Maladaptive Daydreaming

What is maladaptive daydreaming?

Maladaptive daydreaming is a mental health issue where a person daydreams excessively, sometimes for hours at a time. “Maladaptive” means this type of daydreaming is an unhealthy or negative attempt to cope with or adapt to a problem.

People who do this tend to “lose themselves” in extremely vivid and detailed daydreams. Research also shows this kind of daydreaming might be compulsive. That means it’s difficult — if not impossible — to control that you’re doing it.

This issue also overlaps with several other mental health and neurological conditions. However, there’s evidence that maladaptive daydreaming is different from these other conditions and should be declared a separate disorder.

Who does it affect?

Maladaptive daydreaming is most common in people with conditions that affect their mental health or certain types of brain functions. The conditions that are common with maladaptive daydreaming are:

• Attention deficit hyperactivity disorder (ADHD).
• Anxiety disorders.
• Certain types of depression.
• Dissociative disorders.
• Obsessive-compulsive disorder (OCD).

Age can also be a factor in maladaptive daydreaming. Some research suggests it’s more common in younger people, especially young adults and teenagers, and that it can also happen to children. However, more research is necessary to determine how common it is in people depending on their age.

Lastly, many people who experience maladaptive daydreaming have a history of abuse or trauma, especially during childhood. However, this isn’t something that all people with maladaptive daydreaming have.

How common is this issue?

The term “maladaptive daydreaming” is relatively new. Eli Somer, PhD, a clinical psychology professor in Israel, coined the term in 2002.

There’s limited research available on how commonly maladaptive daydreaming happens. That’s partly because this isn’t an officially recognized condition yet. However, one early study put the number at 2.5% of adults in Israel, and slightly higher — about 4.3% — for younger adults who are students.

Another study estimated that maladaptive daydreaming affects about 20% of adults with ADHD. That would mean it affects at least 2.2 million adults in the United States, and that number doesn’t account for people who have it but don’t have ADHD.

How does this condition affect my body?

Maladaptive daydreaming is an issue that affects your mind. Your mind is the unique combination of memories, experiences, thoughts, beliefs, emotions and more that only you have. Your mind and brain aren’t the same thing. Your brain is the physical part of your body that generates all the above elements that make up your mind.

But experts also suspect that maladaptive daydreaming might involve differences in your brain that other people don’t have. People with ADHD have small, but still important, differences in the size of certain parts of their brains. Those areas are usually ones that control executive functions like decision-making, planning and self-motivation.

People with maladaptive daydreaming also seem to have trouble with executive dysfunction, which is why there’s so much overlap between maladaptive daydreaming and ADHD. They also experience similar problems with managing their own emotions. That means people with maladaptive daydreaming may also be more likely to have similar differences in their brains. However, more research is necessary before experts can confirm if this is the case.

What are the symptoms of maladaptive daydreaming?

Maladaptive daydreaming is a condition where all the symptoms revolve around the daydreaming itself. The symptoms tend to fall into two categories: daydreaming behavior and how a person feels about their daydreaming.

Daydreaming behavior

The kind of daydreams that happen with maladaptive daydreaming often involve the following:

• Intensity. These daydreams are extremely vivid and detailed, much more so than a standard daydream.
• Complexity. These daydreams often have elaborate plots, and many people have characters they imagine repeatedly, much like characters in a TV show.
• Duration. People who daydream this way can do so for long periods, even hours at a time.
• Intent. People who do this often can — and do —start daydreaming intentionally.
• Disconnection from what’s happening around them. People who have this can daydream so strongly that they disconnect from the world around them. This is similar to dissociation, a defense or coping mechanism for people with severe anxiety, depression, or a history of abuse or trauma.

How a person feels about their maladaptive daydreaming

People who experience maladaptive daydreaming frequently struggle with negative feelings and the effects from this issue. That often takes the following forms:

• Disruption in social activities. People who have maladaptive daydreaming often choose to daydream rather than spend time with others.
• Interference in work, hobbies and other pursuits. Maladaptive daydreaming can cause problems with work, studying or reaching other goals a person sets for themselves.
• Feelings of shame and guilt. People who experience maladaptive daydreaming commonly feel bad about doing it, especially when it interferes with other parts of their life.
• Compulsively daydreaming. This means that people will feel the need to have maladaptive daydreams. If they don’t have the chance to do so, they may feel upset that they missed the opportunity to do it. Some research shows that the need to daydream may be similar to an addiction.
• Attempts to stop or daydream less. People who have maladaptive daydreaming often struggle to daydream less or stop altogether.

What causes maladaptive daydreaming?

Experts don’t know exactly why maladaptive daydreaming happens. However, they suspect it happens because maladaptive daydreaming can be a coping mechanism for problems like anxiety, depression and other mental health conditions.

Is it contagious?

Maladaptive daydreaming is a mental health issue, which means it isn’t contagious.

How is maladaptive daydreaming diagnosed?

Maladaptive daydreaming isn’t a recognized condition. Because of that, it’s not something a healthcare provider can diagnose directly. There also aren’t any diagnostic or lab tests that can confirm if you have this.

However, clinicians may find signs of this issue using specific questionnaires and diagnostic scales for related conditions like ADHD, OCD, depression, anxiety and dissociative disorders. They can also directly use the Maladaptive Daydreaming Scale-16 (MDS-16), a set of questions that can show if a person is more likely to have this issue.

How is maladaptive daydreaming treated, and is there a cure?

Because maladaptive daydreaming isn't an official diagnosis yet, there’s no standard treatment. However, that doesn't mean there’s no way to treat it. For now, mental health providers can treat it by approaching the condition based on its similarities to related conditions.

The main treatment for maladaptive daydreaming is mental health therapy (psychotherapy). Cognitive behavioral therapy (CBT) is one of the most common types of therapy for conditions like OCD, anxiety, depression and dissociative disorders. The approach of CBT can also help people with maladaptive daydreaming understand why they do it and what they can do to manage it. Other forms of mental health therapy may also offer some benefits.

Because many people who have maladaptive daydreaming also have related conditions like ADHD, treating the related conditions may also help. The type of medication you might take depends strongly on the related condition.

Your healthcare provider is the best person to tell you more about what’s most likely to help you. They can explain more about different forms of mental health therapy, medication options, etc. Everyone is different, and what works for one person might not work for another. Your healthcare provider can consider your unique health history, conditions and circumstances when offering you suggestions.

Complications or side effects of the treatment

Mental health therapy doesn’t have side effects or complications, though it might uncover things that you find painful or difficult to face. Your mental health provider can help you cope and find ways to process and move on from past trauma and struggles. They can also tell you more about what complications are possible or likely with the medications they recommend.

How do I take care of myself and manage the symptoms?

Because maladaptive daydreaming is a mental health issue, it’s difficult to manage it on your own. The best way to deal with it is to talk to a mental healthcare provider. They can guide you on how to reduce your need to daydream and eventually not depend on it at all. They can also help you find medication combinations that can treat related conditions, making it easier for you to rely less on daydreaming.

How can I reduce my risk or prevent developing maladaptive daydreaming?

Maladaptive daydreaming is a mental health issue. Because of that, there’s no way to prevent it or reduce the risk of developing it.

What can I expect if I have this condition?

Maladaptive daydreaming is an issue that can cause severe disruptions in your life, especially if your daydreaming is interfering with work, relationships, housework and hobbies. As a person spends more and more time daydreaming and doing less interacting with others, the weaker their social abilities become and the harder it gets to start and maintain relationships.

As mentioned above, maladaptive daydreaming is often compulsive, which means a person feels like they need to do it. Because the need to daydream is similar to an addiction, daydreaming more often can make it a strong habit, so it’s very hard to stop doing it. That’s why seeking mental healthcare for it sooner rather than later is important.

How long does it last?

Because maladaptive daydreaming isn’t officially recognized, and the idea of it as a distinct condition dates back only to 2002, there’s little available research on how long it lasts. For now, it seems to be a lifelong concern that people can overcome. However, overcoming it is difficult without mental health therapy, medication or both.

What’s the outlook for this condition?

On its own, maladaptive daydreaming isn’t dangerous to your physical health. However, it can have a severe impact on your mental health. It also happens alongside conditions that increase your risk of dying from suicide, which means that this condition can increase a person’s risk of harming themselves.

When should I go to the ER?

You should go to the ER or call 911 (or your local emergency services number) if you have thoughts about harming yourself, including thoughts of suicide, or about harming others. If you have thoughts like this, you can call any of the following:

• National Suicide Prevention Lifeline (United States). To call this line, dial 1.800.273.TALK (1.800.273.8255).
• Local crisis lines. Mental health organizations and centers in your area may offer resources and help through crisis lines.
• 911 (or your local emergency services number): You should call 911 (or the local emergency services number) if you feel like you’re in immediate danger of harming yourself. Operators and dispatchers for 911 lines can often help people in immediate danger because of a severe mental crisis and send first responders to assist.

How do I take care of myself?

If you have maladaptive daydreaming, the best thing you can do is talk to your healthcare provider. Because maladaptive daydreaming isn't an officially recognized condition, some healthcare providers might not have much experience or familiarity with it. In general, healthcare providers that treat ADHD, OCD and similar conditions are most likely to be familiar with this condition.

Once you see your healthcare provider, it’s important to stick to a treatment plan. That includes:

• Seeing your healthcare provider as recommended and not missing visits.
• If your provider prescribes medication, take it exactly as the prescription says.
• Set goals in your treatment and pursue them.
• Avoid self-medication with alcohol or misusing prescription or recreational drugs.
• Remember that the path of recovery and personal care isn’t a straight line, so don’t let discouragement take over when you struggle.

What questions should I ask my doctor?

A common problem for people with maladaptive daydreaming is that this condition doesn’t have official recognition. Many healthcare providers are unfamiliar with it. Because of that, some may act dismissive of your concerns. If that’s the case, it’s important not to give up on mental healthcare. Just because one provider is unfamiliar doesn’t mean they all are or that your case is hopeless.

When looking for a mental health provider, you can ask them the following:

• Are they familiar with maladaptive daydreaming?
• Can they perform screening tests for related conditions like ADHD, OCD, anxiety and depression?
• Do they have experience treating the related conditions mentioned above?

A note from Cleveland Clinic

Maladaptive daydreaming is a mental health issue that causes a person to lose themselves in complex daydreams. These daydreams are usually a coping mechanism for other mental health conditions or circumstances. It’s common — but not required — for people who have this to have a history of childhood trauma or abuse.

Because this condition doesn’t have official recognition yet, not all mental health providers know about it. Some healthcare providers may even dismiss it, which can cause you to feel even more ashamed and avoid seeking care. But it’s important not to give up on finding someone to provide the care you need to deal with and overcome this condition. It’s possible to learn to manage these daydreams — especially with mental healthcare — so you can focus your efforts and attention on living and building relationships with the people around you.