ADHD and maladaptive daydreaming
Description: Why people with ADHD are particularly prone to maladaptive daydreaming and how understimulation, hyperfocus and fantasy interact.
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Teaser (Lead)
Many people with ADHD report intense fantasies that are difficult to control. For some, this develops into maladaptive daydreaming—a kind of "inner substitute world" — when the real environment offers too little stimulation. This article shows the connections and explains why ADHD and MD often occur together.
ADHD and maladaptive daydreaming - the search for stimulation
First, read the detailed main article, Maladaptive daydreaming - understanding, treating and overcoming it - a comprehensive guide
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The overview "Maladaptive daydreaming - causes, symptoms and help". This themed article examines the connections between ADHD and maladaptive daydreaming.
1 Why ADHD is a risk factor
Attention problems, impulsivity and a constant search for stimulation characterise ADHD. Many sufferers find it difficult to endure boredom or complete repetitive tasks. This feeling of "under-stimulation" manifests as inner restlessness, irritability, or a constant search for new stimuli.
Fantasy worlds offer a seemingly perfect solution here: they are unlimited, available at all times and adapt to the dreamer's needs. While a real environment only offers limited stimulation, the inner world provides endless adventure, recognition and emotional intensity. This makes maladaptive daydreaming particularly attractive for many people with ADHD - but also risky, as it reinforces the tendency to seek stimulation and makes everyday tasks even more challenging to focus on.
2 Hyperfocus and inner series
A paradoxical symptom of ADHD is hyperfocus: the ability to become completely absorbed in activities that are experienced as exciting. This focus can be productive, for example, when working on a creative project, but can also be problematic if it is directed towards fantasies.
In maladaptive daydreaming, the hyperfocus leads to those affected "sinking" into their stories for hours on end. The inner films run like multi-part series, often with recurring characters, storylines and dramaturgy. For the person affected, it feels like an intense, exciting experience; for the outside world, it seems like an "absence". The problem: while complex actions take place in the fantasy, in reality, appointments, work, or social obligations fall by the wayside.
3. typical triggers in the ADHD context
· Boredom in class or at work: When tasks are monotonous, the imagination provides much-needed variety.
· Frustration and failure: Many people with ADHD are familiar with rejection or criticism. In their imagination, they create worlds in which they are successful, popular and competent.
· Sensory triggers: Music, series, games or films can immediately act as a "springboard" into the inner world. Recurring soundtracks or visual stimuli in particular activate MD episodes.
· Emotional stress: Stress, excessive demands or conflicts trigger the need to retreat - the imagination becomes a protective space.
4 Overlaps and differences
· Similarities: ADHD and maladaptive daydreaming are both associated with concentration difficulties, impulsivity and problems with self-regulation.
· Differences: In ADHD, the focus is on absent-mindedness - thoughts are constantly jumping around. In MD, the opposite is true: extreme fixation on a fantasy world.
· Special feature: Studies show that around 20% of adults with ADHD also fulfil criteria for maladaptive daydreaming. This overlap makes it clear that MD is more than "just" a secondary symptom, but a risk factor in its own right for this group.
5 Therapeutic implications
· ADHD treatment: Medication (e.g. stimulants) and behavioural therapy stabilise attention and impulse control. This often also reduces the tendency to daydream.
· Focus training: Methods such as mindfulness training, breathing exercises, or neurofeedback help anchor attention in the present moment and specifically interrupt the imagination.
· Structure & stimulus management: Clear daily schedules, routines, and a conscious approach to media can prevent triggers (e.g. music, series) from triggering uncontrolled episodes of MD.
· Combined approaches: The combination of ADHD-specific interventions and MD strategies such as trigger control, grounding and psychoeducation is particularly effective.
6th case study: Ben - between racing thoughts, depersonalisation and creative flow
Initial situation:
· Ben (25) has had an ADHD diagnosis since childhood. His everyday life is a rollercoaster of extremes: phases of agonising boredom and under-stimulation in his studies alternate with moments in which his thoughts race so fast that he can no longer sort himself out. In these moments of overwhelm, he sometimes experiences a feeling of depersonalisation - he feels detached from himself and his surroundings, as if he were observing his own life from afar.
· His complex, action-packed daydreams often turn into racing thoughts, abandoning the narrative structure in which the erratic ideas are woven into an epic plot. (The opposite also happens frequently.) Unfortunately, they are the only activity that is intense enough to break through the feeling of emptiness and dissociation (depersonalisation) and allow him to "feel" something again. In his fantasy, he is a renowned director who is in complete control—a stark contrast to his often chaotic inner life.
· Triggers are boredom, excessive demands and sensory stimuli such as music. His daydreams can run for hours at a time and are often accompanied by repetitive movements (e.g. rocking). His performance in his studies suffers considerably, and the shame of his "absence" and dissociative episodes drives him further into withdrawal.
Therapeutic approach:
1. Differential diagnosis and psychoeducation: First of all, we worked out together that the daydreaming, racing thoughts and depersonalisation are not isolated problems, but closely interwoven attempts by his ADHD brain to cope. This relieved Ben enormously, as he no longer saw his symptoms as a personal failure, but as understandable reactions.
2. ADHD medication: Stimulant medication (methylphenidate) reduced the basic impulsivity and the intensity of the racing thoughts. The "volume" in the head became quieter, which significantly reduced the urge to create order through daydreaming.
3. Mindfulness-based strategies against depersonalisation: Ben learned grounding techniques (hedgehog balls and the 5-4-3-2-1 method) to reconnect with the present at the first signs of dissociation. Sport and breathing exercises helped to regulate the physiological level of arousal and counteract the flooding.
4. Structure and channelled creativity: A fixed daily schedule with clear breaks interrupted the phases of under-stimulation. His creative potential was redirected: hourly "creative note blocks" of 5 minutes allowed him to collect ideas for his screenplay without drifting off into hours of daydreaming.
Result after 9 months:
· The frequency and intensity of the depersonalisation episodes have greatly diminished. Ben feels more present and more "at home" in his body and life.
· His racing thoughts have changed from an uncontrollable stream to a more manageable flow. Daydreaming time has been reduced from often 4-5 hours to around 30-60 minutes per day, which he now consciously uses to relax or find ideas.
· He no longer lives out his creative potential passively in his imagination, but actively through writing. He has learnt to accept his neurological disposition not as an enemy, but as the source of his creativity—and at the same time to control it in such a way that it enriches his real life instead of replacing it.
Conclusion
ADHD and maladaptive daydreaming have a common underlying motive: the search for intense stimulation. Fantasy can provide short-term relief and even creative enrichment - but if it becomes a substitute for reality, there is a risk of withdrawal, a drop in performance and social problems. A dual approach is crucial: stabilising ADHD symptoms and, at the same time, developing more conscious, constructive ways of using fantasy. This turns imagination from an escape into a resource.