Dear Alice,

I have been having very disturbing dreams about a past relationship which ended over three years ago. These dreams affect my moods during the day and give me a depressed feeling. I am currently on an anti-depressant and in therapy which have helped with this situation, but the dreams are lingering and creating more anxiety for me. Any suggestions?

Dear Reader,

While nearly everyone has nightmares from time to time, consistent, unsettling dreams that hinder your day-to-day functioning may be a sign that it could be beneficial to seek professional help. As you’ve experienced, it’s true that bad dreams have the ability to impact mental and emotional health (and vice versa). People who are clinically depressed may dream three to four times more than the average person, and having disturbing dreams may also intensify a person’s anxiety. In order to break free from your bad dream-bad mood cycle, it may be helpful to identify the source of these dreams. While anxiety and stress are the most common causes of nightmares, there are other factors as well.

A few potential causes of nightmares to explore include:

Significant life events: You mentioned that your dreams are often about a past relationship. Is it possible that something from the former relationship is still affecting you? Dreaming about specific things may be an indicator that they’re yet to be resolved. Writing down your dreams and discussing their content with a mental health professional may help you focus on what’s troubling you the most.

Medication, including antidepressants: A common treatment of depression today is selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels and elevate mood. However, SSRIs may also increase the likelihood of experiencing nightmares and bizarre dreams. When looking for treatment options for depression, telling your health care provider about your bad dreams can be helpful because certain medications may make your symptoms worse. It’s especially crucial to let them know if you’re taking any other medications or supplements to help avoid potentially harmful drug interactions.

Alcohol and other drugs: Both excessive alcohol consumption and abrupt alcohol withdrawal may lead to strange or disturbing night visions. In addition, recent withdrawal from a drug, such as sleeping pills, may also influence a person’s dreams and quality of sleep.

Sleep deprivation or insomnia: An irregular sleep schedule or not getting enough sleep increases the risk of having nightmares. Check out Insomnia — A disturbing sleep disturbance! for more on insomnia.

Nightmare disorder or other sleep disorders: Nightmare disorder is a clinical condition characterized by having frequent and persistent nightmares that disrupt your sleep and daytime functioning. To help diagnose sleep disorders, a health care provider may ask about your symptoms, medical history, family history, conduct a physical exam, and have you participate in an overnight sleep study. Treatment options include therapy or counseling, medication, and cognitive behavioral therapy such as imagery rehearsal therapy (IRT). IRT involves working with a mental health professional to modify the content of your nightmares to be less disturbing.

In addition to seeking professional help, it may be beneficial to try:

  • Following a regular physical activity routine, with aerobic activity if possible. You may find that you’ll be able to fall asleep faster, sleep more deeply, and wake up feeling more refreshed.
  • Learning relaxation techniques, such as deep breathing exercises and meditation, to help reduce anxiety. 
  • Practicing good sleep habits such as going to bed at the same time each night, waking up at the same time each morning, and not excessively napping during the day. Avoiding long-term use or overuse of tranquilizers, caffeine, nicotine, other stimulants, and alcohol may help. Try not to eat or engage in physical activity just before bed, which raises your body’s metabolism and brain activity. Also, try your best not to stare at a phone or computer screen right before you hit the hay. 
  • Asking for support from friends and family — it may be helpful to have other forms of emotional and social support in addition to therapy.

List adapted from Mayo Clinic.

Kudos to you for seeking out the help you need! With the appropriate support, you’ll hopefully be able to sort through all your thoughts and emotions, find the root cause of your nightmares, and adopt some skills and healthy lifestyle behaviors to prevent them in the future. Here’s to continuing on a path to healing to help turn your nightly stress into a good night’s rest.

Sweet dreams!

Alice!

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