You wake up hot and sweaty to the same dream again:

You’re back in school and late for a test. You’ve had this recurring dream for years; maybe the school changes or the reason you’re late varies, but you always feel the same. What’s troubling this time is the dream has woken you up four nights in one week. Are you stressed about work? Is your relationship on the fritz? Is your brain trying to tell you something? Style spoke with Kelly Clancey-Spruiell, a licensed marriage and family therapist for Dignity Health Medical Foundation’s Children’s Center South, to learn more about what dreams can reveal about your mental health.

WHAT ARE DREAMS?

On a scientific level, dreams are the firing of neurons in the brain, a way for our minds to process the day’s events. “In order to process your day’s events into long-term memories, you need sleep and those REM dream cycles,” Clancey-Spruiell says. In fact, sleep disorders or medications that interfere with the ability to sleep and dream can affect a person’s long-term memory.

Worried you’re not dreaming? Clancey-Spruiell says you probably are, you just might not remember the dream if you wake up in a non-REM cycle. With our Western culture of alarm clocks and on-the-go schedules, it leaves little time to wake up slowly and remember the night’s events.

ANALYSIS & INTERPRETATION

For most of us, the intrigue of dreams is our interpretation of the subconscious. We’re often eager to interpret images in our dreams as they relate to something bigger in our lives. For instance, does dreaming about water mean a new beginning? Clancey-Spruiell says that while different cultures have different interpretations of specific symbols, mental health therapists are looking for other clues. It’s a repetitiveness that can symbolize something greater in a person’s life, such as a psychosocial stress (trouble in a relationship, mourning a loss or anxiety). And don’t rule out happy stresses: A woman’s pregnancy or a child going back to school can trigger recurring dreams, too.

THE MENTAL HEALTH FACTOR

Interpreting repetitive dreams and their themes can help therapists understand a patient’s mental health. For instance, people diagnosed with bipolar disorder often report vivid dreams. On the flip side, people who are depressed or have insomnia often report having few dreams.
Other mental health diagnoses linked to dreams include acute stress disorders, anxiety, and post-traumatic stress disorder (PTSD). “One of the criteria of people with PTSD is that they have dreams where they’re reliving the experience again and again to try and make sense of something subconsciously,” Clancey-Spruiell says.

There’s also the mental health diagnosis of obsessive-compulsive disorders (OCDs). Those with OCD tend to dream less and instead have parasomnias—a category of sleep disorders that include behaviors such as sleepwalking or sleep talking.

PLAN OF ACTION

What’s the first step to take if you’re having troubling, recurring dreams? First, see a medical doctor to rule out physical health problems. In unison, see a psychologist or counselor about the stressors, and be sure the mental health and medical physicians collaborate. “For instance, if you’re taking medication for a mental health problem, it could be causing you to have strange dreams and your physician should know,” Clancey-Spruiell says.

Most importantly, pay attention. “We often ignore our dreams and say they are just these things that happen,” she says. “But pay attention to repetitive dreams and then try and look for what the theme is and see if it relates to some sort of a stressor, good or bad.”