Diagnosing Maladaptive Daydreaming Disorder – Part 1

Maladaptive Daydreaming Disorder (MaDD) is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the American Psychiatric Association’s standard classification of mental disorders. As such, it is not recognised by the majority of mental health professionals. It is very possible that as more research is done into MaDD this situation will change. However, for the moment, the reality is that the condition is not widely known or understood.

However, Professor Eli Somer of the International Consortium for Maladaptive Daydreaming Research (ICMDR) and the University of Haifa has done a significant amount of research into MaDD and has developed two questionnaires that have been used in scientific studies to identify people with MaDD. The more widely used, the 16-Item Maladaptive Daydreaming Scale (MDS-16), is available in a range of languages on the ICMDR website. It consists of 16 questions, and you rate your answer for each question on a scale from 0 to 100. The overall score is the average of the 16 answers and can therefore range from 0 to 100. A score of 50 or more means that you would probably be classified as having MaDD.

Some of the questions ask about the addictive nature of daydreaming (e.g. “How distressed do you currently feel about the amount of time you spend daydreaming?” and “How difficult has it been for you to keep your daydreaming under control?”). These questions should distinguish maladaptive daydreamers, who will be likely to rate these items highly, from immersive daydreamers, who may score much lower on these questions.

Some of the questions ask about how enjoyable the daydreaming experience is (e.g. “To what extent would you rather daydream than engage with other people or participate in social activities or hobbies?” and “While you are daydreaming, to what extent do you find it comforting and/or enjoyable?”). Both maladaptive daydreamers and immersive daydreamers are likely to score these questions quite highly.

And then there are questions about things that frequently accompany MaDD (e.g. “How often are your daydreams accompanied by physical activity such as pacing, swinging or shaking your hands?” and “How often are your current daydreams accompanied by vocal noises or facial expressions?”). I would be interested to know to what extent these questions are predictive of whether someone has MaDD versus immersive daydreaming. I used to pace and daydream out loud when I was younger. Over time, I’ve trained myself to daydream while doing household chores, simply because as a working parent I need to get things done. So I wouldn’t say my urge to be in motion while daydreaming has gone away, more that I’ve redirected it into more productive activity. Whether I’ve been able to do that because my daydreaming is immersive rather than maladaptive, or whether it’s something most daydreamers can learn to do as their lives get busier, I don’t know.

And then there are the questions about music (“To what extent does music activate your daydreaming?” and “To what extent is your daydreaming dependent on continued listening to music?”). I’m something of an anomaly here. I score a big fat zero on both of these. My daydreaming isn’t and never has been connected to music. But, from talking to other daydreamers on Facebook, I know I’m in a minority and that music is very important for most daydreamers.

As an immersive daydreamer, I score just below 40 on the MDS-16. My daydreaming has intensified and relaxed at various times in my life, and there have undoubtedly been times when I would have crossed the threshold into maladaptive daydreaming. Your score now won’t be the same as your score a year ago or what you will score this time next year. So I’d caution you not to use the MDS-16 to label yourself as a maladaptive daydreamer. We tend to live up to our labels, and although I think the MDS-16 is a useful diagnostic tool to see where you are right now, I think it’s important to remember that just like the screening questionnaires used for depression and anxiety, your score is only representative of what is going on for you right now. It’s not predictive of how things will be in the future.

The great thing about the MDS-16 is that it is freely available; you can answer the questions yourself and calculate your own score. You don’t need to find a mental health professional who is willing to assess you. Unfortunately, because MaDD is not a recognised mental health condition, this self-diagnosis may not mean very much. But I still think there’s great value in knowing that your MaDD is real. If you feel you need help to control your daydreaming, Professor Somer and his team are working on potential treatments – I recommend checking out Professor Somer’s video for some helpful starting points.

The ICMDR website states that “A score of 50 or higher [on the MDS-16] is indicative of probable MD. To establish if an individual meets the suggested diagnostic criteria for MD, the person should be interviewed with the Structured Clinical Interview for Maladaptive Daydreaming (SCIMD).” The SCIMD is also available on the ICMDR website and will be the topic of part 2 of this post.