I do not have bugs, I have mental Illness

August 16, 2022 10:07 PM

I very often have a sensation of bugs crawling on me. I do not have bugs crawling on me, and would like some guidance about how to cope.

I have a very extreme panic/anxiety/PTSD disorder. I also have chronic pain (primarily in my joints and with migraines). Things are mostly ok, except when I get triggered and then I am plagued by imaginary bugs tickling me. This happens on days when I have had a panic attack, usually several hours after it has passed. Sometimes it will also happen several hours before a panic attack, usually if I am feeling agitated. It manifests on my lower legs, my upper arms, neck and chest. Occasionally it will be on my face.

I find this sensation aggravating and upsetting. I usually uncontrollably slap my hand over the spot - as anyone would if they felt a fly or mosquito land on them! - only later realizing that it’s a phantom. My brain amps up and insists that it’s there and I often have people check to make sure they don’t see something there. I know this is alienating behavior but being jittery and shaky because I have invisible bugs on me is just as bad, I think.

What are some strategies that might reduce this feeling or help it pass more quickly? How can I be less aggravated by it when it is happening?

I am open to both physical suggestions and mental mantras or whatever. I would like suggestions from people who have either dealt with similar phantom feelings or who have direct experiences with people who have. I am less interested in people who have professional experience with people like me because I do not like to be pathologized or treated like a specimen. If you approach me with respect, I am ok with interacting with professionals, but please refrain from being clinical. I am open to suggestions of things to check out medically, but want to be clear that this is a life long - not new - affliction. When I was younger I scratched some deep holes trying to get the bugs out. But I now mostly feel them on the surface. Moving somewhere without chiggers really helped me in that regard!

I have had extreme adverse reactions to anti-psychotics- they make me very prone to auditory and visual hallucinations. I don’t believe that there’s likely anything we can add medication wise, as my neurology is very sensitive and I have had poor reactions to basically every class of medication. I was once hospitalized for a psychotic break following benadryl! And not an excessive amount. Just the normal dose listed on the package.

Currently the only medication we have found that decently controls my symptoms is 1mg of clonipin daily. Please do not moralize or suggest that we get off it! It is truly the end of the line medication wise, and I am extremely grateful to have a psych who has gone through many options with me before ending up here. It is a low dose and will hopefully stay low. I am down from multiple panic attacks a day to only one or two a week.

Any ideas about how to make this stop or how to make it stop making me want to peal my skin off to get away from it would be very helpful. I don’t want to do drugs (street or otherwise) about it, and that seems to be how most people cope. (I would be open to trying ketamine or mushrooms in a controlled setting, but I don’t know if that would help or make it worse. So I guess I am open to drugs as an answer, but not as an answer that is “get addicted.”)

posted by anonymous to Health & Fitness (25 answers total)

I would have to ask my family member for more specifics about her tactics, but it might not even necessarily apply...

Has the sensation been absolutely determined to be without physical cause? I ask because I believe my family member, though she does have some mental health issues, has indicated that for her, this sensation is a part of physical health issues. (The only reason I even remember is because she's been talking about it this week, as an upcoming test has meant she's had to not take her badly-needed anti-inflammatory, so EVERYTHING is much more bothersome than it normally would be.)

And yes, I know you've connected it to the anxiety - but for me and for my family member the worse our anxiety is, the more likely our other health issues are to be triggered, too. (For me specifically, it can turn into this nasty little spiral where the stress/anxiety/depression circle into pain and stiffness which makes the anxiety/depression worse and etc.) So just in case...

I *do* know that she does a lot of the same rubbing at her arms and legs that I do. She uses a tens (spelling?) machine. She tries to get plenty of sleep and not get too warm or too cold. Sometimes the pool helps, but when it's really bad, like this week with no anti-inflammatories, she can't even stand the pool because anything touching her makes it worse. She has said she *thinks* certain foods make it worse, but she's still trying to figure that out for sure. Too much or too little activity; but that's of little help, because what is too much or little changes from day to day.

The only other thing that I can think of is that she tries very hard to stay mentally occupied even when she isn't physically occupied, as in, distraction helps. Only reason I know that is because we were talking about how it doesn't always work; when my pain level is high, it's best if I'm at still as possible, and it can be really hard to focus on anything long enough to be distracted by it. She said the crawling sensation is easier for her to ignore than the pain.
posted by stormyteal at 10:45 PM on August 16, 2022 [6 favorites]

Something that's worked for me, as a way of dealing with chronic pain, is reconceptualizing the feeling as something more abstract and less in need of immediate attention. Specifically, I like to think of my pain as a sort of "fire spirit" which visits me from time to time. Then I can learn to live with this entity and even enjoy its company to some extent. It probably sounds a bit hokey as I've typed it out like this, and I'm sure it won't work for everyone, but maybe you could find a similar way to relate to your bug crawling feeling.
posted by panic at 11:42 PM on August 16, 2022 [7 favorites]

Many apologies if this isn’t welcome since it’s not clear to me if you prefer suggestions from people who have experience with this or only want suggestions from people with this exact experience. I have a kind of similar experience (the feeling of lice crawling on my head) but it’s not as severe and I haven’t had to go to great lengths to deal with it. But I can share my thoughts. I also have trauma and anxiety. I notice that dry skin and anxiety triggers this feeling and sensory issues. I feel like anxiety and upset makes me ultra sensitive to the dry skin and that brings on the crawling feeling, using a dandruff shampoo has helped. I also can get the feeling I have worms (ahhhhhhhhhh!) Knowing that my body is sending and experiencing itself differently when I am upset helps and the same goes for my kids who also have sensory issues. Making sure that they and I are bathed and skin is moisturized is so key… because I think when you are upset and blood is pumping around your body and you have dry skin and haven’t exfoliated and/or are wearing clothing that brushes against you in the wrong way and I think your brain can just RUN with that big time sending all kinds of fight or flight messages. So make sure that you investigate the best non irritating clothing (compression/non compression) and that your skin and body is regularly exfoliated (like with one of those gloves) and moisturized- first with a good moisturizer… you can research this… no scents… and see if that helps… it’s helped me a lot. But don’t shower or bathe too much and not at too hot a temp, that would make it worse probably, we’re talking 3-4 times a week tops or just a quick rinse in the shower.
posted by catspajammies at 12:53 AM on August 17, 2022 [4 favorites]

This is very left-field but try a TENS machine, it's very effective in overcoming sensations.
posted by DarlingBri at 2:39 AM on August 17, 2022 [2 favorites]

Oh my gosh, I just had a conversation with my therapist today about panic attacks (I dealt with them several years ago and had one again recently), and she said something that sounds like maybe part of what you’re dealing with. I’m sharing this in part because maybe her advice to me will be helpful to you.

Apologies if you know all this already! So, during a panic attack, she said, our bodies release adrenaline, as if we are in physical danger, and then we have to deal with all that extra adrenaline. Her advice to me is to squeeze and breathe — contract and release my muscles, because relaxing the muscles helps signal to our brains that we are okay, and breathe long deep breaths because we often breathe rapidly during a panic attack and this will help slow things dow .

She also said our bodies pull blood into the trunk/core and often our extremities can feel numb. That sounds to me what might be going on when you are experiencing bugs crawling on you — it’s the tingling that’s happening because your body is keep your blood out of your extremities.

So, I wonder if knowing partly why you have this feeling — that it’s your mind’s way of understanding a very physical thing that’s happening when your body pulls blood into your trunk — might help you at all.

And then squeeze and breathe. Try to contract large muscle groups like your legs and arms or even just your fists and then release. And take long deep breaths.
posted by bluedaisy at 2:54 AM on August 17, 2022 [13 favorites]

My first suggestion would be, rather than having other people check you for bugs you can excuse yourself, go off to the restroom and check yourself. Then you won't have to worry about alienating anyone. You'll probably be more reassured that way anyhow, if you can get a direct look at your own skin and be sure nothing is crawling on you.

I wonder if a Bengay roll-on might help you. I can become miserable from bug bites in the summer, and I'll get some relief from Bengay roll-on or patches. They quickly make your skin feel cool and kind of numb, which might make the crawly bug feeling go away. I'll also sometimes hold my itchy skin under hot tap water (hot enough to be uncomfortable but NOT hot enough to burn) which can kind of short-circuit my nerves for a while and stop the itch. But that's when I'm dealing with actual bug bites and not just the sensation of crawly bugs on my skin, so I don't know if it would work the same way.

Finally, perhaps you can try to spin the crawly bug feeling as a positive thing. You were having a panic attack and now that's all over, which is signaled by a "ticklish" feeling all over as your nerves settle down. It's not bugs, it's just the old post-panic tickles! Try to think of it like the last stage of a migraine or other recurring ailment. It may be lousy in its own right, but at least its arrival means you've just about made it to the end.

I'm sorry you're having to cope with these troubles and I hope you find relief soon.
posted by Ursula Hitler at 2:58 AM on August 17, 2022 [2 favorites]

Bengay roll-on or patches

That was my thought too - sometimes I use things like tiger balm, biofreeze, or salonpas patches just as a distraction from other sensations I can't get away from.
posted by trig at 3:18 AM on August 17, 2022 [2 favorites]

I'll also sometimes hold my itchy skin under hot tap water (hot enough to be uncomfortable but NOT hot enough to burn) which can kind of short-circuit my nerves for a while and stop the itch.

I've found that a handheld hair dryer works well for this too, and needs no towelling or clothes wringing afterwards.
posted by flabdablet at 5:30 AM on August 17, 2022

I don’t have this exact sensation, but i have panic/PTSD/dissociation. I would suggest: ice on the back of the neck / face in cold water, a butterfly hug (you can google this, I’m on my phone) plus another full- body tapping routine, ten jumping jacks if you can handle them, and then taste or smell of something strong (peppermint, lemon). Basically, countering the mental sensations with an array of physical ones to help ground. I would also plan out and practice the counter - routine in advance, so you have a script you’re ready to follow the next time the sensations hit. Good luck !
posted by Merricat Blackwood at 5:45 AM on August 17, 2022 [4 favorites]

I wonder if it might help to wear clothes that would be hard for something to crawl under and would give a more consistent less brushy feeling, like leggings or compression stockings and an undershirt, that kind of thing. If I'm in an area with lots of bugs (like dinner under a tree earlier this week) I can find myself scratching/rubbing/touching my exposed skin constantly from these phantom feelings and the power of suggestion. I can at least look at my arms and confirm it's just the wind blowing my arm hairs and there's nothing there. But it doesn't seem to be as powerful a suggestion feeling for covered skin as for exposed skin, because things can't drop on/ land on skin under my clothes the same way.
posted by Lady Li at 5:50 AM on August 17, 2022 [1 favorite]

I remember reading that this feeling can be related to a vitamin deficiency, maybe get your levels checked? I just did a quick google (the words “formication” and “paresthesia” may be helpful for you to google) and saw possible links to vitamin B, B12, D, E, folate, calcium, magnesium, etc.
posted by nouvelle-personne at 6:15 AM on August 17, 2022 [3 favorites]

I have always considered this a physical symptom of an overstimulated nervous system. I use the mammalian dive reflex to shut down my panic attacks, as well as not-exactly-panic-attack level adrenaline events. For the former, I am not really mobile enough for an actual shower, but that is what I do for the latter - I get in with the shower at a pleasant temperature and turn it down over several minutes until it is just enough below body temperature to definitely not feel great anymore but it doesn't have to be agonizingly cold. I just kind of rotate slowly in the water, like a gyro cone in a restaurant, until my body finally decides "oh, we're a swimming mammal, we should re-allocate resources to not dying in the water" and the zaps stop.

I can do it without getting my hair wet, with a good shower cap so I can get my face cooled off, but it takes longer if you're not "diving" by getting your heat-radiating head good and cool.
posted by Lyn Never at 7:11 AM on August 17, 2022 [6 favorites]

I have neuropathy in my legs and other parts of my body. The sensation ranges from a tingling to an intense burning. I take a tricyclic antidepressant, and also have employed some mitigation strategies.

Generally speaking, the idea is to create real sensations that overwhelm the neuropathic sensations. In my case, that has involved wearing thigh-high and even crotch-high socks. I could imagine wearing gloves that go up to my elbows if I was experiencing this on my arms.

I have worn usb-rechargeable hand warmers under my clothes. Again, the idea is to create sensations that override the neuropathy. I haven't used a tens unit in a long time. I could imagine that helping, or making the sensations worse. I'm not sure.

I also sometimes smoke pot when my neuropathy is bad. I wouldn't recommend that given the other aspects of what you're experiencing.
posted by Winnie the Proust at 7:21 AM on August 17, 2022 [2 favorites]

Not to be that person, but have you tried CBD oil? It tends to balance and center my nerves out because I also have a bit of CPTSD and autism that can cause my nerves to feel haywire.
posted by Cyber666 at 7:50 AM on August 17, 2022

Like another poster, I experienced a less severe form of this where I would periodically 'feel' bugs crawling in my hair. It was no fun, and it often wouldn't resolve until I had concrete confirmation (like from a hairdresser) that I was bug free. For me, the sensation itself seemed to be part of a feedback loop where I'd feel something funny, start to hyper-focus on the threat of bugs, and from there my attention to minor physical sensations would ramp way up, so I'd notice every shifting hair strand in a way I normally wouldn't and filter that through the "what if bugs" question.

If I were getting the sensations on my limbs, I think my first approach would probably be to try replacing with another sensation that's easy to do in the moment, like rubbing my hand over the arm that was tingling/itching.
posted by space snail at 7:57 AM on August 17, 2022

For milder occurrences of a similar issue I like to wear one of those spiral hair ties around my wrist. They provide a light prickly pressure over a pulse point and are tremendous to fidget with. Gives my hands a focus that isn’t scratching my skin idly.

For worse situations (very loosely, anxiety and eczema reinforcing each other) things that have helped me include: very hot or very cold water or heating pads to “shock” the itch away, doing sets of ten body weight squats until I am a wobbly noodle, increasing my daily dosage of sertraline to about double what it used to be, and on the worst occasions taking an old antihistamine drug called hydroxyzine that makes me woozy but unfeeling for a couple hours and then very asleep for another six. I have an intense response to Benadryl too - knocks me out for a day and then I feel nauseous and zonked for another two almost - but I feel fine after a night of sleeping from hydroxyzine.
posted by Mizu at 7:58 AM on August 17, 2022 [1 favorite]

As mammals, we have body hair and they sense movement. We are always moving, so there's a lot of false movement which gets filtered out by the brain or nervous system. If it stops doing this, then you get something very much like what you feel. So I find concentrating on some part of my body I can see, usually the back of my arm, and try to get past the blocking and see if I can replicate the feeling I'm having in the other part of my body. Moving, twisting my arm slightly, blowing on it lightly. Usually that distracts me enough from the other feeling.

Alternately I wonder if this is the same itchiness I get when I've just started sweating. Apparently it is common and it drives me batty. If so, cooling your body down or getting wet would be the way to resolve.
posted by flimflam at 9:10 AM on August 17, 2022 [2 favorites]

This may sound strange, but there is evidence to suggest mirror therapy is a helpful treatment for psychological or neurological-caused pain/itching. It is most commonly used for phantom limb issues, but also successfully cured a case of postherpetic itch. It is simple and inexpensive to set up at home, perhaps you could try that for a while and see if it helps.
posted by ananci at 9:17 AM on August 17, 2022

Happens to me during meditation and is a known side effect of deep concentration.
I literally know this to be the very definition of “my mind playing tricks on me” so I have a mental image of it occurring in the brain / nervous system pathways rather than on the skin. Also agree ca be a hypersensitivity to the hairs on our body.
posted by St. Peepsburg at 10:05 AM on August 17, 2022 [1 favorite]

Not the same but I sometimes get an infuriating sensation in my legs when I'm tired. (Separate to, but often at the same time as restless leg syndrome). It's like an itch but more annoying. I find it helps to change whatever is on my legs, usually for something less restricting. Similarly, I find running my hands in hot or cold water good for redirecting my mind away from particular skin sensations. If there's no physical concern then my understanding is that goal is to encourage your brain to ignore rather than fixate on whatever sensation it has identified.
posted by plonkee at 10:07 AM on August 17, 2022

I experience this; it's a real feeling, exacerbated by stress/ anxiety. I also have a picking disorder, same. When I get bit by mosquitos, I have a really strong reaction, big welt, pain, intense itching. Bites take a while to heal. When I've had a dog with fleas, or in skeeter season, it gets really bad, because anything that causes sensation on my legs will be interpreted as a flea or skeeter. Benadryl helps but causes drowsiness. Distraction helps.

There's some research that suggests vagal nerve stimulation helps anxiety, so when I remember I do the Valsalva maneuver, which you should chat with a doc about 1st.

Brains can have weird imbalances of dopamine, serotonin, epinephrine, norepinephrine(neurotransmitters), and neural pathways can be wonky. It makes life difficult. Sorry you're experiencing this.
posted by theora55 at 10:27 AM on August 17, 2022 [1 favorite]

One thing that's been really helpful for my chronic pain and multiple health issues is to really understand chronic pain. I'm a huge fan of Dr. Rachel Zoffness. Highly recommend listening to her on Ologies and/or The Jordan Harbinger Show. I am working through her book The Pain Management Workbook and it's been a game-changer.

I know this doesn't address your question directly, but working on your holistic bio-psycho-social pain will likely reduce these sensations you're having.
posted by radioamy at 10:42 AM on August 17, 2022

No idea how to change the physical sensation, but it may help your sense of control to add some strong visualizations? Like when the crawling starts, imagine a ball of warm golden light floating over your head, which trickles down your skin like a soothing cortisol cream and eases the itching. Or maybe you dunk yourself in a cool calm river, and the 'bugs' can't cling to you in the water. When you get out you spray yourself with a bug repellent that smells delightfully of lemon. You could even do it preemptively, when you wake up in the morning. Something like that?
posted by lloquat at 5:03 PM on August 17, 2022

I get this sensation when I am very upset and I use alternative sensations to alleviate it. So if I get the creepy crawly sensation on my left calf I use an inanimate object--a backscratcher, usually--to gently scratch a sensitive place that is NOT my left calf, like the inside of my elbow, the back of my knee, etc. It can't be my fingernails or own hands--it has to be something else. The goal is to get a pleasant and relieving tingly sensation to arise, which seems to distract my nervous system from making or noticing that other creepy crawly sensation.
posted by MagnificentVacuum at 6:56 PM on August 17, 2022 [1 favorite]

I get migraines and just read The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain So far, seems promising, and I think the approach would also be applicable to something like this.
posted by katieanne at 8:17 PM on August 17, 2022