Reader’s Question

What is an unprecedented mental urgency to leave immediately? I don’t get it! And now I am fired from a job I loved.

I was at work, minding my business, working alone; I did have a lot of personally stressing relationship issues on my mind that day, so that might have something to do with it, but still it’s weird. Suddenly, with no warning, I felt the urgent need to clock out and leave. There was a lot of work left unfinished and I was the only one there; but no such logic even entered my mind. The only thing on my mind was “LEAVE! Quickly!!!” Weird. I immediately left work, withdrew a ridiculous amount of cash from the bank, and started on a ridiculous bus trip to a random city across the country. Halfway to my destination, I came to my senses and called my wife with great grief about my actions, to assure her that I was not lost. By this time, I had little money, because I had not paid any attention to spending during this “hallucinatory” (?) escapade. I stopped at a friend’s house and borrowed money for my return trip. When I got back I was fired.

I have been trying to figure it out ever since. I have searched on the Internet about such things as panic attacks and hallucinations, and I went and got a cheap “psychological analysis”. They say I have Schizoid Personality Disorder. But I don’t see how that’s related. Do you have any idea as to what the heck this was all about?

I don’t want to have to go through this ever again.

Our Clinical Psychologist’s Reply

What you are describing can be considered a “fugue” or flight reaction. During fugue states, the individual suddenly and unexpectedly leaves, traveling some distance away from home. A fugue state can last hours or even weeks. During the fugue state, you would have acted normally and would have interacted with others in a normal manner. Fugue states are almost always linked to the presence of severe stress at the time of the fugue experience. There are several causes for fugue reactions.

The most dramatic situation is called “dissociative fugue”. In this situation, a fugue state is combined with confusion about one’s identity, at times assuming a completely different identity. Consistent with the dissociative theme, the individual detaches from their previous life and may have little memory of their past life. This may be possible, as you mention paying no attention to the money you spent during your experience.

Another type of fugue state can be caused by depression, stress and/or panic. As you describe, the gradual build-up of anxiety, pressure, and stress affects body/brain chemistry, producing a sense of urgency for action. That sense of urgency is often followed by a panic sensation that produces the fugue state — like the claustrophobic who panics to get out of an elevator. This type of fugue reaction retains more memory for the event and is more common. This is often labeled a “runaway” reaction, and we have many stories of adults who runaway from their jobs, their homes, their lifestyle, etc. This reaction is also responsible for runaway brides and grooms who panic at the marriage ceremony.

Depression can produce these reactions as the individual runs away from their stressful situation. I worked with a patient who left her house to get milk and continued to drive 500 miles beyond the grocery store before contacting her spouse. Like you, she needed money to get back home.

Other causes of fugue states are unlikely in your situation. A type of bizarre fugue can be associated with Bipolar Disorder, Manic Episode in which the individual becomes hyperactive and fixated on a location and exhausts all efforts to get there for some spiritual or grandiose reason. This is often seen with famous geographic locations (Las Vegas) or events (Sturgis, South Dakota USA motorcycle rally). Other fugue states can be prompted by a psychotic reaction, but this seems unlikely in your case.

I would recommend psychiatric consultation. The presence of a fugue state tells us that your stress level was so high that you “blew a fuse”. Treating the underlying severe stress should prevent future fugue states. You might also take a few of the screening tests on this website for depression and anxiety. While a fugue state is disturbing and frightening, it may actually be a blessing by bringing the severity of your emotional distress to the attention of treatment professionals.