Constant daydreaming could be hidden disorder linked to ADHD

Constant daydreaming could be a symptom of Cognitive Disengagement Syndrome (CDS), a unique cognitive disorder first identified in the 1960s and 70s.

While CDS has often been linked to ADHD, there is ongoing debate about whether it should be considered a separate condition or if patients are being misdiagnosed.

Daydreaming is a key symptom of CDS, but not the only one. Those with the disorder experience such intense daydreams that they struggle to concentrate on tasks for long periods.

Unlike ADHD, CDS does not involve hyperactivity or impulsivity.

Instead, CDS is characterised by a consistently sluggish cognitive tempo, which was also an earlier name for the condition. As a result, people with CDS often face vastly different problems than those with ADHD.

A Spanish study urged that the “symptom cluster” be disconnected from ADHD, highlighting: “A group of youth with clinical CDS can be identified as separable from youth with clinical ADHD presentations.” However, it also noted: “Identifying youth with ‘pure’ CDS is likely rare when other disorders and methods are considered... It is likely that the inclusion of CDS as a diagnostic category would spur intervention (and other) research, aid in the identification of youth experiencing clinically significant and impairing levels of CDS symptoms."

Those with ADHD can focus on tasks but become easily distracted and switch their focus while people with CDS can't manage to make themselves focus in the first place.

There is no official criteria for CDS but some psychologists measures certain symptoms according to questionnaires and behavioural observations. These include frequent daydreaming, mental fogginess and a slow processing speed.

The slow processing speed often becomes apparent in childhood, with parents and teachers describing the child as "out of it" or noting that they take longer to respond to questions and complete tasks. This isn't due to a lack of intelligence or effort but is because individuals with CDS process information at a slower pace.

CDS is not currently recognised as a standalone disorder in the Diagnostic and Statistical Manual of Mental Disorders, though there's a push by some experts and an increasing amount of research to consider it separate from ADHD. At present, it's categorised as a "symptom cluster".

Treatment for CDS mirrors that of ADHD, including cognitive behavioural therapy, and researchers are investigating whether stimulant medications used for ADHD could also be effective for CDS.

To manage CDS symptoms, lifestyle adjustments such as establishing consistent sleep patterns and regular exercise are recommended.

The key difference between CDS and a normal personality trait is the impact on daily life; those affected by CDS face significant disruptions to their academic achievements and social interactions due to excessive daydreaming.

The lack of public and professional knowledge about CDS often leads to sufferers being unfairly labelled as lazy or uncommitted, this ignorance creates a stigma preventing help and treatment.

Furthermore, Cincinnati Children's Hospital highlights that "CDS can also be present in children who do not have ADHD", though it is generally seen more frequently in kids with the inattentive presentation of ADHD. The hospital expressed concern that youngsters diagnosed with both conditions tend to experience higher rates of anxiety, depression, sleep disturbances, and social withdrawal, compared to peers only dealing with ADHD.