Dissociative Disorder | Dissociative Fugue or Psychogenic Fugue

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. 

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).

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 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.

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: