Fugue state
Classification and external resources
ICD-10 F44.1
ICD-9 300.13
A fugue state, formally dissociative fugue or psychogenic fugue (DSM-IV Dissociative Disorders 300.13[1]), is a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality and other identifying characteristics of individuality. The state is usually short-lived (ranging from hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity.
After recovery from fugue, previous memories usually return intact, but there is complete amnesia for the fugue episode. Additionally, an episode is not characterized as a fugue if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (Dissociative Amnesia).
About a month ago I was in the middle of a serious nervous breakdown. I received an email that upset me very much. It made me feel devalued and I became a whirlwind of panic and fear and sadness. Apparently my mind decided to take a vacation instead of dealing with the pain.
I read the email and cried in the bathroom. Then I blacked out. I dissociated. I entered a fugue state according to my therapist and psychiatrist.
Thirty minutes later I was sitting in my car parked in front of a CVS drug store. I had no idea why I was there. I didn't even know what town I was in at first.
Then I noticed that there were two shopping bags in the passenger seat full of items from the drug store. Weird thing though. I didn't remember buying these things and they were not things that I would ever buy in another circumstance. I felt like I was in a David Lynch movie.
I don't remember everything that was in the bags but here a few strange items: foam hair curlers, bay rum cologne for men (Spanish language only label), bubblegum-pink footless tights (not my size or my daughter's size). I spent $114 in CVS on stuff I won't ever and have never used.
I couldn't really just drive home and act like nothing happened. I was scared that I really needed to go to the looney bin and never come out. So, even though I knew I needed help I was very scared to ask for help. For some reason I thought I was going to get sent to jail. I guess maybe I was worried that if I was capable of this forgotten shopping I might be capable of any horrible thing.
I called my therapist and she came to CVS in 15 minutes. I had really gotten worked up and panicked by the time she drove up I was out of the car and running to her truck crying.
On the phone she told me that she would take the bags back in for me and I would just return everything and all's fixed. But I couldn't find a receipt. Not in the car, not in my purse, not on the sidewalk from the door to my car. What the heck!!!
She was stern and told me I needed to take the bags in myself. I went in and she explained nicely to the cashier that I needed to return these things because I didn't remember buying them. It's a hard thing to understand and so the cashier did not understand. She thought I was contesting that I actually bought this stuff and just wanted a refund. About seven very quiet and interested customers lined up behind me while this conversation happened. I finally had to slowly say to the cashier, "Listen, I am experiencing a mental health episode and I don't remember buying this stuff 15 minutes ago and I can't find the receipt so I need to return these things.
At this point everyone involved in the drama stopped talking to me or even looking at me. The cashier and the manager only would address my therapist from then on. It was shameful and made me want to die.
She called the manager and my therapist had to explain the whole thing again to another nice but really shocked CVS employee with my ever-more rapt audience.
At one point I said to the manager, "don't you remember me? I was here about 15 minutes ago." He looked at my therapist instead of me and replied, "I see a lot of customers..."
The manager had to go to the office to print out a computer something or other to find my debit card purchase, blah blah blah. That means for about 7 excruciating minutes I stood fidgeting by the National Enquirer stand while my therapist read the headlines loudly and elbowed my ribs to try to make me laugh. She got annoyed that I wouldn't laugh it off but I was in the middle of a raging paranoia.
I was sure that something unspoken had passed from the manager and my therapist. I was convinced that the manager was calling the police and that my therapist was just keeping me there until they could come take me away. So I was super cagey and considering just bolting and starting a new life down in San Diego or something.
When the manager returned we had to get back in line and then the cashier had to manually scan each item and charge back my card. It took longer than any transaction in CVS history. My therapist and the line of customers were very interested in each item and I felt like the fun house mirrors were all around me.
That's basically the end of the story. My therapist bought me a hamburger that I couldn't eat and I thought that all the construction workers in line at Burger King were really just undercover heavies there to take me away. Ugh. That paranoia lasted for a week or so.
My therapist and psychiatrist have done a good job of normalizing my behavior so that I can just keep moving forward through my healing. But, I wasn't sure I deserved to get better at first. I thought that amnesiatic shopping trips were the sign of the end times. Instead, it was a sign of the beginning times. To be continued...
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