Poriomania is an impulse control disorder characterized by unjustified compulsive running away. Running away is always associated with at least partial amnesia. Poriomania can have a variety of causes.
What is poriomania?
Poriomania is not an independent disease, but is a symptom of a mental disorder. It manifests itself as a compulsive and uncontrolled running away in connection with complete or partial amnesia. See howsmb for Hypovolemia Definition and Meaning.
Poriomania was first described by French neurologist Jean-Martin Charcot in 1888. He examined a 37-year-old postman who got lost three times and could not remember anything during this time. Status epilepticus was assumed to be the cause of this behavior in the specific case.
Poriomania is also known as dromomania or fugue and is a special form of impulse control disorder. When impulse control is lost, certain behaviors can no longer be controlled. The actions simply take place without those affected having a chance to influence them at will.
Poriomania is also a dissociative disorder. In psychology, dissociation is understood as the destruction of the connection between the functions of consciousness, perception, memory, motor skills and identity. For the patient, the connection between the functioning motor function and the reason for the action is lost.
Everyone actually goes through this phase under special conditions. However, these disorders are more common in psychological disorders. In addition to poriomania, dissociative disorders also include such behaviors as playing, eating, shopping, masturbating or even self-injury that are carried out uncontrollably by the patients concerned.
There are various causes for poriomania. It occurs as a symptom of several psychological disorders. For example, poriomania is observed in depression, neuroses, schizophrenia, delusions, epilepsy, mental retardation or dementia, along with other forms of impulse control disorders.
This phenomenon is particularly well known in Alzheimer’s disease. It is not yet clear why these flight reflexes occur. In certain explanations, this behavior is viewed as an unconscious defense mechanism to avoid conflict or responsibility. In very difficult life situations, even healthy people can experience an affective behavior that manifests itself, among other things, in running away.
In the context of mental illness, however, such spontaneous uncontrolled actions occur much more frequently. Here, due to illness, there is no control over certain actions. In the case of the postman described by Jean-Martin Charcot, status epilepticus may have led to a loss of control.
Status epilepticus is characterized by many small consecutive epileptic seizures without the patient regaining full consciousness in between. Despite amnesia, however, motor functions remain active in this state. The same applies to other mental illnesses.
Symptoms, Ailments & Signs
As mentioned, poriomania is expressed by unexpected and sudden running away. This can be at home or at work. The patient forgets his own past completely or partially. Your own identity may have been lost. The person concerned may then have assumed a different identity.
Poriomania occurs both as part of a dissociative identity disorder and independently of it. The symptoms lead to significant impairments in the private, professional and social sphere. While in some cases poriomania is the main symptom, in other cases it takes a backseat to the other symptoms.
Often the affected persons remain inconspicuous during poriomania until they are asked for their identity. Your excursions can be both short and long in terms of space and time. Some sufferers disappear for months or years and even assume a new identity during this time.
They may then integrate so well in their new environment that the mental disorder is no longer recognized. In the case of various other diseases, such as dementia, it is of course not possible to assume a new identity because there is no possibility of self-control.
Diagnosis & course of disease
Poriomania can be diagnosed by its typical characteristics. The most important characteristic is the sudden running away in connection with an amnesia, which concerns one’s own identity. In most cases, a mental disorder already exists.
If the symptoms occur in otherwise mentally healthy people, it may be a temporary phenomenon caused by a particularly stressful life situation. Of course, in this context, a fake poriomania cannot be ruled out in order to adopt a new identity.
The expected complications of poriomania are not only medical, but also social or legal. If the acute attacks only last a short time, the possible consequences are usually manageable. However, the patients are often unable to pursue a job or manage their lives on their own.
Patients suffering from seizures that last for months or years can face significant legal complications. In particular, when people simply disappear for years, there is a risk that they will be declared dead and inherited. Those affected then regularly lose all their assets and only get them back, if at all, after lengthy legal disputes.
In older people, poriomania is often associated with Alzheimer’s. Mentally disturbed seniors often injure themselves while wandering around or cause traffic accidents in the process. These individuals often pose a danger to themselves and others, although they are rarely aggressive. Alzheimer’s sufferers are on the run and usually unable to take care of themselves and their physical needs. They don’t eat or drink, so they become dehydrated quickly. Even severe hypothermia can be life-threatening if the patient is not found promptly and spends the night outdoors.
When should you go to the doctor?
Poriomania must always be treated by a doctor. As a rule, with this disease there is no self-healing, and often there are serious psychological disorders that negatively affect the life of the patient. The doctor should be consulted if the person concerned suffers from the compulsion to want to run away. Running away can be from work, school or even from home. Those affected can often no longer remember their name and assume a different identity.
If these symptoms occur, a doctor must be consulted immediately. In some cases, the person’s family or friends have to persuade them to seek treatment. Poriomania is usually treated by a psychologist. Whether it will heal cannot be predicted.
Treatment & Therapy
For the therapy of poriomania, the cause is decisive. If it is a symptom of dementia, schizophrenia or epilepsy, the treatment of the underlying disease has priority. Cognitive behavioral therapy can be carried out in the case of mild cognitive disabilities, neuroses, depression or pubescent adolescents.
In the context of this therapy, the impulse to flee should be avoided. In this therapy, impulse control disorders are treated through conscious attention control. The person concerned should also learn realistic and goal-oriented self-control. The success of therapy depends on the severity of the loss of control and the patient’s ability to develop purposeful action.
To prevent poriomania, it is important to deal with internal conflicts that arise at an early stage. This can only happen in stable family, social and social circumstances. Furthermore, a healthy lifestyle with a balanced diet and plenty of exercise can also help to prevent severe mental illness and dementia in old age.
Mental illness takes a long time to heal. In most cases, the symptoms remain weakened even after treatment. The patient has nevertheless learned to integrate the disease into his everyday life. Follow-up care must be scheduled to stabilize the healing process. It takes place in the context of psychotherapy or behavioral therapy. A combination of both approaches is also common.
Follow-up behavioral therapy is recommended for poriomania. The patient’s impulse control is paramount. A pathological urge to flee is usually not an independent clinical picture. Mania is based on depression, a schizophrenic disorder or delusions. During follow-up care, the cause is already known from the therapy.
A recurrence of the complaints should be prevented. The affected person learns mindfulness and self-control during the follow-up therapy. He must be aware of the situations that trigger flight reflexes in him. In everyday life, he should know these triggers and avoid them. Appropriate exercises with the therapist help him.
The address of the specialist should always be kept by the patient as a note. If the escape reflex sets in unexpectedly and the person concerned has lost their bearings, they can reach the therapist by phone or go directly to him. The doctor will provide crisis intervention and calm the sick person. A taxi should be ordered to bring him back home safely.
You can do that yourself
Poriomania is a serious mental disorder that primarily requires medical and therapeutic treatment. Those affected can support the treatment by taking behavioral therapy measures. By consciously directing your attention, it is possible to reduce seizures and thus improve your quality of life in the long term. In addition, measures must be taken to survive a seizure without risk.
First and foremost, emergency medication must always be carried, to be taken in the event of an attack. In addition, those affected should always carry a mobile phone and a note with them informing any first responders about the disease. Further measures depend on how severe the condition is and whether the underlying psychological problems have already been adequately treated. In the event of a first seizure, the emergency doctor should always be called. Chronic illnesses may require inpatient treatment.
In addition, a healthy lifestyle with a balanced diet and sufficient exercise must be maintained to prevent the development of further psychological problems. Comprehensive treatment prevents serious complications such as depression or dementia in old age.