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What is OCDOCD SubtypesI keep having violent dreams. Should I be concerned? 

I keep having violent dreams. Should I be concerned? 

9 min read
Erica Digap Burson

By Erica Digap Burson

Reviewed by Patrick McGrath, PhD

Jul 24, 2023

Possibly related to:

You bolt upright in bed, drenched in a cold sweat, your heart pounding frantically in your chest as your mind races to catch up with reality. It’s happened again: another night filled with chaotic, violent dreams. 

Having horrific dreams filled with violence can be, quite literally, a nightmare. They might leave you wondering what it means about you: why would your subconscious ever dream up a scenario where you’re participating in violent activities that you would never think of doing in real life? If they’re persistent and recurring, you might be wondering whether it’s a cause for serious concern. 

When violent dreams become a pattern, it’s normal to feel stressed and concerned. In this article, we’ll explore the science behind violent dreams, and discuss ways to cope or prevent them. 

What causes violent dreams? 

Sleep and dreams have fascinated people for ages, which means that plenty of research has been done to determine the exact role of these universal experiences. We know, for example, that sleep is crucial for allowing our bodies and minds to rest and repair from the day before. But when it comes to the science of dreams, there’s still a lot that research has yet to uncover. 

However, there are some things that we do know about the ties between our sleep and our dreams. For example, we know that sleep occurs in cycles that each last roughly 90 minutes, with each cycle consisting of phases with rapid eye movement (REM) and without it (non-REM). 

Many researchers believe that dreams happen throughout your sleep but are most intense during the REM phase. While dreams can also occur during the non-REM phase of your sleep, studies have found that people who are woken up while they are in the REM phase are more likely to report vivid and detailed dreams than someone who is awoken during a different phase.

But what exactly is the purpose of those dreams? This subject is still a topic of ongoing debate among psychologists and neuroscientists, and many different theories exist. For example, some researchers hypothesize that dreams are a way for your brain to strengthen its memory as you sleep. Other evidence suggests that dreams can help people work through the emotions that they were experiencing during their waking hours. 

In the behavioral field of psychology, we don’t really read into dreams in any way whatsoever. In most respects, we can treat them as random firings of the brain overnight.

Dr. Patrick McGrath, PhD

However, when your dreams are violent and disturbing, they might leave you wondering whether they have a deeper meaning.  

It’s critical to note that violent dreams can happen to everyone, and they are not a cause for alarm. NOCD’s Chief Clinical Officer Dr. Patrick McGrath, PhD emphasizes that “having a dream like this is not an indicator of a mental health problem. There are people who experience violent dreams and have this notion that all dreams must mean something. Why would I have this dream, and what does this say about me as a person that I’ve had a dream like this? But for those of us in the behavioral field of psychology, we don’t really read into dreams in any way whatsoever. In most respects, we can treat them as random firings of the brain overnight.” 

So in and of themselves, experts do not believe that violent dreams are a warning sign, nor is it believed that they hold any significant meaning. However, persistent nightmares and violent dreams could potentially be a sign that something else is going on. 

For example, let’s look at sleep disorders: there’s the aptly named “nightmare disorder,” which is characterized by frequent bad dreams (we’ll talk about nightmare disorder more in-depth in a moment). There are also night terrors, where you might wake up from sleep feeling terrified and panicked. Night terrors (sometimes also referred to as “sleep terrors”) are most common in children between 4 and 12 years old, but can also be seen on occasion in adults. 

Perhaps unsurprisingly, stress and anxiety can also be factors that contribute to bad dreams. This was highlighted in a study in 2021 that found that reports of bad dreams and nightmares appeared to increase during the COVID-19 pandemic lockdown, a period marked by high levels of stress and uncertainty. A higher frequency of bad dreams was associated with higher levels of stress, as well as depression and anxiety symptoms. 

4 Mental health disorders that are sometimes linked to persistent violent dreams

Some people with mental health disorders also report persistent scary or disturbing dreams. Here, it’s again important to note that a violent dream alone isn’t an indicator of a mental health disorder. With that said, there are links between persistent violent dreams and certain disorders.


Post-traumatic stress disorder (PTSD) is a mental health disorder that can occur after experiencing trauma. People with PTSD often experience frequent and intrusive moments where they re-experience their traumatic events. This can manifest in flashbacks and memories, but it can also manifest as nightmares. 

What’s more, people who have PTSD are often diagnosed with other comorbid conditions like panic disorder, which can make things worse. One study found that a whopping 96% of patients with PTSD and other comorbid disorders reported nightmares.

Anxiety disorder

Research has shown that people with anxiety disorders often had more intense and negative dreams than others. 

For example, one study found that older adult subjects with generalized anxiety disorder were significantly more likely to have bad dreams than other adults without generalized anxiety disorder. The researchers here also saw connections between the frequency of bad dreams and higher levels of depression, anxiety, and worry. 


Depression is another mental health disorder that can affect your sleep and your dreams. In fact, a 2015 study found that depression and insomnia were among the strongest predictors of frequent nightmares in its research group, even more so than other potential factors like alcohol and drug use. 


Obsessive-compulsive disorder (OCD) is another condition that may be linked to disrupted sleep. Someone with OCD will have obsessions or intrusive thoughts. They might then try to nullify that intrusive thought with compulsions, or ritualistic and repetitive behaviors. As a result, people with OCD can have a harder time sleeping than others. Further, this may also translate to nightmares

However, the focus here may not necessarily be the dreams themselves—rather, we look at how people with OCD react to these dreams

As is true with many areas of dreams, there is still more research to be done to determine the exact links between OCD and nightmares. However, some evidence does suggest that people with OCD tend to have worse dreams than others. For example, one study found that the dreams of OCD patients had significantly fewer positive elements than the dreams of healthy patients. Additionally, the researchers also saw that consistent treatment was linked to decreased negative content of dreams over time. 

So why might someone with OCD have recurrent nightmares in the first place? One possible theory is that their dreams are another manifestation of the intrusive thoughts that are the hallmark of OCD. Explains Dr. McGrath, “There may be people who have OCD and intrusive, violent thoughts who then do have dreams that also follow along those intrusive thoughts as well.” 

However, one of the biggest considerations here for OCD patients and their nightmares is how they may react to those dreams. Dr. McGrath goes on to say, “People with OCD might have a dream and then be afraid. They’ll ask, ‘What if this dream means something? What if it makes me do something? What if I had that dream because I want to do that and it was just coming out of my dream?’” 

In other words, someone with OCD might have a violent and terrifying dream, then become scared and obsessed with the idea that they will somehow act on the dream, even if it is highly unlikely that they would ever actually carry out that behavior. He’s seen patients who have a violent dream and then become obsessed over the idea that they might sleepwalk and act out the dream in their sleep, like a plot from a movie. “OCD loves hearsay,” he explains. “If someone sees a movie where a person sleepwalking walks next door and shoots the neighbor, they might pick up on those things.” They might then put a lock on their door before sleeping so that they couldn’t fulfill that violent act in their sleep, even though the chance of it actually happening are near zero. 

How to cope with persistent violent dreams

The method of treatment for persistent violent dreams can vary based on their underlying causes. 

For example, the treatment for someone with PTSD has various options including psychotherapy and  medication, or a combination of both. Prolonged Exposure (PE) Therapy is one approach used and found to be effective in many PTSD patients. In PE people write down their nightmares and read them aloud to the therapist over and over again until the emotional reaction to them fades into the distance. 

Dr. McGrath finds this script-based treatment to be an effective approach for many different patients with nightmares, including OCD, anxiety disorders, and PTSD. He explains, “I would write a script of the dream and I would have them read it over and over again until they were habituated to it. They were no longer afraid of whatever it was that popped up in the dream.” 

If you find yourself persistently worried that your disturbing, violent dreams mean something about you, it may be a sign of Harm OCD. In this case, exposure and response prevention (ERP) therapy can help you find freedom from your fears and learn to accept anxiety or uncertainty about the content of your dreams. In time, you can teach your brain that dreams, like any other intrusive thoughts, don’t necessarily mean anything at all.

At the end of the day, it’s important to remember that your nightmares don’t need to take hold of your waking life. As Dr. McGrath says, “Just like a thought we have during the day doesn’t have to make something happen, a thought that we have during the night doesn’t have to make it happen either.”

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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