Maladaptive daydreaming: symptoms and management

We all daydream a little. Whether that’s a good or a bad thing is a matter of some debate. If all is well, you can get your head out of the clouds after momentarily zoning out and get back to whatever task is at hand. 

Some people, however, say their minds wander into fantasyland for several hours a day. Their vivid daydreams, running like movies in their heads while they’re wide awake, are a little-understood form of escapism scientists call maladaptive daydreaming—a condition that can make life seriously difficult.

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The human mind tends to wander now and then. Our attentions drift away from a meeting, a lecture, perhaps even the roadway, to ponder other tasks or maybe engage in fantasies unrelated to the moment. That's normal (Marcusson-Clavertz, 2019). 

Such mental meanderings—common daydreams—can be a good thing, spurring creativity. Whether it distracts a kid in school or the classic absent-minded professor, daydreaming has also been linked to higher intelligence. It might indicate a person's brain is too efficient to stay focused on the mundane (Godwin, 2017). 

Maladaptive daydreaming, however, is the wandering mind run amok. 

Maladaptive daydreams go well beyond the occasional flight of fancy. They can stretch into hours and hours of vivid imaginings, causing a person to neglect their everyday responsibilities and relationships. They become both obsessed with their fantasies and distressed over the ensuing disruptions to life (Soffer-Dudek, 2018).

As mental disorders go, maladaptive daydreaming has been recognized relatively recently. The term was coined in 2002 by Eli Somer, Ph.D., a professor of clinical psychology at the University of Haifa in Israel, who offered this definition at the time: “Maladaptive daydreaming (MD) is defined as extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning” (Somer, 2002).

Researchers in the field today often refer to it as maladaptive daydreaming disorder or just daydreaming disorder. But given the short history of study and sparse scientific evidence, the condition has not yet been designated as a formal disorder in standard mental-health diagnostic manuals (Soffer-Dudek, 2018). This has led to doubts and confusion among health practitioners (Witkin, 2019).

Among the most concise of modern definitions: “Maladaptive daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning” (Salomon-Small, 2021).

Maladaptive daydreaming is nothing like regular daydreaming. Experts describe it as addictive (Somer, 2020). Everything about it is different, from the inability to control it to the sheer quantity of experiences to the distress it causes (Bigelsen, 2016). People generate immersive plots, sometimes like soap operas that may or may not include idealized versions of self. The dreamers “watch” the shows in their minds (Soffer-Dudek, 2018).

By absorbing themselves in fantasy for several hours a day, maladaptive daydreamers cut themselves off from human interaction (Pietkiewicz, 2018). Though there’s no official list of symptoms, people report three common ones (Soffer-Dudek, 2018):

• Difficulty controlling the need or desire to fantasize

• Interference of fantasizing with actual relationships and endeavors

• Intense shame and much effort to hide the behavior

“People with this disorder have developed an extraordinary ability to become completely immersed in daydreaming, to such an extent that their daydreams can make them laugh or cry,” said Daniela Jopp, Ph.D., an associate professor of psychology at the University of Lausanne in Switzerland. “This ability to feel fully present in a self-directed imaginal plot is not only a powerful source of the attraction, but it also makes it difficult to disengage from it, creating a mental addiction.”

“I have been lost in daydreams for as long as I can remember,” one 20-year-old woman told researchers. “These daydreams tend to be stories… for which I feel real emotion, usually happiness or sadness, which have the ability to make me laugh and cry... They're as important a part of my life as anything else; I can spend hours alone with my daydreams” (Soffer-Dudek, 2018).

It's not yet clear exactly what causes maladaptive daydreaming. There appear to be multiple possible factors, and the condition often co-exists with other mental disorders (Somer, 2017). A study of 510 people who self-identified as struggling with maladaptive dreaming found the condition related notably to obsessive disorders, and to a lesser extent, compulsive disorders (Salomon-Small, 2021).

One small study of 39 people with maladaptive daydreaming revealed 28 percent had attempted suicide, and the majority of them had several other co-existing conditions, called comorbidities (Somer, 2017):

• 54% had an obsessive-compulsive or related disorder.

• 67% had a depressive disorder.

• 72% had an anxiety disorder.

• 77% had attention deficit hyperactivity disorder (ADHD).

A study of college students in Saudi Arabia found that maladaptive dreamers were more likely to have generalized anxiety disorder and get worse grades (Alenizi, 2020). 

On the internet, one can find questions and speculation about whether autism causes maladaptive daydreaming. But a search of the scientific literature reveals no such associations. The closest sort of connection on this front is the suggestion that adults with an autism spectrum disorder might be prone to some daydreaming, though of a different kind compared to people who don’t have autism (Brewe, 2020).

Scientists have wondered if the escapism inherent in maladaptive daydreaming might be a useful tool to relieve stress. Instead, stressful situations seem to exacerbate the condition, as seen in a survey of maladaptive daydreamers' experiences during the COVID-19 pandemic. Those in lockdown had more vivid and intense daydreams and a stronger urge to daydream than those who weren't locked down (Somer, 2020).

In addition, the maladaptive daydreamers who also had anxiety or depression disorders before the pandemic had a more challenging time controlling their urge to daydream during the pandemic.

The closest thing to a formal test or method for determining if someone could be diagnosed as a maladaptive dreamer is the maladaptive daydreaming scale (MDS). The test, developed in different forms by researchers who study the topic, has people rate their responses from 0 (never or not at all) to 10 (extreme urge or always) on statements like these (Soffer-Dudek, 2018):

• “I felt the need or urge to continue a daydream that was interrupted by a real-world event, at a later point.”

• “My daydreams were accompanied by vocal noises or facial expressions (e.g., laughing, talking, or mouthing the words).”

The responses help determine if a person’s “excessive daydreaming causes clinically significant distress or functional impairment,” which has been suggested as the basis for a diagnosis should the condition be formally elevated to the level of disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Soffer-Dudek, 2018).

There is no official treatment for maladaptive daydreaming (Alenizi, 2020). And because the condition has such a short history of study and is not recognized in diagnostic manuals, therapists are often dismissive of it and may hew to diagnosing other, perhaps somewhat similar conditions that are better known (Soffer-Dudek, 2018).

The drug fluvoxamine, used to treat obsessive-compulsive disorder (OCD), was purported to help control daydreams in a 2009 case study of just a single individual (Schupak, 2009). Studies have explored mindfulness training, which is helpful with OCD, as a therapy for maladaptive daydreaming. But so far, there’s not enough evidence to indicate if they’ll work (Soffer-Dudek, 2018). 

If your daydreaming goes beyond brief, occasional distractions or fun musings, if it’s causing you career or relationship problems, if it’s distressing you, finding a therapist to talk with would be wise. Maybe, just maybe, there are underlying issues you need to acknowledge and work through.

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Current version

July 02, 2021

Written by

Robert Roy Britt

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.