
هل يعتبر التخيل المفرط علامة على مرض عقلي؟
مراجعة من قبل الدكتور كريشنا فاخاريا، MRCGPكتبه أمبرلي ديفيسنُشر في الأصل 14 يونيو 2023
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We all daydream - and letting our thoughts drift into imagined scenarios and fantasies are a normal and healthy part of the human experience. But what about the dark side of daydreaming? We explore when this trait becomes harmful, and how this so-called maladaptive daydreaming is often linked to past trauma and mental illness.
What is maladaptive daydreaming?
When a behaviour is described as maladaptive, it means it stops you being able to participate in or adjust to everyday life. It interferes with day-to-day activities and your ability to enjoy or benefit from them.
The term maladaptive daydreaming was developed in 2002 by clinical psychologist Dr Eli Somer. Although not widely used, many mental health experts have begun to take notice.
One such expert is Azizi Marshall, a licensed clinical professional counsellor: "Maladaptive daydreaming is when an individual spends a disproportionate amount of time daydreaming, becoming engrossed in their imagination to the point it interferes with their day-to-day life," she explains. "This type of daydreaming can become an unhealthy and maladaptive coping skill."
Daydreaming is often seen as a behaviour within our control. But maladaptive daydreaming is involuntary, excessive, and potentially harmful. Whether this is enough to be classified as a condition is up for debate.
هيذر داروال-سميث, psychotherapist and spokesperson for the UK Council for Psychotherapy (UKCP), says that seeking support and guidance from a mental health professional can help manage your symptoms and improve your wellbeing, regardless of whether or not maladaptive daydreaming is classified as a disorder.
"Maladaptive daydreaming can be seen as a natural variation in human experience, whether it's used as a powerful coping mechanism or form of self-expression,"
What are the symptoms of maladaptive daydreaming?
Maladaptive daydreaming can look different between one person and the next. The main question to ask yourself is whether your daydreaming habits are interfering with other aspects of your life in a negative way.
Signs include:
Vivid daydreaming involving complex narratives - as a way of coping with emotional distress, which can lead to social isolation, anxiety, depression, and other negative affects.
Finding your thoughts frequently drifting to upsetting scenarios - these might be hypothetical, or they may involve flashbacks to past events.
Daydreaming is frequent, emotionally intense, and difficult to control.
Healthy or unhealthy?
The occasional daydream can actually be beneficial, boosting creativity and productivity1. "Many creatives use this as a tool for their work," says Marshall. "This is not only true for performing/visual artists but also for those in creative workspaces such as marketing, advertising, entertainment, and education.
"On the other end of the scale, when daydreaming becomes unhealthy, it's used as an emotional escape, is difficult to control, becomes more important than your real life, leads to distress, or lessens productivity in other aspects of your life that were once deemed important."
Darwall-Smith adds that you can ask yourself these questions to determine if your daydreaming has surpassed the tipping point from healthy to unhealthy:
How far is daydreaming interfering with my daily life?
Can I still meet my responsibilities or engage in meaningful social relationships?
How emotionally intense and frequent are my daydreams?
Do they feel difficult to control?
Do my daydreams usually involve distressing or violent themes?
What causes maladaptive daydreaming?
Our thought processes are a complex thing, and maladaptive daydreaming isn't fully understood. Still, research suggests it may be linked to trauma أو abuse, personality traits, neurological factors, environmental factors, and co-occurring mental health conditions. Here, we take a closer look at the relationship between maladaptive daydreaming and mental illness.
اضطراب ما بعد الصدمة (PTSD)
It's thought that maladaptive daydreaming is most often experienced by people with اضطراب ما بعد الصدمة (PTSD) as a coping mechanism in response to trauma - as a means of escaping what has happened2. Darwall-Smith explains that, in these circumstances, excessive daydreaming isn't always a bad thing.
"Research has suggested that certain types of daydreaming may be helpful for people with PTSD - allowing them to escape from distressing thoughts and emotions related to their traumatic experiences. Daydreaming can also provide a sense of control and mastery - it can involve scenarios that provide more empowerment or hope than someone's current reality."
But, if these daydreams involve distressing themes or flashbacks, it's worth seeking help to try and break the habit and prevent the past from haunting your day-to-day life.
الاكتئاب
Maladaptive dreaming also offers an escape from some of the overwhelming feelings associated with الاكتئاب. According to Marshall, it's the re-emergence from a daydream which could cause problems: "Because returning to reality can feel painful, this could potentially increase depressive symptoms and cause a person to want to daydream more often and for longer periods of time."
القلق
Like depression, القلق is a common issue among maladaptive daydreamers3. If you find yourself feeling overwhelmed with nervousness or constant worries, your instinct might be to withdraw into daydreams. This becomes maladaptive when this pattern keeps you isolated from aspects of your life that you should be able to embrace and enjoy.
اضطراب الوسواس القهري
In both obsessive-compulsive disorder (OCD) and maladaptive daydreaming, there's a tendency toward hyper-fixation, compulsion, and obsession. Darwall-Smith explains that maladaptive daydreaming may even be a subtype of OCD - or is at least closely related. This is because some maladaptive daydreamers also exhibit other obsessive-compulsive behaviours, such as ritualising their daydream experiences4.
Is it maladaptive daydreaming?
Or intrusive thoughts?
Intrusive thoughts look pretty similar to unwanted and upsetting daydreams. The key difference is that daydreams tend to take you out of reality into vivid, imaginary settings, while intrusive thoughts can be fleeting and don't tend to remove you from your surroundings.
Examples include thinking:
Someone you love will die.
You'll harm someone.
Scenarios in which you'll die.
"Intrusive thoughts are a common symptom of several mental health conditions, including OCD, PTSD, and anxiety disorders," says Darwall-Smith. The psychotherapist adds that people who maladaptive daydream may also experience intrusive thoughts related to their daydreams.
Or dissociation?
Maladaptive daydreaming and dissociation share some similarities, but they are not the same thing. Darwall-Smith explains:
Dissociation - is a psychological term that refers to a disconnection between thoughts, feelings, and experiences. It can be a symptom of several mental health conditions, including PTSD.
Maladaptive daydreaming - is a condition in which an individual excessively daydreams and creates complex fantasies and narratives in their mind, often as a way of escaping reality.
"While maladaptive daydreaming has been described as a form of dissociation, it is a distinct phenomenon that is not currently recognised as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Dissociation, on the other hand, is a recognised symptom of several mental health conditions."
The dangers of self-diagnosis
Thanks to online forums, more and more people are learning of maladaptive daydreaming. While awareness can help people recognise when they need help, self-diagnosis can raise some issues. Darwall-Smith says that only a qualified mental health professional can make an accurate diagnosis.
She highlights some of the problems with self-diagnosis:
Overestimation of symptoms - leading to unnecessary concern or anxiety.
Misinterpretation of symptoms - leading to an inaccurate diagnosis.
Underestimation of underlying issues - such as trauma or anxiety.
Lack of access to treatment - without input from a mental health professional.
Reinforcement of stigma around mental health conditions - as it implies that individuals should be able to diagnose and treat themselves.
Getting the support you need
If excessive daydreaming is interfering with your daily life - perhaps causing you to become socially isolated, neglectful of your responsibilities, or in a state of poor mental health - it's time to seek support.
Even without a formal diagnosis available, psychotherapists can recognise and treat the effects of maladaptive daydreaming, as well as any mental health issues that may be related.
Some common types of therapy that may be used to treat maladaptive daydreaming include:
Cognitive-behavioural therapy (CBT) - a type of therapy that focuses on changing negative thought patterns and behaviours.
Mindfulness-based therapy - involves developing greater awareness of one’s thoughts and feelings and learning to accept them without judgment.
Psychodynamic therapy - involves exploring unconscious thoughts and emotions and may be helpful for those who have experienced trauma or other underlying psychological issues.
Interpersonal therapy - focuses on improving relationships and communication skills and may be helpful for people with maladaptive daydreaming who have experienced social isolation or difficulties in relationships.
Psychotherapy offers a safe and supportive space to explore your thoughts and emotions, and develop strategies for managing your daydreams - so that you can start to engage in and embrace other aspects of your life, that may have become neglected.
قراءة إضافية
اختيارات المرضى لـ مشاكل أخرى في الصحة النفسية

الصحة النفسية
هل يعتبر التخيل المفرط علامة على مرض عقلي؟
We all daydream - and letting our thoughts drift into imagined scenarios and fantasies are a normal and healthy part of the human experience. But what about the dark side of daydreaming? We explore when this trait becomes harmful, and how this so-called maladaptive daydreaming is often linked to past trauma and mental illness.
بقلم أمبرلي ديفيس

الصحة النفسية
كيفية التوقف عن التسويف
From struggling to start that New Year's fitness resolution to delaying exam revision, procrastination can get in the way of your success. While it's perfectly normal to procrastinate every now and then, it can sometimes become a problem that impacts your health and achievements. By identifying the factors blocking your motivation, you can take steps to break the habit.
بقلم أمبرلي ديفيس
عن المؤلفعرض السيرة الذاتية الكاملة

Amberley Davis
كاتب أول
بكالوريوس (مع مرتبة الشرف)، التنمية المهنية المستمرة
أمبرلي كاتبة كبيرة في موقع Patient وقد كتبت بشكل مكثف حول مجموعة من مواضيع الصحة والرفاهية.
حول المراجععرض السيرة الذاتية الكاملة

الدكتور كريشنا فاخاريا، MRCGP
كبير المسؤولين الطبيين للصحة، أوبتوم المملكة المتحدة
MBChB, MRCGP(2013), BMedSci (hons), DFSRH, DRCOG, PGDipDerm (Distn)
الدكتورة كريشنا فاخاريا هي طبيبة عامة في هيئة الخدمات الصحية الوطنية. كما أنها ممتحنة منتظمة لدبلوم الدراسات العليا في الأمراض الجلدية العملية في جامعة كارديف، بالإضافة إلى كونها كبيرة المسؤولين الطبيين للصحة في Optum UK.
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المقال متاح أيضًا باللغة الإنجليزية, الألمانية, إسبانية, الفرنسية, إيطالي, البرتغالية, الهندية, العبرية, العربية ,، و السويدية.
14 يونيو 2023 | نُشر في الأصل
كتبه:
Amberley Davisمراجعة من قبل
الدكتور كريشنا فاخاريا، MRCGP

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