Maladaptive Daydreaming: a New Form of Behavioral Addiction?

Many people report feeling trapped in behaviors they are compelled to perform, despite facing harmful consequences. These behaviors range from compulsive buying, skin picking, sexual addiction, and excessive tanning to internet addiction (Grant et al., 2010). Some, like internet gaming disorder, have been proposed to be included in the DSM-5 as potential behavioral addictions. So far, only gambling disorder has been officially recognized in the DSM-5 as a behavioral addiction. However, despite this broader acceptance, disagreement remains over what behaviors truly qualify as addictive (Altman et al., 1996). Some argue that virtually any behavior could be considered an addiction (Grant et al., 2010). In light of this, some proposed a new addiction to the literature – maladaptive daydreaming. But could this be a leap too far? 

Maladaptive daydreaming (MD) is characterized by intense, prolonged immersion in fantasy, sometimes even for hours at a time, that disrupts daily life across various domains – whether social, personal, or academic (Pietkiewicz et al., 2018). Yet, daydreaming itself is not unusual – nearly everyone daydreams from time to time (Singer & McRaven, 1961). What sets MD apart from normal daydreaming are the intense urges, significant distress, impaired control, and negative impacts on various aspects of life caused by daydreaming (Bigelsen et al., 2016; Bigelsen & Schupak, 2011). However, because daydreaming is so common, these differences may be easily overlooked, as it is not often seen as a serious issue, leading to the phenomenon being under-researched (Klinger E., 2009; Soffer-Dudek & Somer, 2018). On the other hand, some have been quick to jump to conclusions, labeling MD as a behavioral addiction without sufficient evidence (Pietkiewicz et al., 2018; Soffer-Dudek et al., 2020).

One of the main arguments in the literature supporting the classification of MD as a behavioral addiction is rooted in its phenomenology – the lived experience of those who struggle with it. In qualitative studies, the subjective feeling of compulsivity and addiction is prominent. As one participant put it, “There was a point where it was like an addiction” (Robson, 2022). Another individual shared a similar feeling of being trapped in the daydreaming cycle: “Time goes by, and I’m not really able to control it. I sit at my PC and daydream day by day. I start in the morning and suddenly it’s night. It began in second grade, but it didn’t bother me as much back then. Now, I fear I’ve wasted my life and opportunities.” (Pietkiewicz et al., 2018). Another argument likening MD to addiction is the presence of craving, the powerful urge to daydream (Pietkiewicz et al., 2018). According to Bigelsen et al., 2016, many people with MD report feeling the need to daydream as soon as they wake up, or the overwhelming desire to continue when interrupted. This compulsive pull mirrors the cravings seen in more traditional addictions. And yet, some individuals with MD report they can reduce their daydreaming when necessary, suggesting there is still some degree of control over the behavior. This phenomenological discrepancy raises a question about whether MD fits the criteria for behavioral addiction. Yet, this is not the primary reason why some – me included – see the move to classify MD as a behavioral addiction as rather premature. 

The core issue lies in an overreliance on the phenomenological evidence discussed above. While these accounts are important, they are not sufficient to define MD as an addiction. We need more than personal narratives; we need a deeper understanding of the biological, psychological, and social mechanisms driving MD. For example, gambling disorder underwent years of rigorous research before it earned its classification (Grant et al., 2006; Potenza, 2008). It was studied extensively across multiple domains, from brain activity to social impact. In contrast, MD has not been researched nearly as thoroughly. Although there are indeed similarities between MD and behavioral addictions, particularly in rewarding experiences reported by individuals with MD. Just as many addictions begin with something pleasurable, MD offers an escape into a fantasy world that individuals initially may find enjoyable (Pietkiewicz et al., 2018). However, in recognized addictions like substance use disorder, these pleasurable experiences often diminish over time, while urges to engage in such behavior in persist, despite negative consequences (Robinson & Berridge, 2008). According to the incentive-sensitization theory (Robinson, 1993), this shift results from changes in the brain’s rewarding system. Specifically, the dopamine system becomes hypersensitized, resulting in increased dopamine levels in response to addiction-related cues. This heightened sensitivity amplifies urges and cravings, even as the initial pleasure subsides. While it is possible that MD involves changes in reward pathways, there is insufficient evidence to suggest it follows the same neurobiological patterns as other addictions. 

From a neurobiological standpoint, behavioral addictions—like gambling disorder—affect dopamine indirectly, as there is no external substance directly perturbing neurotransmitter levels (Lubman et al., 2004; Clark, 2014). MD differs here in that it relies on internal, self-generated cues rather than external stimuli that drive reward seeking, such as the flashing lights and winning sounds in gambling disorder. This raises a key question: Can the dopamine spikes seen in behavioral addictions also occur in response to internally generated fantasies? Research on MD could explore whether these internal experiences trigger similar dopamine responses as seen in addictions driven by external cues.

Cognitive deficits, such as impaired executive function, poor inhibition, and difficulties in risk-reward decision-making, are common in individuals with addiction and are driven by changes in the mesolimbic dopamine system, contributing to both development and maintenance of the disorder (Ersche et al., 2020, Koob & Wolkow, 2010). Tasks like the Iowa Gambling Task, which assess a tendency to favor short-term rewards over long-term benefits (Bechara et al., 1994), and the Stroop Task, which measures inhibitory control (Wright et al., 2003), are used to evaluate such cognitive impairments. These assessments highlight a hypersensitivity to immediate rewards, such as drugs, where the craving can become so overwhelming that it overrides the brain’s decision-making processes (Brevers et al., 2013). In the case of maladaptive daydreaming (MD), similar cognitive deficits have been observed (Petry & Casarella, 1999; Cavedini et al., 2002; Bechara, 2003). However, MD centers on internally generated fantasies and rewards, rather than external ones characteristic of drugs. This difference suggests that traditional tasks may need adaptation. For MD, a greater focus on mental inhibition and balancing internal versus external rewards could offer a more accurate assessment of cognitive deficits, as individuals with MD often become fixated on internal stimuli, similar to how external substances hijack attention in addiction. 

Although maladaptive daydreaming (MD) shares similarities with behavioural addictions, labelling it as such may be premature. Instead, examining MD alongside other disorders with shared mechanisms can lead to more effective, targeted treatments. This transdiagnostic approach may reduce stigma and help those struggling, but it must be done with caution. Over-pathologizing MD risks misunderstanding and may undermine what needs to be addressed. A careful balance is needed to avoid turning a normal, creative experience into a disorder while still supporting those for whom MD is distressing and out of control. <<