Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why am I constantly having dreams about dying? A therapist’s advice

By Jessica Migala

Dec 29, 20238 minute read

Reviewed byApril Kilduff, MA, LCPC

Dreams can be fun, hilarious, sexual, weird, boring—and, yes, disturbing. But if you can dream about anything at all, why are you having dreams about dying? Does it mean something? And if so, what? 

While the occasional dream about dying may make you wake up in a cold sweat or need to decompress the next morning, you can likely shake it off as dreams just being dreams. But if dreams about death or dying feel like a regular occurrence, they can really disrupt your life and cause you to obsess over them, says Nicholas Farrell, Ph.D., Director of Clinical Development and Programming at NOCD. 

Here’s what may be going on with your dreams about death, when they cross the line and are considered intrusive, how they can affect your life—and most importantly, how to cope with all of this.

What’s the reason for your dreams about dying?

Dreams are a big industry. There are books that decode your dreams, you can hire a dream interpreter, and there’s a whole internet of articles on how to analyze your dreams, all in an effort to bring meaning and clarity to this ubiquitous nighttime brain activity.

Most people dream for about two hours each night, most of which occurs during the REM (rapid eye movement) stage of sleep, according to the National Institute of Neurological Disorders and Stroke (NINDS). In addition to dreaming, this stage is associated with memory consolidation. When you’re in REM sleep, your eyes move rapidly behind your eyelids (thus the name) and even though your brain is very active, your muscles are temporarily paralyzed, so you can’t act out your dreams.

And despite a lot of research, experts still aren’t sure why we dream, or what our dreams mean. For example, it might be for emotional processing—you need the downtime at night to sort out your feelings or worries from the day. The content of dreams is even more shrouded in mystery, says the U.S. National Science Foundation. People can only wake up and talk about their dreams—scientists can’t enter their minds mid-dream. This makes them more challenging to study.

When a dream about dying may be intrusive

If you have frequent dreams about death, the big question is: How do you feel when you wake up? Are you relieved that you or a loved one didn’t actually die? And are you able to move forward with your day? Or do you feel like you get stuck in a mental loop about what your dream meant—and if you need to take action in order to prevent something really bad from happening?

Despite their disturbing content, not all dreams about death are considered intrusive. In fact, dreaming about death is fairly common. An intrusive dream is defined as a vivid and often disturbing dream that intrudes upon your thoughts and emotions even after waking up. If you basically forget that awful dream by breakfast time, it’s probably not intrusive. If you’re still ruminating about it later in the day, it may be a sign of something more serious.

It’s all in how you feel about it. “A thought is labeled or defined as intrusive not by its raw content, but by a person’s appraisal of it,” says Dr. Farrell. For example, two people could have the same thought, and for one person it’s funny; for the other, the thought is intrusive and distressing. 

Can anyone have intrusive dreams about death?

The answer is yes—anyone can have an intrusive dream, about death or any subject, for that matter. Dreams are incredibly personal, and it’s not uncommon to feel affected by your dreams, especially if they felt so real at the time. 

Dreams can be random and have no real meaning behind them. However, sometimes they may indicate more is going on—like a subconscious red flag. “The experience of recurrent, disturbing dreams around death-related themes may be a prominent symptom of an underlying mental health condition,” says Dr. Farrell. 

A few that come to mind, he adds, include anxiety, depression, OCD, and PTSD. Here’s a quick rundown of each:

Anxiety: There are times when a death-related dream is a manifestation of actual anxiety, says Dr. Farrell: “There’s some evidence to suggest that the content of your dreams is a continuation of the cognitive noise in your head during the day.” In fact, people with anxiety are more likely to have dreams that are more aggressive and less friendly, and contain more failure, misfortune, and negative emotions, compared to those who do not have the condition, according to a 2021 study published in the journal Dreaming.

Depression: “Consistent thoughts around death can be characteristic of depression, especially if these feelings just randomly pop up in your dreams at night, and aren’t something you really worry about during the day,” says Dr. Farrell. Thoughts centered around death may involve suicidal ideation or feeling as if it’d be “convenient or welcome” if you went to sleep and didn’t wake up. These, he says, are not likely to be ego-dystonic in the way that dreams related to OCD and PTSD are, meaning that they may align more closely with your actual feelings. One 2021 study of more than 40,000 people published in Sleep Medicine found that persistent nightmares tended to be indicative of pre-existing depression, though they weren’t shown to cause depression or lead to harmful actions, like suicide.

OCD: Some people with obsessive compulsive disorder (OCD) have intrusive dreams that are intensely worrying and trigger fears about themselves or their life. Obsessions are an intrusive thought, image, sensation, feeling and/or urge that creates significant distress in your life. Compulsions are behaviors that are done to relieve that distress or prevent something unwanted from happening. 

“Obsessions as part of OCD are considered largely ego-dystonic,” says Dr. Farrell. “This simply means that they don’t make sense with your worldview. So there may be a tendency to spend excessive mental energy trying to analyze or interpret the meaning or significance of your dreams the next day. There’s an inability to leave it as just another dream that you had.” 

If you spend a lot of time consumed by your obsessions and compulsions, such as intrusive death-related dreams, or you’re highly distressed or impacted by them in any other way, you might meet the diagnostic criteria for OCD. 

PTSD: Post-traumatic stress disorder (PTSD) occurs after experiencing a traumatic event—and nightmares can be a common symptom. Dreams centered around death are characteristic of PTSD, where there was a precipitating event, trauma, or exposure to actual or threatened death,” notes Dr. Farrell. Still, it’s not always obvious why someone is having these dreams. “A person may recognize the frequency and intensity of these dreams occurring, but not know that their presence is caused by PTSD,” he adds.

How intrusive dreams about death can affect your waking life

Again, it’s your relationship with your dreams that’s important. If you can shake off a bizarre dream the next day, even if it is about death, it’s clear that it’s not affecting your life. However, if you are having repetitive dreams about death and are struggling with persistent fears because of them, you may worry:

When you worry about having a disturbing death-related dream, you may be reluctant to go to bed, or actively try not to sleep at all, says Dr. Farrell. Dream avoidance can manifest in other ways, such as setting an hourly alarm to make sure that you don’t get stuck in a disturbing dream. 

For people with OCD, obsessions in response to these dreams may also include excessive research about dreams, mentally reviewing your dreams to decipher what they mean, seeking reassurance from loved ones or professional dream interpreters, or time-consuming tracking of dreams—all things that disrupt your usual daily activities and quality of life.  

How to cope with persistent dreams about death

If you are having disturbing dreams about death that are affecting your daily life or ability to sleep, it’s important to seek out help from a licensed mental health therapist who specializes in anxiety who can help you develop tools to cope. This will have a far greater impact on you than continuing to attempt to decode the exact content of your dreams and trying to apply it to your life.

While your dreams are part of the problem, a clinician can help you recognize and understand the presence of other possible symptoms of a mental health condition. ”As a clinician, I might ask a patient who may have PTSD if they’re aware of having unwanted recollections of a near-death experience, or may be avoiding things that remind them of that time,” says Dr. Farrell.  

Maintaining good sleep hygiene is also important if you’re struggling with bad dreams. Try to stick to a consistent bedtime and wake time, and practice a wind-down routine before bed that includes pleasant, non-stimulating activities without using screens, such as a warm bath or light stretching. 

If you have OCD, the most powerful treatment is a type of cognitive behavioral therapy called exposure and response prevention, or ERP. With ERP a therapist helps you face the intrusive thoughts, images, sensations, feelings and/or urges that are causing you distress. With repeated exposures in a safe environment, you become accustomed to the stressor, which unhooks your brain from thinking that it’s scary or frightening. With time, it can even become boring. (Yes, that is possible!)

For any type of disturbing dream, including recurring dreams of death, you’ll work with your clinician to develop a plan about how to confront these dreams—which would involve acknowledging their presence and the discomfort they cause, but choosing not to perform your compulsions, such as researching dreams, or calling a friend to talk over your dreams in extreme detail.

The good news is that ERP treatment can not only help you overcome the distress associated with recurrent dreams about death in your waking life; it will also affect how your brain processes information when you’re asleep, so you just might find that the content of your dreams starts to change, too.

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