What is Separation Fugue?

Dissociative wandering, formerly known as wandering state or psychogenic wandering, is a subtype of dissociative amnesia. It involves the loss of memory of personal autobiographical information, coupled with accidental and sudden trips, and sometimes the establishment of new identities.

What is Separation Fugue?

The word “fugue” comes from the word “flying” in Latin. It reflects the essence of dissociative fugue, which involves an element of travel or wondering far away from the current situation.

Dissociative wandering is a reversible amnesia involving personality, memory and personal identity. This temporary amnesia may last for hours, days, weeks, months, or longer. It involves wandering or unplanned travel, in which a person may establish a new identity in a new location that is very different from their previous life.

Although dissociative amnesia was once diagnosed as a separate disease in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is a subtype of dissociative amnesia in the newly updated DSM-5. Generally speaking, dissociative disorder involves impairment of identity, perception, consciousness and memory.

Symptoms of dissociative fugue

What are the symptoms of dissociative wandering? Depending on the circumstances, they may include all of the following:

During the fugue state

If you are in a state of wandering, you may experience the following symptoms:

  • Confused about your identity
  • Seems uncertain about your past
  • If your identity is questioned, you will feel challenged

However, it is important to note that people in a dissociative state of wandering may not show any external signs that they are experiencing mental illness. That’s because, from a human perspective, the new identity is their actual identity. Only when this is challenged will the problem arise.

After the fugue state ends

Once you leave the state of wandering, you may experience the following symptoms:

  • Feeling of depression
  • Sad period
  • Shame
  • Uncomfortable or angry
  • Feel distressed in a strange place
  • It feels as if you have lost time

It should also be noted that a person may experience multiple dissociative wanderings, especially if the root cause of the wanderings has never been resolved.

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Diagnosis of dissociative fugue

How to diagnose dissociative wandering?

Diagnosis in DSM-IV

When it is initially included in DSM-IV as a separate disease, the following diagnostic criteria need to be met:

  • Leaving home or workplace suddenly or accidentally
  • Can’t remember your past experience
  • Confused about your identity and accept the new identity
  • Significant distress and damage to these problems

However, it is important to know that dissociative wanderings can usually only be diagnosed retrospectively, because people in an intermediate state may not show any external signs, and others may be difficult to identify. Therefore, the diagnosis can usually be made only when the wandering is over, whether it is abruptly or gradually.

Diagnosis in DSM-5

Since the release of DSM-5, dissociative amnesia is now a subtype of dissociative amnesia (a disease), which refers to the symptoms of dissociative amnesia accompanied by purposeful travel or confused wandering states.

All other subtypes are listed below: The different types of amnesia that may exist in this situation include:

  • Local amnesia
  • Selective amnesia
  • Generalized amnesia
  • Persistent amnesia
  • Systemic amnesia

Diagnosis and exclusion

If the state of wandering is directly related to any of the following situations or circumstances, it will not be diagnosed as dissociative wandering:

In addition, in rare cases, people may pretend to be dissociative wandering for legal or other reasons.

diagnosis method

The evaluation of dissociative wandering usually begins with medical and neurological examinations. If necessary, neuroimaging studies, such as brain MRI or other testes, such as electroencephalography (EEG), will be performed to rule out diseases such as epilepsy. Once the physical cause has been ruled out, the psychiatrist or psychologist will use a series of assessment tools and conduct interviews to assess whether these symptoms can best be explained by a miraculous diagnosis.

Prevalence

Dissociative wanderings are rare, and are estimated to account for about 0.2% of the total population. It is more common in adults than in children, and it is also more common in people who have been diagnosed with other dissociative disorders.

Reasons for dissociative fugue

What is the reason for dissociative wandering? Some potential related reasons are listed below. Generally speaking, these conditions involve a history of major or repeated trauma:

  • Childhood sexual abuse
  • Violent experience (such as rape, torture)
  • Combat violence
  • Attempted suicide
  • Car accident
  • natural disaster
  • Committed homicide

Although you may look good after the initial trauma, reminders of early trauma may trigger dissociative wanderings. For example, seeing the abuser in your later years or experiencing events that remind you of previous events (for example, seeing a small fire after being involved in a tragic fire).

In addition, there is evidence that there may be a genetic link because family members of people with dissociative disorder are more likely to experience separation.

Separation Fugue Treatment

The duration of the forgotten event may vary. Some episodes will fade away quickly, while others may last for years. There may be multiple episodes.

Therefore, the goals of treatment are twofold:

  1. Help restore your identity and develop coping strategies to prevent the same thing from happening again.
  2. Help you accept and deal with the original trauma that triggered the event.

treat

For those who have experienced dissociative wandering, many different types of treatments can be used;

  • Psychotherapy with insight into thinking patterns
  • Medications to treat related depression and anxiety
  • Family therapy to ensure you are supported
  • Art therapy explores feelings in a safe way
  • Clinical hypnosis
  • Eye movement desensitization and reprocessing (EMDR) to treat flashbacks and post-traumatic stress symptoms
  • Dialectical Behavior Therapy (DBT) can help manage potentially overwhelming emotions
  • Meditation and/or relaxation techniques to manage symptoms and monitor your internal state.

Unfortunately, if the fundamental problem is not dealt with, dissociative wandering may happen many times.

prevention

The best prevention involves treating the underlying problem and/or eliminating the threat that caused the attack.

Coping with dissociative fugue

Dealing with dissociative wanderings can be challenging because most people with this disease don’t know they have it. However, if you have experienced this in the past, there are some steps you can take to prevent it from happening again:

  • Receive treatment to cope with symptoms related to wandering
  • Treat the fundamental problems that lead to mystery through treatment
  • Get support from your family to help you be aware of when you are at risk of wandering
  • Try to reduce or eliminate the potential triggers of dissociative fugue
  • Practice meditation or other techniques to help manage your internal state
  • Find a creative outlet for your emotions, such as painting or painting
  • If your doctor prescribes medicine for anxiety or depression, be sure to take the medicine regularly

Help people with dissociative fugue

How can you help someone diagnosed with dissociative wandering? Here are some suggestions.

  • Attend treatment to understand their problems and how to provide support.
  • Identify and be sensitive to potential triggers and how they affect people experiencing dissociative wanderings.
  • Make sure that the person receives adequate care and takes all prescription medications as directed by the psychiatrist.

What if someone looks confused

There may be many reasons why a person may be confused about his surroundings or identity, and since dissociative wandering is relatively rare, it is unlikely to be the first. If you are concerned about someone’s health, mental state, or safety, it is best to notify their doctor or take them to the emergency room.

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More research is needed to determine how to best deal with this complex and relatively rare psychiatric problem. If you or someone you know suffers from dissociative wandering, please know that you are not alone and others have experienced the same thing. If you haven’t, make sure you are receiving appropriate treatment to prevent the same thing from happening again.

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