Tuesday, March 15, 2011

Wandering Amnesia

A few years ago, Jeff Ingram, drove from his home in Olympia, Washington, to visit a terminally ill friend in Alberta. Four days later, he woke up on a street in Denver—without his car, his wallet, or any memory of who he was.

Ingram suffers from dissociative fugue—a rare form of amnesia in which people suddenly begin traveling (or continue, if on the road). They forget their identity, fail to recognize loved ones, and can't recall how they arrived wherever they are. Some later develop new personalities altogether. The trance lasts from a few hours to several years, and can involve travel across continents and oceans. One study put the average distance traveled by these wandering amnesiacs at 750 miles.

Whereas amnesia is typically precipitated by brain injury, those in fugue states are neurologically intact. Instead, the condition appears to be triggered by stress—often related to marital problems, financial worries, or depression. "They unconsciously run away from traumatic situations," says Philip Coons, professor emeritus at the Indiana University School of Medicine and an authority on the disorder. That's why the incidence of fugue rises during periods of war and natural disasters.

These wanderers sometimes turn to crime, such as vehicle theft and credit-card fraud. No one knows what they're thinking in-fugue, but it appears they live day-to-day with an emphasis on survival. Some have been found with stale bread and pockets full of jelly and ketchup packs. They become aware of their memory loss only after being asked questions about their lives. For Ingram, that occurred when he stumbled into a Denver hospital and was quizzed by the receptionist. He says he became scared and angry and wanted to know who he was.

Most sufferers eventually recover their pre-fugue memories—as suddenly as they lost them. Psychologists remain puzzled as to why. "One problem with trying to understand dissociative fugue is that by the time the patient comes to clinical attention, the fugue state is over," says psychologist Daniel Schachter, a memory expert at Harvard University. In cases where memory does not spontaneously return, therapists focus on resolving the underlying stress or trauma.

Even months after being reunited with his family, Ingram still has no pre-fugue memories. He's scared he might vanish again, so he's ordered a $400 pair of shoes loaded with GPS. "It's a small price to pay for the peace of mind," he says.

Case Study: Jeff Ingram—a former mill worker in Olympia, Washington

  • Possible triggers: A friend's battle with cancer and the anniversary of 9/11.
  • Spotted: His fiancee's brother recognized him when he appealed for help on TV news two months after his disappearance.
  • Dejà vu: Ingram had disappeared once before. In 1995, while living in Alberta, he traveled more than 600 miles to Seattle, where he was discovered after nine months.
  • Never again: In addition to ordering GPS shoes, Ingram has tattooed identifying information on his left arm and wears a zip disk with medical information around his neck.
  • Happy ending: Although he cannot remember his three-year relationship with his fiancee pre-fugue, the two were married that December.

No comments: