An article in press for Consciousness and Cognition reports the case of a 36 year-old woman with a long history of excessive daydreaming where she’d spent long periods of time wrapped up in a fantasy world.
Importantly, the patient has no significant signs of mental illness and can easily distinguish fantasy from reality but just gets caught up in her internal reveries.
The subject of this case report is a professionally accomplished 36-year-old female presenting with a long history of excessive and highly structured daydreaming which she states has contributed to considerable distress during periods of her life. The patient is single, does not smoke, drink or use illegal drugs, and comes from a supportive and healthy family, reporting no abuse or trauma in her history.
Her distress, though subjectively reported as significant enough to seek and continue psychiatric treatment, remains difficult for us to diagnose. The imaginative episodes and their content are experienced as neither dysphoric nor intrusive, and the patient has been rigorously assessed for contributing or comorbid symptoms of mood, anxiety, personality, schizotypal, dissociative, and attentional disorders; indeed we have monitored her for over ten years, and have employed all clinical psychiatric measures available to consistently rule out comorbidity or mental status change in her case.
We have tenuously viewed her symptoms as indicating possible features of obsessive-compulsive behavior, reflected in the prescription of 50 mg/day of fluvoxamine, an antidepressant believed to influence obsessiveness and/or compulsivity. The medication has been continued for 10 years, as the patient affirms this treatment has made her daydreaming much easier to control. She reports that occasionally the amount of time spent daydreaming will rise and she will increase her dosage of fluvoxamine briefly until it subsides…
Recently, the patient discovered a website containing a surprising number of anonymous postings on the topic of excessive or uncontrolled daydreaming. Numerous posters described patterns and tendencies that appeared remarkably consistent with the patient’s experience (including the original pacing behavior) and emphasized the stress of concealing their imaginary lives and the attendant shame, confusion, and difficulty in controlling their divided realities.
Mind Hacks 
Interesting. I call that being a fiction writer. Which has jokingly been referred to as a psychiatric disorder before…but I don’t think it’s ever been medicated before.
Ref: Terry Brooks, who sends postcards of himself lying in a lawn chair entitled “Me, working” to friends and family, and means it in all seriousness.
Ref: Dennis L. McKiernan, who would stop every mile during highway motorcycle road-trips to write down newly imagined story elements.
The disorder here appears instead–to my completely untrained eye (IANAP)–to be one of anxiety and self-worth concerns, possibly brought about by the cultural labeling of fantasizing as a shameful/unproductive behavior.
Interesting. I would like to hear more on this patient’s progress. Good luck in the treatment.
I am the webmaster at:
http://www.daydreamingdisorder.webs.com/
This site has more information about this condition, which is called Maladaptive Daydreaming.
I have this problem, and it has significantly affected my ability to function day-to-day.
People with this problem daydream excessively, and will often compare it to an addiction. This problem often (but not always) begans at a young age.
There is also a forum for this problem at:
http://health.groups.yahoo.com/group/maladaptivedaydreamers/
..it’s interesting..i myself also experiences too much daydreaming and i find it unproductive…
My son who is now 9 experiences excessive daydreaming and has for many years. He performs very well in school but must have a lot of time to daydream everyday he must do it & finish his stories.
I’m glad to realize I’m not as “odd” as I’d come to think!
I do daydream a very lot and am currently struggling to control it. I admit it can take up a lot of valuable time, but it always leaves me feeling so good (when it does end!) especially about a social incident that perhaps occurred and had me feeling like I could’ve done better, so instead of banging my head against the wall, I just “daydream it better” and I feel good again.
Oh well, at the end anything, good or bad, in excess is never good…