Dissociative Fugue and Substance Abuse

Dissociative fugue is a rare subtype of dissociative amnesia that can be brought about by trauma or stress. Learn about how dissociative fugue and substance abuse can co-occur.

While, on the surface, dissociative fugue and substance abuse appear unrelated, both conditions can occur simultaneously. One of the diagnostic criteria for dissociative fugue is that it is not caused or induced by using alcohol or other substances. Another criterion is that a fugue state does not happen as a result of another co-occurring mental health condition. If dissociative amnesia or dissociative fugue happen as a result of taking a substance, then these diagnoses no longer apply.

Nevertheless, after a person becomes aware of their fugue state, they may become extremely upset and experience an array of difficult emotions. To ease the pain of their experienced trauma or stress, individuals may turn to alcohol and other substances. Such traumas may have occurred before or during the fugue state. By abusing substances, individuals dramatically hinder their ability to recover from trauma.

Can Drug Use Cause Dissociative Fugue?

The most simple answer is that no, drug use cannot directly cause dissociative fugue. However, using alcohol and other substances may lead to drug-induced memory loss. In these cases, substance-related memory loss can mirror some of the symptoms associated with dissociative amnesia and dissociative fugue. For instance, a person with drug-induced amnesia may temporarily forget who they are, where they are or what they are doing until the effects of the drug wear off.

Besides illegal or non-prescription drugs, certain drugs are capable of purposefully inducing amnesia. For instance, prescribed sedatives may induce temporary amnesia or memory loss for individuals receiving surgery. Though the exact cause of dissociative fugue is unknown, it is thought to be caused by experiencing high stress levels or trauma, rather than ingesting substances.

Co-Occurring Drug Abuse and Dissociative Fugue

When might dissociative fugue and addiction occur together? There are many productive stress management techniques that involve healthy coping strategies; however, there are also many negative coping strategies that people adopt to ease their pain. Such pain may be a result of experienced trauma, difficult life circumstances or mental health conditions like anxiety and depression. One negative coping mechanism people might use after experiencing dissociative fugue includes relying on alcohol and other drugs.

If an individual’s fugue state was caused by an underlying trauma, facing that trauma may be extremely difficult after the fugue state ends. If a person experienced trauma while in a fugue or amnestic state, recovering these memories may also be a painful and uncomfortable experience. At first, using alcohol or other drugs may numb the pain experienced from trauma or high stress levels. However, over time, using drugs prevents a person from processing and healing from trauma. Certain drugs may also hinder an individual’s ability to recover lost memories from their fugue state.

Differentiating Substance “Blackouts” From Dissociative Fugue

What are substance abuse blackouts? Blackouts occur from ingesting too much alcohol or taking high doses of drugs. In the context of alcohol abuse, an individual may experience short periods while drinking where they cannot remember what transpired. Blackouts can be relatively short or last slightly longer depending on how much alcohol an individual consumes and how quickly their body metabolizes it. In some cases, an individual may be able to recall certain memories and not others.

How can substance-induced blackouts be differentiated from dissociative fugue states? Dissociative fugue states may be very brief on the scale of minutes to hours or can last from months to years in rare cases. For longer-lasting fugue states, it’s easier to differentiate between real fugue and substance blackouts. However, it may be harder to differentiate between fugue states that last only a few minutes to a few hours and substance-induced amnesia or blackouts which last for the same amount of time.

One way the two can be differentiated is that the effects of substance blackouts will dissipate over time as alcohol or other drugs are processed by the body. In contrast, dissociative fugues that last for only a few minutes to a few hours do not have a tapering effect.

Another way to differentiate between the two is that a person in a fugue state often appears normal and goes about their day like the fugue never happened. In contrast, a person under the influence of alcohol and other drugs may appear erratic, have trouble balancing, may talk more slowly or faster than usual or seem generally “off.”

Treating Dissociative Fugue and Co-Occurring Substance Use Disorders

What are the different types of dissociative fugue treatments? Dissociative fugue can be treated together with substance use disorders. There are a few different treatment options that overlap between the two conditions, including:

• Cognitive behavioral therapy
• Family therapy
• Group therapy
• Creative therapy
• Medication (when needed to treat co-occurring mental health conditions like depression and anxiety)
• Hypnosis (when necessary to restore lost memories)

Besides various treatment options, individuals who have experienced both dissociative fugue and addiction can benefit from learning productive and healthy coping strategies. Stress management techniques could be applied to many life situations, particularly those involving triggers or high stress.

If you or a loved one struggle with recurrent dissociative fugue episodes and co-occurring addiction, The Recovery Village can help. Contact a representative today to discuss therapy options for treating both conditions together.  

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Dr. Bonnie Bullock, PHD

Bonnie is a medical communications specialist at Boston Strategic Partners, a global health industry consulting firm. Her recent work in mental health includes developing conference materials for clinical studies in mood disorders and copy-editing clinical manuscripts. Read more