How to talk to your doctor about maladaptive daydreaming

By definition, if you have maladaptive daydreaming disorder, your daydreaming will be causing you distress or dysfunction (if it isn’t, you’re probably an immersive daydreamer). If your daydreaming is making you miserable, or you’ve tried to get it under control and can’t, you may have decided it’s time to seek help. But where do you start? How do you tell your doctor that you need help to overcome your maladaptive daydreaming?

Before your appointment

Doctors are generally busy people, and awareness of maladaptive daydreaming disorder among medical professionals is still, unfortunately, quite low. So you may be faced with the challenge of explaining your condition quickly to someone who has little or no prior knowledge of it. So it’s essential that you do some preparation before your appointment.

  • Print out some brief information about maladaptive daydreaming. I like this description from Verywell Health, which succinctly covers the main features of the condition. This longer article from healthline is also worth looking at.
  • Print out the maladaptive daydreaming scale (MDS-16) from the ICMDR website and score yourself on it. Cut-off scores of 40-50 are generally used to identify maladaptive daydreamers when recruiting people into research studies. If you score more than 50, that’s solid evidence that you have maladaptive daydreaming.
  • Keep a diary (even if only for a few days) recording when and for how long you daydream each day. This will help you demonstrate how much time you are losing because of daydreaming.
  • Write down all the ways your daydreaming negatively affects you. Does it stop you working or studying? Does it make it hard to socialise or maintain friendships? Does it affect your sleep? Has your pacing (or any other daydreaming-related activity) caused you any physical problems? Do you feel your daydreaming makes you unworthy or a bad person?
  • Consider whether you have any other neurodevelopmental or mental health challenges. Maladaptive daydreaming frequently co-occurs with ADHD, OCD, depression and/or anxiety. Knowing what else you might be struggling with will help your doctor to put your maladaptive daydreaming into context, and it makes sense to try to treat everything at once.
During the appointment

You’ll probably only have a short time to convince your doctor of the seriousness of your problem, so it’s vital to be brief and stay on topic. Describe your daydreaming as precisely as you can, emphasising the problems it’s causing. For example:

I get lost in fantasy on a daily basis. I make up stories in my head while pacing around the room. The stories are complex and detailed fantasies that have nothing to do with what’s happening in real life. I do this for between four and six hours every day, and I find it hard to stop. I’ve recently lost my job because I was late for work four times in the same week because I couldn’t stop daydreaming. It’s putting a strain on my friendships because I’d rather daydream than socialise with people. I can’t tell anyone because I’m afraid they’ll laugh at me. I feel embarrassed and ashamed, and I need help to break this habit before it ruins my life.

It shouldn’t be necessary to tell the doctor what you daydream about. If you’d prefer to keep your daydream content private, you can just emphasise that your daydreams are creative fantasies that aren’t related to what’s happening in real life.

Once you’ve explained how your daydreaming affects you on a daily basis, tell your doctor that you believe you have maladaptive daydreaming disorder. If your doctor isn’t familiar with the condition, you can show them the material you printed out. You could say something like:

“I found this description online of maladaptive daydreaming disorder, which describes exactly what I’m experiencing. Although it isn’t yet recognised as a mental disorder, there has been research done on it, and researchers typically use the maladaptive daydreaming scale to assess it. I scored myself on it and came out as a 68, which is well above the cut-off point of 50 that’s usually used to diagnose maladaptive daydreaming.”

Don’t forget to tell your doctor about any co-occurring conditions that you might have, and state clearly what you would like your doctor to do. For example:

“I was diagnosed with ADHD a few years ago but chose not to take medication. I’ve read that a lot of maladaptive daydreamers have ADHD and some of them find the ADHD medication helps with their daydreaming, so perhaps that’s something we could look into? I’ve also been daydreaming more since I broke up with my partner, and I think I would benefit from counselling to help me accept that the relationship is over.”

If your doctor is unsure whether maladaptive daydreaming is a real disorder, ask them to look at the ICMDR website to see the research that has been published in peer-reviewed medical journals.

If you do your preparation before the appointment, your doctor should take you seriously even if they’re not familiar with maladaptive daydreaming. You might even find they’re eager to learn something new and to work with you to find ways to help you manage the condition.

After the appointment

After the appointment, take a few minutes to reflect on how it went and what the outcome was. Make a note of anything you forgot to mention so that you can raise it at your next appointment. It’s important that you take charge of your treatment, so make sure you’re clear on who should be doing what and by when. If the doctor has promised to get back to you or to write you a referral, make a note of when you need to chase this up in case it doesn’t happen.

Most daydreamers find it very difficult to open up to people about their daydreaming, and it can be embarrassing to admit that your fantasy life is taking over your real life. Talking to your doctor can feel daunting, but it can also be the first step towards recovery. Hopefully the suggestions in this article will help you take that first step.

If you decide to talk to your doctor about your maladaptive daydreaming, let me know how you get on in the comments below, and good luck!

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