Vivid Dreams and Nightmares in Bipolar Disorder

Bipolar disorder is a condition that causes extreme swings in mood that affect thoughts, behaviors, and energy levels.  It can also affect a person’s sleep, including causing unusually vivid dreams, nightmares, and night terrors.

This can be a frustrating experience for people who are already dealing with the ups and downs of their condition. Unfortunately, some medications used to treat bipolar disorder are also linked to sleep disturbances and nightmares.

At a Glance

Many people with bipolar disorder experience nightmares and night terrors. These can be especially challenging when combined with insomnia or excessive sleep, depending on whether they are in a manic or depressive episode. Continue reading to learn about sleep disturbances linked to this condition and steps to achieve more restful sleep.

Dreams and Nightmares in Bipolar Disorder

Nightmares are disturbing, well-remembered dreams that can cause anxiety and fear. They typically occur later in the evening during rapid eye movement (REM) sleep and cause a person to wake up abruptly.

Some researchers suggest that nightmares in individuals with bipolar disorder might signal upcoming mood changes.

While the precise causes remain unclear, it’s known that nightmares are more frequent among people with mood disorders. Those with major depressive disorder (MDD), bipolar disorder, and schizophrenia experience nightmares more often than the general population.

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Nightmares in Children

Children who have bipolar disorder may suffer disproportionately from nightmares. Dreams of explicit violence, gore, and death as well as dreams that signal a fear of abandonment have been reported.

Of course, most children experience nightmares on occasion. Children with bipolar disorder, however, can experience these more significantly.

Night Terrors in Bipolar Disorder

Night terrors are also common in people with bipolar disorder. Unlike nightmares, night terrors do not occur during REM sleep.

What Is a Night Terror?

Unlike dreams, a night terror involves waking suddenly with symptoms like intense fear, screaming or thrashing, and increased heart rate and blood pressure.

During a night terror, individuals wake up in a state of terror and are typically confused and inconsolable. They may or may not recall the episode afterward.

Though night terrors are rare in adults, those experiencing them often have disorders like bipolar disorder, depression, or anxiety.

During a night terror, people may sit up abruptly, scream or thrash in fear, appear confused, fail to recognize anyone, or even run from the room to escape perceived danger.

Lamictal and Dream Abnormalities

Lamictal (lamotrigine) is a mood stabilizer approved by the Food and Drug Administration (FDA) to treat bipolar disorder and certain seizure disorders. It effectively prevents the recurrence/relapse of mood episodes in both bipolar I and bipolar II.

However, some people who take Lamictal can experience a variety of sleep-related side effects, including an increase in nightmares and abnormal dreams. According to the manufacturer label, approximately 6% of people with bipolar disorder experience some type of dream abnormality while taking Lamictal.

If you think Lamictal is causing abnormal dreams, talk to your doctor. Remember that it’s never a good idea to stop taking a medication cold turkey or change the dose of a medication without first consulting your healthcare provider.

Coping With Nightmares in Bipolar Disorder

Researchers don’t fully know what causes people with bipolar disorder to experience nightmares and night terrors. What is known is that the continuation of these sleep disturbances increases the severity and frequency of symptoms during both manic and depressive episodes.

Getting a good night’s sleep is essential to living a manageable life with bipolar disorder. If you’re struggling with sleep disturbances such as nightmares or night terrors, experts recommend you do the following:

Bedtime

Establishing a bedtime routine can improve sleep timing and consistency, which is important for sleep quality. Stick to a set of habits that help prepare you for rest each night. Take a bath, read a book, or listen to some music to calm your body and help set the mood for a sound night’s sleep.

Creating a routine can give your mind something to focus on instead of your worries and anxiety.

Avoid Sleep-Interfering Substances

Avoid substances that interfere with sleep. Some substances like caffeine prevent you from sleeping. Others, such as alcohol or marijuana, can help you fall asleep but can affect the quality of your sleep. Avoid all for a more restful sleep.

Exercise

Research suggests that regular exercise can be important in improving sleep quality. It also helps maintain good health.

However, exercising too late in the evening can significantly interfere with your ability to fall and stay asleep, especially if you have bipolar disorder. Exercising in the earlier part of the day, on the other hand, can help support healthy sleep.

Get Medical Help

Talk to your doctor. If you’re concerned about the frequency of your nightmares or night terrors, schedule an appointment to see your doctor. You might also want to ask your doctor whether any of the medications you’re taking (both over-the-counter and prescription) cause sleep problems as a side effect, and whether an alternative option may be more suitable.

Keep in Mind

Adequate sleep is essential for both mental and physical health, and research suggests that poor sleep can contribute to relapses in bipolar disorder. Therefore, if you’re troubled by vivid dreams, be sure to talk to your doctor about it. Some medications may be able to help you can get a more peaceful night’s sleep.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Marcia Purse

Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing.

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