A person with dissociative fugue disorder is unaware of the fact that they have forgotten their identity. In addition to the person being unaware of their memory loss, a crucial part of the dissociative fugue is that the person might travel to a new location away from home and assume a new identity. Dissociative fugue is relatively rare and often undetectable, leading to limited knowledge of the disorder.
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What is Dissociative Fugue?
Dissociative fugue refers to a time-limited disorder in which a person forgets their identity and adopts a new one. Dissociative fugue disorder should not be confused with dissociative amnesia where a person is aware of their memory loss. In order to qualify for a dissociative fugue diagnosis, the fugue state must be determined not to be the result of substance use or dissociative identity disorder.
Symptoms of Dissociative Fugue
Recognizing dissociative fugue can be difficult to recognize because the person outwardly behaves normally. Key symptoms of dissociative fugue focus on someone fleeing their location and starting a new identity.
Other symptoms of dissociative fugue include:
- Sudden and unplanned travel away from home
- Inability to remember details of the past
- Confusion about his or her identity
- Sudden lack of attendance at work
- Extreme distress
- Problems with completing day-to-day tasks
- Wandering to new places
- Detachment from one’s own emotions
Causes and Risk Factors for Dissociative Fugue
Dissociative fugue causes may include traumatic events and other severe stressors. Experiencing a traumatic event is the most significant risk factor for developing dissociative fugue. A person who has experienced trauma during early childhood may be more likely to develop dissociative fugue following a traumatic event later in life.
In the case of a traumatic life event, dissociative fugue may emerge as the brain attempts to protect itself from experiencing the trauma. Forgetting one’s identity and creating a new one may be an abnormal way of handling extreme stressors, but it is one that at least temporarily prevents the experiencing of negative feelings.
Additional causes of dissociative fugue may be widespread events such as natural disasters or war.
Diagnosing Dissociative Fugue
Any medical conditions must be ruled out to diagnose dissociative fugue. Further, a clinician must determine whether or not the fugue episode occurred as a result of substance abuse. If substance abuse is the primary cause of the fugue state, the diagnosis of dissociative fugue will not apply.
Usually, dissociative fugue is not diagnosed until after the fact once the fugue episode has ended and the patient’s memory has returned.
Dissociative Fugue Statistics
Data indicates that dissociative fugue is relatively rare, with the estimated prevalence being less than 0.2 percent. However, the occurrence is higher specific populations, including war veterans, survivors of natural disasters and others affected by trauma. Dissociative fugue, once categorized by itself, was recategorized in the most recent diagnostic manual as a sub-type of dissociative amnesia.
Dissociative Fugue Treatment
There is no set approach to treat dissociative fugue. A person usually does not experience distress until the fugue episode has ended. Further, the disorder is usually diagnosed retroactively, based on reports of the fugue episode. Attempts to force a person to remember their true identity are unlikely to be successful but, in some cases, may accelerate the recovery process.
Medication for Dissociative Fugue
Medication for dissociative fugue is unlikely to end a fugue episode. However, once a person returns to his or her original identity, medication may be helpful in dealing with the flood of feelings that result from a dissociative fugue episode. Once the fugue ends, the person must also deal with the trauma that prompted the fugue episode.
In some sense, medication for dissociative fugue is similar to medications for personality disorders. While there is no personality disorder medication, some medications for personality disorders are used to deal with other symptoms. One of the most common medication types to be used for treating symptoms relating to the diagnosis rather than the specific diagnosis itself is selective serotonin reuptake inhibitors (SSRIs). Anti-depressants medications like SSRIs may also reduce anxiety. Following a fugue, this type of medication may make it easier to accept and move on from the traumatic event.
Therapy for Dissociative Fugue
It is imperative to begin therapy after a dissociative fugue episode to help deal with the trauma.
- Cognitive Behavioral Therapy. Cognitive behavioral therapy (CBT) may be helpful with challenging beliefs and ideas surrounding the trauma. Implementing CBT may also prevent a person from having further behavioral disturbances because of trauma.
- Group Therapy. Group therapy for the traumatic experience may be helpful. As dissociative fugue is rare, it is unlikely that group therapy could be conducted only with people who have experienced dissociative fugue.
- Family Therapy. Based on the type of trauma experienced, family therapy may be beneficial. If the trauma or stressor relates to the family such as a divorce or death in the family, this approach may assist in building upon natural supports.
Dissociative Fugue and Co-Occurring Substance Abuse
While dissociative fugue and substance abuse disorders can co-occur, it is critical to determine whether the fugue state was the result of intoxication. For a person with recurring dissociative fugue states, substance abuse may cause worsening symptoms such as more frequent fugues.
Treatments for dissociative fugue with co-occurring substance use disorders generally do not change. CBT remains the choice approach and will include a recurrence of use prevention component when these disorders co-occur.
If you or someone you know is struggling with a substance use and co-occurring disorder, help is available. At The Recovery Village, a team of professionals provides a continuum of care for substance use and co-occurring disorders. Call and speak with a representative to learn more about which treatment program could work for you.