Dissociative fugue is what mysteries are made of. Seemingly out of nowhere or sometimes after a trauma, a person forgets who they are, where they have come from, and other facts about their identity.
An individual may also appear to vanish from their life and their familiar patterns. This condition, however, is a very real psychological disorder.
One of the best-known cases of a possible dissociative fugue is that of Agatha Christie. On December 3, 1926, the mystery writer suddenly disappeared from her home in England. The next day, her car was found with the headlights on and all of her belongings inside.
Eventually, Christie was found at a health spa where she had checked in under a different name. She never discussed this episode again, and no explanation was ever given for her disappearance.
A dissociative fugue is a form of dissociative amnesia where a person forgets who he or she is.
In addition to the amnesia, someone with a dissociative fugue experiences a sudden and unexpected episode of travel. The word "fugue" comes from the Latin words for "flight" or "to flee."
This fugue state can last anywhere from hours to months, or sometimes longer.
The state may be a way for someone to escape a stressful or traumatic situation. A true dissociative fugue, however, is not a made-up condition. A dissociative fugue is also not an individual's deliberate attempt to avoid a difficult situation.
The symptoms of a dissociative fugue can be difficult to detect. A person in the middle of one may act or appear normal or may act only slightly confused.
An individual experiencing a dissociative fugue may not wish to attract attention to him or herself and may simply disappear.
Other symptoms of a dissociative fugue can include:
- emotional detachment
- confused identity
- 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 cannot remember a specific event, events, or time period. The forgotten period is usually a time that is traumatic or stressful and has clear start and end points. People may experience more than one episode of memory loss.
2. Selective amnesia: The person forgets only some or part of events that had occurred.
3. Generalized amnesia: Generalized amnesia refers to when a person forgets who they are and where they came from. The person completely forgets their life history, sometimes including skills that they have mastered. This type of amnesia is rare but is most common among people with extreme trauma, such as combat veterans or victims of sexual assault.
Once the fugue ends, the person tends to find him or herself in a new life situation with no memory of how they got there or what has happened in the meantime.
This return to normality may leave a person feeling ashamed, uncomfortable, and frightened.
A dissociative fugue is usually, though not always, triggered by a traumatic event, such as:
- natural disaster
- long-term physical or emotional abuse
These events do not have to have happened to the person affected by the fugue. Witnessing these events can also be so traumatic that it triggers a dissociative state.
Diagnosis of this condition usually occurs after the fugue has ended and once the affected person has recounted what has happened to them.
Anyone who has had or may have had a fugue state should see a doctor promptly for an evaluation.
The doctor will recommend a thorough physical exam and medical history to rule out a medical reason for the event, such as epilepsy or other seizure disorder.
If no other cause is found, the person will be referred to a psychologist for a psychological assessment.
In most cases, a dissociative fugue is an isolated event and does not recur. In other cases, however, amnesia related to an event and fugue state will persist even after the fugue has ended.
Treatment will focus on helping the person deal with what has happened and on identifying what triggered the fugue state. This type of treatment is done by working with a trained therapist experienced in helping 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 may be necessary as the person starts to recover from what has happened.
Dissociative fugue and, potentially, the traumatic event that caused it, is associated with several other mental health conditions, including:
- post traumatic stress disorder
- sleep disturbances
- drug or alcohol use
- suicidal thoughts
Because of the seriousness of this condition and the conditions associated with it, it is important to see a medical professional, as soon as possible.
Anytime a loved one is displaying unusual behavior, signs of confusion, or memory loss, a medical professional should be contacted. This is especially true after a traumatic event.
The outlook for someone who had a dissociative fugue is excellent and improves when treatment is initiated.
While some people regain their memories, other people with dissociative fugue may never entirely remember the events that happened during that time period.