One study found that over half of participants with maladaptive daydreaming also exhibited signs of OCD. There seems to be a strong relationship between OCD and maladaptive daydreaming.

Perhaps unsurprisingly, maladaptive daydreaming tends to occur alongside other disorders, the most common being ADHD, anxiety, depression and obsessive compulsive disorder (OCD). In many ways, daydreaming becomes an addictive behaviour that fuels the very problems it was intended to alleviate. But doing so can lead to a vicious cycle of compulsive fantasy, where using fantasy to avoid negative emotions exacerbates the urge to daydream. For example, daydreaming activity can distract from an unpleasant reality which may help to cope with trauma, difficult life events or social isolation. Many discover their ability to create imaginative fantasies in childhood, but not all maladaptive daydreamers may use daydreaming as a coping strategy. By creating an inner world of comfort, they're able to escape from reality. Many discover this ability early on in childhood, realising fantasy and daydreams can be used to regulate distress.

Researchers suspect that people who struggle with maladaptive daydreaming may have an innate ability for immersive imaginative fantasies. What makes daydreaming 'maladaptive' is when it becomes difficult to control, when time to daydream takes precedence over real life, and when the compulsion to daydream interferes with important life goals and relationships. It is important to note that immersive daydreaming and vivid fantasy activity isn't by default maladaptive.

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