The world of mental health is complex and ever-evolving, with new research constantly shedding light on different conditions and their interconnections. One such area of study is the relationship between attention deficit hyperactivity disorder (ADHD) and maladaptive daydreaming (MD).

ADHD is a common neurodevelopmental disorder comprising three main symptoms: inattention, hyperactivity, and impulsivity. Maladaptive daydreaming, on the other hand, is a recently recognized psychological concept characterized by excessive, immersive daydreaming. Furthermore, it’s not currently recognized as an official diagnosis, unlike ADHD.

However, a recent study found that 20.5% of people with ADHD also display the main symptoms of maladaptive daydreaming, suggesting a significant overlap between the two. This overlap raises important questions about the nature of ADHD and MD, and the connection between them.

One implication is that some individuals may be misdiagnosed with ADHD, or that their difficulties may be more complex than initially thought.

Let’s have a look at ADHD and maladaptive dreaming, including:

1. ADHD and maladaptive daydreaming similarities

2. ADHD and maladaptive daydreaming differences

3. The potential implications for diagnosis and treatment

What Is Maladaptive Daydreaming?

Maladaptive daydreaming is a mental health issue where a person daydreams excessively, sometimes for hours. The term "maladaptive" indicates that this form of daydreaming is an unhealthy attempt to cope with or adapt to a problem.

For instance, imagine someone spends half of the day daydreaming about traveling through a fictional universe and forgets to study for their exams or run errands – this would be considered maladaptive.

This condition is not merely musing but a persistent and extreme form of daydreaming that can dominate one's life. It's like being trapped in a dream world, where the boundary between imagination and reality becomes blurred.

This form of daydreaming can also be seen as a special case of spontaneous thought. Spontaneous thought is more restrained than dreaming, granting us more control, yet less restricted than creative thinking and goal-oriented thought, making it less focused and purposeful.

When we're caught in a cycle of maladaptive daydreaming, we're not fully in control of our thoughts, but we're also not letting them run wild. This middle ground can be confusing and distressing, leading to feelings of being trapped in a dream-like state.

Who Is Most Prone to Maladaptive Daydreaming?

Certain conditions and experiences may make individuals more susceptible to maladaptive daydreaming, including:

• OCD: Individuals with obsessive-compulsive disorder (OCD) may be susceptible to maladaptive daydreaming since both conditions involve compulsive behaviors or thoughts that are difficult to control.

• A history of childhood trauma: Individuals who have experienced trauma in their early years may be more prone to maladaptive daydreaming, as creating an imaginary inner world can distract and protect these individuals from their painful early memories. They may also use maladaptive daydreaming as a coping strategy, as evidence shows it can feel empowering and soothing.

• ADHD: Individuals with ADHD may struggle with focusing, following instructions, and completing tasks, which could make them more susceptible to maladaptive daydreaming. One explanation for the high comorbidity rates of ADHD in MD samples is the blurred boundaries between the concept of daydreaming and closely related concepts, such as distraction, mind wandering (MW), and absorption and imaginative involvement. This overlap can make distinguishing between maladaptive daydreaming and ADHD challenging.

• Anxiety and Depression: Recent research shows that individuals with anxiety and depression may be more likely to experience maladaptive daydreaming.

• Past suicide attempts: Emerging research suggests a possible connection between maladaptive daydreaming and a higher incidence of suicidal attempts, indicating a need for further investigation into the underlying mechanisms and potential intervention strategies. Experts suggest that this potential link may be present because people with clinical-level maladaptive daydreaming are typically in a state of extreme distress. Therefore, these individuals may use excessive daydreaming as a coping mechanism to distract from and escape this distress. Furthermore, excessive daydreaming often occurs in tandem with psychopathological disorders like anxiety, depression, and obsessive-compulsive disorder. These individuals are also more prone to experience maladaptive daydreaming as a coping mechanism.

Maladaptive Daydreaming vs. Occasional Daydreaming

Both occasional and maladaptive daydreaming can involve long periods of daydreaming. However, the two differ in terms of their frequency, intensity, and impact on daily functioning. For example, maladaptive daydreaming can get in the way of someone completing daily activities, and can also have detrimental effects on their relationships and overall functioning.

Furthermore, maladaptive daydreaming is also commonly accompanied by a diminished ability to differentiate between what’s real and what’s a fantasy, which can cause significant distress and impairment in various areas of someone’s life.

What’s the Connection Between Maladaptive Daydreaming and ADHD?

People with ADHD often struggle to focus, stay organized, and complete tasks. They may also be impulsive and/or hyperactive, which can cause them to struggle in social and academic settings.

Since both ADHD and maladaptive daydreaming can involve difficulty focusing, distractibility, and a tendency to get lost in thoughts or daydreams, the symptoms of these two conditions can overlap, leading to confusion when it comes to deciphering between the two.

Similarities between the symptoms of Maladaptive Daydreaming and ADHD

• Excessive daydreaming: Both individuals with maladaptive daydreaming and ADHD tend to experience excessive daydreaming, often for hours at a time. This can lead to a disconnection from reality and difficulty focusing on the task at hand.

• Difficulty focusing: People with both conditions often struggle with focusing their attention on one thing at a time. Those with ADHD often report that random thoughts, worries, and ruminations pop into their heads, making it difficult to focus. Whereas, for those with MD, spontaneously daydreaming often gets in the way of focusing on one thing at a time. Explore: 4 Mindfulness Exercises to Sharpen Your Focus and Increase Your Attention Span.

• Overactivity: Both ADHD and maladaptive daydreaming can lead to overactivity, either physically (in the case of ADHD) or mentally (in the case of maladaptive daydreaming). For example, someone with ADHD may fidget, squirm, and find it difficult to sit still due to overactivity. Those with maladaptive daydreaming may experience mental overactivity as daydreaming, which can trigger the reward-related areas of the brain. As people can spend hours of the day in an excessive daydreaming state, this can cause continual brain reward responses. Hence, both involve some form of overactivity.

• Impulsivity: Individuals with both conditions may act on a whim, often without considering the consequences. For example, someone with ADHD may interrupt others during conversations, as they may struggle to wait their turn to speak. In the case of maladaptive daydreaming, evidence suggests that people who experience frequent daydreaming may struggle more to control their behaviors, which is closely associated with impulsivity. As a result, people with maladaptive daydreaming may find it difficult to prioritize tasks like chores over the rewarding feeling of daydreaming.

• High fantasy proneness: ADHD and fantasizing commonly co-occur, as do fantasizing and MD. Typically, individuals with both conditions often exhibit high fantasy proneness, a personality trait characterized by a tendency to withdraw from reality.

Differences between Maladaptive Daydreaming and ADHD

Approximately 20.5% of people with ADHD also report symptoms of maladaptive daydreaming. This suggests a significant overlap and confusion when it comes to identifying whether the difficulties relate to ADHD or MD. It also highlights the need for further research into the relationship between ADHD and maladaptive daydreaming.

• Immersive vs. Disorganized Daydreaming: Individuals with maladaptive daydreaming describe their daydreams as very real, vivid, and immersive. On the other hand, people with ADHD may have more disorganized daydreaming, often jumping from one thought to another.

• Compulsive Daydreaming vs. Hyperactivity and Impulsiveness: While both conditions involve heightened activity, compulsive daydreaming revolves around internal mental activity, while hyperactivity with impulsiveness manifests as visible physical restlessness as well as impulsive actions, and it’s typical for ADHD.

• Escapism vs. Attention Deficit: Maladaptive daydreaming is often used as a form of escapism, to withdraw from reality and create a more satisfying imaginary world. ADHD, on the other hand, is characterized by an attention deficit, with individuals often struggling to focus, follow instructions, and complete tasks.

Maladaptive Daydreaming vs. Inattentive ADHD

Inattentive ADHD is a subtype of ADHD characterized by difficulty sustaining attention and a tendency to daydream.

While both maladaptive daydreaming and inattentive ADHD involve issues with attention and focus, they are distinct phenomena with unique characteristics. In fact, many adults may meet the criteria for ADHD when the underlying problem may actually be MD. This is because, in maladaptive daydreaming, attention deficit is secondary to their core challenge of becoming addicted to their immersive, fanciful daydreaming.

It's crucial to note that only a medical or mental health professional can determine the source of your symptoms. It's important not to self-diagnose based on information read online or in articles. If you or someone you know is struggling with symptoms of ADHD or maladaptive daydreaming, it's essential to seek professional help.

Ways to Manage Maladaptive Daydreaming and ADHD

Managing maladaptive daydreaming and ADHD often involves a combination of treatments, such as cognitive behavioural therapy (CBT), medication, and therapy support groups.

An additional evidence-based therapy is neurofeedback. Neurofeedback is a non-invasive method for alleviating symptoms of various neurodevelopmental conditions, including ADHD. But how does it work?

Inside the intricate workings of our brains, there are ongoing patterns of electrical activity, known as brainwaves. These are closely tied to the different states of consciousness: attentiveness, relaxation, and sleep. Our brainwaves serve as indicators of our tiredness and focus levels, and our overall state of relaxation.

When testing the brainwaves of those with ADHD, experts observe specific patterns of brainwave activity. For instance, people with ADHD often have more theta activity (slow, drowsy, mind-wandering state) and less beta activity (fast, focused, problem-solving state) than usual.

Fortunately, our brains have a remarkable capacity to change, adapt, and learn from experiences, known as neuroplasticity. This enables us to rewire our brains and transform the dysregulated brainwave patterns associated with ADHD. Neurofeedback harnesses neuroplasticity to help change brain activity and alleviate symptoms of conditions such as ADHD.

In the past, brain training neurofeedback was only available in specialized clinics and, more often than not, those clinics were hard to come by. Nowadays, you can train from anywhere in the world while your neurofeedback therapist monitors your progress remotely.

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Conclusion

Although maladaptive daydreaming is not officially recognized as a formal psychiatric syndrome by the Diagnostic and Statistical Manual of Mental Disorders, in some cases, it may provide a more accurate conceptualization of one’s symptoms than ADHD. However, only a trained medical or mental health professional can determine the source of these symptoms and recommend ways to cope.

Therefore, if you or someone you know is experiencing symptoms of either ADHD or MD, it's important to seek professional help.

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