Dissociative Disorder | Dissociative Fugue or Psychogenic Fugue

by Mladen

Individual in dissociative fugue suddenly looses their memory of their identity and leaves their physical surroundings. In some cases one can assume new identity.

Dissociative or psychogenic fugue is one of many dissociative disorders. Besides fugue state, as popularly called, there are few others: dissociative personality disorder (split identity, multiple personality disorder), state of trans and possession (eastern cultures), dissociative amnesia...
For all these conditions, amnesia is common sign. One doesn't recall of the time spent in state of dissociative disorder, nor does one recall of previous lifetime while in fugue, or any other similar state.

Dissociative Fugue: Definition

Patients with Psychogenic fugue wander without goal or plans. They don't remember of their past, and they are confused, lost, sometimes even under new identity.

Dissociative fugue, or psychogenic fugue is caused by defect in mental integration of identity and counsciousness. It is rare disorder (1 in 2.000 people), but with increase during war periods, or during natural disasters. It always happens after some initial psychogenic trauma or emotional shock. 

Individual takes on trip with no previous preparations. Patient is confused, unaware of his real identity, with complete amnesia of his previous life. Person is in state of automatism in motor behavior, which leads to unstoppable traveling to some designated location. One has all characteristics of dissociative amnesia with illusion of rational reason for travel he is doing. In the state of dissociative fugue, one can perform simple social interactions such are ticket and fuel purchase, asking for direction, ordering lunch etc. 

In some cases person in fugue can take on new identity. It is not rare case that patients in psychogenic fugue undertake new identity as subconscious defense against loss of "self". In other cases of this disorder, there is no confusion in one's head. And he can seem quite normal in the eyes of bystander. Especially in early stage of fugue. Later, patient, mostly attracts attention by his confused and distracted look and behavior (he can't understand the purposse of being on the present location). 

This disorder often goes with only one episode, which can last from few hours to few months. The most common scenario is 3 to 5 days of dissociative fugue. In this timeframe, one can travel over few hundred miles. 

Dissociative Disorder | Dissociative Fugue or Psychogenic Fugue
Dissociative Disorder | Dissociative ...

Famous Cases of Dissociative Fugue

Although rare disorder, psychogenic fugue is well documented!

I think the most famous case of this disorder is the mystery of Agatha Christie's vanishing for few days  in December 1926. This happened few months after the death of her mother whom she was very close to. During this period of time her husband was having an affair with Nancy Neel. Day before Agatha went missing, he took trip to Surrey to reunite with Nancy. 

Agatha Christie wrote few confusing letters to her relatives before she disappeared. She was found in a spa near Surrow checked in under the name of Teresa Neel. Spa residents thought they recognized her, but she kept to her story of being a bereaved mother from Cape Town. When her husband was brought to identify her, she just said: "Fancy, my brother just arrived".

Read more on Agatha Christie's Dissociative Fugue

Jeff Ingram went on the trip to Alberta, Canada to visit his close friend dying of cancer. He woke up on Denver with 8 dollar in pocket, and no recall of his past. He didn't know who he was, how come he ended in that hotel room, nor the city he was in. Jeff appeared on local TV station asking for help if anyone can tell him who he was. His fiance's brother recognized him and along with sister he went to Denver to pick up Jeff. Jeff's car was never found, and he's memory of previous life never returned.

Scientists assume that shock of close friend dying could have been trigger of his case of dissociative fugue. This is rare case of compete and permanent loss of memory during state of fugue.

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Quote

"Very few of us are what we seem."

Agatha Christie

Symptoms of Psychogenic Fugue

Dissociative fugue interfears with real life, and makes social functioning impossible.

Main symptoms are:

  • Sudden and unplanned travel away from home (fugue is derived from Latin word "fugare", which means flight),
  • Person finds is impossible to recall past events from his life,
  • Confusion or loss of memory about his identity, likely to assume new identity to compensate the loss of "self",
  • Loss of memory to events happened during the fugue, when person returns to original state of function (dissociative amnesia).

Returning to Original State of Functioning!

It is never easy...

Person who has experienced state of fugue will find himself extremely confused and frightened in situation when he exits this state. It is not pleasant feeling to find yourself in strange surroundings, not knowing where could you be. Sometimes it is in the same city, in some familiar street, but more often it is hundreds of miles away from home, possibly in other state, which language you can't speak. But, it is good thing you are back, no matter how scary new situation can look. Some people never came back from psychogenic fugue. They have lost all the memory on previous events in their lives. They can't even recognize their children. This is rare state of mind, but when it happens it is devastating, and it destroys one's life.

Diagnosis and Treatment of Psychogenic Fugue

Diagnosis of this condition can be tough. If you are not close to person in dissociative fugue, you can assume he is just traveling. In early stages, there could be no signs of confusion. Individual in fugue can seem quite normal. It is easier to notice the change if you know the person. You will then notice he can't recognize you, he is referring to himself as to person with different name etc.

Doctor must exclude physical causes of this condition. Some tumors, brain trauma, appoplexia, or Alzheimer can give the same symptoms. RTG, CT, NMR, blood tests must be performed. These procedures won't show anything in case of psychogenic wandering. 

Treatment in most cases in not needed. Disorder resolves by itself, and there is mostly just one episode of this disorder. In other cases hypnosis can help. There is no medication that can be applied here. Only counseling and hypnosis.

When Problems from Personal Life Grow...

... It can lead to suicide

Every doctor, and human being in general should think of this possibility when encountering person with psychiatric disorder. Every psychiatric disorder is product of repressed emotions, and it is the final state of long lasting unstable mental state. 

It is then, easy to connect A to B and make conclusion that those people suffering from dissociative and any other psychiatric disorder, can privately think of 'suicidum'; in other words to have suicidal thoughts.

In order not to write about something that has been nicely presented on other places, I will just suggest one of my favorite articles on suicidal thoughts and what to do in such case. 

Wizzley author Katiem2 has excellent article on that topic.  In this article Katie explains the most common reasons for suicides; she is writing about what must happen to force someone to think about it and what are the signs suicidal person sends to us. How to discover someone is suicidal early enough to help him?

Why suicide? Are there ways to stop it? What are the vital suicide warnings? That and a lot more, find out in Katie's article:

Katie shares information about fighting suicidal thoughts, and gives advices about reacting in such cases
I want to die, suicide is on the minds of many during these troubled times. Many suffer unbelievable pain and loss. Learn what to do and where to turn to stop the pain.

Read About Other Psychiatric Disorders:

More and more children in modern world develop conversion disorder as consequence of suppressing their emotions (good or bad).
Updated: on 04/02/2012, Mladen
 
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Please, let me know what do you think of this disorder!


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Mladen on 09/30/2012

Brain is wonderful... The way it acts is still great mystery to us. As in this case: who can tell when someone or if someone will recover. Psychologists, therapists are doing excellent job on "fixing" mental conditions. Drugs too. But still, psychiatry is battling with unknown enemy. That mystery is what attracts me to it.
Great to hear from you Sheri, as always!

Sheri_Oz on 08/25/2012

For 30 years I worked with people with dissociative disorders. They can recovery and lead very good and very satisfying lives in personal and professional realms.

Pinkchic18 on 07/13/2012

Very scary, it would be very hard to see this happen to someone close to me. But important to be able to recognize it. Nicely composed article.

Mladen on 04/08/2012

It must be quite unsetting, Sheri. I cannot even image the feeling when they realize their brain was playing with them. Other dissociative disorders are even more devastating (multiple personality disorder i.e.)

Sheri_Oz on 04/08/2012

This is disorder is so frightening to the sufferer. It is true that dissociative fugue spontaneously dissipates. But imagine how unsettling for the individual when they realize what happened to them. Excellent piece.

Mladen on 04/02/2012

Hi, deamons. I am sorry to hear that. If you want, you can share your story with us. And, yes, it is the best to get to know the enemy.
My pleasure!

demons on 04/02/2012

This will be a big help as I learn the disorder I am afflicted with, thank you for the resource

Mladen on 03/29/2012

Pinkchic18, I am glad you have found this article informative and interesting. I appreciate your kind comment and your time.

Pinkchic18 on 03/29/2012

Very interesting article, I knew little about this before so I appreciate your knowledge on the very sad disorder.

Mladen on 03/20/2012

There is never too many doctors. :)
Yes, our lives turned into jobs. That is all we think about. go to work, do overtime, come back, take some sleep and repeat it. And how not to be anxcious. It is important we take moment every day, and just do something we like. I for example love to listen to music when I am under some stress. It is pretty relaxing. Though it can lead to music intoxication, which is some other disorder. I might write about it too. :)
Good to have a word from you on the subject, Katie!




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