The Link Between Depression and Dreams

depression-dreams-death

Image by Eddi 07

Sleep plays a major role in mood regulation; that’s a truism that is behind every mother’s call for “time to go to bed!”    But while the links between dreams and depression are well documented, the role of dreams in maintaining mental health is still one of the most confusing components in the function of sleep.

In the 1970s, psychologists noted that people suffering from depression also report more dreams than average. In fact, people who are clinically depressed may dream three or four times as much. The quality of REM dreams (also called “paradoxical sleep”) is different too: more intense emotions, more negative themes, more nightmares, and more unpleasant dreams, in general.

It’s insult on top of injury that these unpleasant dreams are often mixed with insomnia and less slow-wave sleep: that “deep” sleep that leaves us feeling restored and refreshed.   Rather than waking up refreshed, the clinically depressed dreamer wakes up feeling like he has been in battle all night long and now has to get up and do it again in waking life.

Are Nightmares Harmful or Beneficial?

The correlation between dreams and depression has led to shifts in thinking about the value of dreams.   Some psychologists believe that REM dreams actually makes depression worse.   This is a growing trend in neuroscience, fueling the search for the perfect pill that can eliminate nightmares. This approach has some merit, especially for sufferers of Post Tramatic Stress Disorder (PTSD).  For example, medications like Prazosin, originally prescribed for high blood pressure, reduce adrenaline and reduce the nightmares that plague PTSD sufferers.

However, success with highly traumatized patients has led other researchers to envision an anti-sleeping pill for anyone who wants to have less sleep (and less dreams as a bonus).  Given that we don’t completely understand the function of dreams, — or even of sleep for that matter — I think this is an alarming trend.

Indeed, the age-old belief that nightmares act as a “tension-reducing” mechanism is under fire, as recent finding suggest that nightmares often add to anxiety (Roberts et al., 2009).  This does not necessarily mean that nightmares are bad for us.  Instead, consider the idea that nightmares may “induce” tension, giving dreamers a chance to confront their emotions head-on, both in the dream and later in waking life.  Whether this is beneficial depends on the dreamer’s anxiety level, the life situation, and the cultural preparation for this level of dreamwork.

The Chemistry of Dreams

Highly recommended introduction on dreams and the brain.

A critical perspective to remember is that depression involves irregularities in brain chemistry.  And as Allan Hobson has argued for thirty years, dreams are also a chemical event, and are deeply affected by modulations in the brain’s neurotransmitters.  During REM sleep, acetycholine and its regulators dominate the scene while serotonin is depressed.  As Hobson explains in his classic The Chemistry of Conscious States, this is why dreams may be so overwhelmingly negative.

Hobson notes that three emotions dominate in dreams: anxiety, anger and elation.   In other words, the odds are against you for having a good dream in the first place.   Are dreams depressed by nature?  He writes, “These emotions could fit into the depressive spectrum, but in dreams, the aminergic [dopamine and noradrenaline] deficit is acute and restored immediately upon waking.  Depression takes days or weeks to develop.”

So, metaphorically, we can even say that dreams and depression are like bird on a wire, sharing many of the same cognitive attributes.

The Irony of Insomnia

A common treatment of depression today are SSRIs (selective serotonin re-uptake inhibitors), which increase serotonin levels and elevate moods. Indirectly, this also decreases REM sleep. Sometimes this is a good thing, because the respite from bad dreams is a nice bonus when added to a more restful night’s sleep. However, some patients have noticed that SSRIs can increase their nightmares and give them more bizarre dreams.

Note that SSRIs are great for combating sleep paralysis, a peculiar form of REM sleep disturbance that often leads to hypnagogic hallucinations or lucid nightmares that feel like being held down by some unseen entity.

So when looking for treatment options for depression, it’s recommended to tell the doctor about the insomnia and the bad dreams, because some of the popular antidepressants will just make these symptoms worse.

Relatedly, sometimes getting less sleep can improve certain kinds of depression. This is almost as paradoxical as paradoxical sleep. Controlled sleep deprivation was a common technique suggested by psychologists, but the advent of modern anti-depressant medications took center stage when introduced in the late 1980s.

Dreams and Depression in Perspective

Stepping back, it’s clear that dreams and depression are entwined on many levels.  Depth psychologists, such as James Hillman and Marie von Franz, have said just as much in their mythological pairing of dreams with depression, death, and the afterlife.  Hillman scathingly writes of Western culture’s unexplored link between these associations:

“The dream takes us downward, and the mood that corresponds with this movement is the slowing, saddening, introspective feeling of depression.  This depression has many faces… we need incantations to help us drop off to sleep, a ritual of prayer, toothbrushing and the teddy bear, of masturbation, food cramming, and the late show, of night cap and sleeping pill.  The basic bedtime story of our culture is that to sleep is to dream and to dream is to enter the House of the Lord of the Dead, where our complexes lie in wait.  We do not go gentle into that good night” (p. 35)

What Hillman is getting at is a natural predilection of dreams towards the darker, broodier, and unpleasant aspects of living, an observation made as early as the ancient Greeks and demonstrated scientifically through modern content analysis.

Yet as a culture we no not give credence to our dark dreams, or provide guidance for those who suffer from them more than others. By making these connections clear, we make a little more room for our depressive human natures, and hope can find some real ground to stand on.

Continue the journey with my article on 14 ways to prevent nightmares.

Roberts, J., Lennings, C., & Heard, R. (2009). Nightmares, life stress, and anxiety: An examination of tension reduction. Dreaming, 19 (1), 17-29 DOI: 10.1037/a0014787

Comments

  1. Scott says

    Ryan, thanks for the fascinating article. A few thoughts:

    There is certainly a huge fear of depression in our culture that surely exacerbates the “natural” waves of introspective, sad, withdrawn emotion that are part of the human experience.

    I would think that a healthy embrace of these experiences as they arise in our dreamlife might even “immunize” us against our fear when these emotional states arise or become persistent, much like the practice of sitting meditation can teach us over time that emotional states come and go like weather, and there is a Self that is able to observe and even feel fully these transitory states and yet not be completely pulled into their whirlpool.

    If we paid more attention to teachers like you, we might learn that dreams are fertile ground for experience and self-understanding, and instead of shunning their negative aspects, put them in the context of symbolic messages that are, I believe, ultimately benevolent and healing.

    Of course, for someone who is suffering from deep depression, the first step may be to simply get some relief–and restful sleep–to be able to find some solid ground so that the Self has a chance to begin to heal. In that case, the added “descent into darkness” dreams can give us may be impossible to process and purely a burden or a scourge on an already suffering Soul.

    What to do when our dreams sap us of the very vitality we need to be able to process them in a healthy way?

  2. says

    Scott, thank you for your thoughtful comments!

    and also thanks for summing up this article better than I could have: “There is certainly a huge fear of depression in our culture that surely exacerbates the “natural” waves of introspective, sad, withdrawn emotion that are part of the human experience.” yes – this is so important to keep in mind. Especially as it gets easier as you get older to “go with the wave” of depression when it comes and goes.

    Finally, you’re right about what is most important when suffering from deep depression: Uninterrupted sleep first, working with dreams a distant second.

    There are two recent research articles (mentioned in the Roberts articles cited above) that support the idea that dreaming is associated with lower levels of depression; the idea is that emotionally intense dreams can assist the depressed individual to process their emotions:

    Armitage, R., Rochlen, A., Fitch, T., Trivedi, M. and Rush, A. (1995) Dream recall and major depression. Dreaming, 5, pp. 189-198.

    Cartwright, R. (1991). Dreams that work: the relationship of dream incorporation to adaptation to stressful events. Dreaming, 1, pp. 3-9.

  3. says

    This assumption reminds me of a quote by Nietzsche, (although I had to go find it):

    “What we experience in dreams — assuming that we experience it often — belongs in the end just as much to the over-all economy of our soul as anything experienced “actually”: we are richer or poorer on account of it.”

    What a great statement that is. Dreams are as important as waking life. I believe that.

    But I’m kind of a Jungian. I think the function of dreams is to put the pieces of us back together at night. Projections and identifications during our waking life are reassembled via our cast of characters in dreams.

    But I also have the Freudian belief that all dreams, and all moods, are linked to our fear of death (a subconscious fear, especially in this culture).

    It’s restorative, but it can also become a bane when we are depressed, since dreams mirror, and thus hammer home, our internal conflicts.

    I’m interested in the idea that there is a link to depression as stated here, and that we’re more likely to have bad dreams than good given our neurochemistry. Since I’m a big dreamer, and have suffered from depression on and off most of my life (I’m used to it – no longer afraid of it), I’ll have to see what I think about that.

  4. says

    Diane, thanks for the Nietzsche shout out. there was a man who was ruled by his dreams and visions!

    from a Jungian perspective, we could say that many of the negative dreams we have are “little dreams,” and they certainly don’t negate the awe-inspiring possibilities of big dreams (or archetypal dreams).

    and Freud and the existentialists agree on the point of the fear/urge of death.

    but one idea I am enamored by is “neuroplasticity” which can be seen as the practice of changing the way we think through habit and practice. not that I want to rid the world of bad dreams: that’s the point, they have their own truths!

  5. mona says

    Very interesting. I have major clinical depression, and I dream a lot and can remember most if not all of my dreams in vivid detail. I also have been experiencing nightmares often.

  6. tom says

    As someone who has severe depression most of this stuff rings a bell.
    Too much dreaming especially. Sometimes the night seems to be an endless hallucination. With no real deep sleep. I have dreams where I actually feel exhausted and tired in the dream.

    For me one cycle of deep stage 4 sleep can completely relieve the depression. But it rarely happens.
    I could swear that what I’m experiencing most of the time as “depression” is really stage 3/4 sleep deprivation.

    • says

      thanks so much Tom (and Mona too) for weighing in. and Tom I think there’s some clinical evidence for your hunch that some symptoms of depression are related to deep sleep deprivation.

  7. Stephen says

    I too have been stuck in that place of depression / bad dreams / no sleep…I found that by medicating with Cannabis, I was able to block my memory of dreaming…I have also been free of ssri’s for 11 years now…I feel depression free…..

    • says

      Hi Stephen, thanks for commenting. marijuana does seem to have a REM-blocking mechanism. for some people this is helpful, but for others it instigates a REM rebound later in the night which can lead to more intense dreams and nightmares. in any case, its effect is surely weaker than SSRIs which for many have are like swinging a baseball bat against the wake/sleep cycles.

  8. says

    It is often the case that when someone has a bad depression, they also experience bad or negative dreams at night. Also medications can cause bad dreams for people suffering with depression. The SSRIs don’t effect people as much. Alex

  9. Susan K. says

    I used to suffer nightmares due to BPD, in fact night terrors. My dreams were always quite depressing. Then two things changed. I had to go through a series of ECT treatment to undo the grievous misconduct of a psychiatrist who toxically over medicated me near death (now I’m only on meds for sleep) and I developed MS and have a dozen or more brain lesions. Now everything had changed. I’ve recovered from the BPD although still have mild depression & apathy from the MS. And now –

    I have magnificent dreams with nightly visits from the “A” list of who’s who, Presidents, – all on highly positive terms, and relatives that have passed – again all with warm, secure feelings. The dreams also include turquoise blue water, total serenity, extremely vivid colors and vistas and the sort of stuff that having “dreams come true” would be a delight. My creativity levels have risen (if only I could remember the words and plots that I dream about to write songs and screen plays)I take a small dose of a mild anti-depressant and Klonopin for insomnia, and wake up each morning refreshed, happy on ready to face another day. If only my days were as interesting and pleasurable as my nights!

    I guess I’m just a zebra. Either that or the ECT fried Nightmare Central. LOL

  10. Jean M. says

    I am suffering from vivid nightmares of things done to me a long time ago. I am diagnosed with ptsd and mdd, which, I’m not exactly sure what that means, I just know that I have nightmares and I can’t sleep. I would appreciate any suggestions anyone could give me to help me stop the nightmares. Thank You.

    • says

      Jean,

      I’m not a doctor so I can’t make medical suggestions for you, but I know that many SSRIs can dampen dream recall and stop nightmares. Some psychiatrists also report that using lucid dream work can be effective (realize you’re dreaming, and shift the content of the nightmare with lucid choices), but it’s a challenging path to take. A good PtSD resource on the web that is sympathetic to nightmares is Michele Rosenthal at http://healmyptsd.com/ It’s important to keep open communication with your medical provider about your wish to work with nightmares.

      • Nightmares can be trying to help you says

        I realize that this is an old thread, but thought I’d add in some feedback for people who stumble on this, as I did.

        I run a PTSD support group. One member of our group started a ‘trend'; she had severe violent nightmares that wouldn’t let up and escalated the more she tried to suppress them. Eventually one night in frustration she started to ‘converse’ with them. She laid there after awaking from a particularly graphic nightmare and ‘spoke’ to her nightmares: “I know you’re trying to tell me something. I can tell you’re trying to SCREAM something at me, and I haven’t been listening. What are you trying to tell me that I’m not hearing?” Her nightmares immediately abated, and she started getting all kinds of ‘aha’ realizations in her ‘day life’. Many of our group members have explored this approach, talking to our nightmares, non-visual flashbacks, body memories, etc… It’s not a cure-all, but each member has found some relief.

        If our nightmares are chronic, and certain themes are repeated, our experiences have been that that part of ourselves that creates the nightmares is desperately trying to tell us something. When we stopped viewing the nightmares as something trying to harm us, and started viewing them as something trying to help us, everything shifted for the better.

        It sometimes helps to have someone who knows you (and cares about you, and doesn’t push their own agenda) to help you interpret them; sometimes the images are obscured because we are afraid to see them for what they are.

  11. Mr.Colin O'Malley says

    I’m an avid believer of the waking life and I would prefer additional information about tactics and tips to remembering dreams?

  12. Wednesdayborn says

    From my own personal experience, I believe that 90% of my depression was caused by what happened during my sleep: dreaming. There is a reason why among the first signs/complaints from people who unknowingly suffer from depression is that they experience dull headaches upon waking up in the morning. I think that the real cure to depression lies in devising ways to manipulate one’s dreams. Positive dreams allows the brain to produce dopamine/positive chemicals without the interference of the depressed individual’s negative response or defenses, that become normalized and habitualized over the course of depression. The first thing to do is to find an antidepressant that increases dream recall for you. These dreams (and their interpretation) will provide you the answer to what is the true root cause of your depression (which often ties not so much to the depression trigger but to an idea/belief you formed as a child that dictates your reaction to a trauma). Anti-depressants mostly have a placebo and/or “mind-tricking” effect and mainly work through behavior modification: when thinking about a negative thought or having a PTSD flashback on an anti-depressant that causes aparthy, for example, tricks the mind into producing an apathetic response to something that would ordinarily cause fear or crying spells. By constantly experiencing no emotion following the negative thought, the mind is tricked into believing that the seemingly negative experience associated with that thought is not as bad anymore. I experienced a signficant improvement in my depression by engaging in no-brainer ways such as taking a small amount of my prescribed Vyvanse (adderall would work too) along with remeron (which induces sleep) to increase the chances of improved mood during sleep and, indirectly, a positive dream. I play classical music on low volume at night while I sleep. I also spray my favorite candle scent on onto a fake flower and keep it next to my nose while I sleep. I take a bite of my favorite sweets and try to recall a positive past event all before I sleep. Of course there are variables to this (ie. what smells great to one person might stink and, therefore, not work for another). I really believe that these strategies, as opposed to standard anti-depressants, were what did the trick in significantly improving my depression. I’m not even a doctor and am surprised this method to treating depression hasn’t really been explored in depth since it’s a no-brainer. But I guess it’s because it’s against the interests of certain drug companies…

  13. says

    This in interesting. I never thought that dreams would affect your depression. I suffered from depression for four years. I like the information on your site

  14. Gabriel says

    That’s an interesting and not-so-correct statement that ” The quality of REM dreams (also called “paradoxical sleep”) is different too: more intense emotions, more negative themes, more nightmares, and more unpleasant dreams, in general”
    I suffer from chronic depression, and although I dream much more (as it’s said) I hardly ever remember a dream. Even when I remember one, it has rarely any content, just bits of still pictures and some sound, even though my anti-depressant pill helps me sleep well without side-effects. Whatever dream I remember when I wake-up I soon forget.

  15. M says

    Hi Ryan!

    Thanks for a good article. I think I’ve been having depression since I was around 15, on and off and I dream very much each night and remember a lot of details from them. I really like to dream though so it hasn’t hurt me that much. Unfortunately most of my dreams are nightmares of different kind but I also do dream about very fantastic things and some nights I can control them a bit.

    But the way you described waking up from a dream-full night is the best description I found how I feel when I wake up; Rather than waking up refreshed, the clinically depressed dreamer wakes up feeling like he has been in battle all night long and now has to get up and do it again in waking life.

    I can’t remember the last time I woke up feeling refreshed and often with a light to heavy headache and very tired in the body and mind.

    So again, great article with many good comments as well.

    Best regards

  16. Sis says

    Thanks for a fascinating article.
    I have been depressed for a few years now, but only recently got medication for it (SSRIs).

    I too have noticed an increase in strange and vivid dreams, but like the person above me, I like dreaming. I was actually thinking of trying something like galantamine, which you talk about, but I don’t know whether that and my antidepressant will get along.

    Any thoughts, or perhaps links to other research?
    Thank you for this site, I finding myself coming back more and more :)

  17. Rod says

    Hi,
    A friend passed this article along to me. I’m a psychology professor and I teach biopsychology. Unfortunately I think this article is based almost entirely in anecdotal information at best and just opinion at worst.
    Case in point: “Some psychologists believe that REM dreams actually makes depression worse.”
    Statistically more than 90% of dreaming occurs in REM and people dream in REM almost 95% of the time. This has long been documented through 10’s of thousands of sleep studies. If the statement you make in your article is true then that would mean that the majority of people on the planet are suffering from depression, or likely to because they have REM dreams.
    I notice that you don’t cite any research here. This kind of writing is dangerous! Please base your information on legitimate research if you are claiming to be an expert.

    • Ryan Hurd says

      Hi Rod,

      thanks for your red flag, although I could do without your insults. It’s OK with me if you don’t agree with the source material. Because this is my blog, and not a peer-reviewed paper, I choose when to cite, and don’t cite every statement. I’m not going to address your “case-in-point” reductio ad absurdum, but if you’d like to weigh in on the trend in neuroscience to reduce or eliminate dreaming sleep, and educate us on your perspective, please start a discussion, don’t insult the author.

  18. JJ says

    I am pleased to have found your website and the information contained herein as well as possibly exploring the information more fully in your books. My college major was psychology and have completed masters level courses as well. I have an interest in dreams and how the chemicals released during dreams effects us in our waking hours. While my overall mental health has been as stable as it has been in almost a decade and I have a functional family and successful work life, the traumatic dreams and how they effect the resulting waking hours still poses unresolved issues. Hundreds of hours of therapy in different modalities over 10 years and tens of thousands of dollars still does not take away not only the images but the feelings left behind that these dreams elicit. The feelings are most troublesome as the following waking hours are left with the burden of making it through the day after having lived through guilt, shame, or horror during the night. Once in a while I will have a purely joyful dream filled with comfort and safety and on those days my waking hours feel like the best days of my life. I am curious to understand more on how Ssri’s but more specifically the old TCA’s can alter, hinder or otherwise influence the dream state and if any remedy…whether it be traditional chinese medicine, western medicine etc can tip the tables to not only have no dreams or better dreams but a more restful sleep overall.

  19. Sylvia says

    I have not been diagnosed with clinical depression, so what I say may have no bearing on that, but I have noticed that whenever I feel weary, very low spirits, disheartened, miserable in any way, and this goes on for a few days -if I remember dreams -and especially vivid or long dreams, I feel MUCH lighter and better the next day. It doesn’t even so much matter what the subject of the dreams was…just the fact that they were there at all, and particularly, that I remembered them. The remembering part seems important. I feel as if suddenly a new part of myself has wakened up, in a sense, and it has an instantly uplifting effect on my mind state.
    I always feel more healthy, more balanced, and stronger when I remember vivid dreams. It’s almost as if my mind got into ‘a rut’ and the dream shows me a tiny doorway through to a different bit of me.
    Time leading up to feeling ‘down’ will usually be marked by not recalling dreams, night after night.