Understanding Dissociative Fugues

A rather unusual psychiatric condition that you might not have heard about is called, "dissociative fugue." It is classified as a dissociative disorder in the Diagnostic and Statistical Manual of Mental Disorders, Volume IV, Text Revision (DSM-IV-TR). This text is the bible for those who work in the mental health field. Dissociative disorders in general involve disturbances in a person's memory, perceptions, identity, or consciousness (Psychiatry Online website).

Dissociative Fugue Defined

A dissociative fugue was formerly called a "psychogenic fugue." This disorder involves spontaneous forgetting of who you are, where you live, and where you're from. Someone experiencing a dissociative fugue might be found wandering aimlessly on the street, possibly appearing confused, even to the non-mental-health-trained eye. Such episodes can last from hours to days, weeks, or months before the person's memories return and compel him to return to his life.

One of the reasons so many professionals are fascinated by this condition is that, although the person affected loses a sense of who he is, where he lives, and what he's supposed to be doing, he still usually maintains his ability to speak his own language and has access to other knowledge. For example, if the person is a carpenter and he encounters someone who needs carpentry help, he could exhibit the knowledge and skill that he has without problem. However, he still can't tell you who he is or where he's from.

The word, "fugue" means "flight" in Latin and in a sense, the person is fleeing from his own life. One in a fugue state doesn't engage in strange or unusual behaviors or mannerisms. Sometimes, a person experiencing a fugue will construct an identity for himself since the facts of his own identity have slipped out of his consciousness.

It's likely you've never known or encountered anyone who's experienced a dissociative fugue. The condition is rare. The DSM-IV states it occurs in just 0.2% of the general population.

Symptoms of Dissociative Fugues

Classic fugue symptoms include leaving one's home, not knowing one's own identity, and memory loss for past events and confusion about one's current situation. As you might imagine, such individuals can become hurt or even the victims of crimes, should they remain in the fugue state for any length of time. Some sufferers of fugues have ended up hundreds of miles away from their homes before being discovered by a loved one, due to a picture published in the newspaper or a television news report.

Return of one's memory for his own life is usually sudden but can also be gradual for people experiencing dissociative fugues. In some cases, amnesia for where one went and what one did during the dissociative fugue state occurs (Cleveland Clinic website).

Causes of Dissociative Fugues

You're probably wondering why a dissociative fugue state would happen. Typically, such episodes are traced back to traumatic or stressful life events. Those who've been through a war or natural disaster might be more likely to develop a dissociative fugue state. People who've experienced a fugue state but aren't currently in such an episode seem quite normal and otherwise mentally healthy.

Treatment of Dissociative Fugues

Because there are times that a person in a dissociative fugue state would come to the attention of authorities and be hospitalized, doctors will perform all kinds of tests-physical and psychological-to determine the source of the person's apparent memory problems. Brain injuries, amnesia, and drug use will be ruled out. However, after a fugue has occurred and the individual has returned to his family, mental health therapy should be sought out.

Such therapy is highly recommended for someone with this condition as fugues can and do recur. Therefore, therapy focuses largely on discovering the triggering factors and working with the individual to gain insight into those factors. The therapist can then work with the client to develop other healthier ways to respond the next time such stressors occur.

Medication is not typically prescribed for dissociative fugues (Web MD website), unless the individual is determined to also suffer from other illnesses that could benefit from medicines.

Luckily, those who experience a dissociative fugue might never have another one. However, should you or someone you love experience such a dissociative fugue, it's wise to seek mental health treatment. The professional can provide help in identifying the triggers and learning more effective ways to cope with those stressful events and aid one in avoiding a second fugue in the future.

Sources

Cleveland Clinic website

Diagnostic and Statistical Manual of Mental Disorders, Fourth edition

Professional experience

Psychiatry Online website

Web MD website