “scare” in Paris highlighted trains, ferries, buses and even cinemas as alternative sources of bed bug infestation.

What treatments are available for insect phobia?

Exposure therapy is one of the most effective methods for overcoming a phobia. The goal of this approach is to gradually expose a person to their fear, allowing them to desensitise themselves and eventually overcome it. Cognitive-behavioural therapy (CBT) can also help those struggling with their fear better understand its roots and develop more helpful ways of thinking and acting.

A key element of CBT could well be a rejection of the dated saying, “sleep tight, don’t let the bed bugs bite”. Sleep disturbance and an inability to influence the bed bug’s nocturnal feeding are a more likely reality.