It’s a tempting thought isn’t it? If you’re suffering from maladaptive daydreaming disorder, you probably have days when you wish you could just take a pill and make it all go away. After all, there are pills for other mental health conditions, such as anxiety and depression, so why not maladaptive daydreaming?
Unfortunately, there’s very little published research on the use of medication to treat maladaptive daydreaming disorder. In 2020, Ross et al. asked self-identified maladaptive daydreamers whether the medication they were taking for other conditions affected their daydreaming. The results were remarkably inconclusive. Over half the people surveyed said that their medication had had no effect on their daydreaming; about a third noticed a slight change, and only about 10% reported a significant change. Of the people reporting a change, some had noticed a decrease in their daydreaming, but others had noticed an increase.
Given that three-quarters of maladaptive daydreamers have ADHD and two-thirds have depression, it’s not surprising that stimulants and antidepressants are frequently taken by maladaptive daydreamers. Anecdotal evidence suggests that antidepressants may have a small beneficial effect on maladaptive daydreaming in some daydreamers. I have personally taken three different antidepressants over the course of my life and none of them affected my daydreaming at all. But some people do notice an effect. Is that because there are different types of maladaptive daydreaming, and antidepressants help some but not all? Is it because some daydreamers are able to control their daydreaming once their underlying depression has been treated? Is it a placebo effect? We just don’t know.
Stimulants are another category of medication where more research is needed. Oddly, in Ross et al.’s study, only about 10% of participants reported taking stimulants, which seems low given how many maladaptive daydreamers have ADHD. The small numbers mean that the researchers were unable to draw any conclusions about the effect of stimulant medication on maladaptive daydreaming. Anecdotally, however, some daydreamers report that it helps. Stimulants improve focus in people with ADHD, so it seems reasonable that stimulant medication could make it easier for ADHDers to control their daydreaming. On the other hand, some people report that stimulants make it easier to focus on the daydreams, thereby making maladaptive daydreaming worse.
If you’re using maladaptive daydreaming to cope with, or escape from, some other mental health problem, using medication to treat that other problem might make it easier to control your daydreaming. But that isn’t the same as saying the medication helps your maladaptive daydreaming. The medication helps with your depression, your anxiety, your ADHD or whatever you’re managing, and as a result, it frees up space in your head for you to manage your daydreaming.
In general, I’m sceptical about the use of medication in maladaptive daydreaming. For many of us, maladaptive daydreaming is an unhealthy coping mechanism – it’s the way we run away from some bigger problem. An unhealthy coping mechanism is unhealthy because it does nothing to solve the underlying problem; it just allows us to manage the pain associated with that problem. Medication often does the same thing. I have taken antidepressants several times in my life. They have their place in lifting someone out of the deep pit of depression. But they aren’t the whole story. My experience with depression is that antidepressants get you to a place where you can do the work necessary to overcome the depression. That work usually involves brutally honest self-reflection and a deep commitment to healing, often in the safe environment of therapy. Antidepressants may kick-start the process, but meaningful recovery comes from the inside. I suspect maladaptive daydreaming is the same. Even if there was a medication that reliably gave people more control over their daydreams, it wouldn’t be enough on its own. It’s up to each of us to figure out what healthy daydreaming looks like for us, and then to structure our lives in such a way that that healthy daydreaming becomes achievable. It’s a long and difficult process and there are no short cuts.
Like it or not, daydreaming is a part of who we are. It’s not something we can or should try to medicate away. Even if your daydreaming has become maladaptive, it isn’t a symptom that needs be controlled; it’s a signal that some deeper problem needs addressing. If you’re one of the few daydreamers who finds that a stimulant or an antidepressant makes it harder for you to daydream, then by all means use medication to help you focus on solving your real-life problems. But don’t expect medication to be the whole solution. And if you’re like me and medication doesn’t seem to affect your daydreaming one way or the other, don’t despair. Overcoming maladaptive daydreaming isn’t about popping pills, it’s about investing time and effort in improving real life. And although it’s hard, that’s something all of us have the ability to do.