Imagine a student who stares blankly into space, loses track of conversations, and works more slowly than classmates. She is not disruptive. Her teacher calls her lazy. Her parents suspect depression. Her pediatrician considers ADHD.

But what if none of these labels quite capture what is happening?

That question is driving interest in cognitive disengagement syndrome (CDS), a condition involving excessive daydreaming, mental confusion, and underactivity. Once called sluggish cognitive tempo, CDS is increasingly recognized as related to, but distinct from, ADHD. Yet it is not currently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Should it be? We don’t know. Finding out should be a research priority.

My recent research helps illustrate why. In a study of 306 adults referred for ADHD evaluation, 186 showed elevated CDS symptoms. Of those, nearly one in five did not meet criteria for ADHD, generalized anxiety disorder, major depressive disorder, or persistent depressive disorder. This doesn’t prove that CDS is a distinct disorder, but it makes CDS harder to dismiss as merely another manifestation of disorders we already recognize.

My findings are consistent with a broader body of research distinguishing CDS from other conditions. In a 2025 review, leading CDS researcher Dr. Stephen Becker noted that CDS symptoms are distinct from ADHD symptoms and are associated with important problems in daily life. But Becker also emphasized that being distinct from ADHD and linked to impairment is not enough, on its own, to establish CDS as a psychiatric disorder. We need to learn more about CDS, including what causes it, how it develops over time, how it relates to other conditions, and how best to treat it, before we can determine whether it warrants classification as a disorder.

Some researchers believe the science is settled. Renowned ADHD expert Dr. Russell Barkley has argued for years that CDS should already be recognized as a disorder. Formal recognition could improve identification, spur research, and lead to more targeted treatment and support.

Former DSM-IV task force chair Dr. Allen Frances strongly disagrees. He has called the concept of CDS “dumb” and “dangerous,” warning that modern psychiatry tends to turn ordinary human experiences into disorders, leading to overdiagnosis.

That concern deserves serious consideration. Everyone daydreams. Everyone gets confused. Everyone gets tired. But caution does not require rejecting new disorders simply because they involve universal experiences. These experiences can still become clinically significant when they are persistent, severe, and impairing. After all, depression is not dismissed as a disorder because everyone gets sad. Overdiagnosis, underdiagnosis, and misdiagnosis are all real risks.
Careful research is how we reduce all three.

This debate is not just academic. Becker quoted several unsolicited emails from people who recognized themselves or their children in descriptions of CDS and found the experience profoundly validating. One described discovering CDS as “finding the thing you have been searching for your entire life.” That validation is echoed on Reddit, where thousands of users discuss CDS and their own lived experiences with it. These reactions remind us what’s at stake: people are already seeking explanations for difficulties that existing labels have not fully captured.

The evidence is too strong to justify ignoring CDS, but not yet strong enough to justify calling it a psychiatric disorder. Researchers and funding agencies should prioritize research on CDS without waiting for formal recognition. That research is necessary to determine how CDS should ultimately be classified.

We do not need CDS in the DSM today. We need the evidence that will tell us whether it belongs there tomorrow.