“My friend has saved my life many times"

Ifigenia has had MD for as long as she can remember, and it has put her in some dangerous situations.

“On many occasions, I’ve seen a car too late when crossing the road” she says. “My friend has saved my life many times.”

Two years ago, she realised there are others who have this condition.

 “A cousin saw me talking to myself one time, and they told me they have a friend who does exactly the same thing I was doing, intensely daydreaming and moving my hands.

“They said their friend had MD and I might have the same.”

It is important to note that, alongside intense daydreaming, the symptoms of MD also include facial expressions, repetitive body movements such as moving hands, walking back and forth or even using an object e.g. repeatedly bouncing a tennis ball.

Music is often used as well. MD has often been described as a trance-like state.

Daydreams often consist of wish fulfilment fantasies on topics such as companionship and intimacy and power.

Daydreamers use events from their own lives, or scenes from media like movies or literature to create their imagery. Reading plays a crucial role in Ifigenia’s daydreaming.

“I read literature, and I develop a bond with one character in particular and it becomes like fan fiction.

“I’ll often create my own characters as well. One book I’ve daydreamed about a lot is The Little Woman. I could daydream all day with that, talking with the main characters.”

Researchers have put forward a time of four hours in regards to MD. If someone can daydream for around that time, it’s a strong indicator they have MD.

"I want to be the boss of my mind."

However, they have also been keen to stress this is a rough guide, and many MD’ers can fluctuate from days where they do one hour to others where, like Ifigenia stated, their whole day is taken up by it.

“I try not to read nowadays. I want to be the boss of my mind.”

Ifigenia is estranged from her husband, who lives with her daughter in Venezuela.

“My daughter is eleven. She is very intelligent. She took an IQ test and did very well, but she struggles with attention, and I can’t teach her to focus if I can’t do it.

“I want to be present so I can help my daughter. I want to try.”

"I can be angry, very angry and crying. I can feel very bad.”

Currently, the research doesn’t point to a single, specific cause for daydreaming. It suggests many daydreamers are born with a natural propensity for it.

Most have not had adverse experiences which have caused their disorder. However, some have experienced negative events such as loneliness and trauma, experiences which have fuelled their daydreaming.

Ifigenia feels like one experience in particular has contributed to her MD.

“My father was in the military and his head was in a bad place while he was at home. He was making death threats. At one point, he put a gun to my head. My mum took me away, and we were always hiding.

“Sometimes I daydream about my life, about what I wish could have been different and I can be angry, very angry and crying. I can feel very bad.”

In order to try to get to the root of her daydreaming, Ifigenia has received professional help.

“Since speaking with the psychiatrist, I’ve started to feel good. They prescribed me citalopram, and I just don’t recognise my mind. I can stop daydreaming at any time.”

However, the journey to this stage has been an arduous one, and Ifigenia feels like she would have found help sooner if MD was an official condition.

“I spoke to many psychologists, and they always said I was fine because I didn’t have anything that was in their books.

"I want more people to receive the help they need.”

The Counter-Argument

"I think that rather wonderfully, we come in different shapes and sizes"

Many are willing to argue that MD should be labelled as an official condition, however, as mentioned, there are also people who strongly believe it should not.

One of those people is Peter Kinderman, a Professor of Clinical Psychology at the University of Liverpool. He is also a former President of the British Psychological Society.

Peter has been involved in researching and working as a clinician in mental healthcare for 35 years, and he has expertise in talking about whether issues such as MD should be officially recognised.

“I fundamentally believe on the basis of the evidence I have seen as a clinician that for the majority of us, the reason why we get into difficulties is because of the circumstances that happen to us in our lives” he says. “I think people are anxious and depressed and paranoid as a reaction to the world in which we live.”

Peter picks up on the fact there needs to be more research done into MD, and he’s sceptical that future neurological studies will substantiate the claim that it’s a disorder.

“If people were saying that MD comes about because of a neurological deficit, I'm a scientist, I believe the evidence, but you'd have a hard mountain to climb, because we know that people daydream a lot.”

Research has shown most people daydream for 25% to 50% of their waking hours, however, as mentioned before, this form of daydreaming is the spontaneous attention-shifting of mind-wandering rather than the intentional, focused, consistent scenarios occurring within MD.

"Daydreaming is something we all do"

However, Peter suggests even this is simply the extreme end of a spectrum and is completely natural.

 “I think in terms of neurodiversity, that rather wonderfully, we come in different shapes and sizes.

“If I was to suggest someone has a disorder called Maladaptive Daydreaming disorder, it would imply there was something different about them, and there isn’t, daydreaming is something we all do.”

However, Peter does believe that if someone is struggling with their daydreaming, they should receive assistance.

“If someone tells me that daydreaming is getting in the way of their life, then sure I'm a clinician, I'll talk to them about it. I'll help them find ways to daydream less or handle their dreaming better.

"In the same way, if you told me you were spending too much money on pot noodles and it wasn't good for your diet and your bank balance, I'd talk to you about healthy eating.

“However, I wouldn't give you a diagnosis of pot noodle addiction disorder.”

Crystal Cooper Roy, 60, a retired widow in Louisiana, America, also feels content with her MD. She has daydreamed for most of her life, and she often daydreams about romantic scenarios.

This worsened with the loss of her husband eight years ago. She recognises that her daydreaming has had a detrimental effect on her life.

“I felt like I was cheating on my husband by daydreaming instead of spending time with him.” she said. “If he did something that saddened me, instead of dealing with that feeling, I would go somewhere else in my mind.”

"MD was the third person in my marriage"

This seems similar to Anusha’s situation, as they both rely on MD to deal with negative emotions.

“You remember the famous princess, Diana, talking about three people in a marriage?" she asks. "MD was the third person in my marriage.  But I don’t want to stop.

“Nobody knows about my MD. It doesn't hurt anyone. I'm still a good mother. I'm an awesome grandmother. So this doesn't take away from those relationships.

 “However, the opposite of going into your daydreams is facing everything all day.

"I’ve been very lonely. MD protects me from my loneliness.”

By definition, Crystal doesn’t have MD as she doesn’t want to stop daydreaming. She feels it has positive benefits, but like Anusha, she recognises it has an unhealthy aspect.

This once again throws up the issue of how MD should be defined or whether, like Peter explained, the definition should be cast aside and excessive daydreaming should be looked at on a case by case basis instead.

What needs to be done?

It’s clear there is some way to go before MD is put into a DSM or ICD manual, however, one is prompted to ask, what exactly needs to be done? Dr Soffer-Dudek believes they need neuroscientists.

“We really need brain studies in this field” she says. “We need people who are neuroscientists to take an interest in this.”

The study of MD’s effect on the brain would help to add legitimacy to the cause, however, so far, there is only one woman in the world who has undertaken this.

Jayne Rachael, 51, struggled with MD from age 8 to 26, when she was prescribed fluxovamine and was able to control her daydreaming thereafter.

She studied psychology and has been researching MD alongside Dr Somer. She spoke to me about her experience having an MRI (magnetic resonance imaging) brain scan.

 “The scan revealed that when I was daydreaming, my brain showed purposeful, intentional thought, which is very different to mind wandering.

“The scan showed mind wandering when I was thinking about what I was going to eat for dinner, for example.

“When I was daydreaming, the reward network lit up.  This is the same area of the brain that would light up if you showed an alcoholic a glass of alcohol, or a heroin addict heroin.”

Many would argue this is clear evidence of the existence of MD.

I spoke to Jared Keeley who works as a consultant for the ICD in regards to mental and behavioural disorders. He is therefore an expert on what it takes to get a new disorder accepted into the DSM and ICD.

He tells me the revisions are handled by groups of experts.

“Someone in that group must advocate for adding a disorder” he says, “however, the individuals working on both manuals can place open calls for feedback, which can include calls for the addition of a new disorder.

"Interested parties can also reach out to the work group members.”

Jared claims the evidence required to be included is substantial. One needs:

 (a) information regarding the prevalence of the diagnosis among the population

(b) differentiation of the condition from other existing mental health conditions,

(c) evidence of the adverse impact of the condition on the life of the individual

(d) other evidence of its validity, such as response to a specific treatment

Jared claims the revision process is a lengthy one.

“It is substantial. The process takes somewhere between 5 – 15 years.”

There are clear signs of headway.

Dr Soffer-Dudek tells me that on 27 July 2022, she won a grant of around 200,000 shekel (around £50,000) from the Israel Science Foundation to contribute to funding MD studies.

“This is really exciting” she says. “It’ll be enough to fund studies and participants for five years.”

Dr Somer is also optimistic about the future.

“Nirit and I talked to two leaders in the field, one of whom works for the ICD” he says. “They were both, much to our pleasure, already familiar with MD.

 “We presented our evidence to them, and they both agreed we're very close to being ready to submit it for inclusion.”