The 16-item Maladaptive Daydreaming Scale (MDS-16) developed by Eli Somer, Jayne Bigelsen, Jonathan Lehrfeld & Daniela Jopp in 2016 could be helpful as an initial screening tool.

The measure was translated into many languages and can be accessed here. Although those who score above an average of 40 are most likely to meet the diagnostic criteria for MD, a clinician-administered interview is still necessary to confirm a definite diagnosis. This is because the problem may be more complex than what this self-report scale can evaluate.

For example, MD could serve as a "self-medication" for a separate underlying condition that should be properly assessed and treated.  Moreover, other psychological problems could co-exist with MD, and they too must be assessed and treated.

If your score indicates probable MD,  we strongly recommend you discuss your symptoms and concerns with a qualified mental health professional who specializes in dissociative disorders or behavioral addictions. If they are unfamiliar with MD, we suggest you refer them to the website of the International Consortium for Maladaptive Daydreaming Research. The website offers a wealth of information on the disorder, including research publications and assessment tools.

Recent publications in the field suggest that the innate capacity for immersive daydreaming (ID) is a critical factor in MD development.*

This ability enables some people to experience their fantasies more vividly and intensely than others. Although most individuals capable of ID report it as highly rewarding, ID can also potentially be addictive. In these cases, vicious cycles are often generated. The time wasted in fantasy becomes a source of distress and impairment, the pain of which is regulated with more daydreaming.

It is important to note that not everyone with ID develops MD; some people enjoy their ability to fantasize vividly without losing control over this mental behavior.

You may have read in various internet communities that childhood trauma is a cause of MD.  However, most people with MD do not report childhood trauma. Still, research evidence shows that MD is more likely to occur among survivors of childhood neglect and abuse.

* 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

As the increasing number of help seekers show, maladaptive daydreaming can cause a significant decrease in the quality of life.

The neglect of needs and responsibilities often lead to issues in daily functioning. In addition to social isolation, the contrast between imagination and reality can exacerbate problems with identity and self-confidence. Lack of motivation for real life and severe despair inevitably lead to depression.

Comorbidities can also cause a variety of other problems that cannot be counted here. In recent studies, 28.2 percent of those with maladaptive imagination, reported a history of suicide. *

Although this information calls for attention from MDers and parents who suspect that their child has MD, 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 the research in question 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

Yes. As case studies, controlled research, and expert opinions suggest, improved control of MD is possible.

One of the most desirable recovery goals is to eliminate the maladaptive aspects of immersive daydreaming. That is, the elements that negatively affect a person's mood and their perception of identity and reality. This takes time, motivation, and deep understanding of your MD functions and patterns. For many, the end goal is the freedom to use immersive daydreaming as a means for creativity enhancement, problem solving and constructive mood regulation. People who have reached this stage can discard the descriptor maladaptive and enjoy their immersive daydreaming.

First, consider joining one of the many online MD communities for peer advice and support to find more answers from others who cope with MD. There are many such communities on Facebook and elsewhere. Belonging to a community of individuals who know what you are dealing with could provide you with tips and encouragement on your journey to recovery.

If you wish to better control your fantasy life, you could seek help from a mental health professional specializing in treating habits and behavioral addictions. Careful monitoring of your MD by keeping a daily diary will help you gain awareness and better control of this activity. Drafting several self-statements on the merits of your efforts to control MD and the costs of not changing this behavior could provide you with the motivation boost needed to give up this addictive activity.

Mindfulness training could also be beneficial.

Needless to say, if your MD is a sort of “self-medication” for other underlying issues, they, too, need to be addressed to ensure the sustainability of your gains.

When people try to go cold turkey, many report a rising depression. Trying to stop MD without addressing those issues is the same as yanking away the crutches under someone with a severe orthopedic problem and expecting them to walk unaided.

Yes. Based on Eli Somer's original observation of MD among his trauma patients, MD was initially thought to be a dissociative disorder related to childhood trauma.

However, subsequent research has shown that while victims of childhood trauma may have a higher risk for MD, many people with MD do not have childhood trauma.

To the best of our knowledge, there is currently only one long-term research study on MD.

That study showed that MD was stable across one year, as there was a high correlation between individuals’ score at Time 1 with that of Time 2, suggesting that on average, MD does not tend to dissipate or drastically change in that time period.

Additionally, that study showed that MD predicted a small increase over time in psychopathological distress (symptoms of anxiety and depression). However, this should not be taken to mean that MD cannot be dealt with.

When MD is not accompanied by severe comorbid psychopathology, self-generated efforts to control the problem are probably more likely to succeed.

If painful comorbid disorders are prevalent and adaptive coping skills are underdeveloped, giving up MD as a method of distress regulation might be difficult. In such cases, spontaneous recovery is less likely, and seeking professional help is highly recommended.

No, MD does not generally evolve into schizophrenia. However, there may be cases of schizophrenia occurring independently of and in addition to MD.

Unlike psychotic hallucinations that are often brief and simple, MD fantasies are rich and elaborate. Additionally, one of the most important features of MD is that individuals can distinguish between reality and fantasy.

MDers are in control of their fantasies and can stop daydreaming if external reality demands it. Many people with schizophrenia do not have the same insight or control of their schizophrenia.

Most of the suffering reported by people with MD is related to the distress caused by their daydreaming and the painful contrast between the idealized fantasy and the more dreary reality.

Mental health professionals use a diagnostic book called Diagnostic and Statistical Manual of Mental Disorders (DSM) to categorize the problems of their patients. Currently the DSM is on its fifth edition (DSM-5). This book is revised over the years when deemed necessary such that 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. Only when publications about MD were noticed by the right people did those seeking help begin to raise their voices. It has not been long since this demand triggered serious research on the subject. Since MD has not been included in the diagnostics book yet, it is not generally taught in the relevant departments of universities. As a result, most mental health professionals are uninformed about the subject.

Currently, research on maladaptive daydreaming is at its infancy. Despite this, we can say that a serious accumulation of knowledge has been achieved already, both about its mechanisms and dynamics, and about the potential treatment methods. At this stage, the only thing that can be done is to increase awareness, and to contribute to research when possible. The interest and recognition by mental health professionals will follow.

Research on this subject is still very limited. One published case study of a patient with OCD and MD reported the successful outcome of medical treatment with an SSRI. Another study suggested that SSRIs might offer some relief to certain individuals with MD.

Although ADHD is highly comorbid with MD, no evidence shows stimulants prescribed for ADHD, such as Ritalin, improve the control of MD. Unfortunately, no medication to date is known to help people with MD reliably.

Please note that one study suggested the use of marijuana may be associated with elevated MD.

Childhood fantasy is normal and prevalent. Although most MD cases begin in childhood, most imaginative children do not develop MD.

Still, paying attention to your child's stereotypical movements and the possible tendency to spend hours lost in their mind is important, as this could be a sign of developing MD. It may be helpful to encourage your children to keep open, non-judgmental communication with you about their emotional life and daydreams. If you suspect your child has MD, you should consult with a pediatric mental health professional.

But bear in mind that you may have to educate the mental health professional about MD. The International Consortium for Maladaptive Daydreaming Research (ICMDR)  website is an excellent, reliable source.

Because children have less responsibilities and their needs are generally met by their parents, they may not experience situations in which excessive daydreaming conflicts with their daily needs and functioning. Thus, the fact that their intense daydreaming has not yet negatively affected their lives may result in a lack of motivation to improve the situation.

If the act of daydreaming doesn’t pose a serious problem to them or their other activities, your child may not be suffering from a psychopathology (and it might never turn into a psychopathology). In these cases, keep observing your child with open communication. There is no need to prevent daydreaming behavior, or be a facilitator by easing your child's responsibilities and your expectations from them. In essence, behave as you would as if your child wanted to watch TV or play on the computer for more than what is good for them.

However, if your child's daydreaming behavior has a serious negative impact on their life, this is a problem regardless of whether or not they choose to take it seriously. In this case, turn to expert help. It may be wise to focus on motivational therapies to start. Your child's collaboration is vital to treatment. Therefore, if your child is resistant, you will not get immediate results. Despite this, it is important to get connected to a professional so that they are available when your child is ready for the next steps of treatment.