Dissociative Fugue
People living with dissociative identity disorder are prone to many phenomena you may not have heard about. One of these experiences is known as dissociative fugue.
This article will focus on dissociative fugue, its symptoms, causes, and treatment.
What is Dissociative Fugue?
Dissociative fugue or fugue state is a rare subtype of dissociative amnesia and involves the loss of memory for personal information and unexpected, unplanned, sudden travel. Sometimes the person experiencing this phenomenon sets up a new identity and lives their life as if they were not in a mentally unstable state.
Dissociative fugue is a rare symptom of dissociative identity disorder where a person experiences memory loss and travels or wanders. Fugue can leave the person with DID in an unfamiliar setting with no memory of how they got there. A person who experiences dissociative fugue will slowly regain their memories but nearly always need the help of a mental health professional to recover fully.
A research paper written in 2011 best describes dissociative fugue:
“A dissociative fugue occurs when an individual with dissociative amnesia wanders away from their familiar surroundings, maintaining self‑care and apparently normal behavior to observers, lasting from hours to months in a row.
New identities can be assumed, and even organized travel can occur. While dissociative amnesia by itself may have a prevalence of around 7.2%, dissociative fugue is a rare entity, with unknown prevalence, and there are few reports in
the literature.” (Valadas, M. T., Costa, A. P., & Bravo, L. (2021).
During a fugue state, the survivor, if challenged about their condition, may exhibit the following symptoms: confusion about their identity, appearing unsure of the past, and feeling overwhelmingly confronted when challenged about their identity and biographic identity.
Notably, a person amid dissociative fugue may not look like they are experiencing a mental health crisis because, from the survivor’s perspective, the identity they have assumed is their real one. When challenged, the survivor may feel hostile because they believe the person confronting them is lying.
The Symptoms of Dissociative Fugue
Dissociative fugue symptoms are frightening to those who have experienced it. The fugue state may last for a few hours, months, or even years. During a fugue state, the survivor may seem confused and leave, but they will return to normal sooner or later.
When the person is experiencing a fugue state, it may be recognized by those around them until they begin to return to their usual selves. If the fugue lasts longer than a few hours, they might exhibit the following symptoms:
- Loss of autobiographical memory about themselves, other people in their lives, and events
- Confusion
- Sudden lack of interest leading to a lack of attendance at work or school
- Avoidance of places they had usually frequented
- Depression
- Anxiety
- Thoughts of suicide
- Inability to recognize loved ones
- Severe distress
- Detachment from their emotions
- Wandering and going places they usually do not go
This author has personal experience with fugue as a part of my dissociative identity disorder. In 2016, I woke up in a hospital on a dementia wing because I was exhibiting severe confusion. Apparently, I had dissociated and, as an alter, had lived a separate life from the one I left. I had no memory of what had occurred for ten months and was devastated that I had lost so much time.
Dissociative fugue states, while some might think they would be cool, definitely is not. You can get into some hot water and have no memory of what you did or said.
Some Causes for Dissociative Fugue
While rare, when a person with dissociative identity disorder is in a situation that causes extreme emotional distress, they may experience fugue. Dissociative fugue is believed to happen when the person with DID feels trapped and has no way to escape from the stress they cannot cope with.
The traumatic causes of dissociative fugue are experiencing or witnessing a severely traumatizing event. There is also a genetic link that may make some people predisposed to a dissociative fugue.
Some common causes of a dissociative fugue are:
- Trauma caused by war
- Feeling extreme shame or embarrassment
- Trauma caused by an accident
- Extreme distress
- Extreme stress
It is vital to remember that dissociative fugue is rare among the DID community but probably happens more than has been reported by clients or their therapists.
Treatments for Dissociative Fugue
While there are currently no medications to treat dissociative fugue, a mental health professional may prescribe medication to help with other symptoms such as anxiety and depression.
Along with possible medication intervention, several types of therapies can help ease the person back into their lives. These therapy approaches might be helpful:
- Psychotherapy
- Family therapy
- Music or art therapy
- Clinical hypnosis
- Cognitive-behavioral therapy (CBT)
- Dialectical behavioral therapy (DBT)
While none of these approaches will cure someone who has experienced fugue and its accompanying amnesia, they can help ease the distress that comes with waking up and realizing you have been gone.
Ending Our Time Together
While most people living with dissociative identity disorder may never experience fugue, some do, which is a frightening experience. When I awoke from a ten-month period where I had no memory of my actions, I was terrified and bewildered.
I felt like an intruder when I got out of the hospital and entered my bedroom. Everything had been rearranged, and it felt like the room belonged to someone else. Depression came upon me in a flash, and it was a dark time. I avoided my therapist because I felt ashamed and refused to leave the house.
It took me almost as long to recover from the fugue state as I had been gone.
If you experience a fugue state, don’t panic when you awaken. Yes, you have dissociated from your reality for a while, but that does not mark you as insane. Instead, it says you were under extreme distress.
In my case, my nephew Michael had just been born, and his crying set off my amygdala into a cascade of fearful flashbacks and distress. I was constantly confused about who the baby was, sometimes thinking he was my brother Mike who was abused in front of me by my mother.
I did recover, and so will you. You are not alone.
“You are not alone. You are seen. I am with you. You are not alone.” — Shonda Rhimes
“Many people need desperately to receive this message: I feel and think much as you do, care about many of the things you care about, although most people do not care about them. You are not alone.” — Kurt Vonnegut
References
Igwe, M. N. (2013). Dissociative fugue symptoms in a 28-year-old male Nigerian medical student: a case report. Journal of Medical Case Reports, 7(1), 1-3.
Loewenstein, R. J. (1996). Dissociative amnesia and dissociative fugue. Handbook of dissociation, 307-336.
Valadas, M. T., Costa, A. P., & Bravo, L. (2021). Dissociative Fugue: A Case Report. Revista Portuguesa de Psiquiatria e Saúde Mental, 7(4), 143-146.
CommentThank you for this article.It’s really important that people understand that D.I.D shows up in many forms,so glad you are helping the D.I.D community as a person with this condition.
Thanks, Jade. Shirley