What is dissociative amnesia?
Dissociative amnesia is a condition in which a person cannot remember important information about his or her life. This forgetting may be limited to certain specific areas (thematic), or may include much of the person’s life history and/or identity (general).
In some rare cases called dissociative fugue, the person may forget most or all of his personal information (name, personal history, friends), and may sometimes even travel to a different location and adopt a completely new identity. In all cases of dissociative amnesia, the person has a much greater memory loss than would be expected in the course of normal forgetting.
Dissociative amnesia is one of a group of conditions called “dissociative disorders.” Dissociative disorders are mental illnesses in which there is a breakdown of mental functions that normally operate smoothly, such as memory, consciousness or awareness, and identity and/or perception.
Dissociative symptoms can be mild, but they can also be so severe that they keep the person from being able to function, and can also affect relationships and work activities.
How common is dissociative amnesia?
Dissociative amnesia is rare; it affects about 1% of men and 2.6% of women in the general population. The environment also plays a role; rates of dissociative amnesia tend to increase after natural disasters and during the war.
Symptoms and Causes
What causes dissociative amnesia?
Dissociative amnesia has been linked to overwhelming stress, which may be caused by traumatic events such as war, abuse, accidents, or disasters. The person may have suffered the trauma or just witnessed it. There also seems to be a genetic (inherited) connection in dissociative amnesia, as close relatives often have the tendency to develop amnesia.
What are the symptoms of dissociative amnesia?
There are three types, or patterns, of dissociative amnesia:
- Localized: Memory loss affects specific areas of knowledge or parts of a person’s life, such as a certain period during childhood, or anything about a friend or coworker. Often the memory loss focuses on a specific trauma. For example, a crime victim may have no memory of being robbed at gunpoint but can recall details from the rest of that day.
- Generalized: Memory loss affects major parts of a person’s life and/or identity, such as a young woman being unable to recognize her name, job, family, and friends.
- Fugue: With dissociative fugue, the person has generalized amnesia and adopts a new identity. For example, one middle manager was passed over for promotion. He did not come home from work and was reported as missing by his family. He was found a week later, 600 miles away, living under a different name, working as a short-order cook. When found by the police, he could not recognize any family member, friend, or coworker, and he could not say who he was or explain his lack of identification.
Dissociative amnesia is different from amnesia caused by medical problems, such as illnesses, strokes, or brain injuries. In medically caused amnesia, recovering memories are rare and generally a slow and gradual process.
Most cases of dissociative amnesia are relatively short. Often, when memories return, they do so suddenly and completely. Memory recovery may happen on its own, after being triggered by something in the person’s surroundings, or in therapy.
Another difference is that people who suffer medical amnesia are quite upset by their memory loss, whereas most people with dissociative amnesia seem to have surprisingly little concern over their amnesia.
Diagnosis and Tests
How is dissociative amnesia diagnosed?
If a patient has symptoms of dissociative amnesia, the doctor will perform a complete medical history and physical examination. Although there are no laboratory tests to diagnose dissociative disorders, the doctor might use blood tests or imaging (X-rays, CT scans, or MRIs) to make sure the patient doesn’t have a physical illness or side effects from a medication.
If the person does not have a physical illness, he or she might be referred to a mental health professional such as a psychiatrist, psychologist, or psychiatric social worker who is specially trained to diagnose and treat mental illnesses. This caregiver will perform a clinical interview to get a full picture of the person’s experiences and current functioning. Some psychiatrists and psychologists may use specialized tests or a standard interview such as the Structured Clinical Interview for Dissociation (SCID-D).
Management and Treatment
How is dissociative amnesia treated?
The goals of treatment for dissociative amnesia are to relieve symptoms, to make sure the patient and those around him or her are safe, and to “reconnect” the person with his or her lost memories. Treatment also aims to help the person:
- Safely deal with and manage painful events;
- Develop new coping skills and life skills;
- Get back to functioning as well as possible; and
- Improve relationships.
The best treatment approach depends on the person, the type of amnesia, and how severe the symptoms are. Treatment will most likely include some combination of the following methods:
- Psychotherapy: Psychotherapy, sometimes called “talk therapy,” is the main treatment for dissociative disorders. This is a broad term that includes several forms of therapy.
- Cognitive-behavioral therapy: This form of psychotherapy focuses on changing harmful thinking patterns, feelings, and behaviors.
- Eye movement desensitization and reprocessing: This technique is designed to treat people who have continuing nightmares, flashbacks, and other symptoms of post-traumatic stress disorder (PTSD).
- Dialectic-behavior therapy: This form of psychotherapy is for people with severe personality disturbances (which can include dissociative symptoms), and often takes place after the person has suffered abuse or trauma.
- Family therapy: This helps teach the family about the disorder and helps family members recognize if the patient’s symptoms come back.
- Creative therapies (for example, art therapy, music therapy): These therapies allow patients to explore and express their thoughts, feelings, and experiences in a safe and creative environment.
- Meditation and relaxation techniques: These help people better handle their dissociative symptoms and become more aware of their internal states.
- Clinical hypnosis: This is a treatment that uses intense relaxation, concentration, and focused attention to achieve a different state of consciousness, and allows people to explore thoughts, feelings, and memories they may have hidden from their conscious minds.
- Medication: There is no medication to treat dissociative disorders. However, people with dissociative disorders, especially those with depression and/or anxiety, may benefit from treatment with antidepressant or anti-anxiety medications.
People with dissociative amnesia usually respond well to treatment; however, progress and success depend on many things, including the person’s life situation and if he or she has support from family and friends.
Outlook / Prognosis
What is the outlook for people with dissociative amnesia?
For most people with dissociative amnesia, memory eventually returns, sometimes slowly and sometimes suddenly, which makes the overall outlook very good. In some cases, however, the person is never able to fully recover his or her lost memories.
To improve a person’s outlook, it is important to treat any dissociative amnesia problem as soon as possible. It is also important to treat any other problems or complications, such as depression, anxiety, or substance abuse.
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