TV shows and movies sometimes use memory loss as a plot device. In Breaking Bad, Walter White pretends to experience fugue after a public event.
But clinical cases of dissociative fugue look a little different in real life. If you have dissociative amnesia, you will experience memory loss or even changes in personality and your sense of identity. Dissociative fugue causes people to travel while dissociating, leaving them confused when they finish a dissociative episode.
Our article will discuss the meaning of a fugue state, fugue state symptoms, and causes, and how therapy can help. We will also go over other causes for dissociation.
What Is a Dissociative Fugue State?
A dissociative fugue state is a period of time when someone is disconnected from their thoughts and physical body and travels. Imagine heading home from work and later finding yourself in a town you don't recognize. If you could not recall the trip or explain how you got there, you might have been in a dissociative fugue state. Therapists refer to this pattern of memory loss and travel as "dissociative fugue".
Clinical experts classify fugue as a subtype of dissociative amnesia. Dissociative fugue and amnesia are when memory loss is combined with unexpected travel or wandering. In a dissociative fugue state, someone may use a different name or take on a new identity.
How Does Dissociative Amnesia Differ From Fugue?
Dissociative amnesia happens when you lose access to important personal memories. Dissociative fugue is when you unexpectedly wander or travel. While they differ, you can experience both.
Now, you might dissociate routinely. In fact, many people do during mundane tasks or on familiar roads. And you may also forget important things from time to time. For instance, if you dissociated during a drive home but still arrived home, you probably did not have an episode of dissociative fugue. But if several days passed by or you arrived somewhere unfamiliar, you might have had an episode of dissociative amnesia with dissociative fugue. All fugue cases involve dissociative amnesia, but most cases do not involve travel.
How does fugue differ from other types of memory loss?
There are a couple of types of amnesia. Some types of memory loss include:
Localized amnesia, which affects memories of a specific event. You might not recall a painful event or stressful period of your life.
Retrograde amnesia, which affects memories formed before a certain point. Sometimes people cannot recall memories before they were 5, for instance.
Generalized amnesia involves a wider loss of personal memories. Sometimes people experience generalized amnesia after combat.
Fugue is a state someone can be in, where other types of memory loss happen when someone tries to recall something. People in a fugue state can forget their age, name, and other personal details in real time. They might even adopt a new identity or personality until their memory comes back. In these more severe cases, they would have been in a fugue state for months or years.
How Does a Fugue State Happen, and What Causes It?
You can experience dissociation because of anxiety, stress, or trauma. Dissociation is a type of trauma response; the brain tries to help by providing an escape. A fugue state is a more extreme version of this and can also be triggered by trauma.
Still, experts aren't exactly sure what causes it. A 2023 study examined brain imaging for people with dissociative amnesia. While they found differences and unusual activity in brain networks linked to memory and emotion, the study was limited. More research is needed to draw definitive conclusions.
We do know that fugue state can be triggered by war, natural disasters, or abuse, especially in early childhood. Cleveland Clinic notes that fugue most often occurs with dissociative amnesia and Dissociative Identity Disorder (DID).
How Long Does a Dissociative Amnesia Episode Last?
An episode may last hours or several days. The most severe cases of fugue can last weeks or months, though this is very rare. And while many people regain their missing memories, recovery varies.
Typically, someone with dissociative amnesia and fugue will notice a problem once they arrive somewhere new. If you have a family member who experiences fugue, gaps in their account of recent events could indicate an episode occurred.
What Are the Signs and Symptoms of Fugue?
The main sign is memory loss, especially related to personal details. And of course, arriving at an unknown destination.
Other fugue symptoms may include:
Gaps in memories
Inability to remember personal events
Struggling to remember important relationships
Missing memories from a period of your life
Limited awareness of memory gaps
Sudden travel or wandering without a clear plan
Confusion and disorientation
Picking up and adopting another identity
Flashbacks as memories return, or
Difficulty maintaining close relationships
Short periods of time where you feel detached from your body would not be enough for a diagnosis. But if you believe you might have dissociative amnesia and dissociative fugue, note times when you arrive somewhere confused or feel distant from your body. This is important information to pass along during an assessment.
How Is Dissociative Amnesia Diagnosed?
Unfortunately, there is no blood test, brain scan, or dissociative amnesia test to assess for it. To receive a diagnosis, a doctor would first check for other causes of memory loss. A doctor would assess for a head injury, substance use, or seizures. From there, you will be checked for signs of global amnesia.
Therapists use DSM-5-TR criteria when assessing for dissociative amnesia. Because the condition is rare, they also check whether another health issue might better explain your symptoms. If you are diagnosed, your doctor or therapist will create a formal treatment plan.
What Treatment Options Help with Dissociative Amnesia?
Therapy is the main form of dissociative amnesia treatment. Early therapy sessions focus on your safety and stress management. After learning grounding and coping techniques, your therapist may help you explore traumatic past experiences that could be causing fugue. In some instances, clinicians might prescribe medication if your fugue is related to anxiety or depression.
What other Conditions could be Causing Dissociation?
Other factors could also cause dissociation. If you're not finding yourself in a new city regularly and not forgetting personal details, you probably do not have dissociative amnesia and fugue. It's rare. But you might be dissociating for a variety of other reasons.
These are ordered from most severe to least. If you have a condition at the top of the list, you dissociate very frequently. If you have a condition at the bottom, dissociation is an acute response. If you are experiencing dissociation, consider talking to a therapist about:
Dissociative amnesia, which can occur alongside PTSD and some personality disorders. It may also appear with other mental health concerns.
Conversion disorder, also called functional neurological symptom disorder, can cause physical symptoms such as weakness or trouble walking.
Depersonalization Disorder causes you to feel detached from your body and thoughts.
Derealization disorder makes the world around you seem unreal.
Dissociative Identity Disorder (DID), which causes you to have two or more personality states.
Post-Traumatic Stress Disorder (PTSD) or trauma can cause you to dissociate.
Acute Stress Disorder can trigger a vigilant survival response in your nervous system during or after danger.
Complex childhood trauma or childhood neglect. Having traumatic experiences early teaches your brain to use dissociation to cope with your world.
Borderline Personality Disorder (BPD) calls on dissociation in order to cope with rejection, abandonment, or stress.
Overwhelming stress or anxiety, which can cause you to not be present, panic, and dissociate.
Fatigue and Sleep deprivation can also cause dissociation.
Substances and Medications: Recreational drugs, alcohol, or certain prescription medications can cause dissociation.
These differ from dissociative amnesia, which centers on memory gaps. Depersonalization and derealization can also occur with other mental health conditions. A therapist can assess for these conditions and help you manage dissociation. And if needed, a therapist can provide treatment for dissociative amnesia.
Where Can I Find a Therapist for Trauma-Related Memory Loss?
Dissociation can leave you feeling confused and scared. If you dissociate because of traumatic experiences, we want to help. We can match you with a trauma therapist who can provide dissociation grounding techniques and long-term relief.
Reach out to our front desk today to be matched with a therapist. Clients usually start sessions after 7 days of calling us.
Don't let dissociation take more of your life. Start therapy this week and start living a brighter life.
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