Vivid Dreams and Nightmares in Bipolar Disorder

Dreaming in Depression (and Other Mental Illness)

Vivid Dreams and Nightmares in Bipolar Disorder

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.


Bipolar Disorder and Dreaming

Vivid Dreams and Nightmares in Bipolar Disorder

Everyone dreams right? We all have wishes of what could be or what we’d or even whom. However, dreaming when we should be sleeping is something different. And for those of us with Bipolar Disorder, dreaming can become a minefield we maneuver in our sleeping hours.

Personally, as someone with Bipolar Disorder, I can remember most of my dreams. I’ve written them down in my journals and have even used them in plots for my fiction books. I have written pages and pages of detail about my past dreams, and can even recall them days, months, or even years later. 

One dream was so vivid and my recall was so detailed that I used it for a book that later became published as Trust in the Wind. It’s a Romantic Suspense with some Women’s Fiction elements. 

At first, I always thought my dreams and nightmares were related to the medication I took. Sometimes I dreamed more, other times, I couldn’t remember dreaming at all. With further research I found out differently.

Did you know that people with Bipolar Disorder tend to have more nightmares?

It’s true. Nightmares occur frequently in people with Bipolar Disorder. In The Reinterpretation of Dreams, the authors write:

Bipolar patients report bizarre dreams with death and injury themes before their shift to mania (Beauchemin and Hays, 1995).

Beauchemin and Hays (1996) found that dreams of bipolar depressed patients have more anxiety than those of unipolar patients.

Dreams of bipolar patients, particularly those with rapid cycling, may show evidence of the subsequent shift prior to noticeable affective and behavioral changes (Frayn, 1991).

Having Nightmares is one thing, but that’s not the end of it. Those of us with Bipolar Disorder also tend to have more Night Terrors. I can attest to this as I have them on a semi-regular basis. Mine are mostly silent and I don’t usually remember them once I wake up. I only know I’ve had them if they awaken my husband during the night and he tells me about the episode the next day.

According to some studies, Night Terrors are rare in adults, yet Papolos and Papolos cited a 1999 study by Dr. Maurice Ohayon (1) that found that bipolar disorders and depression with anxiety were the most common factors associated with adults who reported night terrors.

In these episodes, people are known to appear to awaken, recognize no one, and exhibit symptoms of extreme fear, even screaming, thrashing around or running from the bedroom.

Ohayon went on to say that “Arousal parasomnias (night terrors, sleepwalking, and confusional arousals) have seldom been investigated in the adult general population. Clinical studies of Parasomnias, however, show that these disorders may be indicators of underlying mental disorders and may have serious consequences.”

I said earlier, my Night Terrors are nothing that. I have repetitive motions, crying, and some thrashing on a more moderate level. That is what usually awakened my husband. At first, he was very alarmed by them, but as we investigated and became more informed, we take them as normal routine now, and he doesn’t stay up all night watching me to see if I’m going to hurt myself.

“Night Terrors and such conditions as sleepwalking, restless leg syndrome, bruxism (teeth grinding) make up a group of arousal disorders called parasomnias.

Night Terrors do not occur during REM (Rapid Eye Movement) sleep and are not dreams, although they have nightmarish elements.

They occur instead either during deep sleep or in a transitional state between deep and dreaming sleep and are a form of Confusional Arousal Disorder.” – (2)

The Southern States Paranormal Research Society has more to say regarding Paranormal Parasomnia, and you can read about it here:

If anyone has personal experience with Nightmares and/or Night Terrors, I’d love to hear back from you and read your story.

RESOURCES(1) Clin Psychiatry. 1999 Apr;60(4):268-76; quiz 277.Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders.Ohayon MM, Guilleminault C, Priest RG.



5 Hidden Symptoms of Pediatric Bipolar Disorder |

Vivid Dreams and Nightmares in Bipolar Disorder

For many parents of children with bipolar, mornings can be the most difficult part of the day. You are both most pressed for time and it’s never a good combination when both parent and child are stressed.

But did you know that for many kids with bipolar the actual act of waking up can be extremely difficult, even after a good night’s sleep.

It could take as long as an hour to actually get them the bed, let alone get functioning for the rest of the day.

#2 Surprise events

Life events without any prior warning can make children with bipolar feel control and can be difficult for them to handle. This could mean even good surprises a small gift or an impromptu trip to get ice cream can be unsettling and can cause an emotional outburst.

#3 Night terrors

Many children seem to suffer from violent nightmares and parents will awaken to blood curdling screams from their child’s room in the middle of the night. Some children will seem to be in a hypnotic state and may not even wake up.

For those who do remember, they describe horrifyingly real-life nightmares.

Science has revealed these aren’t really nightmares, but in fact ‘night terrors’ because they don’t happen during the dream stage (rapid-eye movement REM stage), but in the deepest part of non-REM sleep or a transitory state in between.

#4 Shifting activities

For children with bipolar, making transitions from one activity to the next can be difficult sometimes.

For example, it can be challenging for these kids to stop doing what they’re doing when asked to get ready for lunch or dinner.

This has been seen even for regularly scheduled activities such as weekly recreational activities. The simple act of going from one activity to another can be an issue.

#5 Temperature issues

Children with bipolar disorder seem to overheat easily no matter what temperature it is. It’s not uncommon to see kids without coats outside in the middle of winter.

Because the heat bothers them, when the weather is hot, children’s moods can change and they become more irritable and quick to anger.

It’s also typical for their ears to turn bright red and their cheeks will become flushed.

Related article:
Bipolar in Kids: Know the Symptoms


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What Do Our Dreams Reveal About Mental Health?

Vivid Dreams and Nightmares in Bipolar Disorder

by Meg Stein

The late comedian Mitch Hedberg has a joke about dreams: “I hate dreaming. Because when you sleep, you wanna sleep. Dreaming is work, you know – there I am in a comfortable bed, the next thing you know I have to build a go-kart with my ex-landlord. I want a dream of me watching myself sleep.”

He raises a good point. Dreams often seem random, and usually involve us engaging in a lot of activity. People often dismiss their dreams as nonsense, but in fact we undergo the same biophysical processes when we’re asleep as when we’re awake.

In other words, dreams affect our physical and mental health the same as waking experience does. And, wise, dreams can reveal truths about both your mental health and your physical health. Nightmares may indicate that you’re sick, for example.

Vivid dreaming may point to sleep deprivation, low blood sugar, or pregnancy.

Dr. Michelle Carr writes in Psychology Today that:

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.

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.

Dreams can indicate a physical or mental state that you may not have been aware of beforehand. For example, many depressed patients are often relatively passive in their dreams, which are frequently less bizarre than normal; and, when waking, depressed patients report lower dream recall frequency, and less detailed dream reports. The U.S.

Department of Veteran Affairs reports that 52 percent of combat vets with PTSD have nightmares frequently, compared with only 3 percent of civilians. Dreams can also provide information about times when you’re feeling stressed or anxious.

By paying attention to the feeling that you had in the dream, rather than the precise details of what happened in the dream, you can often gain clarity about the stressors in your life.

The Live, Love, Laugh Foundation reports that, “If you have vividly detailed and long dreams, you could be suffering from anxiety. Anxious people have higher brain activity during the day and also tend to absorb more information providing more fodder for their dreams. If left unchecked, this can be a recurring theme and lead to changing sleep patterns.“

If you already know that you have a particular condition or diagnosis, then dreams can wise give you accurate information about it.

For example, studies have shown that bipolar patients’ dreams can indicate an oncoming alteration between depressive and manic states.

This happens when bipolar patients reported a shift from experiencing neutral or negative dream content towards more bizarre and unrealistic dreams.

Laura in Bustle magazine reminds us that, “It’s important to note that having vivid dreams or scary dreams is not in itself an indicator that anything is wrong with your mental health.” However, it’s still a good idea to pay attention to your dreams.

Tracking your dreams over time can help you discover larger changes, shifts or resolutions in your life. And stay alert if you find yourself experiencing nightmares or very vivid dreams frequently. If this happens, you may want to discuss your sleep with your doctor and your mental healthcare provider.

While your dreams may or may not point to underlying physical or mental health problems, the fact remains that if your dreams are interrupting your sleep, then it’s a good idea to seek help.

Antonio Zadra, a dream researcher and clinical psychologist, wrote, “In some cases, nightmares represent a primary sleep disorder rather than a symptom of an underlying psychological conflict.”

Your dreams may or may not be signs of a bigger problem, but you should seek help regardless, as frequently disrupted sleep can negatively impact your health. Dream researcher and clinical psychologist Antonio Zadra pointed out in The New York Times that recurrent nightmares need to be addressed simply for their own sake, even if they’re not signs of other issues.

As Hedberg’s joke suggests, dreams can be tiring and can interrupt your sleep. If that’s the case, it’s a good idea to get some help so you can sleep more peacefully.



Ms. Comer’s goal is that her patients feel supported. Noted for her empathy and insight, she prioritizes treating all her patients with dignity and aims to provide a safe place where all clients can feel heard and cared for.

Megan encourages everyone who she works with to feel free to discuss what is really going on in their lives so that she can help improve their overall quality of live.

She has a strong background helping people who have chronic pain issues


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Vivid Dreams and Nightmares in Bipolar Disorder

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5 Sleep Problems Common with Bipolar Disorder

Vivid Dreams and Nightmares in Bipolar Disorder

Bipolar disorder, by definition, comes with sleep problems. Everyone’s body has internal clock that regulates not only sleep habits, but also hunger and thirst. This is your circadian rhythm.

It’s what makes you wake up during the day, fall asleep at night and nourish yourself in between. In bipolar disorder, this rhythm is disrupted. The body does not keep up with the sleep/wake cycle, causing sleepless nights and tired days.

Far from “I just didn’t sleep well,” here are five sleep issues that are more common when you have bipolar disorder.

1 Sleeplessness
Going without sleep is a primary symptom of a manic episode. During these times, patients will survive on only a few hours of sleep or not sleep at all for several days.

You would imagine that doing so would create a zombie, shambling from task to task just craving some shuteye. On the contrary, energy levels stay high as though sleeplessness isn’t even an issue. It might sound great, but people need sleep.

Going without it is dangerous, and can even be deadly.

2 Insomnia
Though they sound similar, insomnia and sleeplessness are not the same. Sleeplessness during mania is often seen by the patient as advantageous- more time to do more things.

Insomnia, on the other hand, is when you want to sleep and are trying to sleep, but are unsuccessful. Think of the times you’ve laid awake thinking “If I fall asleep now, I can still get (so many) hours of sleep.

” That’s insomnia, and with bipolar disorder, it can happen almost every night during a depressive episode.

3 Daytime sleepiness
You’re falling asleep at your desk despite having slept well the night before. You’ve tried caffeine, but now you’re just jittery on top of being tired. This is daytime sleepiness.

People with bipolar disorder are more than twice as ly to experience it than the general population. When depressed, your body can default to sleeping too much instead of sleeping too little.

However, 40% of bipolar disorder patients report having problems with tiredness even between episodes.

4 Night terrors
Though not uncommon in childhood, most people grow having night terrors. For bipolar disorder, that doesn’t seem to be the case.

About 10% of adults with bipolar disorder experience the sweating, screaming, intense fear, rapid breathing and body flailing that come along with night terrors.

Even if these physical symptoms aren’t present, it’s still incredibly common for people with bipolar disorder to have nightmares.

5 Sleepwalking
Walking through hallways with your arms outstretched is a bit of a trope.

With sleepwalking, people engage in all sorts of activities ranging from just sitting up in bed to getting up and leaving the house with no awareness of their actions.

Again, it’s more common in children, but around 2% of the adult population experience it as well. That number goes up to around 9% when dealing with bipolar disorder.

There are a few reasons these sleep disturbances are more common in people with bipolar disorder. They could be an innate part of the disorder, a result of circadian dysrhythmia or side effects from medication taken for either bipolar disorder itself or for medications prescribed to combat sleep issues.

Either way, the best ways to keep sleep disturbances at bay are to eat well, keep a daily routine, take medications as prescribed and practice good sleep hygiene.

You can follow me on @LaRaeRLaBouff or find me on .

Image credit: Flickr user monkeywing

5 Sleep Problems Common with Bipolar Disorder


What Your Dreams Could Indicate About Your Mental Health

Vivid Dreams and Nightmares in Bipolar Disorder

Do you dream in fragmented bursts of images or extended, vivid narratives? Do you remember dreams as if they really happened, or do you forget them immediately upon waking? What do dreams tell us about ourselves? There are a number of things that dreams can indicate about mental health, reflecting conditions ranging from general emotional states to serious mental disorders. Sometimes a dream is just a dream — but, in some cases, it may mean something more.

There’s a lot that we don’t know about dreaming. Despite famous theories by the s of Sigmund Freud, experts still don’t really know what the images and impressions in dreams mean, or even if they mean anything at all.

Even the most basic questions, “Why do people dream?” continue to elude researchers, in part because sleep itself is not well understood. Though we know that sleep is essential to human health, its actual purposeand the purpose of REM sleep, the sleep stage responsible for vivid dreaming — is still largely a mystery.

Another factor that makes dreaming hard to pin down is that it’s difficult to study; though scientists can monitor brain activity while someone is dreaming, the actual content of a dream, as well as how vivid or disjointed a dream feels, can only be described by the dreamer in necessarily subjective terms.

Since one person’s incredibly bizarre dream might be another person’s normal Tuesday snoozefest, coming up with quantitative research about dreaming is complicated, to say the least.

All of that said, studies have shown that certain types of dreaming can say a lot about what’s going on in our bodies and minds. Vivid dreaming, for example, sometimes accompanies sleep deprivation, low blood sugar, and pregnancy. Intense or stressful dreaming can also reflect your mental and emotional state.

It’s important to note that having vivid dreams or scary dreams is not in itself an indicator that anything is wrong with your mental health.

Nightmares are a fairly common phenomenon among adults, and though they can be triggered by stress or anxiety, they are not necessarily linked to any greater mental health issue. In many cases, dreams are simply weird, but very common, aspects of being human.

However, if you do have a mental health condition, certain types of dreaming may appear as one of your symptoms.


According to sleep researcher Michelle Carr, studies have shown that people suffering from depression experience “more negative mood and emotion” in their dreams than others, as well as more frequent nightmares. People who experience suicidal ideation in their waking lives also tend to have death as a recurrent theme in their dreams.

However, depression doesn’t always impact dreaming in the same way. One study, for example, showed that, in some cases, people with depression experience a “neutral affect” in their dreams rather than an overtly negative one; researchers think this might be linked to the “affective flattening” that can occur in people with depression.

Disrupted sleep is a common symptom of bipolar disorder. “The overwhelming majority of people with bipolar have sleep problems,” Dr.

Phillip Gehrman, a sleep specialist at the University of Pennsylvania in Philadelphia, told Everyday Health.

In fact, he said that major sleep changes — from experiencing insomnia, to sleeping all the time, to needing less sleep than usual to stay alert — are often signals of an oncoming bipolar episode.

Unsurprisingly, these disturbances in sleep also affect people’s dreams. A 1995 study of patients with bipolar disorder found that dreams could even predict oncoming shifts in mood.

“By categorizing the dreams that preceded mood shifts, we were able to identify a particular type of dream that seemed to precede a mood shift, particularly in the direction of mania,” researchers Kathleen M. Beauchemin and Peter Hays wrote.

When people were heading into manic states, they tended to dream of “death and bodily injury.” Those moving into depressive episodes didn’t show a tendency toward common dream themes, but they did show a decrease in dreaming overall.


people with depression, people with schizophrenia experience more frequent nightmares than is typical.

According to Carr, studies have shown that the dreams of schizophrenic people “contain heightened levels of anxiety and negative affect,” as well as “hostility directed towards the dreamer.

” These dreams also are more highly populated with strangers (as opposed to friends or other people known to the dreamer) than usual.

Trauma is also closely linked to nightmares. People who develop post traumatic stress disorder (PTSD) following extremely stressful, traumatic experiences are more ly than the general public to experience recurrent nightmares; people with PTSD can have nightmares as often as five days a week or more.

The shape of nightmares related to PTSD is different from typical nightmares. They tend to be similar to flashbacks, in which the dreamer re-experiences parts of or even whole traumatic events. At least half of people with PTSD have these “replicative nightmares,” repeatedly reliving moments of trauma.

If disturbing or nightmarish dreams are routinely interrupting your sleep, take the time to talk to your doctor about it. Your dreams may or may not be signs of a bigger problem, but you should seek help regardless, as frequently disrupted sleep can negatively impact your health.

Dream researcher and clinical psychologist Antonio Zadra pointed out in The New York Times that recurrent nightmares need to be addressed simply for their own sake, even if they’re not signs of other issues, writing, “In some cases, nightmares represent a primary sleep disorder rather than a symptom of an underlying psychological conflict.” So whether you think your disturbed sleep is the result of depression or trauma, or your nightmares seem to crop up the blue, it’s worth talking to an expert — doing so might just help you to get some peaceful sleep.

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