Daydreaming as a Disorder?
A few days ago I came across a paper by Schupak and Rosenthal (2008). They report the case of a patient presenting with a long history of excessive daydreaming.
Their patient is a 36 year old successful, educated woman with a long history of excessive and persistent daydreaming, which according to her reports is a cause of distress. What’s really fascinating in this case is the lack of known injury, drug abuse or other disorder. After more than 10 years of therapy, she only found relief from her symptoms when she was prescribed fluvoxamine, an antidepressant drug believed to influence obsessiveness and/or compulsivity. Even though, she used to spend a big part of her free time engaged in daydreaming, she was never disconnected from reality. Growing older, she was forced to hide her excessive daydreaming from colleagues and friends. However, this behaviour didn’t interfere with her education and her career.
The authors do a short review of the existing literature in mind-wandering suggesting that the hypothesis by Mason et al. (2007), according to which “mind-wandering is associated with activity in the default mode network”, could explain their patient’s symptoms. See suggested readings for alternative theories/hypotheses.
Schupak and Rosenthal (2008) conclude:
The subject of the present case study claims to be adjusted to her high level of fantasy proneness. She manages to orchestrate a complex allocation of cognitive and emotional resources toward the competitive requirements of externally- versus internally-driven attentional demands on a daily basis, though at substantial psychological cost. Our question regards the extent to which this case may represent an unrecognized population, i.e., individuals whose mind wandering/daydreaming is experienced as a causative factor in producing psychological distress or functional impairment without meeting criteria for any DSM disorder. The fact that our patient reports a positive response to a medication that influences serotonergic tone may imply neurochemical irregularity
Unfortunately, there is no report on any neuroimaging studies on this specific patient.
Gilbert, S. J., Frith, C. D., and Burgess, P. W. (2005). Involvement of rostral prefrontal cortex in selection between stimulus-oriented and stimulus-independent thought. The European journal of neuroscience., 21(5):1423-1431.
Mason, M. F., Norton, M. I., Van Horn, J. D., Wegner, D. M., Grafton, S. T., and Macrae, C. N. (2007). Wandering minds: The default network and stimulus-independent thought. Science, 315(5810):393-395.
Raichle, M. E., MacLeod, A. M., Snyder, A. Z., Powers, W. J., Gusnard, D. A., and Shulman, G. L. (2001). A default mode of brain function. Proceedings of the National Academy of Sciences of the United States of America, 98(2):676-682.
(painting: girl-daydreaming by Anthony Staynes)