Nightmares may be a common clinical characteristic for people experiencing psychotic symptoms. Further, the distress associated with them is associated with worse daytime symptoms.
Causes – In adults, the most common conditions associated with recurrent nightmares are acute stress disorder, posttraumatic stress disorder (PTSD), depression, and anxiety. Certain medications and substances can induce or exacerbate nightmares, during either treatment or withdrawal (table 1).
Nightmares occur more frequently in patients with schizophrenia than they do in the general population. Nightmares are profoundly distressing and may exacerbate daytime psychotic symptoms and undermine day-to-day function.
Oneirophrenia is often described as a dream-like state that can lead to hallucinations and confusion. Feelings and emotions are often disturbed but information from the senses is left intact separating it from true schizophrenia.
These nightmares might be triggered by stress, anxiety or trauma, but they might also be a sign of future psychosis, the findings suggest.
Sleep deprivation psychosis—when the absence of sleep causes a disconnection from reality that can present as hallucinations or delusional thinking—is a known effect of severe, prolonged sleep deprivation.
Scary nights
Researchers have long known that people who suffer from schizophrenia tend to report night terrors and frequent, terrifying nightmares.
Borderline schizophrenia is held to be a valid entity that should be included in the DSM-III. It is a chronic illness that may be associated with many other symptoms but is best characterized by perceptual-cognitive abnormalities. It has a familial distribution and a genetic relationship with schizophrenia.
It's true. Nightmares occur frequently in people with Bipolar Disorder. In The Reinterpretation of Dreams, the authors write: Bipolar patients report bizarre dreams with death and injury themes before their shift to mania (Beauchemin and Hays, 1995).
Researchers have reported that dreams in patients with schizophrenia tend to be simpler and less elaborate (2, 8), less emotionally sophisticated and self-involved (2, 9), more bizarre (10–12), and more negative, violent, and unfriendly (9, 11, 13) compared to dreams of healthy individuals.
Indeed, studies suggest that nightmares are often linked to unmet psychological needs and/or frustration with life experiences. Yet those links aren't always easy to make—except in cases of trauma (discussed below), our nightmares tend to reflect our troubles through metaphor rather than literal representation.
The overall pattern seen in the analyses reflect the significant relationship between nightmares and stress, while the finding that nightmares were positively associated with coping bolsters the supposition that nightmares may help to alleviate stress.
For some people, medicines, alcohol, drugs, lack of sleep, fever, or anxiety sometimes cause nightmares. Often, though, nightmares seem to be triggered by emotional issues at home or school, major life changes (such as a move), trauma, and stress — even if what happens in the nightmares seems unrelated to your life.
Hypochondria is itself a form of mild psychosis. The hypochondriac has a deep and ungrounded worry about having or developing a serious mental illness. Paranoia and suspiciousness are classical traits of psychosis but they can be subtle.
Brain tumors and brain injury.
Some brain tumors may cause psychotic symptoms that seem like schizophrenia. Likewise, people who've had a traumatic brain injury may have symptoms such as psychosis.
Psychosis could be triggered by a number of things, such as: Physical illness or injury. You may see or hear things if you have a high fever, head injury, or lead or mercury poisoning. If you have Alzheimer's disease or Parkinson's disease you may also experience hallucinations or delusions.
Symptoms of psychosis
hallucinations – where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices.
Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).
Prodrome
The prodromal phase is the period during which the individual is experiencing changes in feelings, thought, perceptions and behaviour although they have not yet started experiencing clear psychotic symptoms such as hallucinations, delusions or thought disorder.
Night terrors are a sleep disorder in which a person quickly awakens from sleep in a terrified state. The cause is unknown but night terrors are often triggered by fever, lack of sleep or periods of emotional tension, stress or conflict.
Sleep terrors differ from nightmares. The dreamer of a nightmare wakes up from the dream and may remember details, but a person who has a sleep terror episode remains asleep. Children usually don't remember anything about their sleep terrors in the morning.
Night terrors can occur in adults however it is rare. This may be indicative of underlying neurologic disorders that require more work up and investigation.