I watched a pretty great NOVA episode the other day, What Are Dreams?
It was a fascinating look at how and why humans dream, whether other animals dream (yes, they do), and what possible purposes dreams might have. It was back by a lot of research, like most NOVA episodes.
One thing that stuck out, though, is that research showed people with major depressive disorder can dream more often and have more disturbing dreams than those without it. Researchers found this could be due to abnormalities in REM sleep that often show up in patients with depression.
The program didn’t say much else about dreams and mental illness, but it got me wondering whether other illnesses also have links to intense or disturbing dreams.
What I found in my brief survey of research about OCD, bipolar disorder and depression is that depression may be unique among these three.
A quick summary:
- Sleep is often inefficient and disrupted in both OCD patients and bipolar patients — unsurprising, since the comorbidity of anxiety, OCD and bipolar disorder is relatively high.
- A few patients with particularly severe OCD have REM sleep that begins immediately upon sleeping, which is abnormal; however, the results are from a tiny sample (10 OCD patients and 10 people in the control group), so more study is needed.
- Some patients using SSRIs have reported more intense, vivid dreams or nightmares (this is something I’ve experienced myself). One interesting thing to note is that fluvoxemine, an SSRI, may prevent patients from entering REM sleep as frequently.
- One study found that especially vivid dreams are linked to more compulsive behavior in patients with OCD, particularly dreams that included feelings of anger.
But when it comes to dreams, research hasn’t found many differences in how OCD and bipolar patients dream, and how people without mental illnesses dream — at least, not without depression being involved. I haven’t yet looked at sleep studies performed with other mental illnesses.
I also want to note here that my review of the research was limited to Google Scholar; I’m not a trained psychiatrist or biologist. I just find the research interesting!
Anyway, what I took away from it is that we OCDers often have trouble falling and staying asleep, and our sleep is less efficient, but our dreams are likely a lot like everyone else’s. However, I think it’s possible that, like unwanted thoughts, we place more meaning on our dreams — and especially the negative aspects — than others do. The study about angry dreams leading to more compulsive behavior seems to back this up.
I know I tend to remember and obsess over dreams with violent or sexual content because I worry about what they could mean.
In the NOVA episode, one woman talked about an anxiety dream where she was late to class and lost, and when she burst through an elevator door, she accidentally killed a little girl. For her, this was an extremely disturbing dream and she was shaken when she woke, but when she talked about it in the show, it was clear that she treated it as no more than a weird dream.
I would probably obsess over that dream. What if I killed a little girl like that in real life? Should I avoid elevators, or carefully peek out before leaving them from now on? What if the elevator was a metaphor? What if a dream about killing a child was somehow prophetic, or was tapping into a repressed memory?
As researchers in the documentary pointed out, sometimes a cigar is just a cigar, and often a dream is just a dream — a way for our brains to blow off steam and nothing more.