Obsessive compulsive disorder - OCD treatment and therapy from NOCD

My dreams are always depressing. Is there anything I can do?

By Jessica Migala

Nov 30, 20239 min read minute read

Reviewed byApril Kilduff, MA, LCPC

Some dreams may be recognizable to almost anyone. You’re flying. You’re naked and giving a presentation. You forgot where your locker is in high school. Your teeth are falling out. A pet who passed away runs and plays with you again.

Dreams can range from the happy to the bizarre to the utterly devastating. You can experience a full range of emotion during them—feelings that linger long into the morning. There’s no question that the content of your dreams can affect your waking life. 

But whereas many people are able to shake it off and move on, some cannot and they feel emotionally dysregulated for the rest of the day. Here’s why it’s important to pay attention to how your dreams are affecting you, and how you can determine if you need to seek some extra help.

Why are your dreams depressing?

While you sleep, you cycle through four stages of sleep, from light sleep (stages 1 and 2) to deeper sleep (stage 3), and REM sleep, where most dreaming occurs, according to the National Institute of Neurological Disorders and Stroke (NINDS).

Exactly why we dream remains, in part, a mystery. It appears that dreaming aids in memory consolidation and helps you process and prepare for the things you’re going through in life, notes the Cleveland Clinic. One study has called sleep “overnight therapy,” since so much of the content of dreams is based in emotion.  

It’s one thing if you had such a great dream that you’re bummed when you wake up from it. It’s another if the content of your dreams leaves you with a low mood or feeling depressed for the next day. 

If that’s the case—that the content of your dreams is affecting your waking life or your dreams feel reflective of your waking life, it’s time to tune into that, and possibly seek out help. 

Are depressing dreams affecting your waking life?

“Dreaming is something that comes up quite often in therapy sessions,” says Melanie Dideriksen, LPC, CAADC, a licensed therapist with NOCD. If you have a disturbing dream, you may wake up sad and feel thrown off for the next day. 

Research in Sleep Medicine in 2021 has found that 9% of the participants in a study had what was categorized as disturbing dreams, such as content detailing a trauma or their “worst” event that they’ve experienced. But, as past research points out, bad dreams occur far more in people who have mental health disorders. About 75% of people with PTSD, 50% of those with borderline personality disorder, and 10% with schizophrenia have frequent nightmares. Stressful life events can also trigger nightmares. 

The nightmare doesn’t necessarily end when you wake up. One study found that having nightmares was associated with increased worry, depersonalization (a sensation that you’re not in your own body, and watching yourself from a distance), hallucinations, and paranoia. The more severe the nightmares, the more severe these symptoms. 

Do you feel depressed while you’re awake?

You just woke up and now there’s a feeling of dread, hopelessness, or fear in the pit of your stomach. It’s common for your mood in the morning to be affected by the quality of your dreams at night, suggests research in Affective Science in 2022. You may also feel more anxious in response to a depressing dream. In particular—and this is certainly not surprising—dreams about death and anxiety created worse a.m. dispositions. Who could face the day with happiness and optimism when you’ve been shaken to your core?

While we can’t decode your specific dreams and tell you what they mean, we can pay attention to how your dreams affect how you feel and function the next day—and how you respond to these feelings. In some instances, what you’re experiencing may be depression. Post-traumatic stress disorder is also associated with nightmare disorders. And finally, research suggests that people who have obsessive-compulsive disorder may also be more prone to nightmares, and tend to fixate on them as important or meaningful, making them even more disturbing. Here’s what you need to know about each:


Depression, which is also called major depressive disorder, is a serious mental illness in which you have a low mood, and it can affect anyone. According to the National Institute of Mental Health (NIMH), these are a few telltale symptoms of depression, which have to be present for more than two weeks:

  • You feel persistently sad, anxious, or empty.
  • You experience hopelessness.
  • You’re irritable, frustrated, or restless.
  • You feel guilt, worthlessness, or helplessness.
  • You have a loss of interest in the things you once enjoyed.
  • You have fatigue, brain fog, changes in appetite or weight.
  • You have thoughts of death or suicide.

Depression greatly affects your sleep, for many people causing insomnia and nighttime awakenings (what better time to think about your and the world’s problems than at 3 a.m.?). When it comes to dreaming, a systematic review noted that people who have mood disorders have more than twice as many nightmares as those who don’t, though exactly why isn’t quite clear. 

Researchers also question if dreams of suicide also correlate to suicidal ideation during someone’s waking life. In short: Dreams may even indicate a mental health emergency. If the content of your dreams makes you question if you should live or if you’re feeling suicidal for any reason, reach out for help at the Suicide and Crisis Lifeline at 988 or contact a loved one if possible.

Post-traumatic stress disorder

People with PTSD are at risk for nightmare disorder, which you can be diagnosed with if you have frightening or vivid dreams that affect your functioning during the day, according to Cleveland Clinic. In these cases, when nightmares are frequent enough, you may even try to avoid going to sleep at night out of fear of being terrorized in your sleep, and the resulting insomnia means you don’t snag enough shut-eye at night.

Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (OCD) also find that their dreams are indicative of their mental state. OCD is a chronic mental health disorder with typically two components:

Obsessions: Unwelcome thoughts, urges, feelings, sensations, and/or images that cause distress—dreams can even become obsessions.

Compulsions: Repetitive, ritualistic behaviors done to neutralize the anxiety that arises from an obsession or keep something unwanted from happening, such as checking, counting, or reassurance-seeking.

No one’s OCD is the same, but people with OCD are affected by common themes, or OCD subtypes, such as:

  • Contamination: A fear of contracting an illness or spreading germs.
  • Existential: A questioning of one’s purpose that’s all-consuming.
  • Harm: Having intrusive thoughts of hurting others and/or yourself.
  • Pedophilia: Having unwanted sexual thoughts about children. 

Within OCD, there are two main ways that dreams may affect someone with the disorder:

Dreaming about OCD fears 

“For someone who is fixated on something in their waking life, it stands to reason that they’ll possibly dream about these topics,” says Dideriksen. This is a place where obsessions can come into fruition. “Clients will talk about having dreams that they’re engaging in the terrible acts that they fear,” she says. As you can imagine, this results in someone feeling upset, terrified, or depressed when they wake up, and the resulting anxiety can linger during the day. 

Dreaming creates an obsession

Anyone who wakes up remembering a dream knows this: They can be pretty weird. For someone with OCD, though, a dream can be more than just something to brush off as strange. It can mean something so that the content of an extremely disturbing dream—involving anything from murder and incest to sexual assault or pedophilia—can hook them. 

“I’ve seen dreams become an OCD obsession many, many times,” Dideriksen says. “When awake, they ask themselves why they dreamed about that—if it’s something they actually want and what’s wrong with them,” she explains. “The constant rumination and overthinking can become overwhelming when people take really disturbing dreams as a sign of what they really want or feel.”

How can you get help when dreams are impacting your waking life?

If your dreams are affecting your mood during the day, triggering scary thoughts, or you’re concerned for any reason, it may be a good idea to seek out help from a mental health professional.

Therapists won’t directly target your dreams or try to help you understand or decode them—no one is truly able to control their dreams, but your dreams shouldn’t control you either. Rather, the way your dreams are impacting your life can be an indication that you’re struggling with something. Should you have a mental health disorder, it’s important to receive the right diagnosis. As for treatment, here’s what you may expect for depression, PTSD, or OCD:


Treatment for depression leans heavily on therapy and includes techniques such as cognitive-behavioral therapy (how your thoughts and feelings affect your behaviors), behavioral therapy (helping you do the things you once loved), mindfulness-based cognitive therapy (to improve self-compassion), among others, according to the American Psychological Association. Medication, such as SSRIs or SNRIs, may also be recommended.

For dreams specifically, Dideriksen says that the behavioral component is critical. That includes evaluating sleep habits and setting up good sleep hygiene practices, such as maintaining regular sleep times, getting off devices an hour or two before bed (which will help avoid “doom-scrolling” at night), and participating in relaxing habits (stretching, meditation) while avoiding stressful ones (emailing, watching the news, etc).

Post-traumatic stress disorder

If you have a nightmare disorder, treatment includes psychotherapy, including an evidence-based approach called Prolonged Exposure (PE) and medication. During PE, people with PTSD are encouraged to confront traumatic memories or triggers and remain in distressing situations without resorting to safety-seeking behaviors or avoidance. In time, they can retrain their brains to feel less threatened by triggering situations.


OCD is treated with exposure and response prevention therapy, also called ERP. This is considered the gold-standard treatment for OCD, and similar to PE for PTSD, it involves confronting situations that trigger anxiety or distress, and learning to accept these feelings without relying on compulsive behaviors like mental review, avoidance, or reassurance-seeking.

ERP can be employed across all subtypes of OCD. With dreams, says Dideriksen, you might write down the worst thing you could dream about would be. Since OCD loves to latch onto your worst-case fears, this might directly relate to an OCD obsession. Another activity you might do in therapy, says Dideriksen, is write out a detailed script of a horrifying dream and see if it actually happens in your life. In doing so, your brain can learn that your dreams aren’t actually connected to your waking life in the ways you fear.

You can overcome depressing dreams with expert help

Whether depression, PTSD, or OCD is causing your dreams to make an impact on your waking life, you don’t have to feel like this forever. These conditions have highly effective, evidence-based treatments, and specialty-trained therapists can give you the tools you need to live with confidence during the day—even if your dreams don’t always go the way you want.

If you think your struggles with depressing dreams may be related to depression or OCD, I strongly encourage you to learn more about NOCD’s accessible approach to treating OCD, depression, PTSD, and related conditions. You can access the help you deserve today.

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