Clinical Associate Professors at Stanford University’s Department of Anesthesia are exploring a groundbreaking approach to treating PTSD in both adults and teenagers through anesthesia.
Dr. Harrison Chow, Dr. Becky Wong, and Dr. Boris Heifets led a team to investigate the effect of anesthesia-induced operative dreaming on two mothers experiencing severe PTSD.While the treatment is still in its early development, promising results from the two women suggest that revolutionary changes in mental health care may be possible.
One of these mothers, Mare Lucas, lost her son, Zane, to suicide in 2017. Following his death, she experienced vivid and recurring nightmares—daily at first, then weekly—for several years.
“They never went away,” Lucas said. “They maintained their intensity and lessened their frequency.”
In 2022, Lucas was diagnosed with breast cancer. A few months later, she had surgery at Stanford Hospital, where she was under anesthesia for nearly five hours.
Without knowing what she was experiencing, Lucas underwent a common anesthetic that induced “hyper-real” anesthesia dreams: vivid, emotionally intense dream sequences rich in sensory detail. These dreams immerse the patient in intense experiences that sometimes help rewire how the brain processes trauma and distress. For Lucas, these dreams were transformative.
Prior to going under general anesthesia, Lucas recalled that she was experiencing lots of stress, primarily due to the rushed nature of the hospital and feelings of isolation without her husband being there. Once under anesthesia, Lucas experienced multiple hyper-real dreams mainly centered around Zane.
She dreamt about the birth of her two sons in a pleasant environment, hearing the voices of her friends and family inside the comfort of her home. In her second consecutive dream, she recalled seeing Zane run around a park with the dog she got after he passed away. “I’m almost on the verge of crying because I remember it so vividly,” she said.
Coming out of anesthesia, Lucas immediately felt different. The dreams had left such a deep emotional imprint that, just days after surgery, she noticed a profound shift in her mental state.
“When I woke up, I thought there’d be two babies in bassinets over there, and I thought I’d be at the park with my son—because it felt like more than a dream,” she said.
Remarkably, two years later, Lucas has not experienced another nightmare about Zane. “You can try some different medications or go for hikes and do all that stuff. But a lot of us are still just left with nightmares and anxiety, and that continued until my surgery,” Lucas said.
Lucas’ experience with anesthesia-induced dreams offers a glimpse into the potential of this emerging approach to trauma care.
Wong specializes in electroencephalography, often referred to as EEG, which gives her a glimpse into patient consciousness, wakefulness, and awareness under anesthesia. “I’m very attuned to changing the sizes and techniques based on the patient’s age,” Wong said. “Nowhere is there more of that difference than in pediatrics.”
However, caring for adolescent patients involves many shifts in EEG based on normal brain developmental stages, previous medical history, and anesthetic requirements. This challenges Wong to fine-tune her anesthesia methods to benefit the patients’ dreaming experience.
“Once I get an understanding of how [the patient] reacts to the anesthesia based on the EEG and other vital signs, I have a better idea of how I’m going to tailor the end of the anesthetic to try to encourage these dreams under anesthesia,” Wong said.
Patients often have positive outcomes, whether that means experiencing a cheerful dream or not having one at all. Most of Wong’s patients have woken up feeling awake and conversational.
“We noticed that many patients seem to be ready to go home faster after the anesthesia and feel less nausea and pain, but this is an area that still needs more rigorous investigation,” Wong said.
Currently, Chow and Wong’s patients lack symptoms of PTSD as the majority of their patients are adolescents undergoing sports-related orthopedic surgeries. Although these early trials have offered some insights into the medicated minds of a narrow population of adolescents, there is still a lot to be discovered.
“Because [adolescents’] brain growth and development is so rapid at this stage, there are still so many changes going on, so many neurons that are being pruned back and refined,” Wong said.
“A lot of the dreams that we’ve seen, particularly in the orthopedic area, have involved school-related activity,” Chow said. School-related activities, such as hanging out with friends or playing sports, are the adolescent version of being in a “safe space” similar to adults, who often report being in a comfortable environment, such as their home, workplace, or park.
In addition to Chow and Wong’s efforts, Dr. Pilleriin Sikka, a postdoctoral scholar at Stanford University School of Medicine, has been leading experimental studies to determine anesthesia’s wide-ranging effects on an individual’s mind.
By reducing the variability of the experiments down to just anesthesia and the patient—without any surgical procedure—Sikka hopes to expose the mechanisms behind dream induction and how anesthesia can influence it.
“In a surgical setting, one can argue that the patient got relief from the surgery, which created a positive impact,” Sikka said. Sikka emphasized the need to rule out certain anesthetics that could contribute to the patient’s dreams, given the multifactorial nature of anesthesia during surgery. By removing the patient from the surgical setting, Sikka can manipulate the variables of anesthesia without risking harm to the individual.
“That’s why we need to test these observations in a controlled setting if we want to argue that it is specifically anesthesia dreaming, not something else, that has a therapeutic effect,” Sikka added.
Sikka’s findings complement Wong’s regarding the types of dreams their patients experienced. Unlike the typical dreams one may experience in sleep, anesthesia-induced dreams are mostly positive and relevant to what the patient was recently thinking—and anxious—about.
“Recently, we had to reschedule an anesthesia session with a patient because their dog suddenly had an accident and had to be brought to the vet,” Sikka explained. “The patient was very worried about that. And when we did the anesthesia, they dreamt that they were jumping and running with their dog in the meadow, which gave them a bit of relief.”
The positivity of these dreams may offer a similar outlook on the long-term mental effects of anesthesia-induced dreams, especially for teenagers, but this area requires further study.
Dr. Heifets, the head of the laboratory, is also actively involved in the project. The Investigational Dream Emergence under Anesthesia, or IDEA, has already been approved and funded, and patients are being recruited for a spring 2025 launch of anesthesia dream trials in treating PTSD patients.
“Regardless of the dream content, whether positive or negative, we don’t know the long-term effects yet,” Chow said. “But literally nobody complains about dreaming under anesthesia.”
Now, Lucas has devoted her time to helping recruit individuals suffering from PTSD-induced nightmares and similar symptoms stemming from student suicides for Chow, Wong, Sikka, and Heifets’ research.
“Being able to reassure patients that we have a better understanding of when they’re awake, asleep, and dreaming is something that can benefit all of us,” Wong said.
“Part of the beauty of what the team has done is that we aren’t in the same place we were seven years ago. Had this been available, the outcome might have been completely different,” Lucas said.
