Dreaming and psychosis are two states of consciousness that seem worlds apart. The mind is a remarkable creation; it is designed in an extraordinary way. During my psychosis, I could not differentiate between dreaming and being awake. Being awake felt like a dream and sleeping was a waking nightmare. In fact, I was acting out my dreams which was uncontrollable for my family, who had to hold me down during sleep; where I was in a state both in the dream world and in the present world. More can be found on this, in the article Ninety Seven.
Dreaming is a normal, nightly occurrence that transports us to other realms. While psychosis is a debilitating mental health condition characterized by a loss of touch with reality. Researchers have uncovered striking similarities between the two, suggesting a deep and complex connection.
This article explores the intriguing overlap between dreaming and psychosis, shedding light on what it reveals about the human brain and mental illness.
The Brain in Dreaming and Psychosis
At the core of the link between dreaming and psychosis is the brain’s behaviour during these states. Both involve altered activity in key neural networks and regions:
- Default Mode Network (DMN):
The DMN, responsible for self-referential thinking and imagination, is highly active during both dreaming and psychosis.- In dreams, this creates immersive, often bizarre scenarios that feel real.
- In psychosis, overactivity in the DMN can lead to intrusive thoughts, delusions, and hallucinations.
- Prefrontal Cortex:
The prefrontal cortex, which governs logical thinking and reality testing, shows reduced activity in both states.- This explains why dreamers accept illogical events as real and why individuals with psychosis struggle to distinguish between reality and their perceptions.
Hallucinations and Dream Imagery
One of the most striking parallels between dreaming and psychosis is the presence of vivid sensory experiences. In dreams, we see, hear, and feel things that aren’t there, much like the hallucinations experienced during psychotic episodes. Both feel real to the person experiencing them. One is in an unconscious state, while the other is conscious. Both states are also marked by intense emotions, such as fear, anxiety, or euphoria, which can feel overwhelming and real.
Blurred Boundaries of Reality
In both dreaming and psychosis, the line between internal mental states and external reality becomes blurred. In the moment, dreamers often lack insight into the unreality of their experiences. Just as individuals with psychosis may firmly believe in their delusions or hallucinations. This breakdown in reality testing is a hallmark of both states.
Neurochemical Overlaps
Neurotransmitters like dopamine, serotonin, and glutamate play key roles in both dreaming and psychosis:
- Dopamine: Elevated dopamine levels are linked to psychotic symptoms, such as hallucinations and delusions. Similarly, dopamine activity increases during REM sleep, the stage most associated with vivid dreaming.
- Serotonin and Glutamate: These neurotransmitters are also implicated in both states, further highlighting the shared neurobiology.
Sleep, Dreaming, and Psychosis
Sleep disturbances are common in individuals with psychosis, and poor sleep can exacerbate symptoms. Research shows that people with psychosis often have disrupted REM sleep, the stage most closely tied to dreaming. During my worst episodes, I was going days without sleeping, which meant I was getting little REM sleep. It seems as if our bodies demand sleep and if not given the right amounts, the effects rebound on us. In my case, I was experiencing what would be dream-like, in my waking moments.
Additionally, the content of dreams may be more intense, bizarre, or emotionally charged, reflecting wakeful experiences or contributing to symptom severity.
Theories Connecting Dreaming and Psychosis
Several theories attempt to explain the link between dreaming and psychosis:
- Overlap Hypothesis:
This theory suggests that psychosis and dreaming share similar neural mechanisms, with psychosis being likened to a “waking dream.”- In both states, the brain generates perceptions and narratives that feel real despite lacking external input.
- Threat Simulation Theory:
Dreams may serve as a way for the brain to simulate and prepare for potential threats.- In psychosis, this system might become overactive, leading to heightened paranoia or fear.
Clinical Implications
Understanding the connection between dreaming and psychosis has important implications for mental health care:
- Insights into Psychosis:
Studying dreaming can provide valuable insights into the mechanisms of psychosis, helping researchers develop better treatments. - Therapeutic Approaches:
Techniques like lucid dreaming therapy, where individuals learn to recognize they are dreaming, are being explored as potential tools to help people with psychosis gain more control over their thoughts and perceptions. - Sleep Interventions:
Improving sleep quality and addressing sleep disorders may help reduce the severity of psychotic symptoms, offering a non-invasive way to support treatment.
Conclusion
The link between dreaming and psychosis reveals the intricate workings of the human brain and the fine line between normal and altered states of consciousness. While dreaming is a universal and healthy experience, psychosis represents a dysregulation of similar processes. By exploring this connection, researchers and clinicians can develop innovative strategies to diagnose, treat, and support individuals with psychotic disorders. As science continues to unravel the mysteries of the mind, the dream-psychosis link offers a unique window into the nature of reality itself.