- Just like intense sadness may be called depression, daydreaming can be excessive to the point that it is clinically significant.
- Maladaptive daydreamers engage in elaborate fantasy worlds for hours on end at the expense of important life goals and functioning.
- People suffering from maladaptive daydreaming may not get the health care they need due to lack of diagnostic labels and treatments.
In a recent blog post ("Is 'Maladaptive Daydreaming' a Mental Disorder?"), Prof. Jonathan D. Raskin describes himself as a “daydream believer,” suggesting that the idea of maladaptive daydreaming (MD) is pathologizing a normal and positive phenomenon. Raskin humorously suggested that many of us may be inflicted with, for example, “Netflix preoccupation disorder.”
Although I am tempted to diagnose myself with this suggested malady, I remain very conscious of the fact that I am a functional, productive person, whereas our studies have shown that maladaptive daydreamers (MDers) are suffering immensely. In one study, almost half the sample was unemployed and over a quarter of the sample had attempted suicide at least once (Soffer-Dudek & Somer, 2018). In another study, most of the sample met the criteria for 3-4 different DSM diagnoses (Somer, Soffer-Dudek, & Ross, 2017).
For example, here’s one account of maladaptive daydreaming by a young Bolivian woman. The quote has been shared with permission.
“I have suffered from this condition for as long as I can remember. I can't imagine my life without it. My daydreams are usually very vivid to the point that I can laugh, cry, even get angry ... It is very difficult for me to communicate with people. I have always been very shy.
"As a child, I considered my daydreams something normal [but] over time, I realized that it wasn't like that. My classmates looked at me strangely when I did certain movements during class, things like clapping or smiling alone ... I thought that with time it would calm down and I would stop doing it eventually. I was wrong.
"My daydreams are getting worse, even affecting me physically. I'm now 22 years old and I can spend up to 6 hours in a row dreaming. I put my headphones at high volume because the music helps me get much more into the dream, and for at least a couple of hours I’m happy, until I take off my headphones and my eyes are swollen, my ears vibrate from the loud volume of the music [and] my knees and feet hurt because I got so excited that I ended up jumping all over the room. Then when everything ends, I sink into the deepest sadness. I did absolutely nothing all day. I could have helped my parents, I could have played with my little sister, or just hung out with friends but I can't.
"It's like a drug and I feel like I'm wasting my life ... I have tried to quit so many times that I just want to give up. But I still want to believe that in time this will stop being a problem. Thank you.”
If I had not read hundreds of personal accounts like this one, I would probably agree with Raskin. Indeed, I share his concern regarding the ever-growing DSM, and I did not set out to contribute to that trend myself. However, the account of the woman above is just one example out of about 1,000 emails from all over the world our research group has received in recent years pleading for help and urging us to continue studying this phenomenon (see Bershtling & Somer, 2018).
What is maladaptive daydreaming?
MD is defined as a suggested mental disorder (Somer, 2002; Somer, Soffer-Dudek, Ross, & Halpern, 2017), in which individuals are overwhelmingly consumed by compulsive/addictive engagement in a fanciful narrative and emotional daydreams for hours on end at the expense of important life goals and functioning—to the point where they feel completely out of control and helpless.
Many of them use repetitive motion (e.g., spinning in circles, pacing, running, rocking in bed, and even headbanging) to induce the deep state of concentration they need to get into their daydreams. Many also use music as a trigger for this state. As they enter their trance-like state of vivid daydreaming, they may mouth dialogues or make faces. They become completely absorbed, especially if they are alone. If not, most of them remain conscious of their whereabouts and try not to embarrass themselves.
For the typical MDer, daydreaming is the only enjoyable activity imaginable. They may seek out alone time with the sole aim of being able to daydream undisturbed. They may avoid opportunities for social gatherings because they’d rather be alone and daydream—and because they feel so lonely and shamed for doing it that they do not feel comfortable around other people anyway.
Raskin wrote “drift off…” several times. It sounds like Raskin was referring to general mind-wandering. Although MDers may also drift off into their fantasy worlds (e.g., when they try to concentrate in class), they usually enter these episodes fully aware; their dream worlds are always waiting for them, calling them, like a drug or other addiction. Their elaborate fantasy worlds are often characterized by continuation through multiple episodes—they often go back to the same scenery and characters for years, with characters aging and evolving over time, having children and grandchildren, getting sick, and even dying. Intricate dramas, romances, and tragedies are tempting for MDers to enter, just as a good Netflix series may be for most people. This elaborate daydreaming ability is unusual, but it would only be defined as maladaptive if the person sees it as a distress-inducing, impairing, and debilitating problem. In any case, it is very different than the fickle mental contents of typical mind-wandering, such as drifting off to an imagined conversation with our boss or remembering today’s “to-do” list.
Human behavior exists on a spectrum
So, are we pathologizing a normal phenomenon? I suggest that the same thing could be said about sadness or worry. Those are normal human capacities that carry important evolutionary roles. Yet human behavior exists on a spectrum. If sadness or worry become too extensive and pervasive, to the point where they are the center of one’s experience and cause significant distress and dysfunction, we diagnose depression or anxiety. Indeed, we could have easily called depression “maladaptive sadness disorder,” and general anxiety “maladaptive worry disorder.” The same goes for daydreaming. It turns out that for a lot of people, daydreaming can become so excessive that it is clinically significant.
Lack of treatment for maladaptive daydreaming
Moreover, MDers feel that current diagnostic labels and treatments are not suitable for them, leading to misdiagnoses and loneliness. This intensifies their distress and prevents them from receiving proper mental health care (Somer, Somer, & Jopp, 2016). Many state that mental health practitioners are disparaging of their problem, and it is difficult for them to explain their symptoms. For example, one MDer stated: “It was my own decision to stop my therapy because my psychologist didn’t want to listen to the problem. It affected him in some way … they don’t want to hear about the problem” (Somer, Somer, & Jopp, 2016, pp. 475). Discovering the MD term, many state, has helped them finally feel understood. For some, this has been utterly life-changing. I have also received several emails from therapists who were grateful for the term, as it helped them understand their clients.
To conclude, is daydreaming psychopathological? For most people, no. But some people are MDers, and for them, the answer is a definite yes. Our commitment to them is to name their suffering so that it will be easier for them to communicate. This will hopefully allow for the development of empirically supported treatments and, most importantly, help them hold on to some hope.
Bershtling, O. D., & Somer, E. (2018). The micro‐politics of a new mental condition: Legitimization in maldaptive daydreamers' discourse. The Qualitative Report, 23(8), 1983–2002.
Soffer‐Dudek, N., & Somer, E. (2018). Trapped in a daydream: Daily elevations in maladaptive daydreaming are associated with daily psychopathological symptoms. Frontiers in Psychiatry, 9, 1–14. https://doi.org/10.3389/fpsyt.2018.00194
Somer, E. (2002). Maladaptive daydreaming: A qualitative inquiry. Journal of Contemporary Psychotherapy, 32, 197–212. https://doi.org/10.1023/A
Somer, E., Soffer‐Dudek, N., & Ross, C. A. (2017). The comorbidity of daydreaming disorder (maladaptive daydreaming). Journal of Nervous and Mental Disease, 205(7), 525–530. https://doi.org/10.1097/NMD.0000000000000685
Somer, E., Soffer Dudek, N., Ross, C. A., & Halpern, N. (2017). Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview. Psychology of Consciousness: Theory, Research, and Practice, 4(2), 176–189. https://doi.org/10.1037/cns000011
Somer, E., Somer, L., & Jopp, D. S. (2016). Childhood antecedents and maintaining factors in maladaptive daydreaming. Journal of Nervous and Mental Disease, 204(6), 471–478. https://doi.org/10.1097/NMD.0000000000000507