Dissociative fugue is what makes up mysteries. Apparently from nowhere or sometimes after a trauma, a person forgets who he is, where he came from, and other facts about their identity.
An individual can also seem to vanish from their life and from their familiar patterns. However, the condition is a very real psychiatric illness.
One of the most well known examples of a possible dissociative fugue is Agatha Christie’s. The mystery writer suddenly disappeared from her England home on 3 December 1926. Her car was found the next day, with the headlights on and all her belongings inside.
Eventually Christie was discovered in a health spa where she had checked in under a name. She never mentioned this episode again and no explanation for her disappearance has ever been given.
What is dissociative fugue?
A dissociative fugue is a type of dissociative amnesia in which a person forgets who he or she is.
Apart from the amnesia, anyone with a dissociative fugue encounters a sudden and unexpected travel episode. The word “fugue” comes from the Latin words for “run” or “flee.” This state of fugue can last from hours to months, or even even longer.
The state can be a way for one to get away from a painful or traumatic situation. However, a genuine dissociative fugue is not a state of composition. Nor is a dissociative fugue a deliberate effort by an person to escape a difficult situation.
Symptoms
The signs of a dissociative fugue can hardly be observed. A person may act or appear normal in the middle of one, or may act just slightly confused.
An person who has a dissociative fugue may not want to draw attention to him or herself and may simply disappear.
Other dissociative fugue signs can include:
- confusion
- emotional detachment
- confused identity
- depression
- anxiety
- wandering
- going somewhere unusual
- experiencing severe stress at work
- suddenly avoiding places
There are three types of amnesia or forgetfulness connected with a fugue state.
1. Localized amnesia: When a person is unable to recall a specific event, event, or time period. The forgotten phase is typically a painful or stressful time and has consistent beginning and stopping points. People can experience a memory loss in more than one episode.
2. Selective amnesia: The person just forgets some or part of the events that took place.
3. Generalized amnesia: when a person forgets who they are and where they come from, generalized amnesia refers. The person forgets their life history entirely, often including the skills they learned. Such form of amnesia is rare but is the most common in those with serious trauma, such as combat veterans or sexual assault victims.
After the fugue is over, the person appears to find him or herself in a new position in life with no recollection of how they got there or what has happened afterwards.
This return to normality may leave a person embarrassed, uncomfortable and frightened.
Causes
By general, but not always, a dissociative fugue is caused by a traumatic event, such as:
- rape
- accidents
- combat
- natural disaster
- violence
- long-term physical or emotional abuse
Those events should not have happened to the fugue-affected individual. Witnessing these things can be so traumatic as to cause a dissociative state.
Diagnosis
Diagnosis of this condition typically takes place after the fugue has ended and after the person involved has explained what happened to them.
Someone who has had or may have had a condition of fugue will see a doctor immediately for evaluation.
To rule out a medical cause for the case, such as epilepsy or other seizure condition, the doctor may prescribe a detailed physical exam and medical history.
If no other cause is identified, the individual will be referred for a psychological examination with a psychologist.
Treatment
A dissociative fugue is an acute occurrence, which is not chronic in most situations. However, in many situations, amnesia associated with an incident and fugue state will occur, even after the fugue has ended.
Treatment should concentrate on helping the patient cope with what has happened and determining what has caused the fugue disorder. This form of therapy is achieved by working with an skilled, trained therapist to support people through traumatic events.
- Cognitive therapy or “talk therapy” is essential to help the person deal with their thought patterns surrounding the event, and to build up appropriate coping mechanisms, moving forward.
- Hypnotherapy has been used to help patients recover lost memories, and to work through them.
- Creative therapies, such as art or music, help people explore their thoughts and emotions in a creative, safe way. It also helps a person regain a sense of self-control after a fugue state.
- Group therapy can provide ongoing support for the person, as they move through their recovery.
- Family therapy can help to supplement the treatment and help a person’s family move forward and heal after the fugue state.
Antidepressant or anti-anxiety medications can be required as the individual starts recovering from what has happened.
Complications
Several other mental health problems are associated with dissociative fugue and possibly the traumatic event that caused it, including:
- post traumatic stress disorder
- depression
- anxiety
- sleep disturbances
- drug or alcohol use
- suicidal thoughts
It is necessary to see a medical professional as soon as possible, because of the seriousness of this condition and the complications associated with it.
A medical professional should be consulted if a loved one shows odd behaviour, symptoms of confusion or memory loss. It is especially true after a traumatic event.
Outlook
The outlook for someone who has had a dissociative fugue is excellent and increases after initiation of therapy.
Although certain people recover their memory, those with dissociative fugue can never fully recall the events that happened during that period of time.
