I'll try to resume what has been said in the long phonecall I had concerning treatment for MDD. A lot of things were said but maybe not in that order, anyhow, here's a resume.

The root of the cause, at least in my personal case (and I think it's right) would be a heightened sensitivity, probably processing physical sensations and the outer world differently. Also, in my case I am someone with a high baseline, existential anxiety, I don't feel at ease with the world. When children daydream or pretend-play it's a way to "practice" with all that input, but the mecanism becomes a defence strategy, some sort of layer of distance between the self and being in the world. When children become able to think logically and rationally that also becomes a favoured mecanism of creating distance, especially from emotions, as it allows to put a damper on everything by rationalising. They said it's often seen that DDers are actually refraining from feeling their own emotions, and prefer to feel "other people's" (=their avatars') or think about it.

I liked  how they didn't put the daydreaming in a bad perspective. For them, the essence of human life is taking the things that happen to us and weaving them into significance, some story of our own, our personalities, except that daydreamer's have taken this capacity to a pinnacle, and they can integrate and create several environments, personalities, constantly experiencing the plasticity of what "experienced life" is itself.

Unfortunately, coupled with a continuous "overwhelm" from the world (because the senses are too strong or coping mecanisms are put in place badly), and some sort of baseline anxiety (can come from the childhood upbringing, situation you're in, or simply being wired in a high-strung way) the need can become compulsive. That compulsivity is rarely as full blown as in schizophrenia or OCD, because you realise you are still in a daydream and not in real life, but there is an element of need to it, a difficulty to break away and go back to daily life. I personally have some "gray areas" of compulsivity, checking doors and windows a lot, self-medicating with alcohol and sugar, with procrastination, being unable to sleep because I'm in a daydream, not feeling hunger when I DD, etc. 

Now after all the theoretical framework in which this happens, there are some solutions.

They said another coping mecanism can be relearnt but that those are typically the hardest therapies and it's more or less one year of intensive, partially in-patient therapy. They said given that I still have some flexibility (different worlds and sometimes the capacity to break away from it) they don't think it's the best option.

Medication-wise, stimulants are dangerous because they increase the baseline anxiety, even if the overwhelm can feel lessened because you actually do things. They didn't put much credit into anti-depressants. Anti-anxiety medication might work, however, it is often pretty addictive. They would go down the road of a very low level of some atypical anti-psychotics to be able to control the compulsion to dream while not hindering the capacity and allowing for clearer thoughts. I wasn't really open to that, and I must admit I'm not a fan of medication in the first place.

They said the other options were to step outside of the over-intellectualisation which is another of my defense strategies, so no talk-therapy on its own, and turn to things like meditation and yoga. They said it would probably cause a lot of emotions to "get loosened" and that it was really important that I actually make the effort to work though those things, without judging them or trying to analyze them into some sort of grand life lesson.

Sorry for the long post. So basically, now, I'm on a one-month trial period of meditation at least 15 minutes 5 days a week (to be increased) and yoga 2x a week. If I can't seem to make it work they recommend medication, especially since, in my case, my capacity to work and be productive is on the brink of collapsing.

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Comment by Alexis Faith on February 14, 2015 at 7:22pm
Every thing you wrote is true about me too.. I'm trying to see if there's anything that can help without medication
Comment by MatthewR on February 9, 2015 at 8:21pm

I, too, am skeptical about medications. I have been on antidepressants, anti-anxiety meds, and anti-psychotics in the past, but there was no difference in the frequency of my daydreaming. Although the intensity of my DD'ing did decrease, it came at the expense of everything else as well--diminished affect, low motivation, and a constant "spaced out" feeling which made even positive experiences flat and lifeless. In short, I felt like a zombie. 

I will also echo the other comments. I'm glad they are taking you seriously. I've mentioned excessive daydreaming before to my doctor, but it was ignored. I also think your interpretation of the condition is closer to the truth, at least for me. I am approaching the age of 30, and I am only now realizing how much of my emotional self has been closed off. Crying fits, outbursts that don't fit the situation, neurotic symptoms, etc. have always been there, but I've never wanted to admit that i was an emotional person. I've always taken myself for an intellectual, but the way i act in reality is so completely at odds with the way i see myself in daydreams. I've been self monitoring a lot lately, and the things i say or do seem to betray me. It's enough to make me paranoid. I'm taking an alternative approach to medications and am looking at my daydreams as if they are psychodrama in an effort to better understand what's going on subconsciously. It's been really helpful but also very depressing. It's become apparent to me that a significant part of my emotional self is "stuck" in the past, and I need to get it un-stuck somehow if i am to move forward.

Comment by Elizabeth on February 9, 2015 at 6:50pm

Agreed. It's great they are willing to help and seem to treat this seriously the way it should be!

I do have to say that I especially approve of the general skeptical attitude regarding medication for treating MDD. Not that medication in general is bad; it's just that we know so little about MDD as it is that I feel like it could be really dangerous (although tempting) to start medicating, unless it's as a last resort. Particularly with drugs that are meant to treat other things and not MDD. 

Glad to see you have found this though! I hope this goes well for you! 

Comment by Reverie on February 9, 2015 at 12:23pm

It's good that you actually decided to talk about daydreaming with a specialist and that they actually treated you seriously.

I have regular meeting with a psychologist and I told them about my daydreaming (without going into details, because I still feel a mixture of shame and defensiveness), and they told me something quite similar - that in my case daydreaming used to be a coping strategy which worked really well in childhood, but became maladaptive in the teenager years and my early adult life, because it complicates my life more than simplifies it. 

Right now I've been asked to make a list of advantages and disadvantages of having my 'alternative world' and while I could scribble down loads of negative things about it, I quickly ran out of ideas when mentioning the good stuff. They also want me to monitor when I slip into daydreaming to find whether there is some kind of pattern and what can possibly trigger my 'retreat'. 

Anyway, I keep my fingers crossed for you and I hope that you're going to share your thoughts about the treatment during the process. Good luck!

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