September is Suicide Prevention Month, and we’re taking a look at the complicated relationship between maladaptive daydreaming and suicide risk.
By Catherine Cornell
At age thirteen, I stood in the basement dressing room of a theatre and listed the reasons I needed to live. The room was empty. The cast rehearsed upstairs, and my one friend abandoned me for an older, cooler cohort. But I wasn’t alone. A young man stood with me. I danced between images of my tear-streaked face in the mirror and him and me in a fantastic world, encouraging each other and skirting death together.
On a Tuesday morning in October 2021, Kyla couldn’t log on to work, not because of faulty software but the overwhelm of life and obligations. She didn’t want to die, but she couldn’t see any way of living. So, she called a doctor, took leave from work and family, and started on an uncertain journey with two friends who loved her unconditionally. Through the otherworld inside her, they guided her to the love and strength that had always been deep within.
The relationship between maladaptive daydreaming (MD) and suicide is a complicated one. In some ways, daydreaming may have helped Kyla, me, and others stave off the worst. But in other ways, it may have contributed to us finding ourselves in those places to begin with.
Worldwide, more than 700,000 people die from suicide each year, and it’s estimated that for each of those people, there are 20 more who attempt it. It’s concerning, then, that evidence suggests attempt rates double in people who experience MD. To understand this connection better, let’s examine some of the research and associated conditions.
Maladaptive daydreaming and increased suicide rates
In 2017, a study by Eli Somer and colleagues looked at comorbidities—or co-occurring conditions—with maladaptive daydreaming. It found that more than a quarter of the maladaptive daydreaming participants had attempted suicide at least once.
More recently, a 2024 study by Nirit Soffer-Dudek and Hans Oh found that almost twice as many suspected MD participants had considered suicide compared to non-daydreaming participants (about 45% versus 25%). Even more concerningly, over double (27%) had attempted it compared to non-daydreamers (12.8%).
To put this another way, an estimated 2.7% of all people attempt suicide in their lifetime. With that in mind, in a room of ten random people, it’s unlikely that any of them have attempted to take their life. However, in a room of ten maladaptive daydreamers, it’s likely that at least two of them have.
Why the increased rates?
Scientifically speaking, more research is needed to make conclusions about why and how MD is linked with suicide.
However, the 2024 study offers that MD could lead to thoughts of suicide because of the increased loneliness, shame, and difficulty achieving life goals that are faced. Alternatively, suicidal feelings could lead one to maladaptive daydreaming as a means of coping and escape. It could even be that they are unrelated but co-occur because of other difficulties in a person’s life.
Going back to Somer’s 2017 study, we know those other difficulties might include ADHD, OCD, anxiety, depression, and unemployment (over 40% of participants were unemployed). ADHD is shown to lead to greater suicide risk in adults. OCD is also linked to higher risk. Anxiety disorders, particularly PTSD and panic disorder, are related. And according to one study, suicide risk is more than 16 times greater for those who are unemployed for more than six months.
Depression and mental pain may be the most widely discussed links to suicide. They’re significant predictors, but it’s still important to remember that a complex web of factors contributes to any one person’s likelihood of having suicidal thoughts or taking action. Genetics, life experiences, social aspects, and physical and mental conditions all play roles.
Whatever the connections are between maladaptive daydreaming and suicide, it is clear that identifying if a person struggles with MD can help identify if they’re at risk of more. Soffer-Dudek and Oh’s study advocates for MD assessment as additional screening criteria for suicide risk because the more markers that exist, the more opportunities we have to intervene.
What can we do with all this information?
We can talk about it.
Struggling with MD doesn’t mean a person is suicidal, but it does mean they’re struggling, and that can lead to feelings of helplessness. And, when many people feel that talking about “it” may somehow bring “it” closer, a cycle of silence and isolation forms.
One way to counteract that is to let people know there’s non-judgmental help. Anyone can aid in that effort by talking about suicide openly as a health condition rather than a taboo that can only be whispered.
Most countries (even ones where suicide is still a crime) have national hotlines for mental health support. And, if you feel as though talking openly still isn’t an option, simply calling a friend to chat about the weather may help.
If Kyla and I had been able to talk about our struggles more openly before we found ourselves in crisis, our stories might not have played out in hospitals or damp theatre basements. If we had been able to talk about maladaptive daydreaming earlier, our entire lives might have been different.
If you find yourself somewhere similar, know there’s help, and you’re not alone.
Resources
There are many resources for immediate support and long-term wellness. Here are a few we’ve collected.
International Helplines
FindAHelpline.com
A database of international helplines.
HelpGuide.org
Similar to Find A Helpline, but they also have information on mental health, family and relationships, aging, and meditation.
Befrienders Worldwide
They also have resources for how to help yourself and others.
Other resources, no matter where you live
7Cups
7 Cups helps connect people to caring listeners for free emotional support, 24/7. They also provide a group support chat, advice written by experts, and online therapy.
The Trevor Project
The Trevor Project focuses on suicide prevention for LGBTQ+ youth. They also have resources that are helpful for anyone, anywhere. The helplines are for people in the United States. If you’re not ready to talk, not LGBTQ+, or are accessing the site from outside the US, there is a quick calming exercise further down the page.
Trevor Space
A safe, international, online community for LGBTQ+ people aged 13-24
Apps
Moodfit
A free mobile app with evidence-based trackers and tools to help you understand what affects your mood and how to improve it over time.
Happify
A free mobile app with games and activities that use science-driven techniques to help reduce stress and negative thoughts.