There was no label for Jayne Bigelson's unusual habit. For hours a day, she'd weave elaborate storied daydreams in her mind. When she was a child, she did it while walking in circles and shaking a string. When she got older, she learned how to do it standing still.
They were pleasant daydreams. She describes them like personal screenings of sitcoms in which she played a starring role. Stories about joining the "Brady Bunch" on a family vacation or hanging out with members of "General Hospital." But they had become all consuming.
"At the end of the day, it's kind of like alcohol. A lot of people can drink wine and think it's great. There's nothing wrong with daydreaming in this fashion, either. But for some people, it takes over," she says during an interview. "With me it was all day, every day."
The frustrating part was that no one believed her. Her parents and therapists told her there was no such thing as excessive daydreaming, and she should embrace this "special talent."
Eventually, Bigelson was prescribed the antidepressant fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) known to help with obsessive compulsive disorder (OCD). The immersive daydreams eventually stopped and Bigelson moved on.
But 15 years later, the Harvard Law School graduate began to wonder again whether anyone else suffered from obsessive daydreaming. That was the early 2000s, and the internet was becoming a treasure trove of information. Google eventually led her to Eli Somer, Ph.D.'s 2002 paper, "Maladaptive Daydreaming: A Qualitative Inquiry." Finally, she had validation that her symptoms were real, and proof she wasn't alone.
What Is Maladaptive Daydreaming?
Daydreaming and even mind wandering (a form of off-task thinking about mundane real-life events) is normal, says Somer, an Israeli clinician specializing in trauma and dissociative disorders. Immersive daydreaming is different. Somer describes it this way: "extensive absorptive, fantastical, vivid, and fanciful fantasies that are evoked by repetitive physical movement and by exposure to evocative music."
Immersive daydreaming (ID) "is indeed an exceptional trait that generates very pleasurable feelings and therefore may develop into a behavioral addiction," Somer says in an email interview. But when it causes significant distress or impairment to a person's life, then it is considered "maladaptive daydreaming" (MD).
Discovering the Daydreaming Disorder
At the beginning of the millennium, Somer, Professor Emeritus of clinical psychology University of Haifa School of Social Work, discovered something fascinating among several of his patients. They spent an unusual amount of time daydreaming and creating extensive fantasy lives in their minds. The coincidence captured his attention. "I became interested in their inner worlds."
Somer's practice had been comprised of trauma survivors and as such, he concluded that that daydreaming was a distraction or soothing activity patients were using as a "dissociative defense mechanism."
In 2002, he described this observation and coined the term "maladaptive daydreaming," in the paper he published in the Journal of Contemporary Psychology. At the time, his concept appeared to fall flat with colleagues. With lack of interest within the scientific community, Somer abandoned the idea and resumed his clinical and research activity in trauma and dissociation.
A few years later, around the time Bigelson discovered Somer's paper, the term "maladaptive daydreaming" that was non-existent before 2002, had gone viral. Somer began receiving requests to continue his work on the daydreaming disorder.
How Has Research Evolved?
When Somer discovered maladaptive daydreaming in his patients, most of whom suffered from trauma, he assumed that the two conditions were somehow related. But in the two decades since, he says he knows that's not necessarily the case.
"Our research, indeed, shows that there is a statistical relationship between trauma history and MD. However, trauma is not a necessary condition. Individuals with ID can become addicted to this highly rewarding mental experience in the absence of a trauma history," he says.
Part of his understanding was influenced by Bigelson, who in 2008, convinced her psychiatrist to write an MD case study on her immersive daydreaming experience. She later spearheaded research to scan the brains of 90 excessive daydreamers. The scans gave even more validation that immersive daydreaming was real. They revealed that the brain's reward center lit up during moments of immersive daydreaming "much like it does in the brains of heroin addicts when they see pictures of drugs," Bigelson says.
Bigelson also collaborated with Somer on research and wrote about her disorder in 2015 for The Atlantic to help raise awareness and let others with MD know they are not alone.
Is Maladaptive Daydreaming a Mental Disorder?
Researchers who have extensively studied maladaptive daydreaming believe there is "ample scientific evidence that MD is a reliable mental condition that cannot be explained by any existing psychiatric condition," Somer says.
But because the construct of maladaptive disorder is still somewhat new, it is not listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, also referred to as the DSM-5. The manual, published by the American Psychiatric Association, provides information or guidelines for assessing, diagnosis and treating mental disorders.
Nor is it among the International Statistical Classification of Diseases and Related Health Problems (ICD), the global standard for health data, clinical documentation and statistical aggregation.
What Are the Symptoms of Maladaptive Daydreaming?
According to Somer, individuals who meet diagnostic criteria A, B and C could be classified as having a "daydreaming disorder," or "maladaptive daydreaming:"
A. Persistent and recurrent fantasy activity that is vivid and fanciful as indicated by the individual exhibiting two (or more) of the following in a six-month period. At least one of these should include criterion (1):
- While daydreaming, experiences an intense sense of absorption/immersion that includes visual, auditory or affective properties.
- Daydreaming is triggered, maintained, or enhanced with exposure to music.
- Daydreaming is triggered, maintained, or enhanced with exposure to stereotypical movement (e.g., pacing, rocking, hand movements).
- Often daydreams when feels distressed, or bored.
- Daydreaming intensity and length intensify in the absence of others (e.g., daydreams more when alone).
- Is annoyed when unable to daydream or when daydreaming is interrupted or curbed.
- Would rather daydream than engage in daily chores, social, academic or professional activities.
- Has made repeated unsuccessful efforts to control, cut back or stop daydreaming.
B. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The disturbance is not due to the direct physiological effects of a substance or a general medical condition and is not better explained by another disorder.
While not a diagnosing criterion, maladaptive disorder also seems more prevalent in people with certain mental health conditions such as attention deficit hyperactivity disorder (ADHD), OCD spectrum disorders, autism spectrum disorder and social anxiety.
How Is Maladaptive Daydreaming Treated?
It is important to note that extreme and immersive daydreaming, in children or adults, may not need to be treated, especially if it isn't interfering in the daydreamer's life or causing them distress.
For those who want to better control their fantasy life, Somer recommends:
- Seeking help from a mental health professional specialized in treating habits and behavioral addictions.
- Keeping a daily diary of your MD can give you better awareness of your daydreaming and may lead to better control and reduction.
- Meditating or mindful training may help provide the necessary skill for staying present in external reality.
Bigelson's case study also identified fluvoxamine as a possible pharmaceutical option. But because MD is not considered a mental disorder, there are no medications specifically for excessive daydreaming.