Dissociative fugue, formerly called the psychogenic fugue or fugue state, is a subtype of dissociative amnesia . It involves the loss of memory for personal autobiographical information combined with unexpected and sudden trips and sometimes creating a new identity.
What is a dissociative fugue
The word “fugue” comes from the Latin word for “flight,” which reflects the nature of dissociative fugue that involves an element of fleeing from the current situation. Dissociative fugue is a form of reversible amnesia that involves personality, memories, and personal identity. This type of temporary amnesia can last for hours, days, weeks, months, or longer. These are wandering or unplanned trips, in which the person can establish a new identity in a new location very different from his previous life.
While dissociative fugue used to be diagnosed as a separate disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), in the new updated DSM-5 it is a subtype of dissociative amnesia. In general, dissociative disorders involve impaired identity perception, consciousness, and memory.
Dissociative fugue symptoms
What are the symptoms of dissociative fugue? They potentially include all of the following on a case-by-case basis:
- During the fugue state
If you are in the middle of a fugue state, you may have the following symptoms:
- Confusion about your identity
- You seem to be insecure about your past
- Feeling confronted if your identity is questioned
However, it is important to note that a person in the middle of a dissociative fugue may not show any outward signs that suggest they are experiencing mental illness. This is because, from the person’s perspective, the new identity is their real identity. It is only when this is challenged that problems can arise.
- After the leak state ends
Once a dissociative fugue state has passed, you may experience symptoms such as:
- Feelings of depression
- Periods of mourning
- Feelings of shame
- Discomfort or anger
- Feelings of anguish from being in an unfamiliar place
- Feeling like you’ve wasted your time
It should also be noted that a person may experience multiple instances of dissociative fugue, particularly if the underlying cause of the fugue is never addressed.
How is dissociative fugue diagnosed?
Since the launch of DSM-5, dissociative fugue is now a subtype of dissociative amnesia (a disorder) and is known as a confused wandering state. All other subtypes are listed below: selective amnesia, generalized amnesia, continuous amnesia, and systemized amnesia.
Dissociative leak will not be diagnosed if the leak status is directly related to any of the following conditions or situations:
- Consumption of psychotropic substances
- Experience of physical trauma
- General medication conditions
- Dissociative identity disorder
- Diagnosis of delirium
- Diagnosis of dementia
- Dementia trauma
- Head trauma
- Ingestion of drugs or alcohol
- Sleep deprivation
In this way, it is important to emphasize that dissociative fugue and dissociative amnesia as a general condition is a neurological impairment and not due to any physical cause or substance that has been taken. Also, in very rare cases, people can fake a dissociative fugue for legal or other reasons. This would be discovered during a complete physical and mental examination.
Causes of dissociative fugue
What are the causes of dissociative fugue? Below is a list of some possible related causes. In general, these situations involve some kind of violence or terrible trauma: ??
- Child sexual abuse
- Experience of violence (eg rape, torture)
- Fight violence
- Suicide attempt
- Car accident
- Natural disasters
- Commit a homicide
- Severe stress (marital or financial)
While it may show up well after trauma, early trauma triggers could cause dissociative fugue. For example, seeing an abuser later in life or experiencing an event that reminds them of the previous event (for example, seeing a small fire after being involved in a tragic fire). In this way, events have the potential to trigger a massive reaction because they somehow come into contact with the trauma in memory.
Additionally, there is evidence that there may be a genetic link as family members of people with dissociative fugue may also be more likely to experience the condition.
Dissociative fugue treatment
The outlook for dissociative fugue is good since most people regain their memory with everything intact. The goal of treatment is therefore twofold:
- Help regain identity and develop coping strategies to prevent the same thing from happening again.
- Help the person accept and deal with the original trauma that triggered the episode.
There are several types of treatment that can be used with a person who has experienced a dissociative fugue;
- Psychotherapy to understand thought patterns
- Medications for related depression and anxiety
- Family therapy to ensure you receive support
- Art therapy to explore feelings safely
- Clinical hypnosis to explore the original trauma
- Eye movement desensitization and reprocessing to treat nightmares, flashbacks and symptoms of PTSD
- Dialectical behavioral therapy to help with personality disorders, dissociative symptoms, after abuse and / or trauma
- Meditation and / or relaxation techniques to control symptoms and control the internal state.
Unfortunately, without treatment of the underlying problem, dissociative fugue can occur multiple times.
The best prevention involves treating the underlying problem and / or eliminating the threat that caused the episode.
Dealing with dissociative fugue
It is difficult to make recommendations for dealing with dissociative fugue as most people with the condition do not know they have it. However, if you have experienced it in the past, there are things you can do to prevent a recurrence:
- Receive therapy to cope with symptoms related to the leak.
- Treat the underlying problem that caused the leak through therapy.
- Get the support of family members to help you realize when you are at risk of running away.
- Try to reduce or eliminate possible triggers for a dissociative fugue.
- Practice meditation or other techniques to help control bad feelings.
- Find a creative outlet for bad emotions, like painting or drawing.
- If your doctor prescribes medication for anxiety or depression, you have to make sure to take your medication regularly.