Fugue States & Bipolar Disorder
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Q:  Fugue States & Bipolar Disorder

I have had what I came to think of as fugue states when I was younger and specifically in college.  I returned from class and went to watch TV and realized that the programming was that of several hours later.  I was shocked to find that I had lost 4 hours.  My last memory was of leaving class and then walking directly to the room to watch TV.  I did some looking around when I realized the time loss and found that I had checked out some books from the library during that time but have no memory of it at all to this day.  Is this a common occurence with BiPolar?  Since I have gotten control of the disease this has not happened again.

Dear Suzanne -- 
I'm familiar with your experience from patients of mine, but sort of in reverse: before they were clearly "bipolar", they seemed clearly to be having episodes of lost time (dissociative states, of which fugue is one).  In trying to treat those episodes (as a person can't really do much in life if they're having a lot of them, so that becomes target #1), I found that "mood stabilizers" such as I used for folks with bipolar disorder, especially the antiseizure medications in that group, seemed to often help decrease or stop the dissociation.  

In some cases these women (not a single man I can think of offhand; there are probably some fairly obvious reasons for the gender difference) later began to look more like "bipolar disorder" to me, when their more severe symptoms were less prominent and one could see some of the more subtle stuff in the background, like severe problems sleeping. 

So, in answer to your question, I wouldn't say this is at all common, but I definitely think I've seen it. 

Dr. Phelps  


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