Elizabeth Brico shares her personal experience, and expertise on PTSD Nightmares. Elizabeth Brico is a freelance writer from the Pacific Northwest whose work often focuses on trauma, mental illness, and addiction.
Her blog, Betty’s Battleground, was recently ranked on Feedspot’s list of top 75 PTSD blogs. She is also a regular contributor to the trauma blog on HealthyPlace. Her work has appeared in Politico Magazine, Talk Poverty, Tonic/VICE, The Fix, Ozy, Vox, and Racked, among others. In her free time, she can usually be found reading, writing, or watching speculative fiction. You can find her full portfolio–alongside some fiction and other ramblings–on her author site, eb-writes.com. Check out her blog and author pages on Facebook, or find her on Twitter, Instagram, and LinkedIn.
Have you ever had a nightmare?
I’m guessing the answer is yes. Nightmares, like dreams, begin young. I’ve seen my babies twist and squeak, eyelids fluttering, small breaths rapid, until I touch them, brush their hair; soothe them back to better dreams.
Dreams are the human mind’s way of working through thoughts, feelings, and events that we may not have fully processed in our waking life. Our way of dealing with the subconscious. Sometimes, our subconscious thoughts are scary, or sad, or just generally unpleasant. Hence, nightmares.
It is estimated that we spend about a third of our lives sleeping. If you are healthy and sleeping regularly, a fair portion of that sleep should be spent in REM state, or ‘dream sleep.’ Some people are now saying, considering the length of time we spend dreaming, that dreams should be considered another facet of reality; a sort of alternate dimension.
Can you remember it? Can you remember how it made you feel; your thoughts when you woke up? Probably a mixture of lingering fear; your grogginess may have made your imagination wild; the shadows in your room may have borne a vague threat. But you probably also felt relief when you woke up. You were glad that the dream was over, and as the sleepiness wore off, you were probably happy to be awake again.
I pulled that description from my memory. From the time before I was traumatized. I remember what nightmares were like before I developed PTSD. They weren’t fun; I have a vivid imagination and it can definitely run wild with a fearful scenario, but back then, before PTSD, the word nightmare was synonymous with “bad dream.”
PTSD nightmares are far worse than bad dreams. If dreaming takes us to an alternate dimension, then PTSD turns the brains of trauma survivors into gateways to Hell.
The biggest difference between a trauma nightmare and a normal nightmare is that trauma nightmares feel real.
I mean really real.
We’ve all had dreams that seem real while they’re happening. Those dreams seem real because we are so entrenched in the dream state that our mind registers it as reality. When we wake up, however, there is a distinct difference between the feeling of that dream, and the feeling of being awake.
A PTSD nightmare feels like the waking world. Except it’s something really, really scary that is happening. I have PTSD as the result of domestic violence, so my nightmares tend to revolve around being strangled, suffocated, or having my eyes pushed into my head. The feeling is indistinguishable from an actual assault. I feel like I can’t breathe. I feel like there is someone in the bed with me, assaulting me. When I wake up, my brain and body still react to the nightmare as though it were real. As though I have been assaulted just moments ago. Often, I have to leave the bed because, although I know, intellectually, that my husband did not just do these things to me, he’s the actual person in the bed with me, so I feel like he did.
Not all PTSD nightmares manifest
Not all PTSD nightmares manifest as direct re-experiencing of the epidemiological trauma. Sometimes they just conjure the same feelings. I’ve woken screaming from nightmares of being chased by a shadowy phantom down impossible architectures and never-ending streets. Recently, many of my nightmares have revolved around my ex trying to seduce me, which is probably the most horrifying story line of all.
PTSD erases the line between dream and reality. There is no difference between the way a PTSD nightmare feels, and the way a real trauma feels. Which means I am re-traumatized by my own brain almost every night.
How Do PTSD Nightmares Affect Daily Life?
Because I regularly experience nightmares which cause me to re-experience my trauma, I am afraid to go to sleep. Once upon a time, sleep was my sanctuary. It was my happy place; it was my time to rest and revel in the wild, colorful dreams my creative imagination conjured.
Now, I hate sleep. It terrifies me. If I accidentally fall asleep while putting my baby to bed, I inevitably wake up gasping for air. When that happens, I get up, go to the living room, and perform various forms of nothing until 3 or 4 am, when I am able to pass out from sheer exhaustion into a blank, dreamless sleep.
This means that I spent my days exhausted. Mornings are slow starts, riddled with lethargy. I have to drink cup after cup of coffee, which aggravates my anxiety. I spend most of my days in a tired, anxious fog. Chronic sleep deprivation also means my emotions are even more deregulated than normal, and patience, something I need in abundance as a mother of three, is in short supply.
PTSD nightmares don’t just stay in the bedroom. They affect every part of my life.
How To Help PTSD Nightmares Short-term
When I am affected by nightmares, I experience them almost every night. The first thing I do to help myself whenI’ve had one is to leave the room. Just get away from the place where the dream occurred, especially if it was a dream that I was being choked or assaulted in my bed.
Once in the living room, I have to re-integrate with reality. This is very much like grounding during a flashback or panic attack. Different people have different preferred grounding techniques. Most involve engaging one or more senses while focusing on a specific anchor or set of anchors. I like to find something new. Just a distinct object in the room, or even something I’m wearing, that I did not have during the time of my actual assault and is very different from anything I owned back then. I have used new shoes, jewelry, the television, even tomatoes, which I didn’t start eating until my son was almost one year old. I use this anchoring object to remind myself when and where I am. To ground myself in the present.
And then I stay up. It’s not exactly healthy, but who would willingly walk into an assault? Just because I know I won’t be physically harmed does not mean I want to experience it again. Essentially, I try to make staying up too late, if not healthy, then at least productive. I work on my blog. I write. At the end, I unwind with Netflix or a book. Until, at last, sleep overtakes me and I fall into the black slumber of exhaustion.
Regular PTSD therapy is the best long-term antidote to PTSD nightmares. While the science behind PTSD nightmares, and dreams in general, is shaky, we know that it has something to do with adrenaline and hyperarousal of the amygdala. Which are also the systems at play during daytime panic attacks and flashbacks. So getting professional help for PTSD also helps reduce the severity and frequency of nightmares.
After I began engaging in contemplative-based therapy and regularly doing contemplative grounding techniques like yoga and mindful cooking or playing, I stopped having PTSD nightmares. For years. I also stopped having flashback and panic attack. While I still had depressive episodes, general/social anxiety, and trigger responses, my life in general was improving.
Then my abuser re-entered my life. He began to engage me in a custody battle, forcing me to repeatedly see and hear him in court, and to recount the worst instances of my abuse to a variety of strangers.
And everything started up again, especially the nightmares
This time, therapy alone didn’t help. Luckily, there is a medication on the market that can help. It’s a high blood pressure medication called Prazosin that the VA randomly discovered was effective at stopping PTSD related nightmares.
When my doctor handed me the prescription, I was skeptical. How could nightmares be treated with medication? But I was seriously sleep deprived, and the terror from my nightmares was leaking into my waking life in the form of obsessive, fearful thoughts about my ex.
How You Can Help PTSD Nightmares
According to the United States Department of Veteran’s Affairs, 71% to 96% of people with PTSD are affected by nightmares. Considering that about 8 million Americans yearly live with PTSD (and even more globally), that’s a lot of people being terrorized by their dreams. If someone you love has PTSD, or if you have PTSD, nightmares are likely a factor.
The best way to help is to show compassion. To your loved one, or to yourself. Nightmares are not the fault of the person who has PTSD. If they wake up screaming, insist on sleeping in separate beds, stay up late, or behave erratically; it’s not their fault. Showing compassion, behaving gently, and allowing them (or yourself, if it’s you) to have that space,is critical. Don’t take it personally if your lover leaves the bed. She’s not walking away from you; she is walking away from the place where she just experienced trauma.
We spend so much of our lives engaged in dreams and nightmares that they may as well be classed as an alternate reality. For those of us living with PTSD, that reality can be a Hell. Therapy, medication, and compassionate, sustained support from our friends and family are the keys which will unlock those gates. Nightmares are one of the most debilitating symptoms of PTSD, but they can be overcome. Life can get better.
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