Dissociative fugue is a type of amnesia that is caused by an extreme psychological trauma instead of physical trauma, illness, or another medical condition. It’s a form of dissociative amnesia that’s severe, and it’s considered rare.
Someone with dissociative fugue won’t have any memory of their past or about themselves personally. The type of memories that they lose are sometimes referred to as autobiographical memories. The condition is a means of escaping a situation of extreme stress that the person can’t cope with.
A dissociative fugue may last only a few hours. The person undergoing it may seem to be confused and forgetful to others during that time, but they’ll return to normal afterward. In cases with such a short duration, the dissociative fugue might even go unnoticed by others.
However, the condition may also last weeks, months, and sometimes even longer than that. A person with dissociative fugue lasting longer than just a few hours may have the following symptoms:
- sudden lack of attendance at work or avoidance of other places they frequent
- loss of autobiographical memory (about themselves, other people, events in their lives, etc.)
- detachment from their own emotions
- severe stress at work or from relationships
- confused identity
- depression, anxiety, thoughts of suicide, and other mental health issues
- inability to recognize loved ones
- wandering or going places they usually don’t go
Many times, the person with dissociative fugue will abruptly walk away from their current life and start a new one. Their new life is usually very different from the life they’ve left. For example, a Wall Street executive may leave her high-powered career in a city to become a florist in a rural town if she has dissociative fugue.
Dissociative fugue is caused by a situation that gives the person extreme emotional stress. The dissociative fugue is believed to occur as the person’s means of escape from the stress that they can’t otherwise cope with.
A common cause of dissociative fugue is severe sexual trauma of some sort. Other causes may include:
- extreme feelings of shame or embarrassment
- trauma caused by war
- trauma caused by an accident
- trauma caused by a natural disaster
- long-term emotional or physical abuse in childhood
These traumas may have actually happened to the person, or they may have witnessed it happening to others and been severely traumatized by what they saw. There is also a possibility that a genetic link may predispose someone to dissociative fugue.
The first step in treatment of dissociative fugue involves ruling out any medical conditions that might cause memory loss. There isn’t a specific test that can diagnose dissociative fugue. However, a medical doctor will want to perform a variety of tests to rule out possible illnesses or injuries that might cause memory loss.
Once all physical or medical conditions have been ruled out, the person will usually be referred to a psychiatrist or another mental health professional. The mental health professional will diagnose dissociative fugue after a series of clinical interviews and assessments. These interviews may include what is called Structured Clinical Interview for Dissociation or SCID-D. Once a diagnosis is made, then the treatment can begin.
The treatment may include the following:
- creating a safe environment
- help recovering lost memories
- help reconnecting to life prior to the trauma
- gradually discovering, dealing with, and then managing the trauma that originally caused dissociative fugue
- developing coping mechanisms to better handle future stressful situations
- regaining normal life functions
- strengthening and improving relationships
These goals are accomplished through several types of therapies, which may include:
- family therapy
- cognitive behavioral therapy
- meditation and relaxation techniques
- music or art therapy
- clinical hypnosis
- dialectical behavior therapy
Currently, there is no medication known to help dissociative behavior. However, you may be prescribed medications to help other symptoms such as depression or anxiety.
Complications and associated conditions
A number of complications are associated with dissociative fugue. These can range from mild to serious and should be watched for. They include:
- thoughts of suicide
- attempting to harm yourself — including cutting, mutilation, etc.
- post-traumatic stress disorder (PTSD)
- personality disorders
- eating disorders
- relationship and work issues or difficulties
- sleep disorders
- illegal drug use
- seizures (not due to epilepsy)
Some people who experience dissociative fugue may end up missing or may be found wandering in unfamiliar areas.
When to see a doctor
The sooner dissociative fugue is diagnosed, the better. This is because of the range of complications it can cause.
You should contact a medical professional any time a loved one has experienced or witnessed severe or long-term trauma or stress of any kind and exhibits signs of confusion or memory loss. You should also contact a medical professional if a loved one exhibits odd behavior or stops showing up to their job or places they usually frequent after severe stress or trauma. It’s important to rule out any possible medical conditions that may be causing the symptoms.
Then, if there isn’t a medical cause for the symptoms, get help from a mental health professional as soon as possible. Working with a mental health professional early on will help avoid a worsening of symptoms or a lengthening of the time a dissociative fugue lasts.
The outlook for someone with dissociative fugue is generally good. The outlook improves the sooner treatment and intervention are started. Most people with dissociative fugue will regain most or all of their memories. The memories may return quickly and all at once or gradually over a longer period of time. However, in some cases, people aren’t able to recover their memories completely.