Dissociative Fugue: Understanding This Rare Psychological Condition
Key takeaways:
Dissociative identity disorders are conditions that make people feel disconnected from their body and mind.
People with dissociative disorders can sometimes experience dissociative fugue. This is a state in which someone forgets their identity and starts a new life.
Fugue is not well understood, but experts believe it could be related to past trauma. And it may be a way the mind protects someone from difficult emotions.
If you’ve experienced moments where you felt disconnected to yourself or your surroundings, you’re not alone. It’s very common to have short periods where you feel detached from your identity or environment. This experience is called “dissociation.” But when people experience long-lasting periods of disconnection that disrupt memory, they may have a dissociative identity disorder. These conditions are rare and only affect 2% of the population.
Dissociative fugue can happen to people with dissociative identity disorders. This causes someone to forget who they are, wander from home, and start a new life. While fugue is often referenced in TV shows and movies, the condition is very much real and can be very confusing and challenging to go through.
What is dissociative fugue?
In order to understand dissociative fugue, let’s first take a step back to understand dissociative identity disorders. There are three types of dissociative identity disorders:
Depersonalization/derealization disorder: This is when someone feels disconnected from reality and their surroundings.
Dissociative identity disorder: This is when someone has two or more different personality types. This used to be called “multiple personality disorder.”
Dissociative amnesia: This is when someone can’t remember a personal experience or specific event.
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Dissociative fugue is a subtype of dissociative amnesia. Fugue means “flight.” So dissociative fugue is a condition in which someone not only forgets who they are (the amnesia part), but they also travel away from their usual life (the flight part).
Some people experience shorter fugue states, lasting from days to weeks. For other people, it lasts longer. It’s also possible to experience more than one fugue state in a lifetime.
Fugue states are very rare, and only about 0.2% of people with other dissociative disorders experience them.
What causes dissociative fugue?
Experts believe that dissociative fugue is a response to trauma. It may be the brain’s way of protecting someone from a very difficult or stressful situation. A fugue state allows someone to escape a painful experience rather than process the emotions. These emotions could come from sexual abuse or other stressors in your life. People with post-traumatic stress disorder (PTSD) or depression and anxiety may also experience fugue.Researchers do not fully understand what causes someone to experience a fugue state. But it’s likely due to a combination of several factors. Some people may be more likely to experience fugue due to genetics since it seems to be common in members of the same family. It’s also possible that damage to the brain can cause this type of memory loss.
What does dissociative fugue feel like?
People with dissociative fugue may:
Wander or travel away from home
Establish a new identity
Start a new career or family
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People experiencing a fugue state have no memory of their identity. So it can be significantly distressing when they’re diagnosed with the condition. It can be very hard to learn that they left their former life and started a new one without any memory or awareness. This can even be dangerous for them. They may experience confusion, distress, and anxiety that can have a significant effect on their mental and physical health.
People with a dissociative disorder have a higher risk of suicide. If you need help or know someone with suicidal thoughts, call the Suicide and Crisis Lifeline at 988.
How do you treat dissociative fugue?
People experiencing a fugue state do not realize anything is wrong, so it can be very difficult to recognize this condition. And when they’re told about or remember their previous life, it can be very hard to process.
Treatments for people who have experienced fugue include psychotherapy and medications. In a similar way, talk therapy can help people process emotional trauma. There are a few types of therapy that may help:
Psychodynamic therapy focuses on your relationships and your past. It may help you better understand your behavior based on your response to life events.
Cognitive behavioral therapy (CBT) can provide ways to identify negative thought patterns. This method can provide you with tools to help change your way of thinking.
Eye movement desensitization and reprocessing (EMDR) uses side-by-side eye movements to make memories less painful. Although this could also make dissociation worse, so it’s important to follow a treatment plan that your therapist recommends.
There are no medications specifically for dissociative fugue. But antidepressants and anti-anxiety treatments could help manage the stress and emotional trauma that comes along with it.
Coping with dissociative fugue
There’s no one best way to cope with dissociative identity disorder or fugue. But there are some things people can do to support their recovery. For example, the person must address the trauma that triggered the fugue.
In addition to therapy and medical treatment, self-care is important for anyone going through emotional trauma. It's helpful to remember to eat healthy foods, engage in physical activity, and get enough sleep. Sticking to a routine can help people get back into their previous life.
It can also be very hard for friends and family to understand and support someone who is recovering from a fugue state. Friends and family may not be able to understand the memory loss — or they may feel personally rejected. For these reasons, it may be helpful to join a support group. Other people who have experienced a fugue state may provide helpful coping tools.
The bottom line
Dissociative fugue is a very rare psychiatric condition that is not well understood. It may come from the mind’s attempt to protect someone from painful memories. Trauma and its effects show up in very different ways in different people.
If you know someone who has experienced emotional trauma or has had a fugue state, it helps to be patient. You may not understand their behavior, and that’s OK. Everyone’s mind works a little differently, and everyone recovers on their own time. Support from family and friends is crucial to their treatment journey.
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References
Agenagnew, L., et al. (2020). Dissociative amnesia with dissociative fugue and psychosis: A case report from a 25-year-old Ethiopian woman. Case Reports in Psychiatry.
American Psychiatric Association. (2018). What are dissociative disorders?.
American Psychiatric Association. (2022). Dissociative disorders. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
Coons, P. M. (1999). Psychogenic or dissociative fugue: A clinical investigation of five cases. Psychological Reports.
Cotterman, A. (2020). 5 things I wish my loved ones knew about dissociation. National Alliance on Mental Illness.
Fine, C. G., et al. (2001). The wreathing protocol: The imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder and other dissociative responses. Eye movement desensitization reprocessing. American Journal of Clinical Hypnosis.
International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma and Dissociation.
Jha, M., et al. (2014). Dissociative fugue disorder: Identification and psychological intervention. Psychological Studies.
Mamarde, A., et al. (2013). Recurrent dissociative fugue. Indian Journal of Psychological Medicine.
Mangiulli, I., et al. (2021). A critical review of case studies on dissociative amnesia. Clinical Psychological Science.
National Alliance on Mental Illness. (n.d.). Dissociative disorders.
Rajkumar, R. P. (2022). The molecular genetics of dissociative symptomatology: A transdiagnostic literature review. Genes.
Sharma, P., et al. (2015). A case of dissociative amnesia with dissociative fugue and treatment with psychotherapy. The Primary Care Companion for CNS Disorders.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
