What Is Dissociative Fugue?

Dissociative fugue is a rare type of dissociative amnesia that may involve the adoption of a new identity and wandering away from home, even distant travel in some cases. Dissociative amnesia is a mental illness that is triggered by trauma and that results in some degree of loss of memories.

The degree of memory loss, and the duration, varies by individual. Only in rare cases does a person lose nearly all memories including a sense of personal identity. Fugue is used as a qualifier when diagnosing dissociative amnesia.

Dissociative amnesia is memory loss with a lot of individual variation. It can cause loss of memories related just to one person, event, or time period, or it can cause loss of recent memories or all past memories. The loss may last for a few hours or many years. When memory loss triggers intentional travel away from home or aimless wandering, it is called fugue or a fugue state.

When a fugue lasts only a few hours, the person may seem confused, but others may not even notice that they have wandered off, especially adults. Longer cases of fugue are likely to be noticed and even may result in a missing person report. Symptoms and signs of dissociative fugue include:

• Confusion, forgetfulness
• Inexplicable absences, at work or at home
• Emotional detachment
• Loss of personal memories or identity
• A confused sense of identity
• Difficulty recognizing friends and family
• Depression, anxiety
• Wandering away from home or other normal locations
• Traveling far from home, possibly for long periods of time
• The sudden adoption of a new identity, which may be completely different from the original identity

Some people in a fugue state will not be distressed at all. Memories can return suddenly, though, and this often causes fear, confusion, anxiety, and a great deal of distress. A person may have no clear signs of fugue in their new location, but once it ends, they often come to the attention of authorities or mental health professionals.

Because the person experiencing the fugue state does not realize what is happening, dissociative fugue can be hard to identify and diagnose until it has ended. For this reason, most people don’t get treatment. The symptoms tend to resolve on their own, in most cases within a few hours or days, but in some people not for months or years. The fugue state may end suddenly or more gradually, causing a confused and distorted sense of identity.

Most diagnoses of fugue occur after the fact, when a doctor or mental health professional has reviewed the individual’s history. The loss of memories and identity combined with any degree of wandering, travel, or adoption of a new identity are clear diagnostic signs of dissociative fugue.

Fugue is a rare subtype of dissociative amnesia, and like other dissociative conditions it is ultimately caused by one or more traumatic experiences. Any type of dissociative disorder is the brain’s unhealthy way of coping with trauma. A person who goes through this is doing so involuntarily to cope with abuse, assault, a sudden loss of a loved one, or any other traumatic experience. Why someone may dissociate and lose memories in response to trauma, while others do not, is not well understood.

While most people will not get treatment while in the fugue state, it is essential to get professional support after it has passed. Someone who has dissociated in some way is at a greater risk of doing it again. Furthermore, these individuals have experienced trauma that has not been adequately addressed or processed.

Treatment centered on trauma-focused therapy can help an individual process and face the traumatic experience in a safe way. It can also help someone learn better coping strategies and reduce the risk that he or she will experience amnesia or fugue again. Hypnosis may also be used as a treatment strategy, especially for someone who still has not fully recovered all memories and identity.

Dissociative fugue can be distressing and significantly disrupts lives. It is a result of the damage that trauma can cause some people, and while fugue is difficult to diagnose while it is happening, individuals can benefit from treatment as memories and identity return.