A bug’s life: The psychological impacts of living with insects

By Sherina Harris

Two years ago on a May morning, Eduardo Rodríguez, then 25, stood in his room with his phone in one hand and a crumpled tissue encasing a dead bug in the other. He was making his bed when he noticed something small and black crawling on one of his light blue sheets. For the past two weeks he had been waking up with red, itchy bumps on his legs. He assumed they were mosquito bites, since he had experienced those before in his apartment. But the black speck on his sheet made him wonder if this wasn’t the case. Could it be bed bugs? the Ryerson University second-year global management studies student wondered. He recalled reading articles about Toronto’s bed bug infestation problems.

He smashed the insect in a tissue and immediately Googled “bed bugs” on his phone. When the images matched the dead bug in the tissue, Rodríguez knew that what he had thought to be mosquito bites were a sign of something more serious. Some bed bug websites advised replacing an infested mattress, but his mattress was a recent purchase from his parents, who he lived with. Feeling bad about the possibility of having to replace it, Rodríguez continued researching other ways to get rid of bed bugs.

He read that one way to get rid of them is to vacuum the affected areas. But—in a twist of irony—his vacuum “sucked.”  His family took a day to buy a new vacuum cleaner. “The first night I discovered I had [bed bugs], I didn’t want to sleep in my own bed again because I didn’t want to wake up with more bed bug bites on my legs,” Rodríguez recalls. “I was also grossed out by my bed.” That night, he shared a bed with his parents.

In August 2017, Toronto was ranked the worst city in Canada for bed bugs. There are currently 2,270 reports for bed bugs in the city, according to the Toronto Bed Bug Registry. Dense, urban areas where people live in close proximity, like in apartments, make it easier for bed bugs to spread, according to University of Winnipeg entomologist Rob Anderson. Bed bugs can travel through electrical pipes, heat ducts and other openings between walls. This means that when one apartment is infested, it is possible that the bugs will travel to nearby apartments.

Bed bugs have not been found to transmit diseases, but a growing number of studies indicate infestations can cause psychological impacts. “Bed bugs are a stressor,” explains Stéphane Perron, a physician who works at Montreal Public Health and specializes in public health and preventative medicine. Even if someone has no history of mental health issues, “a bed bug infestation will lead to some form of anxiety symptoms in most people, and sleep disturbance.”

 

In August 2017, Toronto was ranked the worst city in Canada for bed bugs

 

In a 2012 study from the journal BMJ Open, a group of researchers compared 39 tenants who had been exposed to bed bugs and 52 tenants who had not. Using sleep quality indexes and anxiety scales, they found that the bed bug sample was more likely to have sleep disturbances and develop symptoms of anxiety and possibly depression. Perron, who was a co-author of that study, says these effects can be “chronicized” if improper extermination leads to reinfestations of the bugs.

But Toronto tenants don’t just deal with bed bugs. A 2016 study by ACORN Toronto—which represents low and moderate income families—found 83 per cent of tenants surveyed have spotted cockroaches in their residences. The Toronto Real Estate Board reported that the average cost of a Toronto apartment is nearly $2,000 in 2017.  With this soaring cost, some students feel like it’s hard for them to find bug-free, affordable housing in Toronto.

Rodríguez said his reaction to the bugs felt like anxiety. In addition to worrying about getting rid of his mattress, he was stressed about how the infestation occurred in the first place. “I was worried … without knowing how it happened,” Rodríguez says. “Do I really live that dirty, that I did it myself?”

Even if someone typically experiences healthier mental states, stressful events, like bed bug infestations, can be the trigger for people to experience heightened levels of anxiety, says Kathleen Stewart, a Ryerson graduate student in psychology. This anxiety can be even worse for someone with a pre-existing bug phobia. “Some people … have a lot of difficulty coping with even just one spider in their house so if you’ve got an infestation, that anxiety can be really overwhelming,” Stewart notes.

Rodríguez’s windows were open, but the fresh air was doing little to combat the heat. He was cleaning his room, trying to move as quickly as possible.

With his TV blaring in the background, he used his new vacuum to clean all the corners of his mattress and the areas around his bed. Bed bugs can lay eggs, so he tried to clean all of the folds and crevices. He also washed all of his sheets and clothes, and purchased a bed bug powder which he sprinkled around his bed.

The cleaning took all weekend. He wasn’t finished the first night, so he slept in his parents’ bed again. The second night, he took a break from cleaning to watch the Mayweather vs. Pacquiao fight with his dad at a bar. When he returned home, he kept cleaning until 3 a.m. It was exhausting but Rodríguez was determined to prevent the bed bugs from returning. The first few nights after, he would wake up and cautiously check to see if he had new bites. His legs were still healing from his previous bites, so it was difficult to tell, but he couldn’t spot any new ones.

Not everyone has Rodríguez’s luck with getting rid of bed bugs, though. Anderson, the entomologist, says the process is problematic. “There are very few registered pesticides in Canada that are allowed for use in dwellings where people are currently residing,” he explains. Urban pesticide resistance means that the products that are approved may not even be effective. Other methods include cold and heat treating, but it can be hard to get the bugs out of the small spaces.

In the darkness, Alp Paksoy thought he was hallucinating. It was the middle of the night, and there were cockroaches and spiders crawling in his room. But it was not a hallucination—a bug-filled apartment is Paksoy’s reality. He went back to sleep and, in the morning, the bugs were gone. He rarely sees them during the day—they hide in the thin cracks in the walls and in frighteningly inconspicuous places, like under the kitchen sink. When he does encounter a bug during the day, he wraps his hand in paper towel and kills it. He lives with his sister in a Toronto apartment building. He kills the bugs that make her scream and jump on his back. Their presence adds a layer of stress to his already-busy life as an international student from Turkey, in his second year of studying business management at Ryerson.

According to a 2016 study from the journal PeerJ, there is an average of 100 different species of bugs living a typical American home. Paksoy, 24, describes having the bugs in his apartment as “morbid.” He says he feels uncomfortable, stressed and unsafe. Although he doesn’t have a phobia of the bugs, his sister is more frightened of them. “No matter how hard I try, she doesn’t really feel comfortable with bugs. Sometimes she doesn’t sleep … she was paranoid.”

The first attempt at extermination was in September, but the bugs quickly returned. Another company came in November, but Paksoy wasn’t convinced that the bugs were gone. Sure enough, less than two weeks after the second extermination, he saw another spider crawling on the wall. Paksoy’s address, on Spadina Avenue, shows up on the Bedbug Registry website, a forum with posts dating back to 2011. Tenants have reported cockroaches, bed bugs, silverfish  and mice. People have reported multiple attempts to spray their rooms, with the bugs always returning. “The real residents of this building are the roaches,” one anonymous poster wrote.

 

“Usually [in] an apartment … you’re supposed to feel safe. But with the bed bugs, I know it’s a matter of when—not if—they’re going to come back”

 

In a 2012 study from the American Journal of Medicine, two scholars studied 135 posts on blogs and bed bug websites. They used the criteria for Post Traumatic Stress Disorder (PTSD) outlined in the Diagnostic and Statistical Manual (considered to be the guide on mental disorders) to score each entry. About 81 per cent of the posts suggested that bed bug infestations caused psychological impacts, although PTSD cannot be formally diagnosed without being aware of the posters’ symptoms before the infestation.

“[For] most students, what it’s going to be is really a fear that won’t get to a point where it’s clinically visible,” Perron says. “But when the bugs do come back, then it will have a bigger impact than the first time around.”

Despite the current studies on the psychological impacts of bed bug infestations, Perron says there is still work to be done. “It’s still seen in many corners as being just a nuisance, not being a public health issue. But it is a public health issue,” he says. More work needs to be done to understand the psychological impact of bed bug infestations, especially for people who are already vulnerable.

Paksoy was in the kitchen cooking dinner with his sister, the scent of vegetables and chicken wafting through the air. Suddenly, his sister screamed—completely altering the mood of the evening. Three spiders were crawling on the white living room wall, their thin brown legs in full view of the kitchen. She told him to stop cooking and kill the bugs. Paksoy obliged. Afterwards, worried about insect eggs, the pair had to wash all of their dishes. “Most of [the bugs] are in the kitchen which is, I think, really disgusting,” Paksoy says.

Paksoy’s apartment was built in 1972, according to a zoning amendment from the city of Toronto. Over the years, the walls have acquired cracks and holes. This is why, despite his two efforts to get his apartment exterminated, he was not counting on the bugs to stay gone. “I don’t really trust them at all,” he says of the exterminators. The first time a company came, “they didn’t really do a good job,” he says. They didn’t exterminate his bathroom because they didn’t think bugs would come in there—but the bugs returned after this attempt, and again after the second attempt by a different company.

The most recent attempt at extermination took several hours to complete, plus around six hours to put everything back in the apartment the following day. The ordeal was an inconvenience for Paksoy—and one he may have to relive, if the bugs return again in full force. He says lots of people have complained about the building and, judging by the online forums, he may have to deal with it again no matter where he moves.

“As soon as my contract is over,” Paksoy says, “I don’t think I’m going to renew it.”

In a 2013 paper from the American Journal of Case Reports, which Perron also co-authored, presents the case of a woman who died by suicide following a bed bug infestation. The woman had previously been diagnosed with bipolar disorder and borderline personality disorder. After two attempts at extermination, the woman woke up at 3 a.m. and found blood on her sleeve. She penned a note, writing that she had experienced depression since the bugs came, and was going to move on to a “better world.” In an email to a friend, she wrote that she was “sure that vampires are back” and that she could not “stand to live in fear of being eaten alive.”

“What this really shows is [that] bed bugs can be a very important stressor,” Perron says. “Bed bugs won’t make you commit suicide, but in extremely vulnerable individuals, it may be the tipping point.”

People may be anxious about the bugs returning, especially in buildings where infestations are common, Stewart says. And even if the bugs are exterminated for good, people may still feel “that urge to check again, [and see] ‘Oh, are they really gone? They came back before.” If these thoughts about bed bugs are consuming people’s minds, that can cause further anxiety. This anxiety can manifest in hyper vigilance, causing people to feel itchy, constantly check if there are bed bugs around them and to over-wash and clean their apartment, according to Stewart.

 

This anxiety can manifest in hyper vigilance, causing people to feel itchy, constantly check if there are bed bugs around them and to over-wash and clean their apartment

 

It was the middle of the night when Maythany Boutthiphon, now 25, woke up and felt something on his foot. He pulled the blanket aside and saw a black dot, which he squished with his thumb. Blood oozed from the dead insect. Alarmed, Boutthiphon took his blanket off his bed and slept on a hard, plastic chair for the remainder of the night. Why is this happening to me? he remembers thinking. Why am I here? Maybe I should go find another place.

Boutthiphon thinks his experiences are similar to many other students in Toronto. “I’d say it’s pretty tough for students, because they’re on a limited budget so they have to find apartments that are, I would say, not well-maintained. I think that’s the reality of some students,” he says. Not all students can afford to move out of an infested apartment or terminate their lease early. The high and often unexpected cost of extermination is also something a student might not factor into their budget.

This night occurred in the middle of a bed bug infestation in his first apartment—Boutthiphon, a third-year business management student who lives with his wife, mom and siblings, has experienced infestations in two different Toronto apartments.

In 2012, he moved out of the apartment to a townhouse, where he stayed until 2016. When he moved to his current apartment, he checked bed bug registries. Although he read about other people’s infestation problems, he didn’t think it would happen to him. But it did. His new apartment was also infested, and the problem extends beyond his unit.

People talk about bed bugs in the elevator of his current building. During the summer months, he regularly saw mattresses and furniture by the elevator for the maintenance crew to take away. “I’m thinking, OK, well, why are these people throwing this furniture out? It still looks good and everything. And that’s when I realized it’s probably because of some sort of infestation,” Boutthiphon says. He noticed black residue on some of the mattresses—likely bed bug feces. He has also noticed extermination vans parked outside his building.

“It’s one of my biggest fears, living in an apartment, because of the cost that I will have to fork up to get rid of them,” Boutthiphon says. In his current apartment, he had to replace his mattress. He estimates that he has spent over $500 on getting rid of the bugs—including a new mattress, pesticides and medication to treat the bites; and that’s just the price of one infested apartment. The air from spraying the pesticides sometimes just blew the bugs to the side, so Boutthiphon and his wife had to resort to killing the bugs by hand, using the pesticide cans. Black residue and blood would emerge from the larger bugs, creating a horrible smell.

Boutthiphon says watching his wife deal with the bed bug infestation makes him feel “helpless.” One day, she came home from work on the verge of tears as she showed him the bug bites on her chest. “It makes me feel like I’m not doing my job [as a husband],” he says. He and his wife are making plans to move out of their apartment in March or April. Another day, Boutthiphon was at work and noticed a bed bug crawling on his backpack. He became worried about spreading the infestation. This, combined with the times when bugs bit his face and neck in places visible to classmates, caused him “unnecessary stress.”

“Usually [in] an apartment … you’re supposed to feel safe. But with the bed bugs, I know it’s a matter of when—not if—they’re going to come back. So it’s kind of an uneasy feeling looming around my head, like, when are they going to come back?” Boutthiphon says. “I really don’t want to go through all the negative feelings, and the whole process, again.”