How to Recognize and Manage Nightmares with Depression

Depression can be debilitating, affecting all areas of life, including sleeping. Those who suffer from depression often have trouble falling asleep or staying asleep. Even when they do sleep, the quality of sleep is often reduced, with frequent awakenings and interruptions. One of the most common sleep disturbances for those with depression is nightmares.

What are Nightmares?

A nightmare is a disturbing dream that evokes feelings of fear and terror. With a nightmare, the sleeper usually wakes up feeling anxious, frightened, and sometimes with a racing heartbeat. Nightmares can occur at any time during the night but are most common during the REM (Rapid Eye Movement) stage of sleep, which is when people dream most vividly. Nightmares can be a normal part of life, but they can become a problem when they are frequent, severe, and affect the quality of sleep.

How are Nightmares and Depression Related?

Those with depression are more likely to experience nightmares than those who don't suffer from depression. People with depression often have a higher level of anxiety, which can trigger nightmares. Additionally, depression affects the sleep-wake cycle, causing the brain to spend more time in the REM stage of sleep. This can lead to more vivid and disturbing dreams, including nightmares.

How to Recognize Nightmares with Depression

Recognizing nightmares can be difficult, as they happen during the night, and the person experiencing them may not realize they are having them. Some signs to look for include:

  • Waking up feeling anxious or scared
  • Frequent awakenings during the night
  • Difficulty falling back asleep after a nightmare
  • Mood changes during the day, such as increased anxiety or sadness

If you notice these symptoms in yourself or a loved one and suspect nightmares may be the cause, it is essential to seek help from a healthcare professional.

How to Manage Nightmares with Depression

There are several ways to manage nightmares for those with depression. These include:

1. Psychotherapy

Talking to a mental health professional, such as a therapist, can help those with depression manage the symptoms of nightmares. A therapist can help the person understand the underlying causes of their nightmares and develop coping strategies for dealing with them. Cognitive-behavioral therapy (CBT) has been shown to be particularly effective in treating nightmares.

2. Medication

Anti-depressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can be effective in treating not only depression but also nightmares. Talk to your healthcare provider about the best medication for your specific needs.

3. Lifestyle Changes

Simple lifestyle changes, such as avoiding alcohol and caffeine before bed, creating a relaxing bedtime routine, and reducing stress, can make a big difference in managing nightmares. Getting regular exercise can also improve sleep quality and reduce the frequency of nightmares.

4. Sleep Environment

The sleep environment can also play a significant role in managing nightmares. Creating a comfortable, calming sleep environment is vital. This can include using comfortable bedding, keeping the room dark and quiet, and keeping electronics out of the bedroom.


Nightmares can be a distressing symptom of depression, but they can be managed. Seeking help from a healthcare professional, making lifestyle changes, and creating a calming sleep environment are all effective methods of managing nightmares. With the right approach, those with depression can improve their sleep quality and reduce the frequency and severity of their nightmares.