What is maladaptive daydreaming?
A person with maladaptive daydreaming will spend long periods engaging in structured daydreams or fantasies. It can affect your ability to focus on your studies or be productive at work. Professor Eliezer Somer of the University of Haifa in Israel first described the condition in 2002.
Maladaptive daydreaming shares features with behavioral addictions, such as addiction to internet gaming or alcohol. This daydreaming can be so intense that it distracts you from real life.
Often, events can trigger daydreams. These events can include:
- topics of conversation
- a picture, movie, or news story
- internet use
- sensory stimuli, such as noises or smells
- physical experiences
Maladaptive daydreaming does not currently have a separate diagnosis. It does not have a category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and there is no specific treatment.
However, it can affect your daily life, and some experts are calling for it to be a specific diagnosis.
What are the symptoms of maladaptive daydreaming?
A person with maladaptive daydreaming may experience one or more of the following:
- extremely vivid daydreams with their own characters, settings, plots, and other detailed, story-like features, reflecting a complex inner world
- daydreams triggered by real-life events
- difficulty completing everyday tasks
- difficulty sleeping at night
- an overwhelming desire to continue daydreaming
- performing repetitive movements while daydreaming
- making facial expressions while daydreaming
- whispering and talking while daydreaming
- daydreaming for lengthy periods (up to several hours)
- significant distress about daydreaming
- awareness that the internal fantasy world is different from external reality
You may also have a diagnosis of another disorder, such as attention deficit hyperactivity disorder (ADHD).
Maladaptive daydreaming is different from regular daydreaming in terms of content, controllability, frequency, and your experience, including the distress it causes and its impact on daily life.
It’s also different from general mind wandering, as it involves “structured, intentionally generated fantasy narratives,” according to experts writing in 2019. In contrast, mind wandering tends to occur spontaneously and relate to everyday life.
Maladaptive daydreaming test
Professor Somer created a 16-item test or scale for doctors to use when assessing whether a person is engaging in maladaptive daydreaming.
It contains 16 questions and asks about:
- daydreaming triggers
- physical signs that accompany daydreaming
- how daydreaming feels to the individual
- the effect of interruptions on daydreaming
- the impact of not being able to daydream
- how daydreaming affects daily life
- whether the person listens to music while daydreaming
The score for each question ranges from zero dependence to 100 percent.
Can a doctor diagnose maladaptive daydreaming?
There is no universal method used to diagnose maladaptive daydreaming, and it does not currently have its own diagnosis. However, some tools can help doctors assess whether you’re experiencing this condition.
The 16-item maladaptive daydreaming test can help show if you’re experiencing maladaptive daydreaming. This is a self-reporting tool, in which you assess your own experiences.
Another tool developed by Professor Somer is the Structured Clinical Interview for Maladaptive Daydreaming (SCIMD). The SCIMD enables doctors to elicit answers that will help assess whether you’re experiencing maladaptive daydreaming.
A doctor may use other tools to evaluate whether you have symptoms of:
- obsessive-compulsive disorder (OCD)
- another condition that can resemble or overlap with maladaptive daydreaming
Maladaptive daydreaming in ADHD
Experts have found links between maladaptive daydreaming and ADHD. A 2017 study looked at 39 people with maladaptive daydreaming. Almost 77 percent of the participants had both maladaptive daydreaming and ADHD.
In 2020, some experts stressed the need to move away from seeing ADHD as mainly a behavioral issue and to focus more on how it affects a person’s internal life.
One aspect of this internal presentation is maladaptive daydreaming, which can impact your productivity and motivation at school and in the workplace. The researchers note that this can affect females in particular.
Sleep disturbances are also common in both ADHD and maladaptive dreaming.
How is maladaptive daydreaming treated?
There is no specific treatment for maladaptive daydreaming.
In a case study from 2018, a person who had 6 months of counseling therapy — including cognitive behavioral therapy (CBT) and mindfulness meditation — reduced their daydreaming time by over 50 percent.
Some researchers have proposed a technique called exposure and response prevention (ERP), which aimed to reduce or stop maladaptive daydreaming by changing the ends of story plots to make them unpleasant to the person.
In an older study, published in 2008, researchers found fluvoxamine (Luvox) was effective in helping a person with maladaptive daydreaming manage their daydreams. Doctors prescribe this drug for OCD.
As researchers learn more about why maladaptive dreaming happens and how it links to other conditions, they may one day identify an effective treatment.
Why does maladaptive daydreaming happen?
Experts do not know precisely why maladaptive daydreaming occurs, but they’ve found some links to other conditions.
People who engage in maladaptive daydreaming may share features with people who engage in behavioral addictions, such as internet gaming.
You may, for example:
- feel the need to escape from real-life difficulties, such as social anxiety and childhood trauma
- use daydreaming to seek out ways of overcoming problems that appear insurmountable in real life
- feel distressed about being unable to control the daydreaming
- find daydreaming so rewarding that it becomes difficult to stop doing it
- have dissociative tendencies, such as an excessive focus on internal thoughts or a mistrust of the senses
In one case study, a person who experienced maladaptive daydreaming described feelings of shame and fear and an inability to ask for what they wanted. They experienced a sense of trauma around these emotions, although they did not have symptoms of PTSD.
- had experienced bullying at school
- had felt neglected at home
- felt that excessive stress and a lack of emotional support had discouraged interaction with others and prevented them from asking for what they needed
There is little research to confirm why maladaptive daydreaming happens, and experts continue to investigate links to past experiences and other conditions. They’re also discussing whether maladaptive daydreaming should be a separate diagnosis.
What is the outlook for maladaptive daydreaming?
Maladaptive daydreaming can interfere with your daily life. You may want to get the help you need to deal with this condition.
Joining a support group to learn how others cope with their condition may make it easier to manage maladaptive daydreaming. There are several online forums for people who experience maladaptive daydreaming, including Daydream In Blue and Wild Minds Network.
Maladaptive daydreaming involves highly structured daydreams or fantasies that can be difficult to manage. You may feel trapped in an internal world that involves complex plots and many characters. However, you’ll also be aware that this is not the real world.
Experts don’t know why maladaptive daydreaming happens. Possible explanations include past trauma, difficulty managing everyday challenges, and having another condition, such as ADHD.
There is no specific diagnosis or treatment for maladaptive daydreaming.
Treatments for OCD and anxiety, such as CBT and ERP, may help. People who experience maladaptive daydreaming may also benefit from treatment aimed at a co-occurring condition.