Eclectic dreams of anxious girls: the stories my brain writes without me
I am used to feeling out of control in my own mind. I have what we in the industry call moderate OCD and comorbid anxiety, and I’ve been taking Fluoxetine for about a year. Nothing is more boring than other people’s dreams. Except when they’re mine. Since starting Fluoxetine, my dreams have been crazy. Before I started medication, I asked everyone I knew who had taken SSRIs about their experiences with side-effects. Nobody mentioned dreams.
Some Examples of my Recent Prozac Dreams:
I am graduating, except it is a combination of the High School Musical East High (2006) graduation and the Tony awards. My childhood bully is there. So is my therapist. My boyfriend was valedictorian, and he sang a song a la Amanda DeBose instead of giving a speech (he is a theatre kid but not... that kind).
I am at a music festival, which is also the Sydney Writers’ Festival, and also the Wednesday markets on Eastern Avenue. The cranky manager at my retail job is having his wedding here. My manager hates me (as he does in real life). I called in sick to attend the festival and spend the dream desperately balancing wedding snooping with running away from my manager and trying to make it to various writers’ talks.
Jacob Wysoki (of Pitch Perfect (2012) and Dropout TV (2022) fame) is in my house. He is trying to murder me. It’s also raining inside. I stab him with an umbrella, and he continues to chase me, impaled by the umbrella (this one was genuinely very scary and doubly upsetting because I find him so funny).
This is what my dreams are. They’re not always nightmares, but they are always bizarre. It isn’t the dreams themselves that scare me, but the not knowing why. Why is it that there are mounds of (public, tested, funded) research on the impacts of antidepressants on erectile dysfunction, but in researching an article on SSRI side effects, all I found were two YouTube videos, three psychological papers and ten AI-authored summaries of those papers? My GP detailed in gruesome specifics what would happen if I stopped taking my meds cold turkey, but when I asked her about the dreams, she just shrugged; “I’ve heard that from other patients, it’s quite common. If they’re distressing you, we can try another medication.”
OCD is just what it says on the tin. Obsessive. So, ‘just don’t worry about your weird dreams’ isn’t really on the cards. In pop culture, OCD is the kid in the medical drama who can’t stop washing his hands. Has to make all his own food. Carries hand sanitiser everywhere. Like almost everything else in medical dramas, that’s bullshit. It is a much more interior experience. Most people with contamination OCD worry about infection more than anything else – although this is not the kind of OCD I have, I struggle with health worries. Ironically, they are almost always about my mental health.
Imagine the sounds of the world constantly deafen you. You hear the footsteps of your neighbours, the breathing of your partner, and the wind whistling through the gap under your front door. Being on the train is insufferable. Shopping centres are terrifying. These noises are pervasive and overwhelming. Taking Fluoxetine is like wearing headphones. The constant spiral of intrusive thoughts that I experience doesn’t disappear, but it is muffled. I can get things done without a barrage of sounds distracting, distressing, dissolving me.
So, you wear headphones all the time. They make life much better. You’re happier, more productive, and a better friend and partner. Except, every night, your headphones play a rotating playlist of insane combinations of music. The catalogue is endless. From songs you made up in the shower, to football chants, to what you danced to at your year ten formal. Pitbull, the Glee Cast, Grimes, a derivative rock band from Paraguay called ‘Prozac Dreams’. This music isn’t distressing — and it is much better than being able to hear your brother snoring in the next room. But why is this happening, and why did nobody warn me about it?
What we do know is that SSRIs suppress REM (Rapid Eye Movement), delaying the phase of deep sleep where dreaming happens. Sometimes, this results in “Rebound REM”, described as a burst of brain activity after an extended period of deep sleep. In this case, the REM phase occurs just before we wake, which could explain why someone on SSRIs remembers their dreams every day.
Many people with OCD don’t want to — or can’t — take medication due to obsessive thoughts about their brain being changed. Further research into the impact of SSRIs on dreams and sleep is therefore essential, as well as how medication impacts OCD differently than it does anxiety or depression. The most important tools we have to treat mental illness are information and empathy, and all healthcare providers should realise this in practice. The under-researched and side-effect heavy experience of SSRIs is not appealing to a brain that loves control. I’m happy relinquishing some of that control, but I wouldn’t mind one good, long, dreamless sleep.