Maladaptive daydreaming: What it is and how to stop it

We all get lost in our own thoughts from time to time. While occasional mind-wandering is common, when these daydreams become prolonged or delusional they can affect your mental and even physical health.

What is maladaptive daydreaming?

Maladaptive daydreaming occurs when a person engages in prolonged bouts of daydreaming, often for hours at a time, to cope with a problem. The daydreaming is "maladaptive" because it causes significant distress and impairment. The daydreams are often vivid and complex plots that elicit a great deal of emotion. A person becomes so consumed by their daydream they may fail to complete work and other daily tasks, or start to withdraw from friends and family.

However, maladaptive daydreaming is not a mental illness.

Maladaptive daydreaming symptoms

Symptoms of this condition are characterized by the daydream itself, as well as by how that daydream affects a person. Daydream behaviors commonly seen in this disorder include:

• intense and extremely vivid daydreams
• complex and elaborate daydreams, often with many people involved
• daydreams accompanied by repetitive movements such as pacing
• prolonged daydreams that may last hours at a time
• a feeling of disconnect or dissociation from people and reality during the episode.

The person experiencing maladaptive daydreams does not confuse what is being imagined with reality. Nonetheless, symptoms often cause significant emotional distress and negatively impact a person's daily functioning. Signs of this include:

• avoiding social interaction and activities
• an inability to perform work or other daily tasks
• extreme feelings of shame or guilt
• feeling a compulsive need to daydream that you can't control
• making a conscious effort to stop or lessen daydreaming episodes.

Maladaptive daydreaming causes

Although the cause of maladaptive daydreaming is unknown, experts believe it may be a coping mechanism for other mental health disorders. And while it may occur independently, maladaptive daydreaming is often seen alongside other mental health disorders.

Some commonly associated mental health disorders include:

• anxiety
• depression
• obsessive-compulsive disorder (OCD)
• attention-deficit hyperactivity disorder (ADHD)
• dissociative disorders.

One study found that nearly 80% of participants with maladaptive daydreaming also had ADHD, followed closely by anxiety disorders (71.8%), depression (56.4%), and OCD (53.9%). It's possible that maladaptive daydreaming may provide a mental escape from depressive or anxiety-provoking thoughts.

The condition is more common in young adults and teenagers, and in those who have experienced abuse or trauma during childhood.

Is there a test to diagnose maladaptive daydreaming?

There are no tests used to diagnose maladaptive daydreaming. Your doctor may use questionnaires related to anxiety, depression, ADHD, OCD, and dissociative disorder to look for signs of maladaptive daydreaming, as well as other mental health disorders.

You can also ask your doctor about a self-assessment tool called Maladaptive Daydreaming Scale-16 (MDS-16). This set of questions is designed to evaluate your daydreams over the past month to assess for the level of maladaptive daydreaming. For example:

• How often do you forget where you are when you daydream?
• How strong is your urge to return to your daydream once it ends?
• How much does daydreaming interfere with your ability to complete work or basic chores?

The higher your score, the higher the likelihood you are experiencing maladaptive daydreaming. However, this screening method is not diagnostic and you should still seek clinical evaluation from a trained mental health professional if daydreaming is causing your severe distress.

How to stop maladaptive daydreaming

If your daydreaming is causing significant distress or interfering with your daily function, talk to your doctor. Maladaptive daydreaming is more than just a habit; it is a strong compulsion like an addiction. Seeking help is important because it can be difficult to manage on your own.

Treatment for maladaptive daydreaming should be personalized based on your individual needs and health history. There is no standard treatment for maladaptive daydreaming, but treating other associated mental health conditions can help. Treatment options for these may include:

• psychotherapy such as cognitive behavioral therapy (CBT)
• anti-anxiety, antidepressant, or antipsychotic medications.

Therapy can help you better understand why the daydreaming is occurring and, if needed, learn strategies to cope with past traumas. Therapy can also help improve your overall mental health.

Improving your mental and physical health helps to not only treat but also prevent maladaptive daydreaming. Other preventive strategies include:

• improving sleep quality
• establishing a healthy diet and exercise routine
• reducing stress
• getting exposure to sunlight 
• breathing exercises
• seeking support from friends and family.