Dissociative Fugue (referred to as Fugue State) is a rare form of dissociative disorder related to amnesia. The name Fugue comes from the French term for “running away,” which describes the main characteristic of this rare psychological disorder, which is the undertaking of abrupt travel.
Dissociative disorders are typically recognized by an involuntary disconnection with reality associated with personal identity, thoughts and memory.
Fugue is a type of dissociative disorder that is specifically characterized by sudden and unexpected travel away from home, which often comes with assuming a new identity in a new location. Abruptly separating yourself from your current environment, forgetting who you are, and even possibly starting a new life as someone else is a unique element of this disorder which separates it from other dissociative disorders and amnesia, although Fugue State is associated with both. Fugue State also separates itself by the way in which it abruptly ends and the person who suffers from it suddenly remembers who they are, their former lives and the stress that triggered the Fugue State.
The Fugue State itself is not considered its own disorder but is associated with dissociative amnesia. People with Fugue State become confused as they suffer a form of amnesia where they forget who they are and important details of their lives such as where they live and with whom they associate. However, they typically don’t show outward signs of having the disorder.
People who suffer from Fugue State dissociative disorder typically do not show outward signs of physical or psychological illness. They may have a difficult time functioning at work or at home; however, these symptoms could appear as normal stress or anxiety, which is why this particular dissociative disorder is so difficult to identify in those who are suffering from it.
What makes this disorder unique is the fact that a person in Fugue State will suddenly travel away from home and forget who they are, where they live, and everything about their original identity. They may assume a new identity and a new life until the Fugue State abruptly ends, which could be in a matter of days or months, and in some cases, even years.
One difference between Fugue State amnesia and medical, or physical, amnesia is the person in the Fugue State often doesn’t seem very concerned with the fact that they cannot remember who they are or any details of their life. Medical amnesia, often caused by physical illnesses such as brain trauma or stroke, tends to leave people feeling stressed and upset about not remembering who they are or the people with whom they associate.
While the person who is actively in Fugue State isn’t outwardly suffering from severe stress, once their true identity returns, they are typically left confused and distressed. After effects can set in including grief, depression, aggressive behavior, and suicidal tendencies as the person is suffering from the stress of the Fugue State and returning to the stress from which they originally fled.
Fugue State isn’t typically identified, as people with this condition don’t know they have lost their memory until they are asked to give personal information about themselves. At that point, they suddenly realize they don’t know who they are or where they came from.
One famous suspected case of Fugue State was that of Agatha Christie. On December 3, 1926, the famous author disappeared from her home in Berkshire, England, after suffering two separate traumas in her life: her mother had died a few months earlier and her husband had been having a public affair. Agatha had written a letter characterized as “confused” to her husband Archie, indicating she was going on vacation. The next day her car was found abandoned and she was found under another name, Teresa Neele (the last name being the same name of the woman with whom her husband was having an affair).
When she was discovered, Agatha insisted she was Teresa Neele who came from Cape Town. Eventually, she came out of her mental state; however, doctors were baffled as to what had happened to her and, at the time, simply considered it bizarre behavior. Her symptoms match those of Fugue State and it’s quite possible, although still unknown for sure, this is what actually happened to Ms. Christie to cause her to wander off and assume a different identity.
Fugue State is generally caused by severe anxiety and stress associated with a traumatic event which triggers this rare condition. In cases of Fugue State, there is typically some kind of severe distressing event that occurs such as war, marital problems, natural disasters, violence, financial stress, and the like, which will cause a person to flee from their current circumstances and forget who they are. They even go so far as to assume a new identity.
While Fugue-like states can also be caused by alcohol abuse or abuse of certain drugs that effect the brain (think about the blackout effect), this is typically not a cause of this condition. Fugue State is not symptomatic of a physical condition; however, there are times when brain damage could be a contributing factor.
If a person suffers an event that is psychologically distressing, their brain will forget their current circumstances as a protection mechanism and cause them to flee the situation by forgetting their identity. This is similar to the “flight” portion of the fight or flight response that includes dissociative amnesia. The person will often create a new identity and form new relationships and even obtain employment, all seemingly normal to them and everyone around them at the time this occurs.
Because the causes of Fugue State are fairly typical of anxiety and stress, symptoms are difficult to recognize.
Fugue State is difficult to diagnose because symptoms typically are not outward or obvious to others, which in turn, makes it a difficult disorder to treat. Fugue State is not usually identified until the person comes out of their dissociative state, when they appear confused about who and where they are and how they got there. They may not remember what happened to them and, therefore, Fugue State could be confused with typical amnesia.
If a person is found in Fugue State and has not come out of it, the main form of treatment is psychotherapy, which is often used to treat dissociative disorders. Hypnosis is also effective in treating the fugue state, with an attempt to get a person to remember their former identity.
Treatment that has been applied in a clinical environment where a patient was identified as being in dissociative Fugue State was to take him out of the stressful atmosphere and provide empathy and support in the form of psychotherapy. Re-teaching the patient through pictures and slowly reminding him of his past identity in a nurturing atmosphere helped him remember who he was. This worked in a specific case; however, a lot more research needs to be done on this disorder.
Currently, doctors are conducting tests to stimulate and inhibit different parts of the brain to trigger the memory of patients’ original identities, enabling them to return to their lives and recover. However, there is still so little known about this disorder.
In most cases, because this disorder is so difficult to identify and often goes unnoticed, the person’s identity and memory suddenly come back on their own, simply leaving them confused. When the person recovers their memory, treatment for Fugue State is not warranted; however, treatment for the stress that caused this disorder should be addressed. The goal of treating Fugue State is similar to treating severe anxiety and stress; the trauma that triggered the Fugue State to begin with must be addressed in order to prevent a future episode from occurring.
There is no prevention for this specific condition as it’s typically not evident when a person will suddenly go into Fugue State. The onset of Fugue State is usually not noticeable and the person suffering from it may be gone from their home or work by the time they are noticed missing. However, the underlying causes of Fugue State – severe stress and anxiety – can be prevented.
There are many stress-reduction therapies available that can help people reduce their stress before it reaches the point where a condition such as Fugue State sets in.
Meditation involves focusing on positive thoughts and deep breathing while getting rid of stressful or negative thoughts. This is typically performed on a daily basis and can decrease stress and alter neural pathways to enable the brain to better deal with stress and anxiety.
Reaching out to family and friends and discussing stressful events can significantly help reduce stress. While more traumatic events may require professional consultation, discussing problems with those close to us helps to defray some everyday stresses that could spiral out of control.
Medications for anxiety and depression can be helpful in keeping severe stress and anxiety under control, which goes a long way in preventing something like Fugue State.
Psychotherapy is one of the most effective treatments for treating associative Fugue State and it can also be effective in reducing anxiety and stress. Consulting a professional to deal with issues that are causing stress, be it a family problem, trauma from violence or post-traumatic stress syndrome (PTSD), sudden financial losses or anything else that can cause problems, can go a long way in reducing stress and anxiety.
CBT is a self-help talking therapy that helps to change the way you think and consequently behave. This form of therapy is used to relieve depression and stress.
Whether or not someone is demonstrating symptoms of Fugue State or not, it’s always wise to reach out for help from friends, family, or a professional therapist when we suffer from anxiety or stress, especially for life-changing events such as the death of a loved one, loss of a job or partner, or in the case of post-traumatic stress disorder (PSTD) or violence against an individual.