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

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