Depression and Maladaptive Daydreaming

Depression and Maladaptive Daydreaming: Vicious Cycle or Coping? (12)

Depression and Maladaptive Daydreaming: Vicious Cycle or Coping? (12)

Symbolic representation of the interplay between depression and maladaptive daydreaming
Symbolic representation of the interplay between depression and maladaptive daydreaming

Description: Learn how depression and maladaptive daydreaming are related - and why daydreaming can be both a symptom and an attempt to cope.

Related

 

Teaser (Lead)

When the real world becomes too painful, many people escape into fantasy worlds. But what begins as a relief can develop into a vicious circle: Depression promotes maladaptive daydreaming - and vice versa. This article decodes the complex relationship between the two phenomena.

Depression and maladaptive daydreaming: when daydreaming becomes a vicious circle

First, read the detailed main article [Understanding, treating and overcoming maladaptive daydreaming]

or

The overview "Maladaptive daydreaming - causes, symptoms and help". This topic article examines the complex interrelationship between depression and maladaptive daydreaming.

1 The interrelationship: two sides of the same coin

Depression and maladaptive daydreaming (MD) are closely intertwined. Studies show that 45-65% of MD sufferers also suffer from depressive symptoms. The relationship is bidirectional:

Depression → MD:

The listlessness and joylessness of depression lead to an escape into alternative realities where positive emotions can be experienced.

MD → Depression:

Excessive daydreaming leads to neglect of real areas of life, which increases isolation and feelings of failure - classic depression triggers.

2. distinguishing features: How can you tell the difference?

Typical for depression:

  • Consistent emotional numbness (≥ 2 weeks)

  • Loss of interest in previously enjoyable activities

  • Reduced appetite and sleep disorders

  • Suicidal thoughts

Typical for maladaptive daydreaming:

  • Deliberate escape into elaborate fantasy worlds

  • Emotional intensity during daydreaming

  • Repetitive movements during daydreaming

  • Clear separation between reality and fantasy

3. The vicious circle: how the two reinforce each other

  1. Depressive symptoms lead to withdrawal and social isolation

  2. Loneliness and emptiness create the breeding ground for daydreams

  3. Daydreams offer short-term emotional relief

  4. Neglecting real duties increases feelings of guilt

  5. Deteriorating life circumstances deepen the depression

4. Treatment: simultaneous management of both phenomena

Therapy approaches for simultaneous depression and MD:

  • Cognitive behavioural therapy: working on depressive thought patterns and daydream triggers

  • Activity building: structured daily planning to counteract the tendency to withdraw

  • Emotion regulation training: developing alternative coping strategies

  • Social integration: Gradual resumption of social contacts

Drug treatment:

  • Antidepressants can reduce depressive withdrawal

  • This often automatically minimises the need to daydream

  • No specific medication for MD

5th case study: Sara's way out of the vicious circle

Initial situation:

  • Sara (28) has been suffering from depression for years

  • Daydreams for 5-6 hours a day about an ideal parallel world

  • Neglects work and friendships

Therapeutic approach:

  1. Medication with SSRIs

  2. CBT: Identification of daydream triggers

  3. Gradual build-up of activity

  4. Social reintegration

Result after 6 months:

  • Depressive symptoms reduced by 70

  • Daydreaming time reduced to 1-2 hours a day

  • Resumption of social contacts

FAQ

Can maladaptive daydreaming cure depression?

No, it only provides short-term relief. In the long term, it exacerbates depressive symptoms through feelings of guilt about escaping reality.

What to treat first: Depression or MD?

As a rule, prioritise depression, as its treatment often automatically reduces daydreaming behaviour.

Can antidepressants increase daydreaming behaviour?

Rarely. They usually reduce the need by improving the lack of motivation.

Is MD a form of depression?

No, it is a separate phenomenon that often occurs co-morbidly with depression.

Where can I find help for both problems?

Firstly, with your GP. You can find specialised contact points in online lists of therapists.

Directions & Opening Hours

Close-up portrait of Dr. Stemper
Close-up portrait of a dog

Psychologie Berlin

c./o. AVATARAS Institut

Kalckreuthstr. 16 – 10777 Berlin

virtual landline: +49 30 26323366

email: info@praxis-psychologie-berlin.de

Monday

11:00 AM to 7:00 PM

Tuesday

11:00 AM to 7:00 PM

Wednesday

11:00 AM to 7:00 PM

Thursday

11:00 AM to 7:00 PM

Friday

11:00 AM to 7:00 PM

a colorful map, drawing

Load Google Maps:

By clicking on this protection screen, you agree to the loading of the Google Maps. Data will be transmitted to Google and cookies will be set. Google may use this information to personalize content and ads.

For more information, please see our privacy policy and Google's privacy policy.

Click here to load the map and give your consent.

Dr. Stemper

©2025 Dr. Dirk Stemper

Sunday, 9/28/2025

a green flower
an orange flower
a blue flower

Technical implementation

Directions & Opening Hours

Close-up portrait of Dr. Stemper
Close-up portrait of a dog

Psychologie Berlin

c./o. AVATARAS Institut

Kalckreuthstr. 16 – 10777 Berlin

virtual landline: +49 30 26323366

email: info@praxis-psychologie-berlin.de

Monday

11:00 AM to 7:00 PM

Tuesday

11:00 AM to 7:00 PM

Wednesday

11:00 AM to 7:00 PM

Thursday

11:00 AM to 7:00 PM

Friday

11:00 AM to 7:00 PM

a colorful map, drawing

Load Google Maps:

By clicking on this protection screen, you agree to the loading of the Google Maps. Data will be transmitted to Google and cookies will be set. Google may use this information to personalize content and ads.

For more information, please see our privacy policy and Google's privacy policy.

Click here to load the map and give your consent.

Dr. Stemper

©2025 Dr. Dirk Stemper

Sunday, 9/28/2025

a green flower
an orange flower
a blue flower

Technical implementation

Directions & Opening Hours

Close-up portrait of Dr. Stemper
Close-up portrait of a dog

Psychologie Berlin

c./o. AVATARAS Institut

Kalckreuthstr. 16 – 10777 Berlin

virtual landline: +49 30 26323366

email: info@praxis-psychologie-berlin.de

Monday

11:00 AM to 7:00 PM

Tuesday

11:00 AM to 7:00 PM

Wednesday

11:00 AM to 7:00 PM

Thursday

11:00 AM to 7:00 PM

Friday

11:00 AM to 7:00 PM

a colorful map, drawing

Load Google Maps:

By clicking on this protection screen, you agree to the loading of the Google Maps. Data will be transmitted to Google and cookies will be set. Google may use this information to personalize content and ads.

For more information, please see our privacy policy and Google's privacy policy.

Click here to load the map and give your consent.

Dr. Stemper

©2025 Dr. Dirk Stemper

Sunday, 9/28/2025

a green flower
an orange flower
a blue flower

Technical implementation