Can Anxiety Cause Bad Dreams?

By Arastou Aminzadeh, Founder, BNI Treatment Centers

Like a vicious circle, teen anxiety can cause sleep disturbances, such as bad dreams, which leave them feeling sleep deprived—and that only exacerbates the anxiety the next day. Because getting quality sleep is so central to adolescent wellbeing, getting to the bottom of the stress or anxiety causing the sleep disturbance should be the primary focus.

About Teen Anxiety Disorder

The teen years are a stressful chapter of life. Teens are under ever-increasing pressure, with heavy academic workloads and multiple extracurricular activities. While some teens have good time management skills and well-developed coping mechanisms, some will have a difficult time. Those who struggle may find themselves overwhelmed, which can result in anxiety.

School pressures are not the only source of teenage anxiety. Some teens may develop an anxiety disorder due to a variety of stressors. These might include:

• Struggling socially
• Being bullied
• Feeling pressure to do it all, and do it all perfectly
• History of abuse
• Covid-19 related anxiety
• Family issues, such as parents getting divorced
• Relocating or starting at a new school
• Death of a parent

Common Types of Teen Anxiety

An estimated 32% of teens between the ages of 13-18 experience some form of an anxiety disorder, according to the National Institute of Mental Health. The following are the more common types of anxiety disorders among adolescents:

Generalized Anxiety Disorder

Teens with generalized anxiety disorder struggle with excessive worry and fear in daily life. Symptoms include irritability, insomnia, sweating, racing heart, shallow breathing, and muscle tension. The teen will often have somatic symptoms, such as recurrent headaches, gastrointestinal distress, and fatigue.

Specific Phobia

Teens with an intense fear of an object or situation may be diagnosed with specific phobia. Teen phobias might be a fear of spiders, fear of certain animals, fear of public speaking, fear of heights, fear of germs, or fear of enclosed spaces. When they encounter the object of their fear they become intensely anxious. In order to avoid the encounter, the teen may begin to isolate.

Social Anxiety

At the core of adolescent social anxiety is a deep fear of rejection, especially by their peers. Teens that suffer with social anxiety are fearful of being judged harshly or publicly humiliated. This can hinder both their academic and athletic performance.

Panic Disorder

Teens that experience recurrent panic attacks often feel an overwhelming lack of control. This disorder can cause chest pain, shortness of breath, a racing heart, sweating, shaking, headache, nausea, and dizziness.

How Does Stress or Anxiety Cause Bad Dreams?

When someone struggles with anxiety they almost always have sleep issues. They may have trouble falling asleep or staying asleep. They may suffer from nightmares, night sweats, sleepwalking, or nighttime panic attacks. In other words, the anxiety seeps into the subconscious and adversely impacts the quality of sleep.

A teen may internalize the fears they live with on a daily basis. While they may manage to function fairly well, at least on the outside, when they fall asleep that fear and anxiety can percolate up and cause bad dreams. Anxiety dreams are common for adolescents who battle anxiety disorder. Their anxiety dream may involve some conflict or struggle that they are unable to manage. They experience intense frustration in the dream, which can cause them to awake in a highly agitated state.

What are Night Terrors?

Night terrors are usually seen in children and young adolescents. These are episodes that occur during the night during which the teen will wake up screaming, crying, or thrashing about in their bed. The child or teen seems terrified, and may experience a racing heart, sweating, and rapid breathing. These events emerge about 90-minutes into the sleep cycle and tend to recur again nightly over a period of time.

Trauma-Related Nightmares

Trauma is another underlying factor in sleep disturbances. Teens with a history of trauma or abuse may suffer from nightmares. Even though the teenager may be able to suppress memories of the traumatic event, the emotions related to it can emerge in the form of bad dreams or nightmares. They may dream about the actual trauma, or of something tangentially related to the trauma, such having a dream about the death of a parent.

How Teens Can Prevent Bad Dreams

There are multiple actions a teenager can take to help reduce the incidence of nightmares. All of these involve relaxation techniques and stress reduction before bedtime. Consider these tips for your teen:

1. Avoid watching violent or scary movies late at night
2. Avoid playing video games late at night
3. Avoid loud music late at night
4. Stick to a daily sleep schedule
5. Get regular exercise during the day
6. Create a relaxing bedtime routine, such as taking a warm bath
7. Use aromatherapy with lavender, valerian, or bergamot, to help induce relaxation and aid sleep
8. Sip chamomile tea prior to bedtime
9. Avoid sugary treats before bed
10. Avoid drugs and alcohol

Parents can help their teen to better manage their stress by remaining engaged with them. Ask them how things are going with their friends, about whether they need any academic support, if they need help prioritizing their tasks, or if they are feeling overwhelmed in general. Giving them a safe, nonjudgmental space to discuss their current mental state can yield important information that will allow you to help them.

Teen Anxiety Treatment

If the teen seems to be struggling with an anxiety disorder, it is probably impacting all areas of life, including their grades, relationships, and general health. One of the common symptoms of anxiety is sleep disturbance. If a parent suspects their teen is dealing with an anxiety disorder, make an appointment with the family physician to rule out a medical condition first.

If no health issue is identified, the teen will be referred to a mental health practitioner who can provide further guidance and support. Treatment will include talk therapy, holistic techniques, and possibly a teen support group. If outpatient care is not sufficient, a residential treatment program for teens can provide a more intensive treatment approach.

About the Author

Dr. Arastou Aminzadeh is a triple board certified physician in psychiatry, child and adolescent psychiatry, and addiction medicine, and is the co-founder of BNI Treatment Centers in Agoura Hills, California. Dr. Aminzadeh is a fellow of the American Society of Addiction Medicine and also a fellow of the American Psychiatric Association. A well respected leader in the field, he also holds an adjunct faculty position at the University of Southern California, Keck School of Medicine, where he completed his residency and fellowship.