How to diagnose dissociative fugue

In this Article

  • What Are the Symptoms of Dissociative Fugue?
  • What Causes Dissociative Fugue?
  • How Common Is Dissociative Fugue?
  • How Is Dissociative Fugue Diagnosed?
  • How Is Dissociative Fugue Treated?
  • What Is the Outlook for People With Dissociative Fugue?
  • Can Dissociative Fugue Be Prevented?

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: 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.В Cognitive therapy is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns and resulting feelings and behaviors.
  • Medication: 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.

, MD, Stanford University School of Medicine

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

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

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

Sometimes hypnosis or drug-facilitated interviews

If people have had dissociative fugues, psychotherapy, 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.

How to diagnose dissociative fugue

Dissociative disorders develop as the mind attempts to protect us from unbearably traumatic experiences, but new dangers arise in the process. Through dissociative amnesia and a dissociative fugue state, a person not only loses a grip on their memories and identity, but they also create physical distance from the trauma by traveling in this confused mindset. Early comprehensive treatment to rehabilitate the dissociation is the best and most secure road to recovery.

Quick Links

  • Understanding Dissociative Amnesia with Fugue State
  • Treating Dissociative Amnesia and Dissociative Fugue Comprehensively

When we accidentally touch a pan on the stove or something else extremely hot, our bodies react immediately by pulling us away from the source of injury and pain. Our brains involuntarily create distance—a barrier between us and further trauma. Similar reactions are also possible when the trauma is of a psychological or emotional nature. The brain has a way of creating distance and limiting the mental injury we experience in the face of a traumatic event. This protective reaction might arise in the moment, or it might surface sometime later to dissociate us from the traumatic memories.

Dissociative disorders effectively distort a person’s sense of reality, perhaps disrupting their memories, untangling the understanding of their own identity, detaching them from the physical world around them, or otherwise separating them from the pain they face. Just as it protects us from burns and other physical injuries, the brain has the best intentions by building these walls against traumatic experience. But these walls also block the individual from processing the pain. Dissociative disorders trade in one challenge but introduce a new range of side effects and suffering.

When the brain muddles our ability to remember, it’s called dissociative amnesia disorder. Not related to organic causes, such as injury to the brain or seizure disorder, dissociative amnesia seriously disrupts a person’s ability to function in daily life, to relate to their past experiences, and perhaps even to relate to their own sense of identity. Every instance of the disorder is unique as it is influenced by an individual’s particular experiences. In some cases, dissociative amnesia is accompanied by a fugue episode, which can involve actual travel or confused wandering when the person is overcome by dissociation. Dissociative amnesia with fugue state can have particularly dangerous consequences and calls for the early intervention of comprehensive and compassionate treatment. It is possible to help an individual safely reconnect with themselves and to move through the source trauma for a freer future.

Understanding Dissociative Amnesia with Fugue State

Whereas dissociative disorders create distance between a person and their experience of trauma on a mental level, dissociative amnesia with fugue state also creates literal distance. People going through dissociative fugue exhibit unplanned, unexpected travel—sometimes to very far away. The person may not appear to be acting strangely to unfamiliar people around them, not at first. Within the context of amnesia symptoms, they are not remembering some or all details of their past and their identity. In some cases, an individual will assume a new identity and even establish a life in the place where they land in their travels.

But more often, they become confused days or even hours after leaving their familiar environment. And they are caught in the middle of a journey that they do not understand in the least. They may still be experiencing symptoms of memory loss, but they are now able to recognize that they don’t know where they are or how they got there. This confusion and distress compounds with any continuing experience of dissociative amnesia.

This act of fleeing, of running away from one’s past and home environment is not intentional with dissociative fugue. It is the mind’s desperate way of creating distance from a traumatic event or traumatic memories. The source trauma is unique for every case of dissociative amnesia with fugue state, but some common precipitating conditions include abuse, natural disaster, witnessing violence, war, or even intolerable stress in life or work.

Dissociative fugue typically does not persist for very long—usually not more than a few months, but the risks of travel when someone is not functioning with their grounded memories, reasoning, and judgment are high. They may be more prone to injury, victimization, and further emotional distress when they realize they don’t know where they are or even who they are. Early treatment is the answer to mitigating these steep risks of dissociative fugue. The complications of dissociative amnesia will likely take longer to reconcile in treatment, but comprehensive therapy can address all aspects of a client’s distress at once.

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Treating Dissociative Amnesia and Dissociative Fugue Comprehensively

For clients with dissociative amnesia and dissociative fugue, the road to recovery is one of reintegration: therapists act as guides to help them reintegrate their memories, including the traumatic ones, and to reconnect with their identity, confidence, relationships, responsibilities, and hopes for a thriving life. Medications may help to relieve some of the symptoms of this dissociative disorder, but the primary mode of treatment is psychotherapy.

Whether the provocative trauma occurred recently or long ago, dedicated treatment will be imperative to help a client process the original experience and all of the reactions, emotions, and dissociation that followed. In a long-term residential treatment program, they can develop trust in the community environment and their therapists—and in themselves—with healing as the collective priority. Especially for long-term recovery, clients need to develop effective methods of coping with any trauma that may resurface throughout their lives. In a compassionate treatment environment, they can practice getting in touch with and expressing their direct experience of the trauma, ideally bypassing the mind’s desperate need to dissociate.

Holistic treatment embraces the whole person. A care plan is personalized and may include a combination of individual therapy modalities, group therapy, family therapy, diet and nutrition, alternative medicines, adventure and recreation therapy. By way of structured treatment, clients gain powerful support systems through the peer community, their team of clinicians and therapists, and their family and friends who will play an integral role in future recovery. Those with dissociative amnesia and fugue episodes can rediscover their sense of self and empowerment. They can live the life they want without being controlled by trauma and uncontrolled reactivity.

BrightQuest is a long-term residential treatment center for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned program and how we can help you or your loved one begin the journey toward recovery.

Dissociative fugue (formerly called psychogenic fugue) is a psychological state in which a person loses awareness of their identity or other important autobiographical information and also engages in some form of unexpected travel. People who experience a dissociative fugue may suddenly find themselves in a place, such as 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

Dissociative fugue is a subtype of dissociative amnesia but 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 as long as weeks or 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, with persisting confusion about identity.

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Dissociative fugue is what makes up mysteries. Apparently from nowhere or sometimes after a trauma, a person forgets who he is, where he came from, and other facts about their identity.

An individual can also seem to vanish from their life and from their familiar patterns. However, the condition is a very real psychiatric illness.

One of the most well known examples of a possible dissociative fugue is Agatha Christie’s. The mystery writer suddenly disappeared from her England home on 3 December 1926. Her car was found the next day, with the headlights on and all her belongings inside.

Eventually Christie was discovered in a health spa where she had checked in under a name. She never mentioned this episode again and no explanation for her disappearance has ever been given.

What is dissociative fugue?

A dissociative fugue is a type of dissociative amnesia in which a person forgets who he or she is.

Apart from the amnesia, anyone with a dissociative fugue encounters a sudden and unexpected travel episode. The word “fugue” comes from the Latin words for “run” or “flee.” This state of fugue can last from hours to months, or even even longer.

The state can be a way for one to get away from a painful or traumatic situation. However, a genuine dissociative fugue is not a state of composition. Nor is a dissociative fugue a deliberate effort by an person to escape a difficult situation.

Symptoms

The signs of a dissociative fugue can hardly be observed. A person may act or appear normal in the middle of one, or may act just slightly confused.

An person who has a dissociative fugue may not want to draw attention to him or herself and may simply disappear.

Other dissociative fugue signs can include:

  • confusion
  • emotional detachment
  • confused identity
  • depression
  • anxiety
  • wandering
  • 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 is unable to recall a specific event, event, or time period. The forgotten phase is typically a painful or stressful time and has consistent beginning and stopping points. People can experience a memory loss in more than one episode.

2. Selective amnesia: The person just forgets some or part of the events that took place.

3. Generalized amnesia: when a person forgets who they are and where they come from, generalized amnesia refers. The person forgets their life history entirely, often including the skills they learned. Such form of amnesia is rare but is the most common in those with serious trauma, such as combat veterans or sexual assault victims.

After the fugue is over, the person appears to find him or herself in a new position in life with no recollection of how they got there or what has happened afterwards.

This return to normality may leave a person embarrassed, uncomfortable and frightened.

Causes

By general, but not always, a dissociative fugue is caused by a traumatic event, such as:

  • rape
  • accidents
  • combat
  • natural disaster
  • violence
  • long-term physical or emotional abuse

Those events should not have happened to the fugue-affected individual. Witnessing these things can be so traumatic as to cause a dissociative state.

Diagnosis

Diagnosis of this condition typically takes place after the fugue has ended and after the person involved has explained what happened to them.

Someone who has had or may have had a condition of fugue will see a doctor immediately for evaluation.

To rule out a medical cause for the case, such as epilepsy or other seizure condition, the doctor may prescribe a detailed physical exam and medical history.

If no other cause is identified, the individual will be referred for a psychological examination with a psychologist.

Treatment

A dissociative fugue is an acute occurrence, which is not chronic in most situations. However, in many situations, amnesia associated with an incident and fugue state will occur, even after the fugue has ended.

Treatment should concentrate on helping the patient cope with what has happened and determining what has caused the fugue disorder. This form of therapy is achieved by working with an skilled, trained therapist to support 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 can be required as the individual starts recovering from what has happened.

Complications

Several other mental health problems are associated with dissociative fugue and possibly the traumatic event that caused it, including:

  • post traumatic stress disorder
  • depression
  • anxiety
  • sleep disturbances
  • drug or alcohol use
  • suicidal thoughts

It is necessary to see a medical professional as soon as possible, because of the seriousness of this condition and the complications associated with it.

A medical professional should be consulted if a loved one shows odd behaviour, symptoms of confusion or memory loss. It is especially true after a traumatic event.

Outlook

The outlook for someone who has had a dissociative fugue is excellent and increases after initiation of therapy.

Although certain people recover their memory, those with dissociative fugue can never fully recall the events that happened during that period of time.

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Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Up to 75% of people experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes. Women are more likely than men to be diagnosed with a dissociative disorder.

The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and cause problems with functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder that a person has.

Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives.

Symptoms

Symptoms and signs of dissociative disorders include:

  • Significant memory loss of specific times, people and events
  • Out-of-body experiences, such as feeling as though you are watching a movie of yourself
  • Mental health problems such as depression, anxiety and thoughts of suicide
  • A sense of detachment from your emotions, or emotional numbness
  • A lack of a sense of self-identity

The symptoms of dissociative disorders depend on the type of disorder that has been diagnosed. There are three types of dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM):

  • Dissociative Amnesia. The main symptom is difficulty remembering important information about one’s self. Dissociative amnesia may surround a particular event, such as combat or abuse, or more rarely, information about identity and life history. The onset for an amnesic episode is usually sudden, and an episode can last minutes, hours, days, or, rarely, months or years. There is no average for age onset or percentage, and a person may experience multiple episodes throughout her life.
  • Depersonalization disorder. This disorder involves ongoing feelings of detachment from actions, feelings, thoughts and sensations as if they are watching a movie (depersonalization). Sometimes other people and things may feel like people and things in the world around them are unreal (derealization). A person may experience depersonalization, derealization or both. Symptoms can last just a matter of moments or return at times over the years. The average onset age is 16, although depersonalization episodes can start anywhere from early to mid childhood. Less than 20% of people with this disorder start experiencing episodes after the age of 20.
  • Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of every day events, personal information and trauma. Women are more likely to be diagnosed, as they more frequently present with acute dissociative symptoms. Men are more likely to deny symptoms and trauma histories, and commonly exhibit more violent behavior, rather than amnesia or fugue states. This can lead to elevated false negative diagnosis.

Causes

Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual or emotional abuse. Natural disasters and combat can also cause dissociative disorders.

Diagnosis

Doctors diagnose dissociative disorders based on a review of symptoms and personal history. A doctor may perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality (for example, head injury, brain lesions or tumors, sleep deprivation or intoxication). If physical causes are ruled out, a mental health specialist is often consulted to make an evaluation.

Many features of dissociative disorders can be influenced by a person’s cultural background. In the case of dissociative identity disorder and dissociative amnesia, patients may present with unexplained, non-epileptic seizures, paralyses or sensory loss. In settings where possession is part of cultural beliefs, the fragmented identities of a person who has DID may take the form of spirits, deities, demons or animals. Intercultural contact may also influence the characteristics of other identities. For example, a person in India exposed to Western culture may present with an “alter” who only speaks English. In cultures with highly restrictive social conditions, amnesia is frequently triggered by severe psychological stress such as conflict caused by oppression. Finally, voluntarily induced states of depersonalization can be a part of meditative practices prevalent in many religions and cultures, and should not be diagnosed as a disorder.

Treatment

Dissociative disorders are managed through various therapies including:

  • Psychotherapiessuch as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT)
  • Eye movement desensitization and reprocessing (EMDR)
  • Medications such as antidepressants can treat symptoms of related conditions

Related Conditions

Because dissociative disorders appear on the trauma spectrum, many patients may have conditions associated with trauma, as well as additional trauma-based conditions.

Dissociative disorders are a range of conditions that can cause physical and psychological problems.

Some dissociative disorders are very shortlived, perhaps following a traumatic life event, and resolve on their own over a matter of weeks or months. Others can last much longer.

Symptoms of a dissociative disorder

Symptoms of dissociative disorder can vary but may include:

  • feeling disconnected from yourself and the world around you
  • forgetting about certain time periods, events and personal information
  • feeling uncertain about who you are
  • having multiple distinct identities
  • feeling little or no physical pain

Dissociation is a way the mind copes with too much stress.

Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months).

It can sometimes last for years, but usually if a person has other dissociative disorders.

Many people with a dissociative disorder have had a traumatic event during childhood.

They may dissociate and avoid dealing with it as a way of coping with it.

Types of dissociative disorder

There are several different types of dissociative disorder.

The 3 main types are:

  • depersonalisation-derealisation disorder
  • dissociative amnesia
  • dissociative identity disorder

Depersonalisation-derealisation disorder

Depersonalisation is where you have the feeling of being outside yourself and observing your actions, feelings or thoughts from a distance.

Derealisation is where you feel the world around is unreal. People and things around you may seem “lifeless” or “foggy”.

You can have depersonalisation or derealisation, or both together. It may last only a few moments or come and go over many years.

Dissociative amnesia

Someone with dissociative amnesia will have periods where they cannot remember information about themselves or events in their past life.

They may also forget a learned talent or skill.

These gaps in memory are much more severe than normal forgetfulness and are not the result of another medical condition.

Some people with dissociative amnesia find themselves in a strange place without knowing how they got there.

They may have travelled there on purpose, or wandered in a confused state.

These blank episodes may last minutes, hours or days. In rare cases, they can last months or years.

Dissociative identity disorder

Dissociative identity disorder (DID) used to be called multiple personality disorder.

Someone diagnosed with DID may feel uncertain about their identity and who they are.

They may feel the presence of other identities, each with their own names, voices, personal histories and mannerisms.

The main symptoms of DID are:

  • memory gaps about everyday events and personal information
  • having several distinct identities

Associated conditions

Someone with a dissociative disorder may also have other mental health conditions, such as:

They may also have problems sleeping (insomnia).

Causes of dissociative disorder

The causes of dissociative disorders are not well understood.

They may be related to a previous traumatic experience, or a tendency to develop more physical than psychological symptoms when stressed or distressed.

Someone with a dissociative disorder may have experienced physical, sexual or emotional abuse during childhood.

Some people dissociate after experiencing war, kidnapping or even an invasive medical procedure.

Switching off from reality is a normal defence mechanism that helps the person cope during a traumatic time.

It’s a form of denial, as if “this is not happening to me”.

It becomes a problem when the environment is no longer traumatic but the person still acts and lives as if it is, and has not dealt with or processed the event.

Diagnosing dissociative disorders

A GP may examine you and do some tests to check if another illness might be the cause of your symptoms.

They may also refer you to a mental health specialist for a full assessment.

Assessment

The specialist who carries out your assessment should have a good understanding of dissociative disorders.

The assessment may include:

  • a physical examination to rule out things like a head injury or drug or alcohol misuse
  • questions about your thoughts, feelings, behaviour and your symptoms

It’s important to be honest about your symptoms and not to feel ashamed or embarrassed, so you can receive the help and support you need.

Treatments for dissociative disorders

Many people with a dissociative disorder make a full recovery with treatment and support.

Talking therapies

Talking therapies are often recommended for dissociative disorders.

The aim of talking therapies such as counselling is to help you cope with the underlying cause of your symptoms, and to learn and practise techniques to manage the periods of feeling disconnected.

Medicines

There’s no specific medicine to treat dissociation, but medicines like antidepressants may be prescribed to treat associated conditions like depression, anxiety and panic attacks.

If you’re feeling suicidal

If you have thoughts about taking your life, it’s important you ask someone for help.

It’s probably difficult for you to see it at this time, but you’re not alone or beyond help.

There are people you can talk to who want to help:

  • speak to a friend, family member or someone you trust, as they may be able to help you calm down and find some breathing space
  • call the Samaritans free 24-hour support service on 116 123
  • go to your nearest A&E and tell the staff how you’re feeling
  • contact NHS 111
  • make an urgent appointment to see a GP

What to do if you’re worried about someone

If you’re worried that someone you know may be considering suicide, try to encourage them to talk about how they’re feeling.

Listening is the best way to help. Try to avoid offering solutions and try not to judge.

If they have previously been diagnosed with a mental health condition, such as depression, you can speak to a member of their care team for help and advice.

Further help and support

If you have a dissociative disorder, getting help and support is an important part of the recovery process.

Talking to your partner, family and friends about how your past experiences have affected you can help you come to terms with what happened, as well as helping them understand how you feel.

Mental health charity Mind has more information on dissociative disorders and a list of support organisations.

Reading about other people with similar experiences may also help.

Page last reviewed: 10 August 2020
Next review due: 10 August 2023

What is Dissociative Disorders

Dissociative disorders, i.e. dissociative fugue, are mental problems involving memory loss, memories, and personal information. Dissociative fugue is one of the disorders under the heading of dissociative disorders. Individuals with dissociative fugue temporarily lose their personal identity and travel impulsively away from their homes or workplaces. Where they go, they often forget who they are, and they are there with a new identity. For example, people with this disorder do not exhibit a peculiar appearance or strange behavior from the outside. They do not show that they have a dissociative disorder from the outside. In this article, we will discuss the symptoms of this disorder, treatment methods, etc.

Dissociative, The most important feature of this, is that but unexpectedly traveling away from home or where daily activities take place is not remembering some or all of the memories ”. Travels can take several hours or several months. Some people may even go thousands of kilometers away while in the dissociative fugue. At first, people may look completely normal where they go. However, confusion arises over time. Suddenly one can understand that he does not belong to his place.

When one or more of the functions deteriorate, such as loss of memory, deterioration of personal information and past life experiences, some symptoms may occur. These symptoms may cause general deterioration in personal relationships, including those in social, academic or business life.

What are the Symptoms?

The symptoms of the disorder present in the person are difficult to recognize by other people in the environment and the behavior of the individual from outside is normal. Common symptoms of the disorder are as follows:

  • Staying away from home by making sudden and unplanned trips
  • Inability to remember past events or important information from one’s life
  • Identity confusion and memory loss
  • Create a new ID to compensate for existing memory loss
  • Excessive distress and problems in the daily operation

What are the Causes?

This disorder can occur in extreme stress situations, which may be the result of traumatic events such as war, rape, accidents, natural disaster, or extreme violence experienced or witnessed by the person himself. Also, dissociative fugue-like conditions may occur as a result of alcohol and substance abuse. In brief, the following common reasons for the emergence of dissociative fugues may have a say:

  • Extreme shame
  • War-induced trauma
  • Trauma caused by accidents or natural disasters
  • Torture
  • Prolonged emotional or physical abuse in childhood
  • One does not necessarily have to experience these traumas. The person may have witnessed them and may have been severely traumatized by what they saw. Also, dissociative disorders in family history are likely to make the person genetically susceptible.

How is Dissociative Fugue Diagnosed?

If signs of the dissociative fugue are present, full life history and clinical observation will be performed by a specialist. Although medical tests are not performed, especially for dissociative disorders, various tests can be performed to ignore the effects of physical diseases or drugs. Epilepsy, head trauma, substance abuse, and alcohol poisoning can also cause symptoms similar to dissociative disorders. The main purpose of these medical tests is to know exactly what the cause of dissociative fugue is.

If a person has a dissociative fugue independent of a physical problem, they can go to a psychologist to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed tests and assessment tools to assess a person with dissociative disorder.

How to Treat Dissociative Fugue?

The main purpose of dissociative fugue is to help resolve the stress or trauma that triggers memory loss in the individual. The treatment also aims to help the person develop mechanisms to deal with traumas and stress that cause dissociative fugue. The treatment approach includes a combination of the following treatment methods. It depends on the individual and the severity or frequency of symptoms.

Cognitive Behavioral Therapy. It is a psychotherapy method that focuses on changing dysfunctional thinking patterns and negative automatic thoughts that occur within the framework of emotion, thought and behavior cycle. This method improves the ability to cope with stress and traumas that cause dissociative fugue.

Can we prevent Dissociative Fugue ?

It may not be entirely possible to prevent dissociative fugue. But as soon as the symptoms mentioned above have begun, it’s helpful to seek help from a specialist and start treatment. In addition, working with the traumatic or stressful condition therapy methods experienced by the person and causing dissociative fugue will also help to reduce the risk of developing a new dissociative fugue.

When Should I Get Expert Help?

In cases where a beloved person is exposed to severe or prolonged trauma or stress, it may be advisable to consult a specialist if any of his thoughts show any signs of confusion as well as memory loss. You should also remember that you should seek help from a psychiatrist and psychologist if you can see that this person also disappeared after stress and trauma, went to other places, and had memory interruptions. Also, if the above-mentioned symptoms do not appear to have any physical condition after medical checks, psychological help should be sought. Working early with dissociative fugue reduces symptoms and worsens the likelihood of developing a new dissociative fugue.

Last Updated on December 12, 2020 by Lucas Berg