Dissociative Fugue: Causes, Symptoms, Description of the Disease and Diagnosis

Wake up in a new city without a memory of a person or former life - this may sound like a script for a Hollywood movie or soap opera. Dissociative fugue is the so-called amnesia effect associated with the identity of what is happening around for several weeks or months.

What is Fugue

Dissociative fugue is considered a disorder that separates a person from previous memories of past experiences, feelings, or people in their lives. People who suffer from it do not remember their personality or any details of life.

Dissociative fugue description of the disease has this: there is a split of consciousness, while reproducing the action. In this case, the surrounding people, seeing the patient, do not understand that something is wrong with him. A typical example of dissociation is to drive a car and skip your turn because of dreaminess. Thoughts inside split the mind about where the car is at the moment. The realization that a person missed his turn, as a rule, returns him to the return route. Thus, dissociation can also occur in healthy people, but it does not last so long.

Is it possible

After severe stress, some of the memory is blocked and a dissociative fugue sets in. Examples from life:

• 57-year-old husband and father of two children, a boy scout - left the garage near his office and disappeared. Six months later he was found, already living under a new name in a shelter for the homeless in Chicago, not knowing who he was and where he came from.

• A middle-aged woman buys a newspaper to find out the date and in which city she is, then turns to the social service to determine her identity. As it turned out later, she was considered missing for 5 years.

• Agatha Christie was, perhaps, the most famous writer of all time. In 1926, the evening of December 3, 36-year-old Christie mysteriously disappeared from her home in England. The next morning her abandoned car was discovered, but she was nowhere to be found. Before the disappearance, her husband Archibald threatened to divorce. On December 14, Christy was found alive and registered under the name Teresa Nile at the Harogate Hotel. She claimed that she did not know how she got there. Someone believes that this disappearance was a play for PR and reunification with her husband. Nevertheless, there is evidence that Christie was in a fugue state and really lost her memory. On the day of her disappearance, people saw her and claimed that she was not wearing warm clothes, despite the cold season, she seemed confused and discouraged. There is an assumption that the upcoming divorce and the recent death of her mother made her go into a deep depression. Agatha Christie died in 1976 and took the whole truth about what really happened, with herself to the grave.

How the fugue manifests itself

Subconsciously separating from all their memories and experiences, a dissociative fugue is activated. Causes, symptoms, diagnosis are always of interest. In some cases, a person may leave work, but never return home. Instead, the individual continues to move without a goal, retaining a partial consciousness responsible for his mechanical actions. In the end, he will be in an unfamiliar city away from home. He will not have the faintest idea who he is and what he does in this new city. Sometimes a man with a fugue creates a new identity to compensate for memory loss. He can exist this way for several days to several months and even years before the fugue dissipates, after that the memory is restored and he returns home.

Symptoms of fugue condition

• Unplanned trips away from home alone.

• Inability to recall past events and experiences.

• Depersonalization or the feeling that a person is outside his body.

• Failure to remember personality and details from his life for a few days to months, in rare cases, can drag on for years.

What to do

Patients who have a dissociative fugue should be under close medical supervision. The case history of the patient should be studied to exclude the organic cause for the disease (eg, epilepsy or other personality disorder). If the reasons are not found, the psychologist or other mental health professionals will conduct interviews with the patient, and also conduct psychological assessments. These assessments may include dissociative experience, a structured clinical interview for disorders called dissociative fugue. Causes of development, the symptoms of the disease can manifest themselves with the use and abuse of certain medicines and illicit drugs. For example, patients with alcohol dependence often remain in a "shutdown" state, while doing some actions, and sometimes doing unplanned trips, a vivid example of such a dissociative fugue is the film "With a light steam".

Dissociative fugue: symptoms of disease, prevention

It is not easy to explain the cause of the fugue condition, but people who suffer from the disorder tend to have some serious injury or stress in life. War veterans or people who have suffered from terrible violence survived the disaster scenarios, may be more prone to these symptoms. Some psychologists believe that fugue sufferers may have an unresolved conflict in life that can be added to the probability of an abnormal dissociation. It is possible that drug abuse can contribute to the development of this disease.

How common is the disease?

Dissociative fugue is relatively rare, with prevalence of 0.2% in the general population. The length of the fugue episode is believed to be related to the severity of the stress or injury that caused it. In most cases, this manifests as single episodes without recurrence. In some cases, a person will not remember the events that occurred during the state of the fugue. In other situations, the amnesia associated with the traumatic event that triggered the fugue may persist to some extent after the episode is completed. Prevention of this disorder can be a conversation with a therapist after a tragic episode of life, good family support and close trusting relationships with friends. If the traumatic psyche has no way out, the brain blocks the memory for protection and there is amnesia.

Psychology of Freud

Freud suggests that psychogenic amnesia is an act of self-preservation, where an alternative may be traumatic anxiety or even suicide. Unpleasant, unwanted or psychologically dangerous memories are blocked from entering the consciousness. Neurologically normal autobiographical treatment of memory is blocked by an imbalance of stress hormones such as glucocorticoids and mineralocorticoids in the brain, especially in regions of the limbic system involved in memory formation.

Such depressed memories can be restored spontaneously with a special smell, taste or other identifier, years or decades after the event. Because it is related to the psychological, not the physiological, causes of psychogenic amnesia.

Dissociative fugue: symptoms, treatment

When treating a dissociative fugue, focus on helping the patient and agreeing with a traumatic event or stress that caused the disorder. This can be achieved through various types of interactive treatments that investigate trauma, and work should also be done to create mechanisms to overcome the patient's difficulties in order to prevent further recurrence. Some therapists use cognitive therapy, which focuses on changing inadequate patterns of thinking. It is based on the principle that inadequate behavior, in this case the fugue episode, is initiated by inappropriate or irrational thinking. The cognitive therapist will try to change these stereotypes of thinking (also known as cognitive distortions), exploring the reasonableness and validity of the assumptions behind them with the patient.

Drug treatment may be a useful adjunct to treating certain symptoms that a patient may experience with respect to dissociative episodes. In some cases, some antidepressants or sedatives may be prescribed.

Treatment with therapy

Creative therapies (art therapy, music therapy ) allow patients to express and guide thoughts and emotions into "safe" channels. They expand the rights and opportunities of the patient by encouraging oneself to self-knowledge and a sense of control.

Group therapy is a therapist, or a counselor can be helpful in supporting the patient on an ongoing basis. He also provides the patient with opportunities to gain self-confidence and to interact with colleagues in a positive way.

Family therapy can be part of the treatment regimen, both in the study of the trauma that triggered the fugue episode, and in clarifying the theme of the disease of the rest of the family.