Symptoms of Dissociative Fugue

Depending on the duration of the fugue state, you might miss a few hours of work or home responsibilities, or go so far as to move and create an entirely different life.

When the fugue ends, you’ll remember your “real” life, but will have no memory of what happened during the fugue state. This can be confusing and scary, especially if you’ve traveled or formed new relationships.

It’s not always easy to tell when someone’s experiencing dissociative fugue. From the outside, there may be no noticeable symptoms.

However, the following signs might signal that someone might be experiencing dissociative fugue:

• confusion
• loss of memory about themselves and their own life
• an inability to recognize people they know
• aimless wandering
• detachment from their emotions
• a lack of attendance at work or other commitments

In extreme cases, someone in a dissociative fugue will start a new life very different from their “old” life. For example, they might move away, start a new career, and develop new relationships, not remembering or knowing the truth about their actual identity and life.

When the fugue state ends, the person will be able to remember details of their “old” life, loved ones, and identity. But they won’t remember what happened during the state. If they traveled, for example, they won’t remember how they got there.

Dissociative fugue is a rare type of dissociative amnesia.

The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) doesn’t recognize dissociative fugue as a disorder in itself. Instead, it’s considered a type of dissociative amnesia.

“Dissociative amnesia” is a condition where someone has no memory of their own life. This could be a short period of their life (localized dissociative amnesia) or they could forget much of their identity and history (general dissociative amnesia).

So, when does dissociative amnesia become dissociative fugue?

The distinguishing factor is that someone in dissociative fugue moves away from their life, even if only for a few hours. In fact, the word “fugue” comes from the Latin words for “fleeing” and “flight.”

Scenario one:

A veteran returns from combat. In a fugue state, they leave their family and travel off to a new town. They don’t remember the details of their life, loved ones, or having been in combat. There, they find a job as a waiter. When the fugue state ends weeks later, they remember their “old” life, but can’t remember having moved or starting this job.

Scenario two:

In a fugue state, a parent drives out of town. They are absent from work and don’t pick their children up from school. A few hours later, the fugue ends, and they find themselves in a different town. They’re not sure how they got there.

Scenario three:

A doctor in a busy city experiences extreme stress. They enter a fugue state and imagine a new identity, not knowing that they’re a doctor. They’re absent from work the next day, and nobody has been in contact with them. When their fugue state ends, they’re staying in a hotel with no recollection of having gone there.

Dissociative fugue happens as a result of extremely stressful situations. It’s believed that the person “flees” as the only way of escaping this psychological trauma. Modern psychology recognizes that there is a strong link between trauma and dissociation.

The stressful situation could be:

• physical, sexual, or emotional abuse
• combat or war
• an accident or natural disaster
• torture or kidnapping
• extreme feelings of shame
• extreme day-to-day stress

These are just examples. Other situations may also trigger dissociative fugue.

Before treating dissociative fugue, it’s important for doctors to rule out any other possible causes for memory loss, including illnesses and injuries. Dissociative fugue can only be diagnosed once the fugue state ends.

When the fugue ends, the memory of your “old” life will return on its own. You might not be able to remember what happened during the fugue state.

Since dissociative fugue is caused by extreme distress and trauma, treatments usually include dealing with the root cause of the problem. For example, therapy might include helping someone process traumatic events and learn skills to cope with day-to-day life.

Treatment for dissociative fugue usually includes talk therapy, also known as psychotherapy. This is a broad term that encompasses many types of therapy.

Talk therapy might help you deal with the stress that caused the fugue in the first place. It can also help you recover forgotten memories. Coming out of a fugue state can be frightening and traumatic in itself, especially if you find yourself in very different circumstances. Therapy can help you process this trauma.

There is no medication for dissociative fugue. However, if you have a mental health condition, you might benefit from medication that is used to treat those conditions. Medication could be prescribed by your doctor or psychiatrist.

It might also be helpful to engage in self-care strategies to help you cope with day-to-day life. This could include:

• basic self-care, like getting enough sleep and eating an adequate diet
• engaging in de-stressing activities, like exercise and meditation
• journaling or starting a creative hobby
• joining a support group
• spending time with loved ones
• taking breaks when possible
• taking on less responsibility at work, at home, or in your community

Your self-care strategy will depend on your personal circumstances.

Although dissociative fugue is caused by severe stress and trauma, the outlook is often positive as memories return on their own.

However, it’s a good idea to consider therapy if you’ve been in a dissociative fugue. This can help you recover memories, process the experience, and deal with the trauma that caused the fugue in the first place.