My life with nightmares: A mental health personal essay.
By: Jenna Wilson
Tags: Personal Essay, Mental Illness, Sleep Disturbances, Sleep Disorders, Mental Health

Nightmares have plagued me ever since I was a little girl. Awful dreams through every stage of life made events even harder to deal with. The level of clarity throughout my dreams makes them terrifyingly real and difficult to escape, even after waking. I often recall my dreams fluently, right after getting up, and the feeling I take from them is not easy to shake.

At times, I haven’t been able to tell reality from my dreams. I’ve gotten confused as to whether something truly happened or not, anxiety rising when I couldn’t get things straight.

When this happens, it takes time for me to go over what I had dreamt and assure myself that it’s not possible I had really lived through what I remember, in order to get on with my day.

I tell myself that I shouldn’t let bad dreams get to me. After all, they’re not real… but the resulting emotion from them is.

Nightmares have caused me guilt and shame.

I’ve asked myself tough questions because of nightmares, such as: What are my nightmares trying to tell me? Am I doing something wrong in my life? And how much attention should I pay to these unsatisfying delusions until I am just feeding into them? The answers are never satisfactory.

When I was 18, I was diagnosed with generalized anxiety disorder.

Like other mental health topics, nightmares are not talked about often, especially among adults.

The two primary disorders resulting in recurring, vivid nightmares are: post-traumatic stress disorder (PTSD) and Nightmare Disorder, the latter usually associated with anxiety or depressive disorders, according to an article published in 2018 by the Journal of Clinical Sleep Medicine (JCSM).

According to the same article, Nightmare Disorder is a parasomnia which is associated with rapid eye movement (REM) sleep and affects 4% of all adults in the United States.

According to The Lancet Neurology, a parasomnia is “a sleep disorder characterized by abnormal or unusual non-stereotyped movements, behaviors, emotions, perceptions, and dreams during sleep or at the transition between wakefulness and sleep; there are non-rapid eye movement sleep parasomnias and rapid eye movement (REM) sleep parasomnias.”

According to the article, Sleep Disturbances in Posttraumatic Stress Disorder, traumatic experiences are associated with nightmares in up to 70% of adults. During a study on nightmares in adult psychiatric inpatients it was found that individuals who have suffered through interpersonal trauma, such as domestic or sexual assault, are more likely to have nightmares than those who have gone through noninterpersonal trauma.

Nightmares can also be seen as the brain playing out “perceived threats.” From this angle, I could theorize that the nightmare I depicted in the beginning of this piece was the result of a subconscious fear that I would drunkenly unleash a mortifying display of dissatisfaction. Oddly, this perspective gave me solace since it determines that my brain is just preparing for the very worst case scenario and not foretelling an inevitable misfortune.

From this perspective, I could even laugh at the nightmare that once had my heart in my stomach.

There are multiple proposed treatments available for adults with nightmares depending on the severity and if there is a coexisting disorder. For PTSD-induced nightmares or those with Nightmare Disorder, Image Rehearsal Therapy (IRT) has become the “first-line” treatment, according to a panel for the American Academy of Sleep Medicine (AASM).

According to the AASM, patients practicing IRT are encouraged to create a more positive outcome for their dreams and play it through mentally for about 10–20 minutes every day.

In conclusion, although nightmares can be terrifying, they should not consume you. There could be many causes of nightmares in adults, some of them associated with other mental health disorders, and some not. There are also treatments that exist.

If you have a nightmare, don’t be afraid to open up about it. They normally seem much less scary when you say them out loud. But at the very least, for the adult with nightmares, just know you’re not alone.