ADHD Comorbidities & Related Conditions

Maladaptive Daydreaming vs. Inattentive ADHD: Comparing Symptoms, Treatments

Maladaptive daydreaming — and its core symptom of distracted hyperfocus — is easily mistaken for inattentive ADHD, resulting in incorrect diagnoses and treatment. Learn how to differentiate the two disorders.

Individuals with inattentive ADHD (a subtype of attention deficit hyperactivity disorder) are often called “daydreamers” and chided for getting lost in their thoughts. But sometimes a wandering ADHD mind is mistaken for maladaptive daydreaming (MD), a condition that involves a different form of inattention.

What Is Maladaptive Daydreaming?

People with maladaptive daydreaming have intentional, vivid, all-consuming daydreams that interfere with their daily functioning. Individuals with inattentive ADHD have trouble sustaining focus; they are easily distracted and forgetful. Because symptoms of inattentive ADHD and maladaptive daydreaming overlap, some patients may receive incorrect diagnoses, according to a study published in the Journal of Clinical Psychology.1

The study found that 21% of 83 participants with ADHD diagnoses also met the diagnostic criteria for MD. “In some cases [of people] presenting with ADHD symptoms, maladaptive daydreaming may better explain the clinical picture” than would an ADHD diagnosis, the study suggested, adding that improper diagnosis may have serious treatment implications.1

Maladaptive Daydreaming vs. Inattentive ADHD

People with inattentive ADHD and MD share these symptoms:

  • They get disproportionately upset by interruptions.
  • They are easily distracted and seem unaware of their surroundings.
  • They have trouble sleeping.

Below are more key similarities — and differences — between inattentive ADHD and maladaptive daydreaming.

Controlled Fantasy vs. Wandering Thoughts

Maladaptive Daydreaming: By engaging in purposeful, consuming daydreaming that lasts for hours on end, some individuals choose to become immersed and lost in their inner fantasy worlds. Many maladaptive daydreamers become addicted to the alternative realities they’ve created.

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Inattentive ADHD: Mind wandering with ADHD is unintentional, scattered, and often allows for jumping from one idea or scenario to another.

Dissociation vs. Hyperfocus

Maladaptive Daydreaming: Dissociation means deliberately detaching from one’s surroundings and body to avoid experiencing them. The dissociative nature of MD can result in neglecting short- and long-term responsibilities.

Inattentive ADHD: In hyperfocus, individuals with ADHD become intensely focused on an interest or activity for hours at a time. This can look like dissociation and cause detachment from one’s surroundings. However, hyperfocus is usually prompted by external stimuli, such as a computer game or a new interest, and it is usually spontaneous and uncontrolled.

Maladaptive Daydreaming Treatment vs. ADHD Treatment

Maladaptive Daydreaming: Some maladaptive daydreamers in the study reported their condition worsened with stimulant medications due to “enhanced focus” on the fantasies.

“The notion that maladaptive daydreaming causes ADHD-like symptoms, as a secondary effect, leads to the conclusion that addressing the addiction to daydream first would be reasonable,” wrote study co-author Nirit Soffer-Dudek, Ph.D., a senior psychology lecturer at Ben-Gurion University of the Negev, in Israel. She called for future studies to explore whether MD should be considered a mental health disorder.

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Inattentive ADHD: ADHD-related mind wandering is manageable with stimulants and other medications that target focus and attention.

Overlapping Symptoms of Depression, Loneliness, and Low Self-Esteem

Maladaptive Daydreaming: Emotional distress may underlie MD, according to the research. “We do not yet have long-term longitudinal data on risk factors for maladaptive daydreaming, but there are definitely correlations with social anxiety. Many people with maladaptive daydreaming have described how it helps them escape from a harsh reality, [such as] trauma, depression, anxiety, and social anxiety,” wrote Soffer-Dudek.

Inattentive ADHD: People with both ADHD and MD were more likely to suffer from depression, loneliness, and low self-esteem, the study found. ADHD is more commonly a genetic condition and is not thought to be a direct result of trauma.

The study describes maladaptive daydreaming as an “independent mental phenomenon,” which often creates an attention deficit as a side effect. “This causes some MDers to meet the criteria for ADHD, but not necessarily vice versa.”

Maladaptive Daydreaming vs. Inattentive ADHD: Next Steps

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View Article Sources

1 Theodor-Katz, N., Somer E., Hesseg R.M., Soffer-Dudek, N. (2022). Could immersive daydreaming underlie a deficit in attention? The prevalence and characteristics of maladaptive daydreaming in individuals with attention-deficit/hyperactivity disorder. Journal of Clinical Psychology. 1002/jclp.23355

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