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The secret life of maladaptive daydreaming
Daydreaming can be a pleasant pastime, but people who suffer from maladaptive daydreaming are trapped by their fantasies.
James Thurber's short story "The Secret Life of Walter Mitty" follows its mild-mannered protagonist through another mundane day of thankless chores. But Mitty is a daydreamer. He spices up his humdrum existence—and, thankfully, the story itself—through fantasies. Real-world events cause Mitty to imagine he's an ace hydroplane pilot, a brilliant surgeon, and an assassin on trial.
Thurber's character fits many readers like a driving glove because, as science has discovered, we all have a little Walter Mitty in us.
Research suggests that our minds wander close to 50 percent of the time, and we use these mental getaways to imagine our lives in all manner of fun and fanciful scenarios. We fantasize about the perfect meet-cute, or starting an exciting new career, or what we'd do with superpowers, or unbridled sexual encounters. Mostly it's sex.
And despite admonishments from our Victorian-styled teachers and supervisors, a mind in the clouds comes associated with a bevy of cognitive benefits. These include greater creativity, improved productivity, better problem-solving, and progress toward goals. Daydreaming is, in short, a virtue.
Except when it isn't, and here the darker undertones of Thurber's story come into play. It's hinted that Mitty may not be enjoying playful escapism but suffering from an uncontrollable urge to disassociate from his life, his responsibilities, and his relationships. Today, psychologists are researching whether such a Mittyesque existence may be the result of a new disorder known as maladaptive daydreaming.
One maladaptive dreamer spent hours a day dreaming he was a powerful man who could solve the world's problems.
Daydreaming is an indulgence of the mind and imagination, one provided courtesy of the default mode network, a network of interacting brain regions that is active even when the conscious mind is not. But like so many of life's indulgences—wine, steak dinners, video games, and even exercise—too much daydreaming can be harmful to our well-being. When daydreaming crosses that threshold, it can be considered maladaptive.
This disorder was first identified by Eli Somer, a professor of clinical psychology at the University of Haifa, School of Social Work, in a 2002 paper. That paper looked to six patients in a trauma center whose daydreaming habits replaced human interactions or interfered with their standard life functions, such as going to school or holding down a job.
Since then, other case studies have looked at maladaptive daydreamers and compiled a list of potential symptoms. These include vivid, richly-detailed daydreams; abnormally long daydreaming sessions; daydreams triggered by real-life events; daydreaming sessions that interrupt sleep; and repetitive motions or whisperings while daydreaming. On average, one study reported, maladaptive daydreamers spend four hours a day housed in their imaginations.
"This is not like rehearsing a conversation that you might have with a boss," Somer told CNN. "This is fanciful, weaving of stories. It produces an intense sense of presence."
While such symptoms are common, though not comprehensive or guaranteed, how maladaptive daydreams manifest are naturally individual to the dreamers. In one case study, researchers analyzed the diary of a man codenamed "Peter." Peter described investing as many as 14 hours a day online. The news and images he happened upon would trigger related fantasies. For example, he may envision himself as a multimillionaire genius who could prevent bad news from occurring or self-insert himself into the power fantasies of superhero movies or police procedurals for hours at a time.
"When I felt this pain as a child, I started imagining how things could be different. I created stories which never happened. To suppress that pain I would hug my pillow or quilt, thinking I was being comforted by someone else," Peter wrote.
In an interview with CNN, Cordellia Rose described her maladaptive daydreaming like a drug and noted that her daydreams developed into intricate storylines that could last for years. These stories proved so distracted that she was unable to complete everyday tasks such as driving lessons.
"You get hooked on it, because it can be like an action movie in your head that's so gripping that you cannot turn off," Rose told CNN. "This [condition] needs to be public, because these are people suffering, and badly."
To be clear, maladaptive dreaming is not a psychotic disorder like schizophrenia. Daydreamers such as Peter and Rose are aware that their fantasies are as unreal as they may be unrealistic. Because of this, many maladaptive dreamers understand the difficulties they face and the real-life losses they have endured for the sake of their fantasies.
More research needed
Researchers don't have a standard diagnosis or treatment for maladaptive daydreaming because they aren't yet sure it's a unique psychological condition. Maladaptive daydreaming has not been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition—blessedly abbreviated as the DMS-5—the definitive book on mental disorders. To date, there isn't enough evidence to determine if maladaptive daydreaming is a separate condition or a manifestation of an already listed disorder.
Somer has developed a 14-point scale to help people determine whether they are experiencing maladaptive-daydreaming symptoms, but the results only indicate whether an individual should seek help. They provide no formal diagnosis.
Also, maladaptive daydreaming is often expressed alongside other conditions, such as anxiety disorders, dissociative disorders, attention deficit disorders, and obsessive-compulsive disorders. And the researchers of Peter's case study noticed a striking similarity between his condition and those with behavioral addition response—including analogous responses with preoccupation, mood modification, tolerance, and withdrawal. It may be that maladaptive daydreaming is an expression of these, or other, disorders.
It's worth noting that similar empirical hurdles exist for other well-known, though not formalized, disorders. Orthorexia, sex addiction, misophonia, internet addiction, and parental alienation syndrome are all likewise absent from the DSM-5. For maladaptive daydreaming and these other conditions, it's simply a case of more evidence and research needed before a determination can be made.
A growing understanding of maladaptive daydreaming
The question of labeling is a tricky one—not only from a medical point-of-view but also a prosocial one. Some people find having a recognized condition validating; they feel it promotes social acceptance and makes seeking treatment easier. Others find such labels stigmatizing and restricting.
But the question of how to label something is an academic one. It isn't to say that the experience doesn't exist. It does, and whether maladaptive daydreaming ultimately enters the DSM-5 or not, awareness is growing. Online communities now exist to give support and spread awareness. And regardless of a condition's presence in the medical literature, if symptoms disrupt work, school, or social lives, help should be sought.
Thanks to the efforts of psychologists and the community, maladaptive daydreaming, unlike Thurber's literary creation, is no longer "inscrutable to the last." And those who suffer it are no longer relegated to a firing-squad of their own mind but can find they help the need.
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Scientists are using bioelectronic medicine to treat inflammatory diseases, an approach that capitalizes on the ancient "hardwiring" of the nervous system.
- Bioelectronic medicine is an emerging field that focuses on manipulating the nervous system to treat diseases.
- Clinical studies show that using electronic devices to stimulate the vagus nerve is effective at treating inflammatory diseases like rheumatoid arthritis.
- Although it's not yet approved by the US Food and Drug Administration, vagus nerve stimulation may also prove effective at treating other diseases like cancer, diabetes and depression.
The nervous system’s ancient reflexes<p>You accidentally place your hand on a hot stove. Almost instantaneously, your hand withdraws.</p><p>What triggered your hand to move? The answer is <em>not</em> that you consciously decided the stove was hot and you should move your hand. Rather, it was a reflex: Skin receptors on your hand sent nerve impulses to the spinal cord, which ultimately sent back motor neurons that caused your hand to move away. This all occurred before your "conscious brain" realized what happened.</p><p>Similarly, the nervous system has reflexes that protect individual cells in the body.</p><p>"The nervous system evolved because we need to respond to stimuli in the environment," said Dr. Tracey. "Neural signals don't come from the brain down first. Instead, when something happens in the environment, our peripheral nervous system senses it and sends a signal to the central nervous system, which comprises the brain and spinal cord. And then the nervous system responds to correct the problem."</p><p>So, what if scientists could "hack" into the nervous system, manipulating the electrical activity in the nervous system to control molecular processes and produce desirable outcomes? That's the chief goal of bioelectronic medicine.</p><p>"There are billions of neurons in the body that interact with almost every cell in the body, and at each of those nerve endings, molecular signals control molecular mechanisms that can be defined and mapped, and potentially put under control," Dr. Tracey said in a <a href="https://www.youtube.com/watch?v=AJH9KsMKi5M" target="_blank">TED Talk</a>.</p><p>"Many of these mechanisms are also involved in important diseases, like cancer, Alzheimer's, diabetes, hypertension and shock. It's very plausible that finding neural signals to control those mechanisms will hold promises for devices replacing some of today's medication for those diseases."</p><p>How can scientists hack the nervous system? For years, researchers in the field of bioelectronic medicine have zeroed in on the longest cranial nerve in the body: the vagus nerve.</p>
The vagus nerve<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYyOTM5OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NTIwNzk0NX0.UCy-3UNpomb3DQZMhyOw_SQG4ThwACXW_rMnc9mLAe8/img.jpg?width=1245&coordinates=0%2C0%2C0%2C0&height=700" id="09add" class="rm-shortcode" data-rm-shortcode-id="f38dbfbbfe470ad85a3b023dd5083557" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
Electrical signals, seen here in a synapse, travel along the vagus nerve to trigger an inflammatory response.
Credit: Adobe Stock via solvod<p>The vagus nerve ("vagus" meaning "wandering" in Latin) comprises two nerve branches that stretch from the brainstem down to the chest and abdomen, where nerve fibers connect to organs. Electrical signals constantly travel up and down the vagus nerve, facilitating communication between the brain and other parts of the body.</p><p>One aspect of this back-and-forth communication is inflammation. When the immune system detects injury or attack, it automatically triggers an inflammatory response, which helps heal injuries and fend off invaders. But when not deployed properly, inflammation can become excessive, exacerbating the original problem and potentially contributing to diseases.</p><p>In 2002, Dr. Tracey and his colleagues discovered that the nervous system plays a key role in monitoring and modifying inflammation. This occurs through a process called the <a href="https://www.nature.com/articles/nature01321" target="_blank" rel="noopener noreferrer">inflammatory reflex</a>. In simple terms, it works like this: When the nervous system detects inflammatory stimuli, it reflexively (and subconsciously) deploys electrical signals through the vagus nerve that trigger anti-inflammatory molecular processes.</p><p>In rodent experiments, Dr. Tracey and his colleagues observed that electrical signals traveling through the vagus nerve control TNF, a protein that, in excess, causes inflammation. These electrical signals travel through the vagus nerve to the spleen. There, electrical signals are converted to chemical signals, triggering a molecular process that ultimately makes TNF, which exacerbates conditions like rheumatoid arthritis.</p><p>The incredible chain reaction of the inflammatory reflex was observed by Dr. Tracey and his colleagues in greater detail through rodent experiments. When inflammatory stimuli are detected, the nervous system sends electrical signals that travel through the vagus nerve to the spleen. There, the electrical signals are converted to chemical signals, which trigger the spleen to create a white blood cell called a T cell, which then creates a neurotransmitter called acetylcholine. The acetylcholine interacts with macrophages, which are a specific type of white blood cell that creates TNF, a protein that, in excess, causes inflammation. At that point, the acetylcholine triggers the macrophages to stop overproducing TNF – or inflammation.</p><p>Experiments showed that when a specific part of the body is inflamed, specific fibers within the vagus nerve start firing. Dr. Tracey and his colleagues were able to map these relationships. More importantly, they were able to stimulate specific parts of the vagus nerve to "shut off" inflammation.</p><p>What's more, clinical trials show that vagus nerve stimulation not only "shuts off" inflammation, but also triggers the production of cells that promote healing.</p><p>"In animal experiments, we understand how this works," Dr. Tracey said. "And now we have clinical trials showing that the human response is what's predicted by the lab experiments. Many scientific thresholds have been crossed in the clinic and the lab. We're literally at the point of regulatory steps and stages, and then marketing and distribution before this idea takes off."<br></p>
The future of bioelectronic medicine<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYxMDYxMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjQwOTExNH0.uBY1TnEs_kv9Dal7zmA_i9L7T0wnIuf9gGtdRXcNNxo/img.jpg?width=980" id="8b5b2" class="rm-shortcode" data-rm-shortcode-id="c005e615e5f23c2817483862354d2cc4" data-rm-shortcode-name="rebelmouse-image" data-width="2000" data-height="1125" />
Vagus nerve stimulation can already treat Crohn's disease and other inflammatory diseases. In the future, it may also be used to treat cancer, diabetes, and depression.
Credit: Adobe Stock via Maridav<p>Vagus nerve stimulation is currently awaiting approval by the US Food and Drug Administration, but so far, it's proven safe and effective in clinical trials on humans. Dr. Tracey said vagus nerve stimulation could become a common treatment for a wide range of diseases, including cancer, Alzheimer's, diabetes, hypertension, shock, depression and diabetes.</p><p>"To the extent that inflammation is the problem in the disease, then stopping inflammation or suppressing the inflammation with vagus nerve stimulation or bioelectronic approaches will be beneficial and therapeutic," he said.</p><p>Receiving vagus nerve stimulation would require having an electronic device, about the size of lima bean, surgically implanted in your neck during a 30-minute procedure. A couple of weeks later, you'd visit, say, your rheumatologist, who would activate the device and determine the right dosage. The stimulation would take a few minutes each day, and it'd likely be unnoticeable.</p><p>But the most revolutionary aspect of bioelectronic medicine, according to Dr. Tracey, is that approaches like vagus nerve stimulation wouldn't come with harmful and potentially deadly side effects, as many pharmaceutical drugs currently do.</p><p>"A device on a nerve is not going to have systemic side effects on the body like taking a steroid does," Dr. Tracey said. "It's a powerful concept that, frankly, scientists are quite accepting of—it's actually quite amazing. But the idea of adopting this into practice is going to take another 10 or 20 years, because it's hard for physicians, who've spent their lives writing prescriptions for pills or injections, that a computer chip can replace the drug."</p><p>But patients could also play a role in advancing bioelectronic medicine.</p><p>"There's a huge demand in this patient cohort for something better than they're taking now," Dr. Tracey said. "Patients don't want to take a drug with a black-box warning, costs $100,000 a year and works half the time."</p><p>Michael Dowling, president and CEO of Northwell Health, elaborated:</p><p>"Why would patients pursue a drug regimen when they could opt for a few electronic pulses? Is it possible that treatments like this, pulses through electronic devices, could replace some drugs in the coming years as preferred treatments? Tracey believes it is, and that is perhaps why the pharmaceutical industry closely follows his work."</p><p>Over the long term, bioelectronic approaches are unlikely to completely replace pharmaceutical drugs, but they could replace many, or at least be used as supplemental treatments.</p><p>Dr. Tracey is optimistic about the future of the field.</p><p>"It's going to spawn a huge new industry that will rival the pharmaceutical industry in the next 50 years," he said. "This is no longer just a startup industry. [...] It's going to be very interesting to see the explosive growth that's going to occur."</p>
Japan looks to replace China as the primary source of critical metals
- Enough rare earth minerals have been found off Japan to last centuries
- Rare earths are important materials for green technology, as well as medicine and manufacturing
- Where would we be without all of our rare-earth magnets?
What are the rare earth elements?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA2MTM0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzODExMjMyMn0.owchAgxSBwji5IofgwKtueKSbHNyjPfT7hTJrHpTi98/img.jpg?width=980" id="fd315" class="rm-shortcode" data-rm-shortcode-id="d8ed70e3d0b67b9cbe78414ffd02c43e" data-rm-shortcode-name="rebelmouse-image" />
(julie deshaies/Shutterstock)<p>The rare earth metals can be mostly found in the second row from the bottom in the Table of Elements. According to the <a href="http://www.rareearthtechalliance.com/What-are-Rare-Earths" target="_blank"><u>Rare Earth Technology Alliance</u></a>, due to the "unique magnetic, luminescent, and electrochemical properties, these elements help make many technologies perform with reduced weight, reduced emissions, and energy consumption; or give them greater efficiency, performance, miniaturization, speed, durability, and thermal stability."</p><p>In order of atomic number, the rare earths are:</p> <ul> <li>Scandium or Sc (21) — This is used in TVs and energy-saving lamps.</li> <li>Yttrium or Y (39) — Yttrium is important in the medical world, used in cancer drugs, rheumatoid arthritis medications, and surgical supplies. It's also used in superconductors and lasers.</li> <li>Lanthanum or La (57) — Lanthanum finds use in camera/telescope lenses, special optical glasses, and infrared absorbing glass.</li> <li>Cerium or Ce (58) — Cerium is found in catalytic converters, and is used for precision glass-polishing. It's also found in alloys, magnets, electrodes, and carbon-arc lighting. </li> <li>Praseodymium or Pr (59) — This is used in magnets and high-strength metals.</li> <li>Neodymium or Nd (60) — Many of the magnets around you have neodymium in them: speakers and headphones, microphones, computer storage, and magnets in your car. It's also found in high-powered industrial and military lasers. The mineral is especially important for green tech. Each <a href="https://www.reuters.com/article/us-mining-toyota/as-hybrid-cars-gobble-rare-metals-shortage-looms-idUSTRE57U02B20090831" target="_blank"><u>Prius</u></a> motor, for example, requires 2.2 lbs of neodymium, and its battery another 22-33 lbs. <a href="https://pubs.usgs.gov/sir/2011/5036/sir2011-5036.pdf" target="_blank"><u>Wind turbine batteries</u></a> require 450 lbs of neodymium per watt. </li> <li>Promethium or Pm (61) — This is used in pacemakers, watches, and research.</li> <li>Samarium or Sm (62) — This mineral is used in magnets in addition to intravenous cancer radiation treatments and nuclear reactor control rods.</li> <li>Europium or Eu (63) — Europium is used in color displays and compact fluorescent light bulbs.</li> <li>Gadolinium or Gd (64) — It's important for nuclear reactor shielding, cancer radiation treatments, as well as x-ray and bone-density diagnostic equipment.</li> <li>Terbium or Tb (65) — Terbium has similar uses to Europium, though it's also soft and thus possesses unique shaping capabilities .</li> <li>Dysprosium or Dy (66) — This is added to other rare-earth magnets to help them work at high temperatures. It's used for computer storage, in nuclear reactors, and in energy-efficient vehicles.</li> <li>Holmium or Ho (67) — Holmium is used in nuclear control rods, microwaves, and magnetic flux concentrators.</li> <li>Erbium or Er (68) — This is used in fiber-optic communication networks and lasers.</li> <li>Thulium or Tm (69) — Thulium is another laser rare earth.</li> <li>Ytterbium or Yb (70) — This mineral is used in cancer treatments, in stainless steel, and in seismic detection devices.</li> <li>Lutetium or Lu (71) — Lutetium can target certain cancers, and is used in petroleum refining and positron emission tomography.</li></ul>
Where Japan found is rare earths<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA2MTM0OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1MTA0NzUxNn0.N3t_iKf6lnnoJ6yVUtl8-wNZICEG2ZxyPzm9ZdE99ks/img.jpg?width=980" id="021b7" class="rm-shortcode" data-rm-shortcode-id="d9dd843fde547a0b69f8798aca18a706" data-rm-shortcode-name="rebelmouse-image" />
Minimatori Torishima Island
(Chief Master Sergeant Don Sutherland, U.S. Air Force)<p>Japan located the rare earths about 1,850 kilometers off the shore of <a href="https://en.wikipedia.org/wiki/Minami-Tori-shima" target="_blank"><u>Minamitori Island</u></a>. Engineers located the minerals in 10-meter-deep cores taken from sea floor sediment. Mapping the cores revealed and area of approximately 2,500 square kilometers containing rare earths.</p><p>Japan's engineers estimate there's 16 million tons of rare earths down there. That's <a href="https://minerals.usgs.gov/minerals/pubs/historical-statistics/ds140-raree.xlsx" target="_blank"><u>five times</u></a> the amount of the rare earth elements ever mined since 1900. According to <a href="https://www.businessinsider.com.au/rare-earth-minerals-found-in-japan-2018-4?r=US&IR=T" target="_blank"><u>Business Insider</u></a>, there's "enough yttrium to meet the global demand for 780 years, dysprosium for 730 years, europium for 620 years, and terbium for 420 years."</p><p>The bad news, of course, is that Japan has to figure out how to extract the minerals from 6-12 feet under the seabed four miles beneath the ocean surface — that's the <a href="https://www.nature.com/articles/s41598-018-23948-5" target="_blank"><u>next step</u></a> for the country's engineers. The good news is that the location sits squarely within Japan's Exclusive Economic Zone, so their rights to the lucrative discovery will be undisputed.</p>
"The Expanse" is the best vision I've ever seen of a space-faring future that may be just a few generations away.
- Want three reasons why that headline is justified? Characters and acting, universe building, and science.
- For those who don't know, "The Expanse" is a series that's run on SyFy and Amazon Prime set about 200 years in the future in a mostly settled solar system with three waring factions: Earth, Mars, and Belters.
- No other show I know of manages to use real science so adeptly in the service of its story and its grand universe building.
Credit: "The Expanse" / Syfy<p>Now, I get it if you don't agree with me. I love "Star Trek" and I thought "Battlestar Galactica" (the new one) was amazing and I do adore "The Mandalorian". They are all fun and important and worth watching and thinking about. And maybe you love them more than anything else. But when you sum up the acting, the universe building, and the use of real science where it matters, I think nothing can beat "The Expanse". And with a <a href="https://www.rottentomatoes.com/tv/the_expanse" target="_blank">Rotten Tomato</a> average rating of 93%, I'm clearly not the only one who feels this way.</p><p>Best.</p><p>Show.</p><p>Ever. </p>
Contrary to what some might think, the brain is a very plastic organ.
As with many other physicians, recommending physical activity to patients was just a doctor chore for me – until a few years ago. That was because I myself was not very active.