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What is dissociative amnesia?
Dissociative amnesia is a condition in which you can’t remember important information about your life. This forgetting may be limited to certain specific areas (thematic) or may include much of your life history and/or identity (general).
In some rare cases called dissociative fugue, you may forget most or all of your 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, you have 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’s 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 you from being able to function. They can also affect relationships and work activities.
How common is dissociative amnesia?
Dissociative amnesia is rare. It affects about 1% of men and people assigned male at birth and 2.6% of women and people assigned female at birth in the general population. The environment also plays a role. Rates of dissociative amnesia tend to increase after natural disasters and during 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. A person with dissociative amnesia may have experienced the trauma or witnessed it. There may 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 your life and/or identity, such as being unable to recognize your name, job, family and friends.
- Fugue: With dissociative fugue, you have generalized amnesia and adopt a new identity. For example, one middle manager was passed over for promotion. They didn’t come home from work and was reported as missing by his family. They were found a week later, 600 miles away, living under a different name, working as a short-order cook. When found by the police, this person couldn’t recognize any family members, friends or coworkers, and couldn’t explain their 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 is rare and generally a slow and gradual process.
Most cases of dissociative amnesia are relatively short. Often, memories return suddenly and completely. Memory recovery may be triggered by something in the person’s surroundings or in therapy.
Also, people who experience medical amnesia are 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 person has symptoms of dissociative amnesia, a healthcare provider will perform a complete medical history (based on what is known) and physical examination. Although there aren’t any laboratory tests to diagnose dissociative disorders, they might use blood tests or imaging (X-rays, CT scans or MRIs) to make sure the person doesn’t have a physical illness or side effects from a medication.
If the person doesn’t have a physical illness, they might be referred to a mental health professional such as a psychiatrist, psychologist or psychiatric social worker. This caregiver performs 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, make sure you and those around you are safe, and “reconnect” you with your lost memories. Treatment also aims to help you:
- Safely deal with and manage painful events.
- Develop new coping skills and life skills.
- Get back to functioning as well as possible.
- Improve relationships.
The best treatment approach depends on the person, the type of amnesia and how severe the symptoms are. Treatment most likely includes 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 experienced abuse or trauma.
- Family therapy: This helps teach family about the disorder and helps them recognize if their loved one’s symptoms come back.
- Creative therapies (for example, art therapy, music therapy): These therapies allow people 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 isn’t a 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. But progress and success depend on many things, including the person’s life situation and if they have 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 their lost memories.
To improve a person’s outlook, it’s important to treat any dissociative amnesia problem as soon as possible. It’s also important to treat any other issues or complications, such as depression, anxiety or substance abuse.
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