Mental Health & ADHD Comorbidities

Demystify Maladaptive Daydreaming with These 6 Q&As

How prevalent is maladaptive daydreaming? Is it a trauma response? What are the potential treatment options? How is it different from ADHD hyperfocus? Learn more about this daydreaming disorder with the help of ADDitude editors, below.

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Maladaptive daydreaming (MD) is a disorder characterized by immersive daydreams that can last for hours at a time. Though not formally recognized in the DSM-5, this daydreaming disorder is quickly gaining research and recognition. Following a recent ADHD Experts webinar titled “Maladaptive Daydreaming vs. ADHD: Important Similarities and Distinctive Differences,” we received hundreds of questions from listeners eager to learn more. ADDitude editors answer some of the most common questions below — with links to relevant resources.

Q1: What is the difference between dissociation and MD?

Dissociation describes the disconnect between mind, body, memories, and physical surroundings. It is often observed as a result of stress or complex trauma. Individuals experiencing dissociation may lose track of time, experience flashbacks, and feel detached from themselves and reality.

MD involves high levels of dissociation but also the indulgence of vivid, elaborate fantasies that are not found through dissociation alone. These narrative fantasies can last for hours and may involve fictional characters and strong emotional attachments.

Q2: Is MD a trauma response?

Some people experience MD as a coping response to trauma and abuse, but not all. Researchers believe that MD may be caused by an innate ability to conjure immersive daydreaming that becomes addictive in nature. Coupled with a history of traumatic stress, social anxiety, difficult childhoods, or attachment issues, daydreaming can become a form of escapism and problematic for the individual. MD is often seen in individuals with depression, anxiety, ADHD, or OCD.

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Q3: How significant is the overlap between ADHD and MD?

Approximately 77% of maladaptive daydreamers will meet clinical criteria for the inattentive subtype of ADHD.1 According to a recent study, however, only 20% of adults with ADHD met the criteria for MD.2 These findings suggest that MD is a distinct disorder separate from ADHD and may be a diagnosis better suited for some individuals presenting with attention deficits.

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Q4: How prevalent is maladaptive daydreaming among autistic people?

Research has established a connection between MD and ASD, but the cause is still unclear. Difficulties with social interactions, emotional regulation, and repetitive movement (“stimming”) are common traits found in both conditions. In a study of autistic adults, the level of ASD traits significantly predicted MD symptoms.3 Loneliness and difficulties with emotional regulation, though not exclusive to ASD, may contribute to higher levels of daydreaming.

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Q5: Do the treatments for MD and ADHD differ?

Stimulant medications — used to target focus and attention for those with ADHD — have been found to worsen symptoms for some maladaptive daydreamers by enhancing their focus on daydreams. Suggested treatments for MD include psychotherapy, cognitive behavioral techniques, mindfulness training, and certain pharmaceuticals such as SSRIs.

Q6: How do I find out more about MD?

Follow Dr. Nirit Soffer-Dudek’s work by visiting The Consciousness and Psychopathology Laboratory online. Explore additional communities, creators, research updates, and studies open for participation on the Maladaptive Daydreaming Center website and r/MaladaptiveDreaming on Reddit.

The content for this article was based on questions submitted by live attendees during the ADDitude ADHD Experts webinar titled, “Maladaptive Daydreaming vs. ADHD: Important Similarities and Distinctive Differences” [Video Replay & Podcast #412] with Nirit Soffer-Dudek, Ph.D., which was broadcast live on July 20, 2022.

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View Article Sources

1Somer E., Soffer-Dudek N., Ross C.A.. (July 2017). The Comorbidity of Daydreaming Disorder (Maladaptive Daydreaming). J Nerv Ment Dis. 205(7):525-530. doi: 10.1097/NMD.0000000000000685. PMID: 28598955.

2Theodor-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

3West, M., Somer, E., & Eigsti, I. M. (June 2020). The association between autism traits and maladaptive daydreaming. Poster presented at the International Society for Autism Research 2020 Virtual Meeting.