Dissociative fugue: symptoms, types, causes, and treatment.

A strange mental alteration in which the person goes far away and forgets his past, literally.

We wake up in an unfamiliar place. We wander the streets, but we are not at home, not even in our town. Where am I and what am I doing here? We ask a local, who seems to recognize us and calls us by a name that is not ours. Apparently we have been in the town for a month. How is this possible?

One of the possible answers to this question is that we have experienced a disorder called dissociative fugue. a disorder called dissociative fugue.

Dissociative fugue: definition and characteristic symptoms

Dissociative fugue is defined as an associative disorder characterized by the occurrence of unexpected trips away from the subject's usual environment in which the individual is unable to remember his past. Such a trip takes place with apparent normality, without calling attention to the subject's behavior and without the appearance of symptoms of a mental disorder or cognitive alterations. It is also frequent, although it may not occur, that the individual has doubts about his own identity, either losing it or assuming a new one.

In the vast majority of cases, the person recover his or her former identity and memory.. However, there are cases in which parts of the past are not remembered and even in some cases the patient has not been able to remember his or her past prior to the escape. In most cases, when the identity is recovered, there may be a post-episode amnesia in which the patient forgets what happened during the episode.

After recovering the memory, the individual usually feels discomfort.The patient may experience guilt, depression, anxiety, irritability, impulsivity and even suicide attempts. Guilt, depression, anxiety, irritability, impulsivity and even suicide attempts may occur.

Nowadays, dissociative fugue is no longer considered a disorder by itself, being a specifier of dissociative or psychogenic amnesia because with the exception of the presence of the fugue in question, it shares most of the characteristics of the latter.

Subtypes of fugue

While most of the symptoms of fugue most of the symptoms of dissociative fugue are similar, this disorder can manifest itself in different ways.This disorder can manifest itself in different ways and have different repercussions. Specifically, three major subtypes of dissociative fugue can be considered.

Classic fugue

In this subtype of dissociative fugue there is a trip or escape to an unknown place, presenting autobiographical amnesia and partial or total loss of one's own identity and the assumption of a new one. The subject may even settling down in the new place with a new identitywithout knowing his previous history until he recovers his memory.

Personal identity amnesia

This type of fugue assumes that the individual has a loss of autobiographical memory along with the loss of autobiographical memory along with his or her identity.However, in this case there is no change of identity. The individual does not believe he/she is someone else, but knows that he/she does not know who he/she is.

Return to a previous period of one's own life

This type of dissociative fugue refers to the psychic return to a previous period of one's life, presenting amnesia with respect to the period of time elapsed between the period in question and the present. However, the personal identity remains intact.

Causes

The causes of the dissociative fugue are associated with the experience of very stressful and traumatic events.. For example, it is not uncommon for subjects to have suffered sexual abuse or to have experienced misfortunes such as wars or natural disasters during childhood or throughout their lives, so that their psyche splits in order to avoid the pain generated by the event in question.

Intoxication or substance abuse, traumatic brain injury and certain disorders such as epilepsy also seem to predispose to their suffering.

At the Biological level, it is considered that the following may have an influence noradrenergic and serotonergic systems, as well as opioids.as well as opioids. Cerebrally, changes in the limbic system and its connection with the neocortex seem to be observed.

Treatment

Dissociative fugue is a disorder whose treatment is mainly focused on recovery and symptom control. It should be taken into account that, although there is generally only a single episode, it is possible that new escapes may appear, so that prevention is another aspect to be taken into account.

It is necessary to work with the patient on the causes of this amnesia, the situation that generated the escape and what this situation means for the subject. Cognitive restructuring or work on emotional expression and stress management can be helpful. and stress management can be of great help for this type of patient. Hypnosis and suggestion have also been used to try to unblock the blocked contents of the subject's mind, as well as facilitated interviews using hypnotic substances.

It is essential to work not only with the subject but also with the family and environment. also with the family and environment. Providing them with information about the disorder and what has happened is reassuring and can help to take into account and control factors that may have triggered the episode. Also, couple or family therapy to help manage the conflicts that may have triggered or may have been produced by the escape is also recommended.