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Does
Bipolar Disorder Affect Dreams?
from Marcia Purse
Part 1: Sleep Disorders, Vivid Dreams
A reader asked us: "Do people with bipolar disorder have extra-vivid
dreams and an inordinate number of nightmares or other sleeping
disorders?" The simple answer is yes, we do - but looking a little further
into the subject yields some fascinating information.
Dreams and nightmares occur during REM (rapid-eye-movement) sleep. In
normal sleepers, there is more deep sleep at first, and then as the hours
pass, periods of REM sleep become longer. This general pattern, however,
can be distorted or disrupted by any one of a number of sleep disorders or
disturbances, many of which have been shown to be associated with bipolar
disorder.
According to the article Stormy Sleep by Terrance Malloy, RPSGT,
"Psychiatric disorders are common in sleep disorder patients, and
disturbed sleep often afflicts patients with psychiatric disorders." The
article notes a study showing that a very high percentage of insomniacs
and hypersomniacs met the criteria for mental illness.
Sleep deeper and longer Non-prescription sleep solution Without the
next-day side effectswww.mpdirect.com I've had them for as long as I can
remember, except for a few periods when they were suppressed by
medications. The following paragraph from Bipolar II Diagnosis at Psych
education.org describes my own un-medicated sleep/dream experience of
about 10 years ago almost perfectly:
T]here are people with depression whose most noticeable symptom is severe
insomnia. These people can go for days with 2-3 hours of sleep per night.
Usually they fall asleep without much delay, but wake up 2-4 hours later
and the rest of the night, if they get any more sleep at all, is broken
into 15-60 minute segments of very restless, almost "waking" sleep. Dreams
can be vivid, almost real. They finally get up feeling completely un-rested.
Note that this is not "decreased need for sleep" (the Bipolar I pattern).
These people want desperately to sleep better and are very frustrated.
[For me, falling asleep was also difficult - could take up to an hour.]
Part 2: Sleep Disorders, Vivid Dreams Terrors
Nightmares also occur frequently in 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).
Bipolar children particularly suffer from nightmares. The July 2000 issue
of "The Bipolar Child Newsletter" notes that for these children, dreams of
explicit violence, gore and death are common. In the January 2000 issue of
the same newsletter, authors Papolos and Papolos wrote, "Many of these
children suffer night terrors and fears of abandonment and annihilation.
Whereas most children sleep and dream and have a nightmare or bad dream
once in a while, many children with bipolar disorder are trapped through
the night in hour after hour of night terrors (parents may not even
realize it because often the children do not truly wake up but seem in
anesthetized states)."
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 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.
When a child is experiencing a night terror and actually remembers it, he
or she later reports dreams that are extremely threatening. The content
has to do with some predatory person or animal chasing them, or terrible
fears of abandonment such as their parents being killed. Some adults who
suffer them and seem to have greater recall speak of ceilings and walls
pushing down on them, and others report snakes and spiders slithering and
crawling all over the bed or room" (Bipolar Child Newsletter, January
2000).
Night terrors are rare in adults, yet Papolos and Papolos cited a 1999
study by Dr. Maurice Ohayon which 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. In her article comparing nightmares
with night terrors, Sleep Disorders Guide Florence Cardinal gives tips on
how to help prevent and treat these conditions. Dr. Alan Greene suggests
an interesting theory and treatment for a child with night terrors who is
at potty-training age.
I do not have nightmares often; but in the morning, my last dream before
waking might be so involved and detailed that it could take three or four
full pages if I tried to write it all down. I could describe the colours
and textures of a dinosaur-like creature's scales; I could tell you today
15 minutes of details about a dream I had five years ago where Bill Cosby
was standing on our front lawn (I won't, though). The effect of bipolar
disorder on dreams can be interesting and entertaining - or utterly
terrifying.
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