Is making up scenarios in your head a mental illness?

Do you find yourself constantly making up scenarios in your head that may or may not be likely to happen? Are you the parent or caregiver of a child with an “overactive imagination”? Maybe hypothetical situations take up all of your thoughts? Is it ruminating, overthinking, or daydreaming? If so, you might be wondering, is this a problem? 

First, it’s important to understand that daydreaming can be enjoyable, harmless, and even beneficial at times. “Creating scenarios in your head, and imagining different things occurring is a very natural human experience. It’s part of the way your brain tries to make sense of the world. Your brain is very creative,” says Taylor Newendorp, M.A., LCPC, a Network Clinical Training Director at NOCD.

However, there are times when daydreaming can become problematic. “If the situation is that you’re supposed to be doing something and you’re daydreaming, it could be an avoidance behavior,”  says NOCD’s Chief Clinical Officer Dr. Patrick McGrath. “Avoidant behaviors are not things that we wanna do because they do not help us. If someone is daydreaming to escape their thoughts, it’s a problem then.”

Identifying the root causes of excessive daydreaming can help you treat or find a way to balance daydreaming and staying engaged in the present moment—whether that’s managing your thoughts more effectively, using grounding techniques, mindfulness practices, or seeking professional support.

Daydreaming and mental health conditions 

While making up scenarios in your head doesn’t necessarily indicate a mental health condition, excessive daydreaming can be a symptom of underlying issues, such as anxiety, depression, attention-deficit hyperactivity disorder (ADHD), or obsessive-compulsive disorder (OCD). For others, daydreaming may be maladaptive, characterized as vivid daydreams for hours on end causing someone to neglect their responsibilities and relationships. 

Daydreaming might look different for everyone depending on their mental state and situation. For someone experiencing depression, daydreaming may be a form of escapism. Escapism involves trying to avoid difficult or stressful situations by distracting yourself with enjoyable ones. This can include daydreaming, watching movies, reading books, or playing video games. 

Used as a coping skill, escapism was linked to depression and had both a direct effect on future depression—worsening the negative impact of stress. 

Someone with anxiety might daydream about what might happen in the future. This might cause anticipatory anxiety, or feeling of anxiety or dread that occurs in response to upcoming events or situations before they actually happen. You might daydream about being late to work, failing a test, or stumbling over your words during a presentation. These thoughts can spiral into worst-case scenarios, fueling feelings of panic or helplessness. 

Additionally, struggling to concentrate might look like daydreaming for someone with ADHD. For those who find it hard to focus on tasks, daydreaming can act as a way to escape from the pressure of their responsibilities. “It can also be hard for some folks whether or not you have a diagnosis [of ADHD] just to sustain attention for very long periods of time,” Dr. McGrath says. “Other people may find that they get really creative and things pop into their head when they think.”

OCD and intrusive thoughts

Intrusive thoughts can often intertwine with daydreaming, causing you to play scenarios in your head that are similar to daydreaming. However, intrusive thoughts are often disturbing and unwanted. They may include:

• Imagining hurting someone or yourself
• Thinking about death, whether your own or a loved one’s
• Visualizing catastrophic events, such as accidents or natural disasters
• Fearing that you will lose control over your actions

Although anyone can have intrusive thoughts, they are also a symptom of obsessive-compulsive disorder. OCD is characterized by obsessions, or recurrent or unwanted thoughts, urges, feelings, sensations, and images that cause distress. In response, you may perform compulsions, or repetitive behaviors or mental acts that are done to neutralize a thought or decrease anxiety caused by obsessions. 

“Intrusive thoughts can get into anything, even daydreaming,” Dr. McGrath says. “So you could just be kinda daydreaming, and then suddenly, an intrusive thought pops into your head. Dreams, daydreams, whatever it is, they know no limits, whatsoever.”

Exposure and response prevention therapy (ERP) is an evidence-based treatment specifically created to treat OCD. Working alongside a trained therapist, you work to carefully confront your triggers while resisting the urge to do compulsions. Long-term, you will develop the tools to handle intrusive thoughts so they’ll become less distressing over time. 

Dissociation

Dissociation is a mental process where a person feels disconnected from their thoughts, feelings, memories, or sense of identity. When you’re experiencing dissociation, your brain is trying to protect itself from stressful situations or from experiencing extreme emotions after a traumatic event. This can be a natural reaction to trauma and a coping mechanism. 

Although dissociation can include daydreaming, dissociation often involves a disconnection from one’s thoughts, feelings, or sense of self. While daydreaming can be a creative or imaginative escape, dissociation may lead to feelings of detachment or unreality, making it difficult to engage with the present moment. People who experience dissociation might feel as though they are observing themselves from outside their body, or they may have gaps in memory regarding certain events. However, they still have awareness of their surroundings. 

Often described as a psyche escape, dissociation is a symptom of multiple mental health conditions including depression, anxiety, OCD, borderline personality disorder (BPD), and posttraumatic stress disorder (PTSD). 

Treatment for dissociation includes trauma-focused therapies such as eye movement desensitization and reprocessing (EMDR), psychotherapy, or specialized trauma therapy. These therapies work to address the root cause of trauma and reprocess old traumatic events. 

Maladaptive daydreaming

Maladaptive daydreaming (MD) describes individuals who immerse themselves in vivid, elaborate daydreams for hours, often neglecting real-life relationships and responsibilities. 

Some examples of maladaptive daydreaming include: 

• You find yourself pacing around your room, completely lost in your own world
• You’ll start thinking about a story or scenario and suddenly realize it’s 4 a.m. 
• You spend hours developing characters and plots in your mind, crafting entire worlds
• You feel real emotion during these daydreams, which have the ability to make you laugh and cry 

Daydreaming is a universal phenomena that does not have a negative impact on most people’s lives. In fact, daydreaming can enhance learning, planning, and thinking, promotes creativity, and facilitates problem solving. Maladaptive daydreaming, however, can interfere with aspects of life, such as relationships, work, and daily responsibilities. People may find themselves spending hours lost in elaborate fantasies, which can lead to neglecting important tasks or failing to talk to loved ones. 

Although maladaptive daydreaming is not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is often described as a symptom of mental health conditions such as anxiety disorders, OCD, ADHD, PTSD, and depression. Like dissociation, maladaptive dreaming can also develop as a coping strategy against negative events. 

Therapies like cognitive behavioral therapy (CBT) and talk therapy can help you manage maladaptive daydreaming since there is no official treatment for the condition. CBT works to eliminate avoidant behaviors by identifying and changing thought patterns that have a negative effect on emotions and behaviors. Through this process, you can learn to recognize triggers for your daydreaming and develop healthier coping mechanisms.

How to stop daydreaming

Dr. McGrath reiterates that daydreaming is a normal experience for many people. “I don’t want to say that daydreaming is bad for everybody because for some people, it can be a very great experience. But for other people, it might be a very interfering experience. If you’re daydreaming and it’s affecting your daily functioning, you should get help.”

If you believe that you are using daydreaming as a form of avoidance, here are some tips:

• Talk to a therapist. To better understand how your daydreaming is affecting you, and how you can make positive changes, talk with a mental health professional. 
• Practice mindfulness. Mindfulness techniques, such as meditation or grounding exercises, including the awareness of your thoughts, feelings, bodily sensations, and surrounding environment, can encourage you to focus on the present moment and reduce the urge to daydream. Practicing mindfulness can be as easy as focusing on your breathing, sitting, walking, or scanning your body for any sensations. 
• Create balance. Setting a short amount of time to daydream can be helpful instead of trying to completely eliminate it from your life. By scheduling specific periods for daydreaming, you can create a structured way to enjoy these thoughts without letting them interfere with daily responsibilities. “You should program some specific daydreaming time,” Dr. McGrath suggests. “You can purposely just kind of get it out of the way. Because whether you worry for 5 hours or 20 minutes, you’re gonna get the same result.”

When should I seek help?

Everyone daydreams and creates scenarios in their heads. It’s only when you feel like daydreaming is disrupting your life—interfering with your responsibilities, relationships, or overall well-being—that it may be time to take a closer look. 

If you think that you’re daydreaming as a result of a mental health condition, speaking to a therapist can help you identify any underlying issues that may be contributing to your daydreaming, such as anxiety, depression, trauma, or OCD.