The anxiety, stress and worry brought on by COVID-19 is not limited to daytime hours.
The pandemic is affecting our dreams as well, infusing more anxiety and negative emotions into dreams and spurring dreams about the virus itself, particularly among women, according to research published by the American Psychological Association.
In a special section in the journal Dreaming, researchers reported on the results of four studies from around the world about people’s dreams during the pandemic. Previous research has suggested that our dreams often reflect what’s happening in our waking lives and that other crises–including war, natural disasters and terrorist attacks–have led to an increase in anxious dreams.
The four studies in this special section found that the same is true of COVID-19.
“All of these studies support the continuity hypothesis of dreaming: That dreams are consistent with our waking concerns rather than being some outlet for compensation, as some older psychoanalytic theories had hypothesized,” said Deirdre Barrett, PhD, editor of Dreaming and an assistant professor of psychology in the Department of Psychiatry at Harvard Medical School.
“The higher levels of anxiety, dreams about illness and death in general, and COVID-19 specifically, are in line with that.”
Overall, the new studies also suggest that women’s dreams have been more strongly affected by the pandemic than men’s–possibly, Barrett suggested, because women are bearing more of the burden of caregiving, job loss and other hardships.
“Dreams can help us understand our emotional reactions to the pandemic,” Barrett said. For example, one mother in a study by Barrett dreamed that her child’s school contacted her to say that the child’s whole class was being sent to her condominium to be home-schooled for the duration of the pandemic.
“When mothers of young children hear that dream, there is a laughter but also usually a strong empathy at the overwhelmed feeling the dream dramatizes. Your dreams can make you more aware of just what about the pandemic is bothering you the most–and sharing them with trusted others is a good conversation-starter for talking about these shared feelings,” Barrett said.
The four COVID-19 articles in the issue are:
Michael Schredl, PhD, Zentralinstitut fur Seelische Gesundheit, and Kelly Bulkeley, PhD, The Sleep and Dream Database
This study of more than 3,000 U.S. adults surveyed in early May 2020 found that people who had been most strongly affected by the pandemic–such as those who had gotten sick or lost their job–also reported the strongest effects on their dream life (heightened dream recall, more negative dreams and more pandemic-related dreams). Women and people with more education also reported stronger effects of the pandemic on their dreams.
The findings suggest that changes in the frequency, tone and content of dreams can help identify those at risk for mental health problems during the pandemic, according to the researchers.
Deirdre Barrett, PhD, Harvard University
Women’s dreams have been more negatively affected by COVID-19 than men’s dreams, according to this international study of 2,888 participants.
The researcher asked online survey respondents to recount their dreams about the pandemic and then compared the responses to a database of dreams from before the pandemic.
Overall, women showed significantly lower rates of positive emotions and higher levels of anxiety, sadness, anger and references to biological processes, health and death in their pandemic dreams compared with the pre-pandemic dreams.
Men’s pandemic dreams showed slightly higher levels of negative emotions, anxiety and death than in pre-pandemic dreams, but the effects were less pronounced than they were for women.
Ilaria Iorio, PhD, Massimiliano Sommantico, PhD, and Santa Parrello, PhD, Universita degli Studi di Napoli Federico II
Researchers analyzed the dreams of 796 Italian participants, all of whom completed a dream questionnaire in April and May 2020 and described their most recent dream in detail.
Twenty percent of the dreams included an explicit reference to COVID-19, the researchers found. Overall, women reported higher emotional intensity and a more negative emotional tone in their dreams, as did participants who knew people affected by COVID-19.
Cassidy MacKay, BSc, and Teresa L. DeCicco, PhD, Trent University
Pandemic-era dreams resemble the dreams of people with anxiety, suggests this study of Canadian college students. Researchers analyzed detailed dream journals from 19 Canadian college students recorded between mid-February and mid-March 2020, as the pandemic and pandemic-related physical distancing restrictions were taking hold in Canada.
They found that the pandemic-era dreams contained more location changes, as well as animal, head, food and virus-related dream imagery compared with a control group of people who kept dream journals before the pandemic.
This type of dream imagery is similar to previous findings of the dream imagery of people experiencing waking day anxiety, according to the researchers.
The sudden appearance of the COVID-19 epidemic has caused concerns among frontline medical staff, patients and the general public. Epidemiological evidence suggests that approximately 5–12% of people may develop post-traumatic stress disorder after a traumatic event (Ursano et al., 2009).
To understand the mental health of the parents of children hospitalized during the COVID-19 epidemic, we used the Hospital Anxiety and Depression Scale (HADS), Van Dream Anxiety Scale (VDAS), and Short Form (SF)-36.
Questionnaires were completed by the parents of children hospitalized at different times. We divided the parents of hospitalized children into “non-epidemic hospitalization” (NEH) and “epidemic hospitalization” (EH). We compared the scores for anxiety, depression, and dream anxiety of the two groups of parents to ascertain their mental health.
We collected basic information (age, sex of parents and children) and scores for anxiety, depression, dream anxiety, and SF-36 (Table 1). We obtained data for 100 parents of hospitalized children: 50 parents of children hospitalized during the COVID-19 epidemic (EH), and 50 parents of children hospitalized during the non-epidemic period (NEH).
Table 1. The basic information of parents of children hospitalized during epidemic periods and parents of children hospitalized during non-epidemic periods
|Clinical characteristics||Parents of children hospitalized during the epidemic period (n = 50)||Parents of children hospitalized during the non-epidemic period (n = 50)||t||P value||OR (95% CI)|
|Parents age (years)||36.80 ± 5.20||37.22 ± 5.40||−0.396||0.218||35.963–38.057|
|Parents Gender (male / female)||19/31||24/26||1.005||0.317||–|
|Child age (years)||8.42 ± 3.34||8.94 ± 3.31||−0.782||0.436||8.022–9.338|
|Child Gender (male / female)||34/16||24/26||−0.828||0.410||–|
|Anxiety score||7.02 ± 3.01||3.62 ± 2.10||6.557||<0.001||4.706–5.934|
|Depression score||7.72 ± 2.81||4.54 ± 2.56||5.922||<0.001||5.512–6.748|
|Dream anxiety score||25.28 ± 8.01||16.58 ± 7.28||5.682||<0.001||19.187–22.673|
|SF-36||580.74 ± 66.27||649.62 ± 46.60||−6.012||<0.001||601.948–628.412|
Abbreviations: OR, odds ratio; CI, confidence interval
The anxiety score of parents of EH children was 7.02 ± 3.01, of which 21 parents were anxious (≥8 points). The anxiety score of parents of NEH children was 3.62 ± 2.10, of which four parents were anxious. The anxiety score of parents of EH children was significantly higher than that of parents of NEH children (t = 6.557, p < 0.001). The depression score of parents of EH children was 7.72 ± 2.81, of which 24 parents were positive for depression.
The depression score of parents of NEH children was 4.54 ± 2.56, of which four parents were positive for depression. The depression score of parents of EH children was higher than that of NEH children (t = 5.922, p < 0.001). Simultaneously, the VDAS score and SF-36 score of parents of EH children was significantly higher than that of NEH children (t = 5.682, p < 0.001 and t = 5.419, p < 0.001, respectively).
There was a positive correlation between the anxiety score, depression score, and dream-anxiety score of parents of EH children (Fig. 1A–C). We documented a positive correlation between the depression score and dream-anxiety score of the parents of NEH children (Fig. 1F).
The mental-health problems of parents of EH children were more serious, and their anxiety and depression were more obvious, than the mental-health problems of parents of NEH children.
The COVID-19 epidemic is a public-health emergency, and has spread rapidly and widely. Being highly contagious, SARS-CoV-2 has many transmission routes. A specific treatment for COVID-2 is lacking.
Therefore, SARS-CoV-2 poses a huge threat to life and health, and can lead to tension and anxiety. During the COVID-19 epidemic, if children must be hospitalized when they are sick, a densely populated hospital is a high-risk area for virus-borne infections. Simultaneously, children’s immunity is low, so the possibility of infection is greater than that for adults. Parents will also worry that they may get infected in hospital.
Also, children are curious about life. During hospitalization, if parents or physicians do not pay sufficient attention, children may touch various items randomly, leading to SARS-CoV-2 transmission.
Therefore, the parents of children hospitalized during the COVID-19 epidemic face huge pressure and anxiety. Post-traumatic stress disorder and mental-health problems may occur in parents, which may affect the child’s recovery.
Hence, early detection of the mental health of such parents, and timely provision of certain psychologic interventions, will help parents take better care of their children in hospital, and help children recover and be discharged from hospital as soon as possible.
R.J. Ursano, L. Zhang, H. Li, et al.PTSD and traumatic stress from gene to community and bench to bedside
Brain Res., 1293 (2009), pp. 2-12
WHO director-general’s opening remarks at the media briefing on COVID-19 – 9 March2020
About this psychology research article