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The Scary Truth About Nightmare Disorder And Top Treatments that Work

The Scary Truth About Nightmare Disorder And Top Treatments that Work

Most of us have had the experience of deeply distressing nightmares that wake us up. But for those suffering symptoms of nightmare disorder, the experience can be terrifying, let alone the idea of falling asleep in the first place.

Untreated, nightmare disorder can have a significant, dastardly impact on our ability to just function normally, day to day. It’s not just about having a restless night’s sleep and struggling to get out of bed the next morning laden with fatigue.

If you suffer nightmare disorder, you often experience greater frequency of your nightmares either across different nights or as a sequence of disturbing dreams in the same night.

Fear and anxiety often wreak havoc on you emotionally, mentally and physically when trying to fall asleep, during and between your sleep cycles and also upon waking. You’re terrified of sleeping!

If you’re tired of experiencing no change even though you’ve reduced your alcohol intake, started exercising and have been going to bed earlier, there is help at hand.

Yes, physical changes you make can be extremely helpful (e.g. modifying your diet and eating plan, listening more to positive, inspiring audio books, music and podcasts, doing yoga) but you may be missing some key psychological strategies that can really help to kick your symptoms to the kerb.

How to know if I have nightmare disorder?

The International Classification of Sleep Disorders III provides minimum criteria to determine if individuals suffer from nightmare disorder described below:

a) Dreams are recurrent, clearly recalled and involve vividly feeling threats to survival, safety or physical integrity which often jolt you to awaken;

b) Upon wakening, you rapidly feel highly alert and become quickly oriented;

c) The nightmare itself or the sleep disturbance caused when awakening from it, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning as indicated by experiencing at least one of the following:

Mood disturbance – emotions upon waking persist after the nightmare

The emotions aren’t vivid and distressing only during your nightmare. Even as you awaken they remain very real, are highly intense and usually contain intense levels of anger, fear, terror and/or sadness.

In fact the mood you experience can persist for awhile after you awake from the nightmare and the feeling is difficult to shake.

Dream recall is vivid

Many people find it difficult to recall their dreams upon waking even with making a concerted effort to do so.

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With nightmare disorder, dream recall is quick and vivid and there is little to no confusion about the details of the dream.

Falling asleep again is challenging

You can often suffer physical symptoms upon waking. Breathlessness, sweatiness and tightness in the chest can heighten your attention to remain awake.

Being unable to calm yourself physically and mentally makes falling asleep again not only difficult, but awfully frightening.

There also can remain the fear of re-entering the nightmare you’ve jolted awake from or re-experiencing the dream again.

You develop avoidant behaviors

Bedtime anxiety can become a common feature. A fear of the darkness associated with sleep time can also develop.

Social, interpersonal and occupational function starts to subside

Your ability to concentrate and focus at work or be fully present during social interactions starts to drop.

You might also start to feel silly and ashamed that you can’t ‘get over’ a silly nightmare.

Daytime sleepiness, fatigue and low energy

Your energy levels and fatigue can suffer from not getting enough of the right quality sleep, having incomplete sleep cycles and not getting enough cycles in the first place.

During the day you wake up groggy and feel like you’re dragging your feet to concentrate, focus and get anything done.

Other symptoms

In addition to the above, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) explains that a diagnosis of nightmare disorder is not catalyzed by the effect of medication nor drugs and also is not attributed to the presence of another mental disorder (e.g. post-traumatic stress disorder). The DSM-V also indicates how severe a diagnosis might be pending the different time periods of experiencing the symptoms.

To gain an accurate diagnosis, work with a qualified, registered mental health professional. Explore your medical history, your previous and current use of drugs and medication, your previous sleep disturbances as well as presence of any similar sleep disturbance in your family and the experience of traumatic events and/or relationships.

Whilst there doesn’t yet exist a stand-alone diagnostic tool for nightmare disorder, there can be valuable clues in exploring these potential influences as well.

The Scary Truth About Untreated Nightmare Disorder

According to the American Academy of Sleep Medicine, 4 % of the population suffer from nightmare disorder.[1] Untreated, prolonged effects can lead to the development of anxiety and depressive disorders. For those who might already be suffering symptoms of these, it can worsen them.

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Whilst development of different types of insomnia, breathing problems such as asthma and snoring have been linked to nightmare disorder, one of the most alarming links is the likelihood of the disorder to suicidality. Studies have not only discovered relationships between nightmares and the presence of suicidal thoughts (ideation) but also suicide attempts.

For many, time is not on their side. Having suffered long enough, medication can be a quick and instant way to dampen and numb the symptoms and provide temporarily relief.

However, there are some incredibly effective psychological treatments that have not only helped restore an astonishing quality of slumber to sufferers but opened their gateway to rebuilding a remarkable quality of life.

5 Top Treatments to Turn Your Sleep Experience Around

If you don’t feel you have time on your side, you may wish to consult with a medical professional to explore medication that could provide instant relief.

Medication or not, the guidance of suitably trained and qualified mental health professionals can help you learn incredible strategies that will accelerate you back to experiencing a far better quality of life.

Let’s look at some of the top recommended strategies below.

1. Image Rehearsal Therapy (IRT)

Image rehearsal is a great technique applied whilst you are awake. You write down your dream but change the theme, story line, ending, or any part of the dream to be a far more positive one.

In rewriting the dream scenario, you build in all the sensations, thoughts and emotions you want to experience instead. You are working to displace the distressing experiences you originally had with your newly orchestrated dream.

This technique works by challenging the traumatic theme of your original nightmare by injecting a cognitive shift. You choose and design the shift.

By then rehearsing this scenario for just 10 – 20 minutes a day, you can be on your way to greatly reducing your symptoms and enjoying a slumber journey to paradise as opposed to the Amityville Horror House.

2. Eye Movement Desensitization Reprocessing (EMDR)

EMDR combines elements from a number of different therapies. It has become a primary treatment for those suffering from nightmares connected with having experienced either a single traumatic event or multiple events over time.

Using an eight-step approach a therapist manually induces processing of disturbing memories and experiences by stimulating neural mechanisms similar to those activated during rapid eye movement (REM) sleep.[2]

During sessions, therapists direct clients to switch their eye movements to swing back and forth, left to right either following the therapists fingers (or some other object) whilst recalling the disturbed memory. Tones directed through headphones alternately into each ear might be used in similar fashion, or alternate physical taps to each hand.

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Clients identify and process the disturbed memory and past experience, current triggers and also positive experiences to develop a helpful adaptive response to the traumatic experience.

Even though EMDR is a highly effective treatment, there are pre-requisites for engaging this method and this process should only be applied by well-trained professionals who are licensed and qualified to administer it.

However, when you experience the benefits, not just your sleep but your quality life can turn around in a massive way!

3. Graded Exposure Therapy

Graded exposure therapy is also known as systematic desensitization. Once again it is best advised to undertake the first steps of this process with a qualified, trained professional.

With this method, you build resilience to the distressing parts of the nightmare through gradually exposing yourself to recalling the experience of it.

Re-experiencing the memory of the traumatic parts of the dream are identified and organized into a hierarchy of what is least distressing to what is most distressing. Working with parts you feel you can handle, you gradually expose yourself to the different parts of the nightmare memory and re-ignite the stressful emotions, thoughts and sensations one by one at a pace you can handle.

As you experience and learn that you are not in danger, your resilience builds and your fear of experiencing the nightmare again gradually drops.

Research has shown graded-exposure therapy to be helpful in reducing the frequency of nightmares but more effective when used in combination with progressive deep muscle relaxation (PDMR).

4. Progressive Deep Muscle Relaxation

Whilst research has shown that PDMR has been effective in reducing the frequency of nightmares, the technique has a wide range of uses in managing types of anxiety.

In itself, it is an incredible mental health and physical self-care strategy everyone can benefit from, nightmare disorder or not.

Working sequentially through the muscle groups in your body – from head to toe or in the reverse direction – you deliberately tense your muscles for a few seconds, then let the tension go and concentrate on how relaxed you feel for longer.

By deliberately telling your body to relax and increasing focus on how calm and relaxed you physically feel, you send messages to your brain to relax. Working through the muscle groups sequentially helps to pacify those of us who can get particularly wound up.

There are plenty of electronic apps you can access for free on your android phone or download to your iPod (e.g. Calm, Relax Lite). Guided PDMR (i.e. with instructions) is extremely helpful to start with. You surrender to the voice guiding you how and when to tense and relax each muscle group. By creating a deeply relaxed state just before falling sleep, you increase the potential for you to have a more pleasurable sleep experience.

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By getting started with PDMR straight away you not only have a tool to help you alleviate your nightmare symptoms, but a great relaxation technique to help you combat the challenges life throws at you.

Just be sure to consult a medical professional beforehand if you are recovering from an injury or could be at risk some other way. If so, whatever muscle groups could be affected, simply skip those and go on to the next ones.

5. Exposure, Relaxation and Re-scripting Therapy (ERRT)

ERRT is a combination of different steps targeting the anxiety symptoms that exist with the experience of nightmare disorder. If you’re not yet familiar with them, you’ll undertake an introduction to sleep hygiene practices.

Clearing out electronic devices from your bedroom, reducing your exposure to blue light from electronic tablets, television and android phones at least 1 ½ hours prior to wanting to fall asleep…..they all help to reduce symptoms of anxiety that can escalate your experiencing nightmares.

Looking at bedding and undertaking relaxing activities at night before bed time all contribute to creating blissful sleep opportunities.

Once you have your bedroom and pre-sleep activities sorted, you then apply the PDMR strategies which direct your focus on sensations of feeling completely relaxed. You are telling and preparing your mind and body to wind down and prepare for calm, serene sleep.

Looking at problem-solving, rescripting (similar to IRT) and coping strategies when you might awaken are all reviewed so you have an all round plan to (i) prepare your mind and body for sleep, (ii) help catalyze a far better dreaming experience and (iii) also have a plan of what to do when you awake suddenly.

The bottom line

Today might have been a wake-up call and you might have thought medication might be the only solution. You have been suffering and letting those symptoms rob you of your ability to rest, restore and regenerate your mind and body long enough.

If you have not been aware until now of the techniques and strategies above, make the decision today to get acquainted and consider undertaking an assessment with a mental health professional.

You might just turn the tables to discover a whole new lease on life!

Featured photo credit: rawpixel via unsplash.com

Reference

More by this author

Helen D'Silva

Performance Psychologist for Business and Entrepreneurship, Sport and Personal Development

How to Improve Focus: 7 Ways to Train Your Brain How to Calm Down When You’re Stressed and Anxious How to Cope with Anxiety at Work: 5 Psychology Techniques How to Cultivate a Positive Mindset (A Step-By-Step Guide) How to Manage Anxiety: Sound Advice from a Mental Health Expert

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Last Updated on September 18, 2020

7 Simple Rules to Live by to Get in Shape in Two Weeks

7 Simple Rules to Live by to Get in Shape in Two Weeks

Learning how to get in shape and set goals is important if you’re looking to live a healthier lifestyle and get closer to your goal weight. While this does require changes to your daily routine, you’ll find that you are able to look and feel better in only two weeks.

Over the years, I’ve learned a lot about what it takes to get in shape. Although anyone can cover the basics (eat right and exercise), there are some things that I could only learn through trial and error. Let’s cover some of the most important points for how to get in shape in two weeks.

1. Exercise Daily

It is far easier to make exercise a habit if it is a daily one. If you aren’t exercising at all, I recommend starting by exercising a half hour every day. When you only exercise a couple times per week, it is much easier to turn one day off into three days off, a week off, or a month off.

If you are already used to exercising, switching to three or four times a week to fit your schedule may be preferable, but it is a lot harder to maintain a workout program you don’t do every day.

Be careful to not repeat the same exercise routine each day. If you do an intense ab workout one day, try switching it up to general cardio the next. You can also squeeze in a day of light walking to break up the intensity.

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If you’re a morning person, check out these morning exercises that will start your day off right.

2. Duration Doesn’t Substitute for Intensity

Once you get into the habit of regular exercise, where do you go if you still aren’t reaching your goals? Most people will solve the problem by exercising for longer periods of time, turning forty-minute workouts into two hour stretches. Not only does this drain your time, but it doesn’t work particularly well.

One study shows that “exercising for a whole hour instead of a half does not provide any additional loss in either body weight or fat”[1].

This is great news for both your schedule and your levels of motivation. You’ll likely find it much easier to exercise for 30 minutes a day instead of an hour. In those 30 minutes, do your best to up the intensity to your appropriate edge to get the most out of the time.

3. Acknowledge Your Limits

Many people get frustrated when they plateau in their weight loss or muscle gaining goals as they’re learning how to get in shape. Everyone has an equilibrium and genetic set point where their body wants to remain. This doesn’t mean that you can’t achieve your fitness goals, but don’t be too hard on yourself if you are struggling to lose weight or put on muscle.

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Acknowledging a set point doesn’t mean giving up, but it does mean realizing the obstacles you face.

Expect to hit a plateau in your own fitness results[2]. When you expect a plateau, you can manage around it so you can continue your progress at a more realistic rate. When expectations meet reality, you can avoid dietary crashes.

4. Eat Healthy, Not Just Food That Looks Healthy

Know what you eat. Don’t fuss over minutia like whether you’re getting enough Omega 3’s or tryptophan, but be aware of the big things. Look at the foods you eat regularly and figure out whether they are healthy or not. Don’t get fooled by the deceptively healthy snacks just pretending to be good for you.

The basic nutritional advice includes:

  • Eat unprocessed foods
  • Eat more veggies
  • Use meat as a side dish, not a main course
  • Eat whole grains, not refined grains[3]

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Eat whole grains when you want to learn how to get in shape.

    5. Watch Out for Travel

    Don’t let a four-day holiday interfere with your attempts when you’re learning how to get in shape. I don’t mean that you need to follow your diet and exercise plan without any excursion, but when you are in the first few weeks, still forming habits, be careful that a week long break doesn’t terminate your progress.

    This is also true of schedule changes that leave you suddenly busy or make it difficult to exercise. Have a backup plan so you can be consistent, at least for the first month when you are forming habits.

    If travel is on your schedule and can’t be avoided, make an exercise plan before you go[4], and make sure to pack exercise clothes and an exercise mat as motivation to keep you on track.

    6. Start Slow

    Ever start an exercise plan by running ten miles and then puking your guts out? Maybe you aren’t that extreme, but burnout is common early on when learning how to get in shape. You have a lifetime to be healthy, so don’t try to go from couch potato to athletic superstar in a week.

    If you are starting a running regime, for example, run less than you can to start. Starting strength training? Work with less weight than you could theoretically lift. Increasing intensity and pushing yourself can come later when your body becomes comfortable with regular exercise.

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    7. Be Careful When Choosing a Workout Partner

    Should you have a workout partner? That depends. Workout partners can help you stay motivated and make exercising more fun. But they can also stop you from reaching your goals.

    My suggestion would be to have a workout partner, but when you start to plateau (either in physical ability, weight loss/gain, or overall health) and you haven’t reached your goals, consider mixing things up a bit.

    If you plateau, you may need to make changes to continue improving. In this case it’s important to talk to your workout partner about the changes you want to make, and if they don’t seem motivated to continue, offer a thirty day break where you both try different activities.

    I notice that guys working out together tend to match strength after a brief adjustment phase. Even if both are trying to improve, something seems to stall improvement once they reach a certain point. I found that I was able to lift as much as 30-50% more after taking a short break from my regular workout partner.

    Final Thoughts

    Learning how to get in shape in as little as two weeks sounds daunting, but if you’re motivated and have the time and energy to devote to it, it’s certainly possible.

    Find an exercise routine that works for you, eat healthy, drink lots of water, and watch as the transformation begins.

    More Tips on Getting in Shape

    Featured photo credit: Alexander Redl via unsplash.com

    Reference

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