What Is Maladaptive Daydreaming?
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Medically reviewed by Valerie Cacho, MD
Everyone daydreams from time to time. When you daydream, you'll likely experience some sort of temporary separation from reality which is replaced by a fantasy or vision. But daydreaming too much or always being in a daydreaming state can become severe and cause a mental health condition called maladaptive daydreaming.
Maladaptive daydreaming occurs when you become deeply immersed in a vivid fantasy that often involves complex scenarios. Unlike regular daydreaming, maladaptive daydreaming often involves music and repetitive movements. Some research shows evidence that people who experience maladaptive daydreaming may also have dissociative identity disorder, obsessive-compulsive disorder (OCD), or attention deficit hyperactivity disorder (ADHD).
Studies show maladaptive daydreaming can affect your daily life and functioning. Experts believe that this condition may often cause academic, relationship, and work-related problems. You may also experience difficulty completing your regular activities and tasks. Fortunately, treatment from a mental health provider can sometimes help improve these symptoms.
Symptoms of Maladaptive Daydreaming
When someone experiences maladaptive daydreaming, they can spend hours at a time in a daydream. Many report experiencing vivid imagery that features idealized versions of themselves. Others say that they experience more soap opera-like plots that they watch with their minds. Researchers have found that people with maladaptive daydreaming have an innate talent for creating vivid fantasies.
Maladaptive daydreaming also can cause significant stress—especially since it interferes with a person's day-to-day function and relationships. There's also an increased likelihood that a person with maladaptive daydreaming may have other conditions as well.
For instance, one study reports that people with maladaptive daydreaming often have a diagnosis for attention-deficit hyperactivity disorder (ADHD), anxiety disorder, dissociative identity disorder, major depressive disorder, or obsessive-compulsive disorder (OCD).
If you experience maladaptive daydreaming, you may also have the following symptoms:
Forgetting where you are when daydreaming
Having daydreams that are triggered by music
Wanting to return to a daydream when you're at work or school
Making noises such as talking, whispering, or laughing while daydreaming
Being stressed when life prevents you from daydreaming
Feeling concerned about the amount of time you spent daydreaming
Not being able to control or limit your daydreaming
Needing to daydream instead of pursuing hobbies or spending time with others
Moving repeatedly while daydreaming (such as pacing back and forth)
What Causes Maladaptive Daydreaming?
Although scientists do not know exactly what causes maladaptive daydreaming, they have discovered that people who experience maladaptive daydreaming may also live with ADHD, anxiety disorders, depression, OCD, or dissociative disorders.
Early evidence also shows that people who experience maladaptive daydreaming share the same characteristics as those with behavioral addictions. In particular, scientists are exploring the similarities between maladaptive daydreaming and certain types of fantasy-oriented addictions like extensive book-reading, binge-watching films or shows, and internet gaming.
Like maladaptive daydreaming, these other activities replace human interaction and impair a person's functioning. What's more, people often engage in these activities to avoid real-life challenges or use fantasy to experience things that are not likely to happen in real life.
Some evidence also suggests that experiencing trauma, having a difficult childhood, or being bullied also can contribute to maladaptive daydreaming. Likewise, having low self-esteem and wanting to avoid conflict or difficulties also may play a role.
Complications
While daydreaming is a normal part of life, those with maladaptive daydreaming spend more than half of their waking hours in a daydream. This extensive amount of time spent in a fictional world can not only interfere with their responsibilities, but can also make it difficult to concentrate on other tasks or schoolwork because of feeling a constant pull to return to the daydream.
People with maladaptive daydreaming are likely to experience relationship challenges with friends, family, and significant others because their daydreaming causes them to be unavailable much of the time. This condition can even interfere with sleep—especially if they put off sleeping to daydream—which may cause additional symptoms like mood swings, fatigue, and stress.
Diagnosis
Because maladaptive daydreaming is not classified as an official mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are no standardized ways to diagnose the condition. That said, many mental health professionals use a 16-item test to screen for the condition—known as the Maladaptive Daydreaming Scale (MDS-16).
This scale was developed by Eli Somer and includes 16 questions about daydreaming. People answer the questions and the higher their score, the more likely they engage in maladaptive daydreaming. One study found that a score of 35 on the scale can distinguish between excessive and normal daydreamers. That said, researchers caution that this tool should be considered a screening survey rather than an actual diagnostic tool.
How To Treat Maladaptive Daydreaming
Similar to how there is no official way to diagnose maladaptive daydreaming, there is no standard of treatment for this condition either. That said, there are a few different treatment options that have helped some people with maladaptive daydreaming. If you think you have symptoms of maladaptive daydreaming, working with a mental health professional (such as a psychiatrist or psychologist) can help you get the treatment you need.
Therapy and Mindfulness
One case study found that after six months of therapy—including cognitive behavioral therapy (CBT) and mindfulness meditation—the person in the study was able to reduce their daydreaming. In fact, their daydreaming declined by more than 50% and their time on the internet went down by more than 70%. They also noted a 70% improvement in their work and social adjustment.
Exposure and Response Prevention
Another group of researchers has proposed using a treatment known as exposure and response prevention (ERP) alongside mindfulness—especially since these treatments may be useful for people with OCD and dissociative disorders.
When addressing maladaptive daydreaming, this treatment helps reduce or stop daydreaming by changing the ends of stories or fantasies to make them unpleasant to the people who are having these daydreams. While this treatment appeared to work in their study, the researchers note that the usefulness of this approach should be examined in larger studies and clinical trials.
Medications
An older case study found that treating people with maladaptive daydreaming with fluvoxamine (a type of selective serotonin reuptake inhibitor) helps to control daydreaming. Fluvoxamine is a drug that providers can sometimes diagnose to treat OCD. But, it's important to note that there is little evidence supporting the use of this medication in treating maladaptive daydreaming and you should talk to your healthcare provider if they suggest any medications to help reduce symptoms.
Other Methods
Because daydreaming could be caused by stress, past trauma, or other difficulties, it is important to find a mental health professional who can help you process and work through the challenges you are facing in therapy. It can also help to reduce fatigue and lower stress by prioritizing sleep, eating nutritious foods, participating in physical activity, and spending time with loved ones.
When to Contact a Healthcare Provider
If you are displaying signs of maladaptive daydreaming, it's essential to talk to a mental health professional about your symptoms—especially if this condition is interfering with your daily life, affecting your relationships, or making school or work challenging.
Keep in mind: because this condition is not recognized as a mental health disorder and has limited studies, many researchers and healthcare providers have not fully understood maladaptive daydreaming. Instead, it can help to ask your provider for a referral to a specialist who may be more familiar with this condition.
You could also ask your provider to screen you for conditions that commonly occur alongside maladaptive daydreaming like ADHD, OCD, anxiety, depression, and dissociative disorders. Getting treatment for these conditions may lead to an improvement in your maladaptive daydreaming.
A Quick Review
Maladaptive daydreaming occurs when you spend too much time daydreaming. While some daydreaming is normal, people who spend more than half their day living in a fantasy world can experience difficulties in their relationships, career, and daily life. This condition often occurs with other mental health conditions such as ADHD, OCD, anxiety, and depression. That said, seeking out care from a mental health provider can help you improve your symptoms and quality of life.
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