Nightmares and Depression

A nightmare is a frightening dream that can wake people up from their sleep. They are vivid and real; A disturbing dream wakes you up from a deep sleep. They often cause an increased heart rate, and your heart pounds with fear.

Nightmares typically occur during REM sleep, i.e. rapid eye movement sleep which is when most dreams tend to happen. Almost all of us experience nightmares at some point in our lives. For most people, Nightmares are rare. Some people experience night terrors more regularly but not frequently. Not even the world’s top sleep experts are immune to nightmares.

Before we go any further, we must distinguish between a nightmare and a bad dream. There is a fine line between the two and it is important note that:

  • Bad dreams are essentially a less disruptive and disturbing form of a nightmare.
  • Technically, if having a bad dream will not cause you to cross the sleep/wake threshold — or even into the gray area between sleeping and waking up — then, it it’s not a nightmare.
  • Like nightmares, bad dreams can cause heartache and affect your emotional state the next day, but the emotional distress is less severe.
  • Nightmares are less common than bad dreams.

Depression and anxiety are associated with nightmares. Of course, frequent nightmares can be a sign of more serious depression. Researchers say that people diagnosed with depression or anxiety may have harmful, disturbing, or frightening dreams, and sometimes they even recur.

There is a complex relationship between nightmares and depression that is two fold:
(a) Depression can cause frequent nightmares
(b) Sleep disorders themselves can worsen depression.

Although nightmares are sometimes a common and normal response to the stress of waking up, frequent disturbing dreams and nightmares can indicate underlying problems.


Frequent and stressful nightmares, along with many other qualities of disturbing dreams, such as mood swings, an increase in anxiety, or unusual human interactions, have been linked to specific behavioral problems and illnesses, including depression.

To add to the above, depressed patients with a history of suicidal thoughts report themes of death in their nightmares. It has also been found that people with depression are known to play a passive role in their own dreams, sometimes reporting less bizarre dreams, less ability to recall their dreams, and less detail in their reporting of their dreams.

Why Do Nightmares Happen?

There is no 100% proven reason for dreams and nightmares, but many sleep scientists believe that dreams and nightmares exist for some purpose. Given that, studies show that:

  • The #1 cause of nightmares is depression, anxiety and stress.
  • Withdrawal from some medications, drugs, or other substances – like alcohol or tranquilizers – can trigger nightmares.
  • Sleep deprevation is known to cause nightmares. This is also linked to depression as insomnia is a common symptom of depression.
  • Sometimes, dreaming is the brain’s way of making us prepare, as we often expect difficult and dangerous situations in our waking life. Therefore, nightmares can be the brain’s way of leading us to problems or emotions that need attention in our waking life.

How to Get Relief?

There are steps you can take to stop those dreaded disturbances when you’re trying to sleep at night.

  1. Get Immediate Help for Depression People with depression and anxiety often have nightmares with frequency and intensity. Talk to your health professional and get the treatment needed to overcome your depression.
  2. Imagery Rehearsal Therapy is a promising cognitive-behavioral therapy for recurring nightmares and restless sleep. This is a method that can help reduce nightmare which in turn makes sleeping easier and less stressful. In this therapy, people write down the stories of their nightmares, turning their fearful writings into happy and peaceful texts. In this type of therapy you would write down every detail of your dream, telling its story from start to finish. Then, you create a new version of the dream, which turns the narrative from scary to bright and positive. You follow this by visualizing the new dream, playing it out in your mind.
  3. Adjust Your Medication Many medications can contribute to nightmares, including blood pressure drugs and sleeping pills. Talk to your doctor and discuss if you feel that your medication could be contributing to your ability to getting a good night’s sleep. If there’s a possibility they are, you can discuss with your doctor about other options that would alleviate nightmares for you.
  4. Improve Sleep Habits Sleep hygiene is important to prevent sleep deprivation and nightmares that have evolved into adulthood. An easy way to do this is to create a safe haven for yourself in the bedroom for relaxing and sleeping. It is important to separate stress-related activities, like studying and working, from the place where you sleep at night.
  5. Watch Your Diet Avoid alcohol, caffeine, nicotine, etcetera at least 12 hours before your sleeping hour, as having these types of substances in your system can disrupt sleep patterns.