How to diagnose dissociative fugue

Formerly called psychogenic fugue, dissociative fugue, is a psychological state in which a person loses awareness of their identity or other important autobiographical information. This subtype of dissociative amnesia often includes some form of unexpected travel. People who experience a dissociative fugue may suddenly find themselves in a place, such as on the beach or at work, with no memory of traveling there. Similarly, they may find themselves somewhere in their home, such as a closet or in the corner of a room, with no memory of getting there. The DSM-5 refers to dissociative fugue as a state of “bewildered wandering.”

In addition to confusion about identity, people experiencing a dissociative fugue state may also develop a new identity. Dissociative fugue is a rare condition, with prevalence estimates as low as 0.2 percent in the general population. Dissociative fugue states are more common in adults than in children; symptoms usually appear in a person’s 20s and 30s, but sometimes it can show up in kids as young as 8 years of age.

Contents

  • Symptoms
  • Causes
  • Treatment

Symptoms

Dissociative fugue is more commonly found in people who experience dissociative identity disorder. Dissociation is generally thought of as a defense against trauma that helps people disconnect from extreme psychological distress. A dissociative fugue state is a condition in which a person may be mentally and physically escaping an environment that is threatening or otherwise intolerable.

The travel that may occur in a dissociative fugue state can last for as little as a few hours or a few weeks, or sometimes even months. In some cases, dissociative fugue can be very difficult to distinguish from sleepwalking. When the fugue state is over, people usually cannot remember what happened during the period of fugue. The fugue state can end suddenly or more gradually. Symptoms include:

  • Persisting confusion about identity
  • Persisting confusion about the past
  • Refuses to be challenged about their beliefs, especially who they are

What is the difference between dissociative fugue and dissociative amnesia?

Dissociative fugue is a subtype of dissociative amnesia. In these two types of dissociation, a person can lose awareness of identity or personal history or other autobiographical information. The person with dissociative fugue may find himself wandering physically to other locations, oftentimes in far-off destinations. Fugue can last longer than dissociative amnesia, sometimes up to months.

What is the difference between dissociative fugue and dissociative identity disorder?

Dissociative identity disorder is formerly known as multiple personality disorder, where identity is fragmented into two or more personality states. It has been described as a state of possession. Memory loss can also be severe. This disorder often presents itself in people who have been abused.

Is dissociative fugue similar to an out-of-body experience?

These are not the same, though the out-of-body experience is a dissociative state. In the out-of-body experience, the person is awake but views his body from outside his body. Researchers believe that this state involves the brain’s right temporoparietal cortex.

Causes

The onset of a dissociative fugue state is usually sudden and follows a traumatic or highly stressful event. Dissociative fugues are associated with difficult events, such as natural disasters and wars, as well as severe marital or financial distress, alcohol abuse, depression, and a history of child abuse. There may also be a genetic link because individuals with dissociative disorders sometimes have family members with the same condition.

Treatment

There is no specific treatment for dissociative fugue, in part due to the rarity of the condition. The process of recovery may begin when people experiencing dissociative fugue become spontaneously aware of the situation, or when they are unable to appropriately respond to questions about their background during an episode of dissociative fugue.

Effective treatment practices include removing a person from the threats or stressful situations that may have contributed to the development of a dissociative fugue state. An empathic, supportive approach to psychotherapy will help people who have experienced dissociative fugue, feel safe and open to treatment. The treatment process may include developing healthy coping skills that help people manage stress and psychological pain more effectively. Other forms of therapy, such as cognitive-behavioral therapy and dialectical behavioral therapy may also be employed.

Dissociative fugue, formerly called psychogenic fugue, is one of a group of conditions called dissociative disorders. The word fugue comes from the Latin word for “flight.” People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander or travel away from their homes or places of work. They often become confused about who they are and might even create new identities. Outwardly, people with this disorder show no signs of illness, such as a strange appearance or odd behavior.

Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, conscious awareness, identity, and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person’s general functioning, including social and work activities, and relationships.

What Are the Symptoms of Dissociative Fugue?

A fugue in progress often is difficult for others to recognize because the person’s outward behavior appears normal. Symptoms of dissociative fugue might include the following:

  • Sudden and unplanned travel away from home
  • Inability to recall past events or important information from the person’s life
  • Confusion or loss of memory about their identity, possibly assuming a new identity to make up for the loss
  • Extreme distress and problems with daily functioning (due to the fugue episodes)

What Causes Dissociative Fugue?

Dissociative fugue has been linked to severe stress, which might be the result of traumatic events — such as war, abuse, accidents, disasters, or extreme violence — that the person has experienced or witnessed. The use or abuse of alcohol and certain drugs also can cause fugue-like states, such as alcohol-induced “blackouts.”

How Common Is Dissociative Fugue?

Dissociative fugue is relatively rare. The frequency of dissociative fugue tends to increase during stressful or traumatic periods, such as during wartime or after a natural disaster.

How Is Dissociative Fugue Diagnosed?

If symptoms of dissociative fugue are present, the doctor will often begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose dissociative disorders, the doctor might sometimes recommend various diagnostic tests, such as neuroimaging studies, electroencephalograms (EEGs), and blood tests, to rule out physical illness or medication side effects if these are suspected as causing the symptoms. Certain conditions — including brain diseases (such as epilepsy), head injuries, drug and alcohol intoxication, and sleep deprivation — can lead to symptoms similar to those of dissociative disorders, including amnesia (loss of memory).

If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a dissociative disorder.

How Is Dissociative Fugue Treated?

The goal of dissociative fugue treatment is to help the person come to terms with the stress or trauma that triggered the fugue. Treatment also aims to develop new coping methods to prevent further fugue episodes. The best treatment approach depends on the individual and the severity of their symptoms, but most likely will include some combination of the following treatment methods:

    Psychotherapy, a type of counseling, is the main treatment for dissociative disorders. This treatment uses techniques designed to encourage communication of conflicts and increase insight into problems. Cognitive therapy is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns and resulting feelings and behaviors. There is no established medication to treat the dissociative disorders themselves. However, if a person with a dissociative disorder also suffers from depression or anxiety, they might benefit from treatment with a medication such as antidepressant, anti-anxiety, or antipsychotic drugs.
  • Family therapy: This helps to teach the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.
  • Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express their thoughts and feelings in a safe and creative way.
  • Clinical hypnosis: This is a treatment method that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness (awareness), allowing people to explore thoughts, feelings, and memories they might have hidden from their conscious minds. The use of hypnosis for treating dissociative disorders is controversial due to the risk of creating false memories.

What Is the Outlook for People With Dissociative Fugue?

Most dissociative fugues are brief, lasting from less than a day to several months. Often, the disorder goes away on its own. The outlook, therefore, is quite good. However, without treatment to work out the underlying problem, additional fugue episodes can occur.

Can Dissociative Fugue Be Prevented?

Although it might not be possible to prevent dissociative fugue, it might be helpful to begin treatment in people as soon as they begin to have symptoms. Further, quick intervention following a traumatic event or emotionally distressing experience might help reduce the risk of developing dissociative disorders.

Dissociative fugue is a rare form of dissociative amnesia.

A dissociative fugue may last from hours to months, occasionally longer. If the fugue is brief, people may appear simply to have missed some work or come home late. If the fugue lasts several days or longer, people may travel far from home, form a new identity, and begin a new job, unaware of any change in their life.

Many fugues appear to represent disguised wish fulfillment or the only permissible way to escape from severe distress or embarrassment. For example, a financially distressed executive leaves a hectic life and lives as a farm hand in the country.

Thus, dissociative fugue is often mistaken for malingering (faking physical or psychologic symptoms to obtain a benefit) because both conditions can give people an excuse to avoid their responsibilities (as in an intolerable marriage), to avoid accountability for their actions, or to reduce their exposure to a known hazard, such as a battle. However, dissociative fugue, unlike malingering, occurs spontaneously and is not faked. Doctors can usually distinguish the two because malingerers typically exaggerate and dramatize their symptoms and because they have obvious financial, legal, or personal reasons (such as avoiding work) for faking memory loss.

Symptoms of Dissociative Fugue

During the fugue, people may appear and act normal or appear only mildly confused and attract no attention. However, when the fugue ends, people suddenly find themselves in a new situation with no memory of how they came to be there or what they have been doing. At this point, many people feel ashamed or upset that they cannot remember what happened. Some people are frightened. If they are confused, they may come to the attention of medical or legal authorities.

After the fugue ends, many people remember their past identity and life up to when the fugue began. However, for others, remembering takes longer and occurs more gradually. Some people never remember parts of their past. A very few people remember nothing or almost nothing about their past for the rest of their life.

Diagnosis of Dissociative Fugue

A doctor’s evaluation

Doctors may suspect dissociative fugue when people seem confused about their identity or are puzzled about their past or when confrontations challenge their new identity or absence of one.

Sometimes dissociative fugue cannot be diagnosed until people abruptly return to their pre-fugue identity and are distressed to find themselves in unfamiliar circumstances.

Usually, dissociative fugue is diagnosed after the fact, when a doctor reviews the history and collects information that documents the circumstances before people left home, the travel itself, and the establishment of an alternate life.

Treatment of Dissociative Fugue

Sometimes hypnosis or drug-facilitated interviews

If people have had dissociative fugues, psychotherapy Psychotherapy Extraordinary advances have been made in the treatment of mental illness. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Most treatment. read more , sometimes combined with hypnosis or drug-facilitated interviews (interviews conducted after a sedative is given intravenously), may be used to try to help people remember the events of the fugue period. However, these efforts are often unsuccessful.

Regardless, a therapist can help people explore how they handle the types of situations, conflicts, and emotions that triggered the fugue and help them find better ways to respond in the future. This approach can help prevent fugues from recurring.

This article was co-authored by Noel Hunter, Psy.D. Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.

There are 17 references cited in this article, which can be found at the bottom of the page.

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A dissociative fugue, which is a form of dissociative amnesia, occurs when someone temporarily loses his sense of identity, usually due to extreme stress. A person may become confused of who he is or create a new identity entirely. This may last for a few hours, a few months — sometimes even for years. [1] X Trustworthy Source National Alliance on Mental Illness Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness Go to source During dissociative fugue, the person will travel or wander from his home and normal life — sometimes traveling a great distance. A dissociative fugue cannot be predicted and while the person may have lapses in memory, perception, and identity, the individual doesn’t appear as mentally ill or as having disruptive functioning.[ [2] X Trustworthy Source National Alliance on Mental Illness Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness Go to source Despite the elusiveness of dissociative fugue, there are treatment options available.

Dissociative fugue, formerly called psychogenic fugue, is one of a group of conditions called dissociative disorders. The word fugue comes from the Latin word for “flight.” People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander or travel away from their homes or places of work. They often become confused about who they are and might even create new identities. Outwardly, people with this disorder show no signs of illness, such as a strange appearance or odd behavior.

Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, conscious awareness, identity, and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person’s general functioning, including social and work activities, and relationships.

What Are the Symptoms of Dissociative Fugue?

A fugue in progress often is difficult for others to recognize because the person’s outward behavior appears normal. Symptoms of dissociative fugue might include the following:

  • Sudden and unplanned travel away from home
  • Inability to recall past events or important information from the person’s life
  • Confusion or loss of memory about their identity, possibly assuming a new identity to make up for the loss
  • Extreme distress and problems with daily functioning (due to the fugue episodes)

What Causes Dissociative Fugue?

Dissociative fugue has been linked to severe stress, which might be the result of traumatic events — such as war, abuse, accidents, disasters, or extreme violence — that the person has experienced or witnessed. The use or abuse of alcohol and certain drugs also can cause fugue-like states, such as alcohol-induced “blackouts.”

How Common Is Dissociative Fugue?

Dissociative fugue is relatively rare. The frequency of dissociative fugue tends to increase during stressful or traumatic periods, such as during wartime or after a natural disaster.

How Is Dissociative Fugue Diagnosed?

If symptoms of dissociative fugue are present, the doctor will often begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose dissociative disorders, the doctor might sometimes recommend various diagnostic tests, such as neuroimaging studies, electroencephalograms (EEGs), and blood tests, to rule out physical illness or medication side effects if these are suspected as causing the symptoms. Certain conditions — including brain diseases (such as epilepsy), head injuries, drug and alcohol intoxication, and sleep deprivation — can lead to symptoms similar to those of dissociative disorders, including amnesia (loss of memory).

If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a dissociative disorder.

How Is Dissociative Fugue Treated?

The goal of dissociative fugue treatment is to help the person come to terms with the stress or trauma that triggered the fugue. Treatment also aims to develop new coping methods to prevent further fugue episodes. The best treatment approach depends on the individual and the severity of their symptoms, but most likely will include some combination of the following treatment methods:

    Psychotherapy, a type of counseling, is the main treatment for dissociative disorders. This treatment uses techniques designed to encourage communication of conflicts and increase insight into problems. Cognitive therapy is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns and resulting feelings and behaviors. There is no established medication to treat the dissociative disorders themselves. However, if a person with a dissociative disorder also suffers from depression or anxiety, they might benefit from treatment with a medication such as antidepressant, anti-anxiety, or antipsychotic drugs.
  • Family therapy: This helps to teach the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.
  • Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express their thoughts and feelings in a safe and creative way.
  • Clinical hypnosis: This is a treatment method that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness (awareness), allowing people to explore thoughts, feelings, and memories they might have hidden from their conscious minds. The use of hypnosis for treating dissociative disorders is controversial due to the risk of creating false memories.

What Is the Outlook for People With Dissociative Fugue?

Most dissociative fugues are brief, lasting from less than a day to several months. Often, the disorder goes away on its own. The outlook, therefore, is quite good. However, without treatment to work out the underlying problem, additional fugue episodes can occur.

Can Dissociative Fugue Be Prevented?

Although it might not be possible to prevent dissociative fugue, it might be helpful to begin treatment in people as soon as they begin to have symptoms. Further, quick intervention following a traumatic event or emotionally distressing experience might help reduce the risk of developing dissociative disorders.

Since dissociative fugue is fairly rare, treatment options vary depending on the individual and the specific circumstances of their fugue. In most cases, an individual will not receive treatment during their fugue state but will need treatment once they become aware of their state or memories return of their previous life. Because dissociative fugue is a subtype of dissociative amnesia , dissociative fugue treatment often overlaps with its parent condition. One of the main commonalities in treating dissociative fugue is to address underlying stressors that potentially caused the fugue state.

Table of Contents

Psychotherapy

One of the most common treatments for dissociative fugue includes different forms of psychotherapy. In simple terms, psychotherapy is known as talk therapy and is a space where individuals discuss their thoughts, feelings, emotions and anything else that has been on their mind, with their therapist of choice. Therapy for dissociative disorders may also extend beyond individual sessions to family or group settings. Psychotherapy for dissociative fugue also sometimes encompasses different creative therapies where individuals are encouraged to use their imagination and think outside the box to restore memories.

Common methods of psychotherapy used to address dissociative fugue include:

  • Cognitive Behavioral Therapy:Cognitive behavioral therapy (CBT) is a form of psychotherapy that focuses on understanding emotions and modifying behaviors. CBT for dissociative disorders, including dissociative fugue, can be extremely helpful in providing relief from stressors that lead to dissociation.
  • Group Therapy:Group therapy after experiencing dissociative fugue may be useful for some individuals. Since dissociative fugue is rare, it is unlikely that everyone in group therapy will have experienced this type of dissociation. Nevertheless, talking to individuals that share similar experiences often helps a person feel less isolated.
  • Family Therapy:Family therapy may be beneficial if the individual who experienced dissociative fugue has a positive relationship with their family members. However, if the stressor that induced a fugue state is directly related to family issues such as a divorce or sudden death in the family, this type of therapy should be used with caution.
  • Creative Therapy: Creative therapy may help an individual relax or channel their nervous energy into positive outlets. Alternatively, it can help individuals express their feelings and emotions during and after the fugue state in a different way than talk therapy typically allows. Creative therapies include music and art therapy like taking photos, making collages and painting.

Medication

Unfortunately, medication is unlikely to resolve a fugue state. Once an individual remembers their old life and previous self, medication may be helpful for those struggling with anxiety , depression , addiction or other co-occurring disorders as a result of experiencing the fugue.

For individuals who choose to try medication after their fugue state, some of the most commonly prescribed medications include s elective serotonin reuptake inhibitors (SSRIs) . SSRIs are typically used to treat anxiety or depression, though there are many other types of medication that can help a person through this difficult time. Following a fugue, medication may ease the transition from the fugue state to a person’s previous life.

Hypnosis

Hypnosis is a technique that can be employed for dissociative amnesia and dissociative fugue. However, hypnosis treatment for dissociative disorders may not always be an effective means of restoring memories while in an amnestic or fugue state.

In some cases, memories will naturally come back to a person, particularly if they recover in an environment that is both safe and supportive . A therapist may employ hypnosis techniques, sometimes with the aid of a sedative , in the event that the fugue state was brought about by or included experienced trauma. It is important that therapists not suggest that certain events happened so as to not create false or exaggerated memories in the patient. The overall goal of hypnosis is to recover lost memories or restore the patient’s life narrative in the most accurate way possible so that they can recover from this experience.

Stress Management Techniques

Stress management may be an effective way to help individuals that experienced a fugue state in the recent past. Often times, therapy will include learning different coping skills to deal with stress, anxiety, depression and other co-occurring conditions. Some examples of stress management techniques and coping skills include:

  • Practicing meditation
  • Practicing yoga and other recreational activities
  • Deep breathing exercises
  • Reading
  • Walking
  • Writing about thoughts, feelings and emotions in a journal
  • Talking openly with others
  • Spending time with animals
  • Spending time in nature
  • Playing sports or participating in other forms of exercise
  • Getting involved in the community
  • Volunteering for an important cause

Treating Dissociative Fugue and Co-Occurring Conditions

While dissociative fugue can co-occur with other conditions like anxiety, depression, addiction and post-traumatic stress disorder , having an accurate understanding of what caused the fugue state is extremely important to a person’s recovery. It is important to remember that managing stress levels can immensely help a person recover from a fugue state.

If you or a loved one live with recurrent dissociative fugue episodes and co-occurring addiction, The Recovery Village can help. Contact a representative today to discuss therapy options for treating both conditions together.

  • Sources

Spiegel, David. “ Dissociative Fugue .” Merck Manuals-Consumer Version, March 2019. Accessed June 26, 2019.

Spiegel, David. “ Dissociative Amnesia .” Merck Manuals-Professional Version, March 2019. Accessed June 26, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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This paper discusses the way informed psychiatrists are expected to handle dissociative patients in clinical situations, with a specific focus on dissociative identity disorders and dissociative fugue. On the initial interview with dissociative patients, information on their history of trauma and any nascent dissociative symptoms in their childhood should be carefully obtained. Their level of stress in their current life should also be assessed in order to understand their symptomatology, as well as to predict their future clinical course. A psychoeducational approach is crucial; it might be helpful to give information on dissociative disorder to these patients as well as their family members in order to promote their adherence to treatment. Regarding the symptomatology of dissociative disorders, detailed symptoms and the general clinical course are presented. It was stressed that dissociative identity disorder and dissociative fugue, the most high-profile dissociative disorders, are essentially different in their etiology and clinical presentation. Dissociative disorders are often confused with and misdiagnosed as psychotic disorders, such as schizophrenia. Other conditions considered in terms of the differential diagnosis include borderline personality disorder as well as temporal lobe epilepsy. Lastly, the therapeutic approach to dissociative identity disorder is discussed. Each dissociative identity should be understood as potentially representing some traumatically stressful event in the past. The therapist should be careful not to excessively promote the creation or elaboration of any dissociative identities. Three stages are proposed in the individual psychotherapeutic process. In the initial stage, a secure environment and stabilization of symptoms should be sought. The second stage consists of aiding the “host” personality to make use of other more adaptive coping skills in their life. The third stage involves coaching as well as continuous awareness of their comorbid psychiatric conditions. Lastly, factors preventing the patients’ smooth recovery process are mentioned. They include their contact with past and current aggressors, chronic and ongoing stress within the family, including abuse and violence, and comorbid conditions such as depression and chronic medical conditions.

Dissociative fugue is a kind of amnesia caused by a severe psychological trauma rather than a physical trauma, sickness or other medical illness. It’s an uncommon kind of severe dissociative amnesia.

A person suffering from dissociative fugue will have no recollection of their history or of themselves personally. The memories they lose are often known as autobiographical memories. The condition is a way for a person to get out of a situation that is too stressful for them to handle.

Symptoms

A dissociative fugue might last anywhere from a few minutes to many hours. During this period, the individual experiencing it may appear confused and forgetful to others, but they will return to normal afterward. The dissociative fugue may be unnoticed by others in situations where the duration is so short.

However, the illness might continue for weeks, months, or even years in certain cases. A person experiencing dissociative fugue for more than a few hours may have the following symptoms:

  • Confusion
  • Unexpected absence from work or avoidance of other areas they often visit
  • Autobiographical memory loss (about themselves, other people, events in their lives etc.)
  • Detachment from their own feelings
  • Extreme work-related or relationship-related stress
  • Identity confusion
  • Depression, anxiety, suicidal ideation and other mental health problems
  • Not being able to identify loved ones
  • Wandering or traveling to locations they wouldn’t normally go

Often, a person suffering from dissociative fugue will abruptly leave their present life and begin a new one. Their new existence is generally nothing like the one they left behind. If a Wall Street executive suffers dissociative fugue, she may abandon her high-powered metropolis job to work as a florist in a small village.

Causes

A circumstance that puts the person under a lot of emotional stress might cause dissociative fugue. The fugue state is said to be a person’s way of escaping from the stress that they can’t handle otherwise.

Severe sexual trauma is one of the most prevalent causes of dissociative fugue. Other factors to consider are:

  • Feelings of severe humiliation or embarrassment
  • Traumacaused by war, an accident or natural disaster
  • Kidnapping
  • Torture
  • A kid who has been subjected to long-term mental or physical abuse

These traumas may have occurred to the individual directly, or they may have watched them occurring to others and been badly traumatized as a result of what they witnessed. There’s also the chance that someone is vulnerable to dissociative fugue due to a genetic connection.

Treatment

To treat dissociative fugue, the first step is to rule out any medical problems that might induce memory loss. Dissociative fugue cannot be diagnosed using a particular test. However, a medical professional will want to run a number of tests to rule out any illnesses or traumas that may induce memory loss.

The person will typically be sent to a psychiatrist or another mental health expert once all physical or medical problems have been checked out. A set of clinical interviews and exams will help the mental health specialist to identify dissociative fugue. Structured Clinical Interview for Dissociation, or SCID-D, may be used in these interviews. After a diagnosis has been determined, therapy can begin.

The following treatments may be used:

  • Establishing a secure environment
  • Assisting in the recovery of forgotten memories
  • Assistance in reuniting with life before the trauma
  • Progressively identifying, addressing, and finally managing the trauma that has occurred
  • Originally caused dissociative fugue
  • Building coping skills to help you deal with unpleasant circumstances in the future
  • Resuming normal life activities
  • Connection building and improvement

These objectives are met by a variety of therapies, which may include:

  • Family therapy
  • Psychotherapy
  • Cognitive behavioral therapy
  • Techniques for meditation and relaxation
  • Art or music therapy
  • Clinical hypnosis
  • Dialectical behavior therapy

There is currently no medicine that can aid with dissociative behavior. However, you may be offered medicines to aid with other symptoms such as sadness or anxiety.

Complications and their consequences

Dissociative fugue is linked to a number of complications. These can range from moderate to severe, and they should be kept an eye out for. They are as follows:

  • Suicidal thoughts
  • Attempted self-harm — includes cutting, mutilation, and other forms of self-harm
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Personality disorders
  • Eating disorders
  • Issues or problems in relationships and at work
  • Sleep disorders
  • Usage of illegal drugs
  • Alcoholism
  • Seizures (not due to epilepsy)

Some persons who suffer from dissociative fugue go missing or are found wandering in strange places.

When should you see a doctor

It is preferable to diagnose dissociative fugue as soon as possible. This is due to the wide spectrum of problems it might create.

You should consult a medical expert, any time a loved one displays indications of disorientation or memory loss after experiencing or witnessing severe or long-term trauma or stress of any sort.

After extreme stress or trauma, you should also call a medical expert if a loved one shows strange behavior or ceases showing up to work or locations they regularly visit. It’s critical to rule out any underlying medical issues that might be causing the symptoms.

Then, if the symptoms aren’t due to a medical condition, get treatment from a mental health specialist as soon as feasible. Working with a mental health expert early on can help prevent symptoms from intensifying or a dissociative fugue from lasting longer.

Outlook

The prognosis for someone suffering from dissociative fugue is typically positive. As soon as treatment and intervention begin, the outlook improves.

The majority of persons who suffer from fugue state regain most or all of their memories. The memories may come back fast and all at once, or they may come back gradually over time. However, some people are unable to totally regain their memories.

DSM-5 Conversion Disorders which are Dissociative Disorders in the ICD-10

Dissociative Disorders of movement or sensation DSM5 300.11 (ICD-10 F44.4, F44.5, F44.6)

The Core Symptoms of Dissociative Disorders

  • amnesiarecurrent memory problems , often described as “losing time”, these gaps in memory can vary from several minutes to years
  • depersonalizationa sense of detachment or disconnection from one’s self, this can include feeling like a stranger to yourself, feeling detached from your emotions , feeling robotic or like you are on autopilot , or feeling like a part of your body does not belong to you. Some people self-injure when depersonalized, for example in order to feel “real”.
  • derealizationa sense of disconnection from familiar people or one’s surroundings, for example, close relatives or your own home may seem unreal or foreign. Episodes of derealization may happen during flashbacks; you may suddenly feel much younger and feel your present environment is unreal during this time.
  • identity confusionan inner struggle about one’s sense of self/identity, which may involve uncertainty, puzzlement or conflict. Severe identity confusion regarding sexual identity has been reported in people who have been sexually abused.
  • identity alterationa sense of acting like a different person some of the time Recognizable signs of identity alteration include using of different names in different situations, discovering you have items you don’t recognize, or having a learned skill which you have no recollection of learning. Mild identity alteration is widespread in the non-clinical population and does not cause difficulties for the person, for example a person assumes different roles but remained aware of this alteration. Mood or behavior changes which don’t feel under your control , but don’t involve using different names or changes in memory or perceived age, etc, indicate moderate identity alteration. This is common in non-dissociative disorders, for example in borderline personality disorder. [6, 7:9-12, 232]

References

1. Black, Donald W. (2014) (coauthors: Grant, Jon E.). DSM-5 Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Pub. ISBN 9781585624652.
2. World Health Organisation. (2014) Classification of Diseases (ICD). Retrieved November 16, 2014, from http://www.who.int/classifications/icd/revision/en/
3. Task Force on Nomenclature and Statistics American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3d ed.). Washington, D.C.: American Psychiatric Association.
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