What Is Dissociative Fugue?

Have you ever experienced feeling disconnected or unsure about your own identity, or found yourself somewhere unfamiliar without knowing how you got there?¹ 
Maybe you've noticed someone close to you suddenly acting very different, having trouble remembering people or events, or unexpectedly going far from home without explanation^1,2

These are some of the signs and symptoms of a mental health condition called dissociative fugue, or psychogenic fugue.¹ 

Dissociative fugue is a rare but serious dissociative disorder that can have a significant impact on a person's life.^1,3 If you’ve noticed these symptoms in yourself or someone close to you, it’s important to seek help from a mental health professional.¹ In the following article, we’ll explore what causes dissociative fugue, how to spot a fugue episode, as well as look into the available management and treatment options. We’ll also answer some frequently asked questions about this condition.  

Overview

Dissociative disorders are mental health problems that involve temporary or long-term disruptions in how a person thinks, remembers, perceives, feels about themselves, or connects to the world.³ These conditions make it difficult for people to feel like themselves or relate to others in their lives and can cause various distressing symptoms.^1,3

Dissociative fugue is rare a subtype of dissociative amnesia (memory loss), typically triggered by severe psychological stress or trauma.^3,4 The word "fugue" comes from the Latin word "fuga," which means "flight".⁵ As the name suggests, this condition involves fleeing, mentally and physically, from a psychologically overwhelming situation.^1,4

Causes of dissociative fugue

When we have an extremely distressing experience, like a natural disaster, war, sexual abuse or a personal tragedy, the brain sometimes uses dissociation as a way to protect us from overwhelming emotions.^1,3,6 The exact reason why some people develop dissociative fugue isn't fully understood, but experts believe it may be triggered by a traumatic event in someone who has an underlying genetic risk.² However, if you have a genetic risk, it doesn't mean that this will definitely happen to you.⁷

In dissociative fugue, the areas of your brain involved in remembering personal experiences get blocked by the frontal areas of your brain. This pattern leads you to temporarily lose your memory and sense of personal identity.⁷

Signs and symptoms of dissociative fugue

Dissociative fugue usually causes you to suddenly and temporarily lose your sense and memory of who you are, and to unexpectedly leave your home or familiar surroundings.³ The way you travel may appear organised and purposeful to others, or you could look aimless and confused — a state that’s sometimes called “bewildered wandering”.^1,3 

You might take on a completely new identity, having no memory of your previous life, personal information, or events leading up to the episode.^1,2 You may no longer recognise your own family and friends.⁶

During a dissociative fugue episode, you may feel detached from your own thoughts and actions, like you’re on autopilot (depersonalisation), and/or have a sense that the world around you is unreal or distant (derealisation).^2,3

Other symptoms you might experience with dissociative fugue include anxiety, confusion, insomnia and emotional numbness.^1,2

In a dissociative fugue state you’ll likely maintain your normal self-care routines — like eating, washing, grooming — and may not display any obviously abnormal behaviour to people around you.² You might travel long distances, sometimes up to several thousand miles, and stay in this condition for a few hours, days, months, or even years.^2,3,8

When your fugue episode ends, you may abruptly find yourself in a new, unexpected environment with no memory of how you got there or what happened during the fugue.³ Understandably, you might feel upset, frightened, confused or ashamed that you can’t remember what has happened to you.⁴ Most likely, you’ll begin to remember your real identity and life from before the fugue episode naturally. But how quickly and completely you remember these details varies from person to person.⁴

Management and treatment for dissociative fugue

Talk therapy

The main treatment you’ll receive if you are diagnosed with dissociative fugue is talk therapy.⁹ Your treatment plan will usually focus on building a positive relationship with your therapist, feeling safe, getting your condition under control, and reducing your symptoms.⁹ You’ll also work with your therapist to process and come to terms with any difficult experiences that may have triggered your dissociative state.⁹ The final step will be helping you to return to your normal everyday life and to feel strong going forward.⁹

Creating safety and stability

Your care team will make every effort to put your safety and wellbeing first.³ Their first priority will be to provide a safe place for you where you can relax and be away from anything or anyone that is causing you stress.^1,3 They may also guide you through some relaxation and grounding techniques to help you feel calmer and more comfortable where you are.¹⁰

Reassurance and memory training

After your fugue episode ends, your doctor or therapist will carefully explain your condition to you to help you to understand what has happened.¹¹ Your therapist will help you regain lost memories and provide emotional support and reassurance so that you feel safe during your treatment.^1,3,11 

Complementary treatments

Your therapy plan may involve hypnosis or medication-assisted interviews to help you recall lost memories, but the effectiveness of these treatments may vary.^4,7

The role of medication

There is no evidence-based medication approved for treating dissociative fugue,^2,10 and there’s a good chance that you’ll recover from your dissociative symptoms over time without it.^3,11 However, you might be prescribed medications such as antidepressants, anxiety-relieving medications and sedatives to help manage symptoms associated with dissociative fugue or overlapping conditions, such as anxiety, depression, or insomnia.^7,10

FAQs

How is dissociative fugue diagnosed?

If you have memory loss for your identity or past, or have found yourself in a strange place with no recollection of how you got there, a healthcare professional assessing you might suspect that you have dissociative fugue.⁴

To make this diagnosis formally, and distinguish your condition from other types of amnesia, your healthcare provider will need to confirm that:⁷

• You unexpectedly travelled away from your home or usual surroundings, while still taking care of yourself
• You experience partial or complete memory loss for the journey and recent stressful events
• There is no physical explanation for your symptoms
• Your symptoms are related to stressful events, problems or needs

They’ll also want to check whether you can recall new information and think clearly, even though you can't remember things that happened before.¹

It's okay if you struggle to remember what happened before you left home, during your travels, or if you find it hard to make sense of your current situation.⁴ Your doctor will help you to make sense of what happened and create a plan for your recovery.⁴

Can dissociative fugue be prevented?

To help prevent dissociative fugue from happening again, your therapist can teach you and your family about ways to deal with stressful situations, conflicts, and emotions. This type of psychoeducation can help you develop better coping mechanisms and prevent future episodes.^3,4,10 

Who is at risk of dissociative fugue?

Dissociative fugue usually starts when you're a teenager or young adult.³ 

While doctors don't know exactly what causes it, they believe it may be triggered by a traumatic experience in someone who has a genetic predisposition.² This means that if you have a family history of dissociative fugue, you may be more likely to experience it after a traumatic event.²

However, just because you have a genetic predisposition to dissociative fugue, it doesn't necessarily mean you will develop this condition.⁷

How common is dissociative fugue?

Dissociative fugue is exceptionally rare, with an estimated prevalence of 0.2%.^1,2 

When should I see a doctor?

If you or someone close to you experiences any of the dissociative symptoms discussed in this article, it's important to reach out to a healthcare professional as soon as possible.⁹

With the right treatment, you can recover from dissociative fugue and regain your sense of identity and memories.⁹ Remember, it's okay to ask for help – you don't have to go through this alone.

Summary

If you or someone you know experiences a sudden loss of personal identity and memory of past events, it may be a sign of dissociative fugue. This rare mental health condition is typically triggered by severe psychological stress or trauma and can be frightening and confusing to experience.

It's important to seek help from a mental health professional if you or someone you know is experiencing these symptoms.

Experts believe that dissociative fugue occurs when the brain uses dissociation as a way to protect itself from overwhelming emotions. Although the cause of this condition is not fully understood, genetics may play a role.

The good news is that dissociative fugue can be treated with talk therapy. Your therapist will work with you to build a positive relationship, feel safe, restore your memory, reduce your symptoms, and process difficult experiences that may have triggered your dissociative state. 

Remember that seeking help from a mental health professional is the first step in managing dissociative fugue. With proper treatment and support, you can regain your sense of self and move forward with your life.