Dissociative Amnesia

What is dissociative amnesia?

Dissociative amnesia is when your mind blocks out important information about yourself, causing “gaps” in your memory. One of the most common reasons your mind blocks out things is to protect you from unpleasant, distressing or traumatic experiences. It’s not the same as simply forgetting something. In most cases, you still have the memories but can’t access them.

Dissociative amnesia often happens because of very traumatic experiences, including abuse, war and natural disasters. People with dissociative amnesia have an increased risk of self-harm or suicidal behaviors.

You should get emergency care if you have disturbing thoughts about harming yourself, including thoughts of suicide or harming others. If you have thoughts like these, you can call any of the following:

• Suicide and Crisis Lifeline (United States). To call this line, dial 988.
• Local crisis lines. Mental health organizations and centers in your area may offer resources and help through crisis lines.
• 911 (or your local emergency services number): You should call 911 (or the local emergency services number) if you feel like you’re in immediate danger of harming yourself. If you believe someone you know might attempt to harm themselves or attempt suicide, you should also call 911 or your local emergency services number.

What is dissociation?

All your experiences rely on several brain processes and abilities working together. Those include:

• Memory.
• Consciousness (awareness of yourself and your surroundings).
• Identity.
• Emotions.
• Perception (senses like vision and hearing).
• Motor ability (control of your muscles so you can move around).
• Behavior.

Dissociation is a defense mechanism that your mind can use to keep one or more of the above from working with the rest. That can affect how you experience and understand things that happen and what you can remember.

Dissociative amnesia is when dissociation causes memory loss (amnesia).

How dissociative amnesia works

To understand dissociative amnesia, it helps to know a little bit about how memory works. When you think back on events in your life, you’re using what’s called autobiographical memory. It’s like a library inside your mind where every book is a memory of an event from your life.

To create the memories that fill that library, your brain goes through a step-by-step process:

• Encoding: This is when your brain forms the memory. It’s like your brain writing and publishing a book for your library.
• Storage: This is how your brain stores the memory. Your brain files the book away in your library. Your brain also tags the memory so you can return and find it, if needed.
• Retrieval: This is when you go back into your library, open the book and access details of the memory to recall what happened.

Types of dissociative amnesia

There are two main ways that dissociative amnesia can work:

• Retrograde: This is when dissociative amnesia affects finding old memories. It’s like a glitch or error that keeps you from accessing or checking out a specific memory.
• Anterograde: This is when dissociative amnesia blocks the formation or storage of new memories. It’s like a gap in the recording or your brain misplacing the book after creating it. This form is less common than retrograde dissociative amnesia.

How common is dissociative amnesia?

Dissociative amnesia is uncommon, but experts also aren’t sure how uncommon it really is. Estimates range from as low as 0.2% to as high as 7.3%. The American Psychiatric Association estimates about 1.8% of people experience it each year worldwide.

What are the symptoms of dissociative amnesia?

The main symptom of dissociative amnesia is memory loss. That memory loss can take different forms. Some people experience just one form, while others have multiple forms. The forms include:

• Localized: Memory loss affects everything within a short, specific time period in your life.
• Selective: Memory loss affects one event or all events of a certain type within a specific time period in your life. Experts sometimes call this “patchy” amnesia because it affects certain memories but not others.
• Generalized: Memory loss affects everything within a longer period (months or years).
• Continuous: This is the anterograde form of dissociative amnesia. “Anterograde” means it affects your ability to form new memories, so this is memory loss that happens as events occur.
• Systematized: Memory loss that affects everything under a particular topic or category. It can also apply to a specific person or multiple people (like your family).

People with dissociative amnesia may also have certain behaviors or traits related to memory loss. Those can include:

• Lack of awareness. People with dissociative amnesia may not realize they have gaps in their memory. This can last until memory loss affects part of their sense of identity or if someone brings up or asks something a person knows they should remember but can’t.
• Flashbacks. People with dissociative amnesia may develop flashbacks as they regain their memories. A flashback is more than just remembering something unpleasant. People who have them describe them as reliving a traumatic event or experience to the point where they can’t tell it apart from reality.
• Confusion or disorientation. People with dissociative amnesia (especially the generalized form) may seem unaware, or like they’re having trouble understanding what’s going on around them. In very severe cases, people may not seem or be aware of their own identity.
• Relationship and trust issues. People with dissociative amnesia often have trouble forming friendships or romantic attachments.
• Travel or wandering (dissociative fugue). When someone wanders or travels during a period they can’t remember, it’s known as dissociative fugue. This is rare, and the memory loss usually only affects brief periods.

Even when people are aware of the missing memories, they’ll usually avoid, minimize or rationalize why they can’t remember.

What causes dissociative amnesia?

Dissociative amnesia can happen in connection with one-time, isolated events or long-term stress or trauma. Things that can cause this kind of trauma include:

• Experiencing neglect or abuse — including physical, sexual or emotional — especially during childhood (but it’s also possible for adults). This is especially true when the abuser is a relative or another close, trusted individual.
• Experiencing or witnessing violence.
• Experiencing sexual violence (including sexual assault, rape or human trafficking).
• War (for both military personnel and civilians).
• Witnessing a serious injury or death of another person or experiencing a serious injury yourself.
• Other life-changing or traumatic experiences, like becoming a refugee.

Stress and traumatic events later in life can also cause dissociative amnesia symptoms to reappear or get worse.

What are the risk factors for dissociative amnesia?

Experts think that multiple factors can increase the risk of developing dissociative amnesia. That’s partly because the risk is cumulative, meaning it goes up when a person has more risk factors. When the trauma is longer-lasting, repeated or more severe, that usually makes this condition worse.

Research also shows there may be a link to genetics. While genes can’t cause dissociative amnesia on their own, they can lower the threshold for it to happen. That means a person with a family history of dissociative amnesia may develop it with fewer contributing factors.

How is dissociative amnesia diagnosed?

A healthcare provider can diagnose dissociative amnesia based on the symptoms you describe and by asking questions about what you can or can’t remember, what you’re experiencing and details about your life. Your provider may also use a questionnaire designed to help diagnose dissociative amnesia. These questionnaires are like guides or checklists to your provider, helping them as they try to determine what’s affecting you and how severe it is.

If you’re feeling anxious or worried about answering that you don’t know or remember something, it’s okay to tell your provider that. Not remembering something is a symptom of dissociative amnesia and telling them can help them make the diagnosis.

What tests will be done to diagnose this condition?

There aren’t any tests that can diagnose dissociative amnesia directly, but some lab, imaging or diagnostic tests are still likely. Providers will often use them to rule out other conditions that could be causing your memory loss. Some of the most likely tests include:

• Magnetic resonance imaging (MRI) scans.
• Electroencephalogram (EEG).
• Blood and lab tests to look for evidence of other conditions or toxic substances that could contribute to your symptoms.

How is dissociative amnesia treated?

Dissociative amnesia isn’t directly curable, but there are many treatment approaches that might help. One of the first steps is to remove or stop anything that might be causing or contributing to the amnesia. An example of this would be taking military personnel out of situations — especially combat — that might trigger or worsen amnesia. Some people may need care in a medical facility or specialized hospital setting to get the most benefit from this approach.

There aren’t any medications that can specifically treat dissociative amnesia. But many medications can treat associated conditions, like anxiety or depression. Treatment can help if, and when, memories do resurface. For many, the memories they regain are upsetting or overwhelming. Mental health therapy can help you cope with those feelings and manage them in a healthy and safe way.

The treatments that can help you may vary. Your healthcare provider is the best person to tell you about treatment options or approaches. Their recommendations will be the most relevant to your specific situation and needs.

What can I expect if I have dissociative amnesia?

Many people who have amnesia aren’t aware they have it. You might not realize you have memory gaps until someone else asks or mentions something you should remember but can’t. Some people may feel upset, afraid or anxious about this. Others will seem indifferent or unbothered.

Dissociative amnesia can range from mild and limited to severe and disabling. People with dissociative amnesia are more likely to have other mental health conditions, too. Some of the most common examples include:

• Anxiety.
• Depression.
• Eating disorders.
• Personality disorders.
• Post-traumatic stress disorder (PTSD) or complex PTSD (CPTSD).
• Self-harm and suicidal behaviors.
• Substance use disorder (SUD) or alcohol use disorder.

Most people will regain their memories over time. Treatment can speed up that process and help you manage the effects of regaining those memories, too.

Unfortunately, some people won’t regain their missing memories. While that’s not the case for most people with dissociative amnesia, it does happen. If you’re concerned about this happening, talk to your healthcare provider. They can help you develop coping strategies to manage the feelings you experience surrounding this.

How long does dissociative amnesia last?

For some people, dissociative anemia may last weeks or months. For others, it may be permanent. Your healthcare provider can tell you more about what you may expect with what’s happening to you.

What’s the outlook for dissociative amnesia?

The outlook for dissociative amnesia is as unique as the person who has it. With treatment, many people can regain their memories, manage the feelings that come with them and continue with life as usual (or nearly so).

The severity of dissociative amnesia often corresponds to the severity of the underlying cause(s) or contributing factor(s). The more severe the trauma that causes the amnesia, the more severe the amnesia and its effects will be.

People with severe dissociative amnesia who don’t recover their memories may find that memory loss disrupts their lives. It can affect their ability to form relationships (romantic and otherwise).

Recovering memories can also come with its own challenges. Some feel overwhelmed and struggle to deal with the feelings and memories. Treatment is critical for people going through this because the risk of dangerous behaviors, including self-harm and suicide, is much higher.

How do I take care of myself?

If you have dissociative amnesia, it’s important to remember that this isn’t something you can control. Your mind does this on its own to try to protect you. You also can’t force yourself to remember. Instead, it’s best to focus on being patient. Many people regain lost memories with time.

It’s also crucial for you to feel you can trust your mental health provider. Trust is very important to effectively treating and managing the effects of dissociative amnesia. Not everyone “clicks” with the first provider they see. You may feel discouraged if that’s the case for you early on. But it’s important to remember that this is common, and many people need to see more than one professional before they find someone who’s a good “fit” for their needs and personality.

When should I see my healthcare provider, or when should I seek care?

If you have dissociative amnesia or are worried you have it, it’s a good idea to talk to a mental health provider. They can talk to you about what you’re experiencing and either do an assessment or refer you to a provider for one.

After you see a provider, they can recommend a schedule for follow-up visits. You should also see them if you experience any of the following:

• A change in symptoms, especially changes that affect daily life and routine. Some examples include nightmares that affect your sleep, flashbacks that affect work or other activities, etc.
• Mood changes, especially ones that affect your daily life and routine. Examples include feeling more anxious, depressed or irritable.
• A change in treatment effectiveness, especially if you notice that treatments aren’t as effective.