Dissociative Fugue

Dissociative Fugue is a psychological disorder categorised under a broad term called Dissociative Disorder. Also called Psychogenic Fugue, this psychological ailment causes a temporary loss of identity which causes patients to lose themselves. At certain times, patients are not able to remember their autobiographical details and can even create new identities. There is a complete disruption of perception, identity and consciousness impacting work and daily life.
Read on to learn more about Dissociative Fugue symptoms, Dissociative Fugue causes and Dissociative Fugue treatment.

What is Dissociative Fugue?

Dissociative Fugue is a psychological disorder in which a patient suffers from a temporary loss of memory. Such patients forget their details, cannot recollect their past and can also end up in unexpected locations. Patients fail to realize that there are gaps in their memory and only accept them when presented with evidence.
A fugue state can last for weeks, days or even months. While shorter episodes last a few hours, longer episodes can lead a patient far from familiar surroundings. They might adopt a new identity, travel and create a different life which makes it even more difficult for them to recall their identity.

Common Myths and Misconceptions

Myth 1: Patients with Dissociative Fugue are aware of their disorder.
Fact 1: False. Patients who have Dissociative Fugue are not always aware of their condition. Professional intervention is the only way to make them aware of their problem.

Myth 2: Symptoms of Dissociative Fugue are exhibited.
Fact 2: False. Patients suffering from Dissociative Fugue might not exhibit their symptoms. They only realise it once they are out of the state of fugue.

Statistics and Facts

On average, 1-5% of the total population has been diagnosed with a dissociative disorder. On a global level, 0.2% of the total population has been estimated to suffer from Dissociative Fugue. The disorder is most commonly found among patients who have witnessed wars, natural disasters and accidents first-hand.
The percentage of reported cases, however, could be understated due to a lack of awareness about the disorder, difficulty in diagnosing the disorder and lack of enough psychological professionals.

What are the most common causes of Dissociative Fugue?

The three main causes of a patient suffering from Dissociative Fugue are:

• Dissociative Amnesia
  Dissociative Fugue often accompanies Dissociative Amnesia which is often triggered by trauma or stress. The symptoms include unexpected travel or identity confusion during memory loss. Dissociative Fugue also serves as a defence mechanism against harsh and painful memories.
• Dissociative Identity Disorder (DID)
  Dissociative Identity Disorder can cause dissociative identity disorder due to memory gaps between distinct personalities. These personalities usually develop in childhood in response to trauma and do not share the same experiences. Therefore, Dissociative Fugue occurs when an individual switches personalities without any recollection of any event or actions performed by another personality.
• Traumatic Events
  Traumatic events often trigger Dissociative Fugue as the brain blocks distressing memories, confusing the identity. Wars, experiencing natural disasters, losing loved ones in an accident or to a disease can make a person suffer from Dissociative Fugue. There are gaps in the memory and patients adopt new identities. Dissociative Fugue is also triggered as a defence mechanism to protect oneself from emotional pain and stress.

Signs and Symptoms of Dissociative Fugue

1. Symptoms Exhibited by Patients During Fugue State:

Confusion regarding identity and being unsure of one’s past is the main symptom. However, patients suffering from Dissociative Fugue might not display any outward symptoms of any mental illness. The adopted identity feels real and natural, therefore, patients only exhibit issues when this identity is challenged.

2. Symptoms Exhibited by Patients After Fugue State:

Once the state of fugue ends, patients feel depressed and grieve. There is a sense of shame, guilt and stress of being in an unfamiliar state of being. Patients can experience multiple episodes of fugue especially if symptoms are left unaddressed. They also experience feelings of sadness as though they have missed significant events in life.

How is Dissociative Fugue treated?

Diagnosis

Once the symptoms of Dissociative Fugue appear, doctors start by analysing the complete medical history of a patient. There are no laboratory tests that can confirm if a patient is suffering from Dissociative Fugue, however, blood tests and scans help in ruling out other problems. Therapists make sure that the episodes are not caused because of epilepsy, injury to the head, substance abuse and so on.
Patients are later referred to psychologists and psychiatrists for a final diagnosis. Patients are interviewed extensively and various other assessment tools are used to confirm the diagnosis.

Treatment Options

The treatment process of Dissociative Fugue is two-fold:

• Helping patients to recover their identity and coming to terms with the original trauma.
• Developing coping strategies to prevent the recurrence of these episodes.

Therapies are essential to treat Dissociative Fugue. Psychotherapy, also called Talk Therapy, helps patients to open up about their thoughts and emotions. There isn’t any particular medication prescribed for Dissociative Fugue. However, those exhibiting symptoms of depression and anxiety are prescribed drugs accordingly.
Here are other effective therapies that help a patient recover from Dissociative Fugue.

• Cognitive Behavioural Therapy (CBT)
  CBT is a structured form of psychotherapy that aids an individual in identifying and modifying negative thought patterns. For patients suffering from Dissociative Fugue, this therapy provides relief to patients by addressing stressors that could lead to dissociative episodes. The therapy aims to help individuals process emotions and manage triggers.
• Group Therapy
  Group therapy is helpful for patients recovering from Dissociative Fugue. Once the patients accept their problem and are willing to seek treatment, group therapy helps them shake off the taboo attached to therapy and mental health disorders. Healthy discussions and shared experiences reduce feelings of isolation among patients. This support gives them validation and the motivation to recover.
• Family Therapy
  Family therapy is particularly beneficial to patients who have positive relationships with their parents and siblings. The purpose of the therapy is to provide emotional support to patients from the family and help them to understand their condition. However, therapists must exercise caution and administer this therapy only if the relationships are cordial.
• Creative Therapies
  Certain creative therapies like music therapy and art therapy allow reserved patients to express their emotions nonverbally. The therapy offers an expressive outlet for patients to relieve their stored nervous tension. The therapy works effectively as an outlet for pent-up emotions and ideas that could be considered deviant by the society. It allows emotional healing especially when talk therapy gets overwhelming.
  Other than these, here are other therapeutic approaches that can treat patients suffering from Dissociative Fugue:
• Eye Movement Desensitization and Reprocessing (EMDR)
  For patients experiencing flashbacks and suffering from post-traumatic stress, EMDR aids patients in coping with stress. These guided eye movement tests help a therapist process traumatic memories and lower their emotional impact. This is one of the most effective and technical approaches towards treatment that is useful in tracing the cause of the problem.
• Dialectical Behaviour Therapy (DBT)
  DBT focuses on managing overwhelming emotions during the treatment. This therapy regulates emotions, develops coping mechanisms and handles stressful situations smartly. The purpose of the therapy is to enhance self-awareness and reduce the frequency of fugue episodes.
• Relaxation Sessions
  Relaxation techniques and supervised meditation sessions prevent relapse. Certain techniques like deep breathing, grounding activities and yoga or any other physical form of therapy helps in improving the overall health of a patient. Monitoring the internal state of emotions is essential to control the frequency of Dissociative Fugue episodes.

Living with Dissociative Fugue

• Before starting the treatment, understanding the frame of mind of a patient is essential. Those suffering from Dissociative Fugue can suffer from extreme confusion as they are shuttling between personalities and identities.
• Patients live in an unpredictable state of emotions which creates practical difficulties in leading life. Therefore, recognising triggering emotions and events is essential.
• Therapy may seem daunting at first. Therefore, going slow is the best technique to start the treatment. Building a support system is essential for a holistic recovery.
• Self-care is an important aspect of the treatment. Therefore, patients must devote some time to themselves. Meditation, skincare, journaling and so on are some of the most effective techniques that aid recovery.

How to Support Loved Ones Suffering from Dissociative Fugue?

• The family must develop an empathetic approach to psychotherapy. Make sure that the patient knows that the family will offer the right kind of support during harsh times.
• Stay close to the patient but do not invade their privacy. Give them time and pace to recover as acceptance can be a time-consuming process. Empathy goes a long way, therefore, stay close to them and understand their point of view.
• Encourage patients to go to therapy. Attending counselling sessions regularly is essential for a complete recovery that prevents relapse. However, let the patient decide independently if they need company to attend therapy or not.
• Dissociative Fugue is something that cannot be controlled at home. Patients might express anger when they are confronted about the symptoms. Therefore, gradual exposure to problems under professional supervision is the best.
• Hire professional help that can stay with the patient at all times. Since patients suffering from Dissociative Fugue tend to wander, keeping them under surveillance is essential for safety purposes. Families must ensure that patients do not feel uncomfortable with constant surveillance.

Jagruti Treatment and Recovery

• Residential and Out-Patient Program
  Inpatient and outpatient treatment programs are available at Jagruti Rehab Centre. Patients who are working or are busy can opt for outpatient treatment programs. Sessions are arranged according to their convenience and therapists frame the treatment accordingly. However, admission of patients is also an option especially when the case is serious and constant monitoring is required.
• Expert Medical Professionals
  Medical health professionals like doctors and psychiatrists are empanelled by Jagruti Rehab Centre. Trained nursing staff and experienced therapists ensure the complete recovery of patients. While therapists also work on relapse prevention, nursing staff helps patients with performing routine tasks and more.
• Diverse Recovery Programs
  Tailored treatment programs set Jagruti Rehab Centre apart from others. Every patient is treated separately and every case is considered as a unique one. Therapists ensure that patients respond to therapies properly and are not overwhelmed by activities. Patients are first briefed about the treatment and the family is involved after their consent.
• Social Activities and Psychotherapy
  Social activities are organised for patients of all age groups. Common areas are equipped with screens for maximum comfort so that patients can enjoy themselves when free. Diet plans are also included in the treatment. However, social and cultural factors are given due consideration at every step.