1- Q: Am I a Maladaptive Daydreamer? How would I know for sure?

The MDS-16 (Maladaptive Daydreaming Scale) developed by Eli Somer, Jayne Bigelsen, Jonathan Lehrfeld & Daniela Jopp in 2016 could be helpful to get an idea about the answer of this question. You can find it here, translated into many languages. 
People with probable MD score higher than 40 points on this scale. But please be aware! Your problem might be more complex than what this scale could answer, MD could be a secondary problem to another main one, or there could be (and in many cases, there would be) other problems that accompany MD. Even if your problems fit perfectly with MD criterion, every case has its own unique aspects and mechanics. So if you get a positive score, we still strongly recommend you to discuss those details with a mental health professional before feeling absolutely sure.

Whether it is a psychopathology or a physical problem, it is always dangerous to self-diagnose. There are some professionals aware of MD and capable of “unofficially” diagnosing it for you, but there aren’t a lot of them in the field just yet. MD is newly discovered and named and it is not included in diagnostic books of mental health professionals; we rarely have an alternative to self-diagnosing.

2- Q: What caused Maladaptive Daydreaming? What are the underlying causes?

Recent research shows that the most important factor is the innate capacity for immersive imagination. *This ability enables people to experience what they imagine much more powerfully and vividly than most other people can. Because of this immersion, the activity of daydreaming becomes extremely rewarding. As it is with every rewarding activity, this makes the behaviour of daydreaming potentially addictive for some people. This addiction can create a vicious cycle in time and turn into Daydreaming Disorder (MD). We assume that not everyone with this ability develops maladaptive aspects or perhaps some people resolve them relatively easily over time.

You may hear that trauma is the common cause, as the effect of trauma was examined in early studies, but subsequent research has shown that even though trauma worsens the situation, as it does with any psychopathology, it is not the cause or a prerequisite of Maladaptive Daydreaming. 

* Schimmenti, A., Somer, E. & Regis, M. (2019). Maladaptive daydreaming: Towards a nosological definition. Annales Medico-Psychologiques, 177, 865-874. https://doi.org/10.1016/j.amp.2019.08.014

3- Q: How seriously should I take Maladaptive Daydreaming? Is it serious?

It cannot be denied that Daydreaming Disorder (MD) causes a significant decrease in the quality of life, as the increasing number of help-seekers show. The neglect of people’s needs and responsibilities can cause them to have problems in continuing their daily lives. More importantly, the difficulty of meeting core social needs worsens the situation; and the contrast of imagination and reality reinforce the problems of identity and self-confidence. Lack of motivation for real life and severe despair inevitably lead to negative outcomes.

Also comorbidities, accompanying psychopathologies to MD, cause a variety of other problems that cannot be counted here. In recent studies, *a history of suicide has been identified to be as high as 28.2% of those with Maladaptive Daydreaming. 

Although this information calls for attention from the parents who suspect that their child has this disorder, they should not panic. With the necessary attention, supportive attitude, and readiness to intervene, this risk can easily be reduced. It should be remembered that the people in these studies were people who had no chance of getting the support they needed, neither from their parents nor from professionals.

Field professionals should carefully evaluate this information. The severity of the distress experienced and the help needed can also be read from this data.

* Somer, E., Soffer-Dudek, N., & Ross, CA (2017). The comorbidity of daydreaming disorder (Maladaptive Daydreaming). Journal of Nervous and Mental Disease. 205 (7), 525-530. DOI: http://dx.doi.org/10.1097/NMD.0000000000000685

4- Q: Is it possible to recover from Maladaptive Daydreaming? Can it be cured?

Yes. Despite limited research, we can say that recovery is possible, as both sample cases and expert opinions suggest.

One of the most effective recovery goals is to eliminate the maladaptive aspects of daydreaming, that is, the parts that hinder life and negatively affect a person’s mood and perception of identity and reality. It takes time and effort to work on these aspects one by one. But in the end one becomes able to use their powerful imagination as a tool in healthy ways. 

Some people may want to stop daydreaming altogether. People who say they managed to do this can also be found on various social media platforms. This could also be possible depending on the mechanisms of the personal case. But there needs to be more research on this issue to say for sure if this is possible for everyone with MD. Experts needs to examine whether the people in question are talking about whether they are giving up fantasy rather than imagining, whether they are directing the imagination mechanism to functionality, and whether they will experience relapse in the long term.

5- Q: How can I recover from Maladaptive Daydreaming?

Even though there are some ways to cope with MD, and lead its progression towards recovery on your own, we strongly recommend you reach out to mental health professionals. Even though they might not know MD well enough, they could help with unresolved trauma and/or ongoing psychological issues that perpetuate MD. 

MD causes serious problems that feed itself; therefore it creates a cycle that needs to be addressed and broken with careful consideration. MD, in many cases, is used as a coping mechanism to deal with the issues MD itself creates. That is why, in many cases, people try to go “cold-turkey”… Trying to stop daydreaming without addressing those issues is pretty much the same as yanking away the crutch from someone with mobility issues and expecting them to walk without physiotherapy.


6- Q: I think I have MD but I never experienced childhood trauma, could I still have it?

Yes. Early research was conducted by Prof. Eli Somer who specializes in trauma. Upon discovering this behaviour in six of his trauma practice patients he initially thought it to be specific to abuse and neglect. But subsequent research has shown that there are different paths to MD and victims of childhood trauma only account for one quarter of Maladaptive Daydreamers. Which is pretty much the same ratio of people with trauma in the general population.

7- Q: Would Maladaptive Daydreaming get worse in time?  Or would it get better on its own?

In the absence of long-term research on the subject, one can only speculate with an educated eye. Therefore, the following information should be taken with a pinch of salt.

When the comorbidity is not strong, that is, the psychopathologies that may accompany MD are minimal, we can predict that the troubles associated with Maladaptive Daydreaming will draw a kind of bell curve over time. So we can expect less distress at the beginning (childhood), the most during adolescence and early adulthood, and then gradually lessen or regress to a certain point. The basis of this reasoning goes like this: 

The person usually has fewer responsibilities in childhood, and playing imaginary games is even expected from a child, therefore the pressure of society is much lower. Children can benefit more from the pleasant and stress-reducing function of dreaming, and since that is at the beginning of the addiction cycle, the urge to daydream is not as challenging as it will be in the future. 

In adolescence and early adulthood, the urge to dream, which has been reinforced over the years, has strengthened at the same time the responsibilities of the person increase. Neglected needs, social isolation, and failed responsibilities can lead to the development of depression. The behavior of escaping reality no longer works as an effective coping mechanism, and it also prevents the person from practicing real-life problem-solving skills. 

In  adulthood we expect the real responsibilities and needs will direct the person to reality, even if involuntarily at the beginning. But the need to postpone daydreaming, the constant practice of  keeping it under control, would lead to better mind control; and the person will develop instinctive methods to cope with the urge and the need to daydream, which would be, at least, effective enough to continue their lives. 

But if comorbidities seen with MD are prevalent, the problem and perceived distress may cause a vicious cycle. Especially when alternative stress coping methods and real life problems solving capacities are not developed enough, this almost becomes inevitable. In this case, we strongly recommend seeking professional help.

8- Q: Could Maladaptive Daydreaming turn into Schizophrenia? Could one complete forget reality one day?

No. We can comfortably say that MD cannot evolve into Schizophrenia, excluding the potential cases of Schizophrenia that might occur independently, and in addition to, Maladaptive Daydreaming.

One of the most important features of Maladaptive Daydreaming is that one can easily distinguish between reality and fantasy. Although they can experience these fantasies with intensity and vitality, while they are daydreaming, they almost never lose this distinction. Many of their troubles are based on knowing that their daydreams are not real. In Schizophrenia, most of the problems arise from the inability to distinguish between reality and fiction. Both the mechanism and the symptoms of Schizophrenia are fundamentally incompatible with Maladaptive Daydreaming.

The only possibility that is close to the pessimistic picture drawn by this question is a scenario in which the person completely gives up on life and tries to ignore reality by submitting themselves to imagination. This is only possible with an enabler who meets the needs of the person in real life. Even in this case, the person will be aware that their fictions are not real.

-I am not sure if this should be here, it might be TMI or confusing to lay reader- On the other hand, there is a fledgling theory about a possible link between maladaptive daydreaming and disassociative identity disorder. There needs to be more research on this to say anything for sure, but to avoid misunderstandings, it should perhaps be emphasise: “a connection” that does not mean DID follows MD cases; it is just a theory of whether two groups of people have a larger intersection when compared to some other disorders.

9- Q: I asked a psychologist/psychiatrist about MD, but they said there is no such thing? Why?

Mental health professionals use a diagnostic book called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to categorize the problems of their counselees. Currently the DSM is in its fifth edition (DSM-5). This book is revised over the years when deemed necessary, newly discovered disorders are added, outdated ones are removed, and new classifications are made. The concept of Maladaptive Daydreaming first entered the literature in 2002. In the following few years, when the publications about it were noticed by the right people, those seeking help in this regard began to raise their voices. It has not been long since this demand triggered serious research and studies on the subject. Since this disorder has not been included in the diagnostics book yet, it is not taught in the relevant departments of universities; so most mental health professionals are uninformed about the subject.

Currently, research on Maladaptive Daydreaming is in it’s infancy. Despite this, we can say that a substantial accumulation of knowledge has been achieved already, both about its mechanisms and dynamics, and about potential treatment methods.  At this stage, the only thing that can be done is to increase awareness and to contribute to research when possible. Interest and recognition by mental health professionals will follow this stage.

10- Q: Should I use medication? Is there a drug that helps?

Research on this subject is very limited yet. One case was recorded of an SSRI being helpful; but as further research showed, this single case also had OCD components, and SSRIs are the common medication for OCD. So unfortunately, SSRIs may not have any effect on most people with MD. 

It has also been seen that Ritalin and similar drugs used in Attention Deficit Disorder do not help, and even worsened the situation in one case. Unfortunately there is no medication that is known to reliably help MDers. But we can reliably say stress and depression makes the urge to daydream stronger and more frequent in MD.  If you have also depression, antidepressants could help alleviate the problem.

!! Never decide to take medication on your own; consult your psychiatrist. Every drug has side effects and interactions, it should be remembered that the risk is much higher with psychiatric drugs. Most of these drugs cause emotional instability when taken in the wrong dosage and condition, which creates a risk of suicide.

11- Q: I was a maladaptive daydreamer. I stopped daydreaming for a while / I cannot daydream for some reason. But now I feel awful. (For example: I am nervous, irritable / I feel physically ill / I feel lost and out of place / I have suicidal thoughts…) Why?

Although there is no visible chemical factor, it should not be forgotten that Maladaptive Daydreaming is a serious addiction. Even if you do not take any chemicals from outside, the chemicals produced in our brain create an addiction with the same intensity. What you are experiencing may be withdrawal symptoms of addiction.

There is another factor that needs to be taken more seriously than withdrawal symptoms: Among those who say that they have stopped daydreaming and went cold-turkey, we encounter those who experience negative feelings more often, compared to those who describe their experience or new mindset as pleasant. There are some cases where they cannot find the time to spend for daydreaming due to busy daily life, medication or other reasons; many of them experiences a serious mental breakdown. To speculate on the reason for this, we can guess that the act of daydreaming has become a building block in some mental processes in these people and is used as a fundamental coping strategy or basic stress reliever. We can predict that going cold-turkey can cause this breakdown if the act of daydreaming is removed from this mental equation before learning and acquiring the habits of alternative ways of coping. 

Even though, in many cases, the problems have arisen due to intense daydreaming, the solution to these problems may not be to stop daydreaming suddenly and unprepared. Prior to this, working on problems such as self-confidence, identity, coping methods of stress and emotional processes could be vital. Through therapy you may identify the processes in which dreaming is used and then develop alternative ways for these mechanisms to keep functioning.

12- Q: I have concerns that my child might have Maladaptive Daydreaming. What should I do?

Most case start in childhood; but every intensely imaginative child does not develop maladaptive components. So know that it is not a certainty; your child’s future is not dark as you fear. If you support your child in maintaining an open communication with you about their daydreams, problems and thoughts, if you let them know that you will be there when they need help, you can provide this help when the need arises. This gives you and your child an advantage that hardly any Maladaptive Daydreamer has had so far: you are aware of the risk and have access to both solutions and support.

When it comes to children, we often face different problems and advantages. Because children have less responsibilities and their needs are met by their parents. They do not experience situations in which excessive daydreaming conflicts with these needs; this results in their lack of motivation to improve the situation. In a way, at least as perceived by them, their intense daydreaming has not yet negatively affected their lives.

If your impression is also just a suspicion, if the act of daydreaming doesn’t objectively pose a serious problem to their other activities, your child technically is not suffering from a psychopathology; and it might never turn into a psychopathology. In this case, keep observing your child with open communication. Do not try to prevent daydreaming behavior; but don’t be a facilitator by easing your child’s responsibilities and your expectations from them. In essence, behave as you would as if your child wants to watch TV or play computers for more than that is good for them.

However, if your child’s daydreaming behavior seriously negatively affects their life in terms of intensity and timing, this is a problem even if they don’t take these problems seriously. In this case, turn to expert help; It would be wise to focus on motivational therapies for a start. Your child’s collaboration is vital to treatment; therefore, you may not get immediate results. Although your child may not be convinced to act on this issue in the short term, over time, especially as his age grows and his practical concerns begin to change with adolescence, he will most likely change his mind, in which case help would be immediately available to them.

13- Q: My daydreams are not fantastical, they are things that can technically become real. What makes a daydream the kind of fantasy in Maladaptive Daydreaming? What kind of daydreams are maladaptive?

The content of fantasies in MD varies according to the emotional needs, mental mechanisms and areas of interest of the people. That’s why we hear such a wide variety of daydreams. It is natural that people who do not like or are not inclined to fantasy scenarios, do not have such daydreams; instead you may be daydreaming rather realistic scenarios. The themes of dreams that people create also vary according to age and needs. Regardless of its “fantastical/realistic” content, the criterion for a daydreaming to be called a fantasy is its utilization. If you daydream as a part of planning for your activities, as a kind of preparation, we call it daydreaming; if they are detached from reality, and is usually just used as a way of entertainment, we call that fantasy.

It is very important to note that, with or without MD, everyone daydreams, and everyone does have fantasies. Every person daydreams, usually as short bursts, many times during the day. Maybe they dream of dinner as a way to plan dinner, a meeting or a trip soon. Or maybe, while they do menial tasks they imagine meeting the love of their life, or winning the lottery; but that activity of fantasy usually ends in less than an hour or so. The existence of daydreams and fantasies alone are not what makes a person Maladaptive Daydreamer. “Maladaptive” refers to that activity becoming an impediment to a person’s life; they fail to “adapt” in real life. If your daydreaming impedes your life, decreases your quality of life, and/or causes you distress, that is when we can talk about a possible MD diagnosis.

If you are having doubts on “Is this certain daydream maladaptive? Is this other daydream/planning in my head a healthy daydream?” that is a non applicable question. For the reasons above, no daydreaming or fantasy action alone is maladaptive or adaptive. The term refers to the sum of them and how it affects your life; not the individual daydream or the behaviour of daydreaming on its own.