The Relationship Between Dreams and Mental Health

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Written by Afy Okoye

Reviewed by Dr. Michael Breus

Our Editorial Process

Table of Contents

If you’re like most adults, you probably spend around two hours dreaming each night.

Whether pleasant or frightening, dreams can affect your mental health or be a reflection of your current mental state. We explore the connection between dreams and mental health, including theories for why we dream and the role of dreaming in mental health conditions. 

Dreams and Mental Health

Although the purpose of dreams is still not well understood, studies suggest that dreams can be influenced by a person’s mental health. Mental health encompasses how a person thinks, behaves, and feels, and the content of dreams is often drawn from these daytime experiences.

Most of the research on the connections between mental health and dreaming has focused on people with symptoms of mental health conditions. Mental health conditions can develop when common challenges lead to severe changes in a person’s mood, how they think, or how they act. 

Research indicates that most mental health conditions are associated with bad dreams and nightmares, but the nature of this relationship is complex and still not fully understood. 

How Mental Health Affects Dreaming

Mental health can influence the content and frequency of dreams. People with mental health conditions like anxiety or depression may experience more disturbing dreams. On the other hand, people in good mental health may have more positive dreams.

Medications used to treat mental health conditions can also affect dreams. For example, nightmares are a side effect of the use and withdrawal from certain antidepressants and antipsychotic medications.

How Do Dreams Affect Us?

The effect dreams have can vary from person to person. Some people are more inclined to remember their dreams and to look for meanings that might inform their waking life. Other people have less of an interest in remembering or interpreting the content of their dreams and may feel that dreams have no lingering effects after waking up. 

Dreaming appears to be associated with the same parts of the brain that are responsible for regulating emotions. Although not well understood, there appears to be a connection between dream content and mental well-being. For example, some people report that the emotions from both good and bad dreams can carry over and affect their mood the following day.

For people with mental health conditions, bad dreams and nightmares tend to occur more frequently. Recurrent nightmares are also associated with mental health issues like self-harm.

Research suggests that the severity of a person’s mental health condition may be more closely related to how they react to their nightmares, rather than how often they have them. This finding offers hope for people seeking to understand their dreams and reduce their effect on waking life and mental health.

Nightmares

Nightmares are frightening, dreams that interrupt a person’s sleep. As many as 50% of children and 85% of adults report having occasional nightmares. 

Unlike bad dreams, nightmares cause a person to awaken, negatively affecting their sleep quality. Nightmares are often detailed and easy to remember after waking up, so the memory and feeling of the nightmare may be carried over into a person’s waking life.

A sleeper may start having nightmares after a personal loss, during periods of stress or anxiety, or after a difficult or traumatic experience. Nightmares can also be triggered by certain medications and by alcohol or drug withdrawal.

As many as 20% of children and 6% of adults have frequent nightmares. Persistent nightmares that interfere with a person’s ability to function in their daily life may be diagnosed as a nightmare disorder. Unlike occasional nightmares, nightmare disorder is a mental health condition in which frequent and severe nightmares can make it difficult to get through the day.

Depression

People with depression have an increased risk of bad dreams, and they tend to have nightmares about twice as often as people without depression. More than temporary feelings of sadness or anger, depression is a mental health condition in which negative shifts in mood make it difficult to function normally for an extended period of time.

Researchers suggest that bad dreams and nightmares may be more common in depression due to how this mental health condition affects a person’s sleep, particularly rapid eye movement (REM) sleep

REM sleep is the stage of sleep when a person’s eyes move quickly back and forth, and when the majority of dreaming happens. People with depression tend to enter REM sleep more quickly and have more eye movements during this stage of sleep compared to people without depression.

Anxiety

Anxiety is also associated with negative dreams and nightmares, both in children and older adults. In fact, nightmares are sometimes called dream anxiety attacks.

Anxiety is a normal experience that increases focus and helps the body respond to stressful situations. But when anxiety is out of proportion to the stressor, persists over time, and interferes with other parts of a person’s life, it may be diagnosed as an anxiety disorder. 

Several anxiety disorders are associated with nightmares. One type, called generalized anxiety disorder, may be diagnosed when symptoms occur nearly every day and last six months or longer. Research in older adults suggests that around 20% of people with generalized anxiety disorder have regular bad dreams and nightmares.

Stress and PTSD

Post-traumatic stress disorder (PTSD) is another type of anxiety disorder linked to bad dreams and nightmares. PTSD can develop when normal reactions to a traumatic experience, like fear, anxiety, and hypervigilance, persist and begin to affect other parts of a person’s life.

Nightmares are defining features of PTSD. A person with PTSD may relive a traumatic episode through thoughts, flashbacks, and dreams. Around 80% of people with PTSD have nightmares, often containing emotions they felt during the traumatic experience. Children with PTSD may have scary dream content that is unrelated to their trauma.

Psychosis and Schizophrenia

Dreams and psychosis may be related, with some researchers suggesting that they share similar underlying mechanisms. Psychotic disorders are a group of mental health conditions in which a person struggles to distinguish the real from the unreal. As many as 55% of people with psychotic disorders also have persistent nightmares.

Schizophrenia is one type of psychotic disorder. Studies have found that individuals with schizophrenia tend to have more bizarre dreams, often in which they are victimized. Some people with schizophrenia may struggle to distinguish between their dreams and reality.

Why Do You Dream?

Although there is not yet a clear scientific explanation of why people dream, many theories offer ideas on the purpose of dreams.

  • Wish fulfillment: Sigmund Freud famously theorized that dreams represent an opportunity for the mind to fulfill unconscious desires or wishes. This theory suggests that dreams allow people to express feelings, thoughts, and impulses that may be unacceptable or suppressed during waking hours.
  • Memory storage: A common theory proposes that memories are stored in the brain during sleep, and that dreams help to strengthen or integrate new memories with older ones. A related theory suggests that dreams help the brain to process and understand emotions, work through problems, and store emotional memories.
  • Generalization: A more recent theory suggests that dreams help the brain to generalize, which means to apply prior experiences and knowledge to the present. Because dreams are usually out of the ordinary, they help the brain to shift from memorizing daily details to incorporating them into a broader perspective.
  • Brain activity: Some theorists believe that dreams serve no function at all. According to this theory, dreaming may be an inconsequential feature of the sleeping brain, pulling from memories and knowledge with no specific function.

What Do Dreams Mean?

While there is no single way to interpret dreams, cultures throughout history have emphasized the importance and meaning of these nighttime visions. Taking time to think about the content of your dreams may give you insights into your life or mental state. Some popular interpretations of common dreams may help you ponder the meaning of your own.

  • Teeth falling out: Dreaming about your teeth falling out is one of the most common types of dreams. Philosophers from different eras suggest that these dreams could relate to tooth pain, financial debt, childbirth, or a fear of aging.
  • Falling: Dreaming that you’re falling may be linked to daytime stress or negative feelings. If the sensation of falling happens as a person is starting to fall asleep, it may be related to a type of muscle twitch called a hypnic jerk
  • Being chased: Many people dream about being chased by something or someone. A dream of being chased may symbolize an internal conflict or fears in your life.
  • Nude in public: A particularly off-putting dream is one in which you realize that you’re naked in a public place. Popular interpretations of these dreams include vulnerability, embarrassment, and feeling exposed.
  • Flying: Taking flight in a dream may be thrilling or frightening. Flying in your dreams could mean that you’re feeling a sense of freedom or discovering previously unknown abilities.
  • Insects: Cultures around the world have theorized about what it means to dream about bugs. Crickets may symbolize that a sleeper is looking inward, while a butterfly could represent creativity and transition.

How to Remember Your Dreams

Considering that dreams may offer insights into your mental health, remembering your dreams could help you use your dreams as a source of self-discovery. There are several tips that may help you improve your dream recall.

  • Be open: The first step to remembering your dreams may be to develop your interest in dreams and simply be open to the experience.
  • Keep a dream journal: Try starting a dream journal to record your dreams after waking up. Experts suggest that writing them down may help you develop the skill of remembering your dreams.
  • Try lucid dreaming: Lucid dreaming is a skill in which you develop the ability to recognize when you are dreaming. Lucid dreaming may help you gain awareness of your dreams and even transform their content from frightening to pleasant.

Remembering your dreams may be helpful for personal growth and boosting your creativity. It may take some time and experimenting to find the method that works best for you.

When to Talk to a Professional

If you are concerned about the frequency or content of your dreams, it can be helpful to talk to a doctor or a mental health professional. They can offer support, talk about potential causes, and discuss treatment options for disturbing dreams.

It can also be helpful to talk to a doctor or mental health professional if you notice changes in your general mood or state of mind, or if people in your life have expressed concern about your mental health. Some signs of mental health changes that are important to discuss with a professional include:

  • Trouble sleeping
  • Unexpected changes in appetite or weight
  • Mood changes that make it difficult to get out of bed
  • Difficulty focusing
  • New or increased drug use
  • No longer feeling interested in activities you used to enjoy
  • Difficulty functioning at work, school, or in relationships
  • Thoughts related to death or self-harm

Mental health professionals can also help you to improve your mental health, even if you don’t have a mental health condition. Improving your mental health can make you feel a greater sense of well-being and may even make your dreams a little sweeter.

About The Author

Afy Okoye

Staff Writer, Sleep Health


Afy is a writer and creative strategist in San Francisco with a master’s degree in international health policy from the London School of Economics. She has written for VeryWell Health, BlackDoctor.org, and Paste magazine and edited peer-reviewed journal manuscripts for Elsevier. Afy says her work with The Sleep Doctor is anything but “sleepy.” She enjoys the opportunity to learn new information and share knowledge that gives people the power to make better choices. Afy also likes to read non-fiction, do creative writing, and travel solo.

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