Dreaming in Depression (and Other Mental Illness)

While occasional nightmares are a common and normal responses to waking stress, more frequent disturbed dreams and nightmares may be indicative of underlying psychopathology. In the more benign case, the frequency and intensity of disturbing dreams may show a progression and resolution over time, whereas chronic nightmares are repetitive, persistent, and associated with lower psychological well-being, as well as histories of trauma or abuse.1

In fact, frequent and distressing nightmares, along with several other qualities of disturbed dreaming, such as changes in emotional intensity, increased bizarreness, or unusual character interactions, have been associated with specific psychological disorders, including depression, schizophrenia, and personality disorder.


Perhaps unsurprisingly, depressed patients report dreams with more negative mood and emotion than control subjects, as well as more failures and misfortunes (compared to people with schizophrenia).2,13 Patients with depression also experience more frequent nightmares.4,14

Further, depressed patients with a history of suicidal thoughts or behaviors report more death themes in their dreams. However, one study found that depressed patients reported less negative, but more neutral affect in their dreams; the authors interpret this finding to be consistent with the affective flattening seen in depression. Further, one study of bipolar disorder found that shifts from neutral or negative dream content (as in depression) towards more bizarre and unrealistic dreams can predict alterations between depressive and manic states.16 This suggests that shifts in affective content of dreaming may occur congruently with vacillations in waking mood in depression.

Besides affective content, depressed patients have been found to play a relatively passive role in their dreams, along with reporting less bizarre dreams, lower dream recall frequency, and less detailed dream reports.17,18 One study repeatedly awakened depressed patients five minutes into REM sleep episodes—a period that typically promotes high dream recall—and found that depressed patients were consistently unable to recall their dreams.19 These findings altogether are suggestive of a relative inhibition or flattening of dream content in depressed patients.


Several studies have found the dreams of schizophrenic patients to contain heightened levels of anxiety and negative affect. For instance, they report higher frequencies of hostility in their dreams in comparison to controls—specifically, increased hostility directed toward the dreamer.2,3 They also have more frequent nightmares than healthy subjects.4,5

When assessing the character involvement in the dreams of schizophrenics, several studies have found presence of more strangers and fewer familiar characters or friends—as well as an idiosyncratic finding that the patient is often not the main character of the dream.6-9 The combination of anxious and apprehensive dreams with perceived hostility from strangers and unfamiliar characters is consistent with experiences of persecutory delusions in waking life.

Reports on bizarreness have been inconsistent. Some studies report more bizarreness and implausibility in the dreams of people with schizophrenia, while others find no differences in bizarreness compared to controls.10-12 This inconsistency may be due to the methodology use for rating dream bizarreness; for instance, one study showed that schizophrenics self-rate their dreams as less bizarre than judges do (perhaps because they are so used to how bizarre their dreams are).8 On the contrary, waking daydreams are consistently found to be more bizarre in schizophrenic patients.

In general, the increased negative affect, higher frequency of nightmares, and unusual character profile of patients’ dreams is consistent with waking symptoms of schizophrenia.

Borderline Personality Disorder

Patients with borderline personality disorder experience more negative dreams, as well as more distress within their dreams and after awakening from dreams.20,21 Further, BPD is consistently associated with higher-than-average nightmare frequency,20-22 and increasing nightmare frequency is associated with more severe symptoms.23 Some researchers suggest that these chronic nightmares may be related to childhood traumatic experiences, which are often implicated in the development of borderline personality disorder.24

However, in another study, character interactions in the dreams of borderline patients were found to contain more friendliness and less aggressiveness, as well as less confusion than control subjects dreams.25 They also contained heightened levels of sensory vividness, including movement and auditory attributes.

These findings seem somewhat contradictory to the prevalence of nightmares and anxious, distressing dreams, but could be indicative of a general intensification of dreaming processes that may result in either nightmares or vivid non-nightmare dreams, depending on current levels of stress.

Clinical Implications

Patterns in disturbed dreaming may be useful as indicators of psychiatric progression. For instance, increasing reference to death in the dreams of depressed patients could reveal the presence of suicidal thoughts, and is thus a potent cue for clinicians—especially since nightmares themselves are associated with greater risk for suicide.22

On the other hand, shifts towards more positive themes may be indicative of successful treatment. As mentioned, in bipolar disorder, shifts from negative to bizarre dreams may reflect shifts from depressive to manic states, and can thus alert the patient and clinician to oncoming symptoms.16

The prevalence of nightmares in all three psychological disorders examined here further suggests that treatments incorporating targeted nightmare reduction may be more successful than those that neglect nightmares. In general, assessment of dreams can serve as a useful barometer for changes in psychopathology and can thus be effectively used within treatment contexts.

Your Nightmares Could Be a Sign of This Mood Disorder

As much as you want to forget a bad dream as soon as you wake up, don’t brush it off so quickly: Frequent nightmares are common in people with early symptoms of depression, reports a new study in the journal Sleep.

Of almost 14,000 adults, 45 percent reported occasional nightmares in the past 30 days. So does that mean they’re all at risk for depression? No. Finnish researchers found that the strongest independent risk factors for nightmares were insomnia, exhaustion, and the depressive symptom of “negative attitude toward self.” But the mood disorder was the strongest of the three connections, the study authors admit. (Although being scared isn’t always bad! Why Being Scared Is a Good Thing.)

In fact, researchers found that 28 percent of people with severe depressive symptoms had frequent nightmares. And women were slightly more likely to have nightmares than men-interesting, considering the fairer sex is about twice as likely to suffer from depression.

While the study authors aren’t sure why this connection exists, previous research has found that abnormal sleeping patterns and depression are closely linked as well. A British study found that insomnia and hypersomnia (excessive tiredness) are present in roughly 40 percent of young depressed adults, especially females. And a study last year from the American Academy of Sleep Medicine found that people who sleep shorter or longer than the recommended eight hours have an increased genetic risk for depression. The British researchers speculate that the link stems from sleep’s regulation of certain mood-balancing neurotransmitters. (Bad dreams and missed sleep are also two of of 8 Surprising Symptoms of Stress.)

So while it could be perfectly innocent (find out What’s Behind Your Weirdest Dreams), if you wake up from scares often-especially if you also have trouble sleeping or waking up-consider talking to your doctor about a possible mood connection.

  • By Rachael Schultz

(Picture: Ella Byworth/ Metro.co.uk)

Constantly having nightmares can be very stressful on mental health.

It disrupts your sleep; your mind doesn’t get the rest it needs and you could wake up feeling down, tired or sleep-deprived, which in turn affects your day-to-day activity.

But why do these unhelpful dreams sneak their way into your head and are they a sign that something bigger is going on in your life?

It can be particularly difficult to deal with a barrage of nightmares if you aren’t aware of any mental health issues that you’re suffering, because you might not have tools to deal with these issues.

We find out what having consistent nightmares can be an indication of and how to manage them (so that you can finally get a good night’s rest).

What causes nightmares?

Nightmares usually occur during REM sleep – similar to dreams – and although they can be a sign of an underlying issue, they’re not always this complex.

Advertisement Advertisement

According to WebMD, having a snack late at night can trigger nightmares as it boosts your metabolism and tells your brain to ‘be more active’. Taking medication or coming off medication can also stimulate nightmares, as can alcohol withdrawal.

You get less REM sleep when you drink, and although it may seem tempting to have a nightcap, reduced REM sleep also means your mind’s ability to process dreams is impaired – so you might not be able to deal with what you’re dreaming about.

Interestingly, sleep-deprivation in itself can also lead to nightmares, meaning you’re effectively stuck in a loop of bad sleep.

A study from 2016, which measured the role of insomnia, nightmares and chronotype (essentially your biological clock) in relation to mental illness revealed that 8% to 18% of the population is ‘dissatisfied’ with their quality of sleep, and between 6% to 10% suffer with some form of insomnia disorder.

The same study showed that a disruption in sleep patterns ‘commonly presents prior to acute psychiatric difficulties’, such as a manic episode, paranoia or ‘transition to major depression’.

(Picture: Ella Byworth for Metro.co.uk)

Lola, 21, is currently going through a phase of sleep disruption – she’s only sleeping a few hours per night and when she does, her sleep frequently consists of nightmares.

‘After every night’s sleep, I wake up and remember the wholly vivid nightmares I’ve just had’, she tells Metro.co.uk.

‘They vary from being a mash-up of several short intertwined dreams about people, some good that I don’t want to wake up from, but mostly horrible ones.

Advertisement Advertisement

‘Sometimes they involve people from my life, sometimes faceless figures, which makes it even more creepy. Mostly I will wake up intermittently throughout the night.

‘I’ve had dreams of my teeth crumbling out of my mouth and anxiety nightmares, where I spend the entire time feeling anxious within the dream.

‘When I wake up, I’m worn out and extremely tired, which makes me not want to get out of bed – it’s paralysing. I’ve pretty much had nightmares my whole life, but they never used to be as frequent as they are now. They definitely happen more when I’m stressed or anxious, but I’ve never spoken to anyone about them because I’m so used to it.’

When should you seek help for your nightmares?

Just like mental health problems are very individual, so are nightmares, and having the occasional one doesn’t automatically mean you also have a mental health problem.

Therapist Sally Baker tells Metro.co.uk it’s how these affect you that could be a sign of something troubling underneath the surface.

‘Occasional nightmares are completely normal and many people experience them,’ she said.

‘It is how you feel about having those nightmares and the judgements you make about them that indicates how you are feeling about yourself and can give you insights into whether you are feeling emotionally balanced and okay, or may need to seek professional help.

‘Dreams and nightmares are one of the ways the sub-conscious mind processes emotional challenges, so recurring nightmares can be a clue that your mind is struggling to cope with real life negative emotions or events.


‘The nightmares may even vary with different narratives but if they engender the same feelings on waking from them such as heightened anxiety or feeling of dread you are definitely struggling to process.’

How can you deal with constant nightmares?

Hayley, 30, has suffered from night terrors for years and tells Metro.co.uk these are similar to nightmares, but completely ‘take over’ her mind.

‘It’s hard to deal with them, as I’m not sure when they will happen,’ she said.

‘I can go for nights without anything and then bam, suddenly I’m screaming in my sleep. The main difference between nightmares and night terrors is that night terrors completely take over. I also remember them a lot more vividly than nightmares.

‘They’re always the same – someone is trying to kill me.

‘Counselling helps and communicating what happens in my night terrors helps too, as it allows me to process and understand what’s happening in my head.

‘For example, whenever they happen, it’s always in the flat I lived in with my mum and I have a lot of negative emotions and memories in that place that I’ve never addressed.

‘The night terrors have actually allowed me to understand this and address these fears directly.

‘I often find if I’m relaxed or I’ve done a workout in the evening, this will rest my mind but ironically, my night terrors seem to be worse when things are going great – it’s a cruel twist.’


Sally also recommends speaking with a therapist about your nightmares, especially if you experience persistent after effects or if they’re anxiety-inducing.

‘If you are left with heightened anxiety or depression after recurrent nightmares, you can work with a therapist to resolve the negative emotions even when you are not sure what is bothering you,’ she said.

‘Be your own detective and focus on the feelings you’re left with, not the storyline of your nightmares as that will be more helpful in finding out what is at the root of your scary or disturbing dreams.

‘Also ask yourself what you may have been ignoring in your life or overlooking.

‘Your intuition or your gut reactions are always on your side and are your best friend, so ask yourself what have you been overriding in your life that in your heart of hearts you’re not really sure about.’

Having singular nightmares are usually not a sign of mental health problems.

But if you’re having trouble falling asleep or staying asleep and suffering from nightmares or even night terrors, it’s worthwhile speaking to a medical or mental health professional about it.

Don’t ignore your sub-conscious mind – it can be just as telling as your conscious one.

MORE: Why so many influencers are getting therapy

MORE: We all know about workplace stress, but let’s not forget self-employed stress

MORE: What is an ‘anxiety hangover’?

Advertisement Advertisement

The Fix

The daily lifestyle email from Metro.co.uk.

Find out more

Nightmares Linked to Depression, Insomnia

New research focuses on an area that is often associated with a poor night’s sleep — nightmares.

In the study, investigators suggest that nightmares may serve as a barometer of a person’s mental health or life satisfaction.

The American Academy of Sleep Medicine describes nightmares as vivid, realistic and disturbing dreams typically involving threats to survival or security. The experience often evokes emotions of anxiety, fear, or terror. A nightmare disorder may occur when repeated nightmares cause distress or impairment in social or occupational functioning.

Finnish researchers say that nightmares are often linked to how we feel about ourselves and our health in general.

“Our study shows a clear connection between well-being and nightmares,” said lead author Nils Sandman, a researcher in the Centre for Cognitive Neuroscience at the University of Turku in Finland.

The study was a joint effort of the University of Turku and the Finnish National Institute of Health and Welfare. Sandman and the research team analyzed data from two independent cross-sectional surveys of the Finnish general adult population conducted in 2007 and 2012.

Results show that 3.9 percent of participants reported having frequent nightmares during the previous 30 days, including 4.8 percent of women and 2.9 percent of men.

Frequent nightmares were reported by 28.4 percent of participants with severe depressive symptoms and 17.1 percent of those with frequent insomnia.

Researchers discovered the strongest independent risk factors for nightmares were insomnia, exhaustion, and the depressive symptom of “negative attitude toward self.”

“This is most evident in the connection between nightmares and depression, but also apparent in many other analyses involving nightmares and questions measuring life satisfaction and health.”

Study results are published in the journal Sleep.

Study participants were 13,922 adults between 25 and 74 years of age. Fifty-three percent were women. The surveys involved a questionnaire that was mailed to the participants and a health examination at the local primary health care center, where the completed questionnaire was returned and checked by a nurse.

Occasional nightmares in the past 30 days were reported by more than 45 percent of participants, and 50.6 percent reported no nightmares at all.

Sandman noted that the cross-sectional study did not allow for an examination of cause and effect. However, he suggested that the results do raise intriguing possibilities worth investigating in the future.

“It might be possible that nightmares could function as early indicators of onset of depression and therefore have previously untapped diagnostic value,” he said.

“Also, because nightmares, insomnia and depression often appear together, would it be possible to treat all of these problems with an intervention directed solely toward nightmares?”

Source: American Academy of Sleep Medicine/EurekAlert!

Nightmares Linked to Depression, Insomnia

Depression and Dreams: How Mental Health Affects Your Dreams

From the outlandish claims of Sigmund Freud to modern-day dream interpretation, dreams have long been a mystery to many.

Some people tend to have scarier dreams. Others have dreams that simply don’t make sense. Still, other people have lucid dreams that they can control. Everybody is unique, but is there a connection between dreams and mental health?

The Connection Between Dreams and Mental Illness

As a Boca mental illness treatment center, we know that the brain is a fascinating and complex structure that may never be fully understood. When we fall asleep at night, our brains remain active and part of the result is dreaming. The brain is also responsible for our mental health when we are awake. Mental illness isn’t just troubling emotions from poor mental health; often mental illness is accompanied by changes in brain structure and chemistry as well. Depression specifically has shown evidence of these changes. Because there are differences between depressed brains and normal brains, are there differences in dreaming as well?

Do Depressed People Dream More?

The answer is yes. In fact, one study found that people who are depressed can dream up to three times more than people who are not depressed.1 Why is this? Dreams can help us regulate our emotions and process negative ones, and because depressed people often struggle with both, dreaming more frequently is a way to deal with these emotions.
Although dreaming more sounds pleasant enough, dreaming doesn’t actually help people feel restored. Although depressed people are dreaming more frequently, they are often left feeling more tired as well. People who are depressed may have a harder time falling asleep, but they enter REM sleep, the stage of sleep when dreaming occurs, earlier and stay in this stage longer. REM sleep sees brain waves that are almost as active as when someone is awake and also includes an increased heart rate and more heavy breathing. Because depressed people dream more frequently, it is no wonder that a common symptom of depression is fatigue.
Just because you dream doesn’t mean you will be able to recall it. If you are struggling with depression and dreams are something you never remember, you are also not alone. Depressed people may dream more than the average person, but they are also less likely to remember those dreams.2 Antidepressants can be the source of this problem, but for people who have yet to get treatment for depression, this can often still occur.
There is also a connection between depression and dreams that are more disturbing. Nightmares for people with depression are common.3 One study found that 28.4% of participants with severe depression reported frequent nightmares and that depression was one of the strongest indicators of frequent nightmares.4

Alcohol use and drug abuse may also be contributing factors to these sleep disturbances. Because many people who are depressed will turn to drugs or alcohol to cope, they may actually be making their sleep problems worse. It is important that these people receive dual diagnosis treatment to work on both problems.
Your dreams may be trying to tell you something. If you suspect that you or a loved one is struggling with depression or another mental illness, there is hope. At Banyan Mental Health, we want to help.

Call us today at 888-280-4763 so that you can finally wake up from this nightmare and move forward.


  1. Clinical-Depression.co.uk – Depression and dreaming
  2. Healthline – How Much Deep, Light, and REM Sleep Do You Need?
  3. Netflix – The Mind Explained
  4. American Academy of Sleep Medicine – Depression and insomnia are strongest risk factors for frequent nightmares

How Your Depression Can Affect Your Dreams

If you’ve ever gone through depression you know it can affect many different parts of our bodies, from our energy levels to how well our brains function. It has such far-reaching effects that depression can even have an impact on our dreaming. Research has revealed that for many people, rapid eye movement (REM) sleep, the period in which we dream, has mood-regulating effects; people often feel better the morning after a traumatic or upsetting event if we’ve had sufficient REM sleep to process it. For people with depression, however, that healing element is absent — and studies have shown that there’s a relationship between depression and bad dreams.

The connection between depression and nightmares appears to be complex. If you have depression, you’re more likely to have bad dreams, and having nightmares are also a strong predictor of depressive symptoms. A study of nightmares in the Finnish population published in Sleep in 2015 (and led by the appropriately named Dr. Nils Sandman) found that people with depression, insomnia or exhaustion were the most likely to experience nightmares. Research by Dr. Rosalind Cartwright, Ph.D., an expert on dreaming and depression, found that people experiencing painful divorces tended to have bad dreams featuring their ex-spouses in punishing or negative roles, while those who were coping better with divorce tended to dream of their exes in more distant, unemotional ways.

Boy_Anupong/Moment/Getty Images

However, scientists are still figuring out how the link between depression and dreaming works. Studies of the brains of people with depression have shown that the dark dreams accompanying depression may be the brain’s attempt to work through negative feelings and triggers from their daytime experience. A study on firefighters published in Journal of Clinical Sleep Medicine in 2016 found that nightmares and disturbed sleep might increase depression because they can affect our waking ability to regulate our feelings and solve emotional problems.

The influence of depression on dreams is also influenced by anti-depressants. Selective serotonin re-uptake inhibitors (SSRIS) are commonly prescribed to people with depressive symptoms, but Dr. Michael Breus Ph.D., a sleep expert, tells Bustle that they can also influence dream content. SSRIs can make us less capable of remembering dreams and possibly increase the positive emotional content of dreams, but withdrawal from SSRIs might increase nightmares.

For people who have depression related to post-traumatic stress disorder (PTSD), studies show they’ll likely experience recurring nightmares — but they’ll be of a different kind to depressive nightmares. Sleep scientist Matthew Walker, Ph.D., writes in Why We Sleep that REM sleep tends to be a safe place for emotional playback for many people because it coincides with a shutdown in noradrenaline, a neurotransmitter related to fear that regulates the fight-or-flight response. The absence of noradrenaline in the brain means that memories don’t have a lot of emotional “punch” during dreams, so we can contemplate them without getting too upset.

In people with PTSD, however, Walker notes that noradrenaline levels during REM sleep continue to be high — which means that their memories retain their terrifying quality, and can’t be processed. People with PTSD are now commonly prescribed a drug that lowers the brain’s noradrenaline levels to help reduce their nightmares.

Depression and bad dreams are intrinsically linked — but Cartwright’s research found that increased REM sleep appears to help people with undiagnosed depression experienced reduced symptoms. If you’re seeking treatment for depression, it might be a good idea to take note of your dreams and how they affect you; they may be more interconnected than you’d think.

Studies cited:


Dr. Michael Breus, Ph.D., a clinical psychologist, diplomate of the American Board of Sleep Medicine, and fellow of The American Academy of Sleep Medicine.

Depression dreams and nightmares

Leave a Reply

Your email address will not be published. Required fields are marked *