Dissociative Amnesia

What is dissociative amnesia?

Dissociative amnesia is a condition in which a person becomes unable to remember events from a part of their life. It affects about one percent to three percent of people in the general population and has a few main forms that have different effects. Generally, people with dissociative amnesia remember new facts and how to perform daily activities.

Symptoms include memory loss that can vary in severity from details to entire gaps of time. It also can result in a struggle with one's identity, as well as experiencing a bewildered state of wandering, called a dissociative fugue.

Treatments focus on creating a safe environment for the individual, psychotherapy (talk therapy), possible medication-induced hypnosis, and medications for mood.

You should visit your primary care physician, who can begin an evaluation and rule out other diseases that could cause these symptoms. If dissociative amnesia is still possible, your doctor will likely refer you to a psychiatrist or psychologist.

Dissociative amnesia symptoms

In some forms, sometimes referred to as overt dissociative amnesia, the person may be unable to remember all details from a period of their lives or from their entire lives. In others, sometimes referred to as covert dissociative amnesia, people may have gaps in memories of their lives and may remember some but not all details from specific time periods.

People with dissociative amnesia may appear relatively unconcerned about their symptoms, but others may see symptoms of dissociative amnesia, described by the inability to remember events, one's identity, and bewildered wandering.

Type and duration of memory loss

The type and duration of memory loss can vary among people. Dissociative amnesia can also be classified into one of three types:

1. Localized amnesia: People with localized amnesia are unable to remember all the details from a certain time.
2. Selective amnesia: People with selective amnesia are unable to remember some details from a certain time.
3. Generalized amnesia: People with generalized amnesia are unable to remember anything from their entire life history or from the time of an initial traumatic event and may be unable to recall their identity.

Other memory symptoms

Other memory symptoms include:

• Inability to remember one's own identity: In some forms of dissociative amnesia, people may be unable to remember their own identity, including their name, profession, and relationships with other people.
• Bewildered wandering: In one form of dissociative amnesia, called a dissociative fugue, people may exhibit a behavior of bewildered wandering, which may seem purposeful, but the person usually does not remember it occurring. This behavior may subsequently be associated with trying to form a new identity.

Dissociative amnesia causes

The specific cause of dissociative amnesia is unknown but is strongly linked with having experienced some form of psychological trauma, especially as a child. Factors contributing to the development of dissociative amnesia include:

• Having a genetic predisposition: This may lead to the development of dissociative amnesia in some people. An example of a possible genetic influence is a variant in a gene involved with the neurotransmitter serotonin, which is involved in certain psychiatric disorders such as depression and anxiety.
• Having experienced psychological trauma: This is strongly associated with developing dissociative amnesia. Examples include childhood physical or sexual abuse, adult sexual assault, military combat, experiencing a natural disaster, or being subjected to torture. Repeated episodes of trauma, trauma of a longer duration, and trauma at an earlier age are all associated with a greater risk of developing dissociative amnesia.

Treatment options and prevention for dissociative amnesia

Dissociative amnesia is a chronic condition that may require long-term treatment to manage the symptoms. People with dissociative amnesia may not always regain their memories with treatment or may regain only some of their memories. In some cases, the person may not want to regain their memories, such as if the memories are from a painful event. A mental health professional can work with the person to develop the most appropriate treatment plan. Specific components of treatment for dissociative amnesia include creating a safe environment, psychotherapy, clinical or medication-induced hypnosis, and medications to manage mood.

Creating a safe environment

Creating a safe and supportive environment is the first step in treating dissociative amnesia. A mental health professional, friends, and family can help the person to begin recollecting aspects of their memories. In some cases, this alone may be sufficient to help the person, especially if they do not feel the need to remember a painful or traumatic event.

Psychotherapy

Psychotherapy (talk therapy) may be beneficial in helping people regain memories and manage any symptoms associated with the dissociative amnesia. In addition to regaining lost memories, therapy can help the person learn how to resolve problems created by the amnesia, safely deal with new events, and get back to a normal functioning level. There are several types of psychotherapy that can be used:

• Cognitive behavioral therapy (CBT): This helps people recognize and correct harmful ways of thinking that can lead to negative emotions.
• Dialectical-behavior therapy: This helps address personality disorders that may be contributing to the dissociative amnesia.
• Family therapy: This teaches family members about dissociative amnesia and ways to support the person in managing his or her symptoms.

Clinical or medication-induced hypnosis

Some people with dissociative amnesia may benefit from being questioned while placed under a hypnotic state. The hypnotic state can be induced clinically or, rarely, by drugs such as barbiturates or benzodiazepines. Being questioned under a hypnotic state may help bring out memories that are difficult to recall otherwise. This is usually attempted when the need to remember events is more urgent and needs to be done gently as it could be potentially upsetting to the person.

Medications to manage mood

Medications usually cannot be used to treat the dissociative amnesia. However, medications may be helpful in managing psychiatric symptoms associated with the dissociative amnesia, such as depression or anxiety. Some medications that may be helpful include: sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro) and paroxetine (Paxil).

When to seek further consultation for dissociative amnesia

If you or someone you know develops any symptoms of dissociative amnesia, such as an inability to remember events or periods of time, a physician should be consulted. The physician can ask questions to determine if you have dissociative amnesia and then offer the appropriate treatment.

If you have experienced a traumatic event

If you or someone you know has experienced a traumatic event, you may consider seeing a healthcare professional, even if you do not develop symptoms of dissociative amnesia. The healthcare professional can help you cope with the experience of the traumatic event and, in cases of abuse, connect you with resources to prevent the traumatic event from recurring.