“…And it had all been a dream.” I wonder how many primary school creative writing tasks I concluded with that tremendously original denouement?
Over the past few days, I have been dreaming depression. Just before I woke this morning I was dreaming vividly, experiencing the emotional and physical sensations of acute depression and trying to seek out ways to alleviate the pain. Only when I woke, it wasn’t “only a dream”. Those awful sensations were still there, and I immediately remembered that depression has been stealing upon me over the last few weeks. It started when I returned from my holiday; despite my many misgivings, I had ended up enjoying myself very much. There had been so much to see and do that was completely new to me, and at times I was a little over-stimulated by the unfamiliar sights, sounds and flavours. On a couple of nights I had to take a little extra quetiapine to ensure that I slept enough and did not get too “fast”. Once I was back in London I very quickly began to feel that now my holiday was over, I had nothing to do and nothing to look forward to. Days at home alone which I had filled quite satisfactorily before going away now seemed to stretch ahead of me, long and empty.
Before I could regain a sense of perspective, I met with my employer and it was agreed that it was unrealistic to expect me back at work any time soon. The organisation I work for has been generous and patient in holding my job open this long, but that can’t go on and, inevitably, my contract will be ending. So now it’s official: I’m economically inactive and not in a position to look for work until I’m well into recovery. Now there is no visible end to those empty, lonely days. I’ve been trying hard to counter this sense of emptiness, signing up for adult education classes and planning projects, but I am failing to convince myself. And as my mood gets lower, the depression and anxiety works its way into my dreams.
There’s plenty of evidence that people with mood disorders suffer disrupted sleep, including distressing dreams. One theory has it that people with mood disturbance “over dream”, spending too much time in REM dream sleep, and too little in the deep, restorative phase. This means that rather than night-time creating a break from the emotional arousal involved in states of distress, anxiety, irritation or elation during the day, our dreams continue to keep us in a state of emotional arousal. This makes perfect sense to me, as this is far from the first time that my mood states have stolen into my dreams. When I am predominantly anxious, I have nightmares, from which I wake gasping and flailing like a fish tossed onto the quay. The content of my dreams can also indicate an approaching high. It’s not just that I begin to sleep less; it’s that my dreams are so rich and vivid that when I do sleep I feel stimulated, rather than refreshed. They are usually delightful, sometimes outright humorous (I have woken up laughing aloud at a hypomanic dream before now), and sometimes X-rated, reflecting the increase in libido that is common in a bipolar high.
Dreaming depression means that the minute I wake, I feel very low. This morning I was in tears pretty much straight away. For the last few days, my mood has improved somewhat during the middle of the day, before dipping again in the evenings. It’s getting harder to get out of bed in the morning, but later I am reluctant to go to bed at night. I cried myself to sleep last night. Often in previous episodes of depression I have escaped into sleep, giving in to the seductive urge to sleep longer and longer to stop me feeling the pain of depression. This time it seems that sleep is no refuge at all.