Periodically someone will come in to our office or call us on the phone complaining of tiny pests biting them, often at night.  Sometimes they will have physical symptoms such as rashes or sores and scabs.  They say they've seen doctors and tried everything; Home remedies, over the counter pesticides, professional pest control services, but nothing seems to help.  Some bring in plastic bags, or other containers with "specimens" which are actually only lint, dust, bits of debris and sometimes scabs or other unsavory detritus, hoping that we can identify them as pests.  They are in genuine anguish and we want to help them so we go to their houses, we inspect and find nothing.  Unfortunately, everything they believe they are experiencing appears, in the final analysis, to be imaginary and we are powerless to alleviate their suffering.  Without positive identification of a pest organism we can't prescribe or perform a treatment.

The suffering of these individuals is real but not pest related.  So what could be causing their misery?  Sometimes there are physical reasons for their symptoms as with a condition described by the Mayo Clinic called Morgellons Disease.  This is a mysterious controversial condition that is still under investigation and not all researchers agree that it's real or what its causes may be.  According to the Mayo Clinic website, Morgellons symptoms include:

• Crawling sensations on and under the skin, often compared to insects moving, stinging or biting.
• Fibers, threads or black stringy material in and on the skin
• Severe Fatigue
• Inability to concentrate and short-term memory loss
• Behavioral changes
• Joint Pain
• Vision Changes

More often however, the problem appears to be psychological in nature.  There are different terms used by the medical profession when referring to this condition:

• Illusory Parasitosis
• Delusory Parasistosis
• Delusional Parasitosis
• Delusions of Parasitosis.

The Minnesota Department of Public Health says on their website that, "Delusional Parasitosis is a psychiatric condition, suffered mainly by older women although younger people, including men, can be affected.  DP is a disorder characterized by people having the mistaken belief that they are parasitized by bugs, worms or other creatures."  According to University of California, "This belief is based on the sensations felt in the skin that are very real to the sufferer."  They state that causes for sufferer's symptoms can include stress, reaction to use or abuse of prescription or illicit drugs, a variety of environmental factors or Delusory Parasitosis.    This condition can be induced by various kinds of stress, including work-related pressures, relationship issues, or financial stress.  Individuals suffering from delusions of parasites can sometimes scratch themselves so badly as to damage their skin, causing rashes and infections resulting in sores and scabbing.  These can serve to reinforce the patient's belief that biting arthropods or other organisms are involved.  According to the University of California, persons with DP sometimes employ desperate measures to alleviate their symptoms.  They will apply unconventional and toxic substances, including pesticides, to their bodies, jeopardizing their health (and possibly their lives) in the process.  It's been observed that persons afflicted by this disorder will sometimes mutilate themselves in an effort to get rid of the perceived infestation.

This condition can become serious and should not be ignored.  The consensus of my sources seems to be that, If you suspect that you are suffering from DP or you suspect that someone you know is suffering from it and an actual pest or parasite infestation has been ruled out, medical attention should be sought as soon as possible and tests should be run to rule out any physiological causes for the symptoms.  If no physical conditions are diagnosed your physician may refer you to a counselor or mental health professional.  Patience is indicated as your health care providers sort through the causes and prescribe the best treatment for your individual case.