Dissociative amnesia is a mental health condition that causes memory loss that is more severe than typical forgetfulness. The memory loss is usually associated with an experience of trauma and is an involuntary strategy for coping with that trauma. Someone with dissociative amnesia may forget a period of time, an event, a person, or very rarely their entire past and identity. Treatment targets recovering memories but also facing the traumatic experience and learning healthy ways to cope with those troubling memories. With treatment, most people regain their memories.
What is Dissociative Amnesia?
Dissociative amnesia is a type of dissociative disorder. These are mental illnesses that cause a disconnection from reality in a specific way. These conditions cause a person to have problems with thinking, memories, identity, and perception. Dissociative disorders are commonly associated with trauma and are unhealthy and involuntary ways of coping with traumatic events.
Amnesia is a loss of memories that can be short-term or that may persist. Dissociative amnesia causes a person to be unable to remember periods of time in their lives, specific events or certain aspects of events, self-identity, or other people. It is rare but possible for this condition to cause someone to forget everything about their identity and past. Dissociative amnesia may also cause fugue, a type of wandering or travel along with memory loss.
Types of Dissociative Amnesia
Cases of dissociative amnesia can vary from one person to another in a few different ways, although there are no distinctive diagnostic types. How and what a person forgets is one way in which the experience can differ:
- Localized amnesia. This occurs when a person forgets a period of time or an event. Some people may forget one short episode in their lives, while others lose long periods of time.
- Selective amnesia. Selective amnesia occurs when a person has memory loss associated with something specific, such as an aspect of an event or a person.
- Generalized amnesia. This is rare and causes a complete loss of memory of one’s personal identity and history.
Dissociative amnesia can also be further categorized by how long it lasts. Some people will regain their memories after a few minutes or a few hours. Others may forget for days, weeks, or months. Rarely a person with this condition will lose memories for years at a time.
There is one specifier for dissociative amnesia. Dissociative fugue was once considered a separate diagnosis, but it is now a specifier, meaning a person with dissociative amnesia may also experience fugue. Dissociative fugue causes a person to leave their usual lives for a period of time and wander or travel, either with purpose or in a bewildered, confused manner. It may last for a day and involve wandering around one’s neighborhood, or it may be more long-term and involve distant travel.
Facts and Statistics
Dissociative amnesia is one of three types of dissociative disorders that is more common than many people realize.
- About two percent of the U.S. adult population will ever be diagnosed with a dissociative disorder.
- More women than men are diagnosed with dissociative disorders.
- About one percent of men and 2.6 percent of women are ever diagnosed with dissociative amnesia.
- Dissociative amnesia is more likely to occur after a person experiences a traumatic event.
- Most cases of amnesia are short-term and memories do return.
- Memories may return suddenly, for no apparent reason, although there is often a trigger in the environment or therapy that causes it.
- As compared to those with medical amnesia—memory loss caused by a medical condition—people with dissociative amnesia are not greatly distressed by the loss of memories.
Symptoms and Diagnosis of Dissociative Amnesia
Dissociative amnesia is categorized as a type of dissociative disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 outlines the symptoms this condition may cause and that must be present for a person to be diagnosed with it. Memory loss is the characteristic symptom, but it can take many forms, including:
- Being unable to remember anything about a particular event or period of time
- Forgetting specific aspects of an event or period of time
- Losing memories associated with a specific person, social group, family, or other group of people
- Forgetting aspects of one’s identity
- Completely forgetting one’s identity and entire past up to the point the amnesia began
Many people who have this kind of amnesia are unaware of the memory loss to some degree. However, the amnesia does generally cause confusion and distress. It is also important to remember that dissociative amnesia memory loss is not the same as typical forgetfulness. It is normal to forget some aspects of the past, but amnesia memory loss is not consistent with what is expected with forgetting.
When diagnosing dissociative amnesia, there are a few other criteria besides the memory loss symptoms. For instance, the forgetting cannot be caused by a medical condition or substance use. It also cannot be better explained by another mental health condition, such as dissociative identity disorder.
Symptoms of dissociative fugue, which not all people with this condition experience, include wandering or traveling with mild confusion, sudden travel that is unexpected, and memory loss. When the individual comes out of the fugue, he or she is generally uncertain where they are or why. A person with fugue may adopt a new identity. Episodes may be short and occur often, or they can be long-lasting. Shorter, regular fugues can cause issues such as work absences, missed activities and responsibilities, and difficulties in relationships.
Causes and Risk Factors
Dissociative disorders, including dissociative amnesia, are unusual among mental illnesses for most often having a known cause. They are generally triggered by a traumatic experience or extremely stressful situation. The brain uses memory loss as a mechanism for coping with the stress or trauma. It is not something that a person does on purpose; it is both involuntary and unhealthy.
While this is a common cause of dissociative amnesia, all underlying factors are likely more complicated. Not everyone who experiences trauma will develop this condition, and why that is the case is not understood. It is likely there is a genetic component that makes some people more prone to experience dissociative amnesia after trauma.
Children can dissociate and lose memories more easily than adults. If a child experiences trauma and then develops dissociative amnesia, this may be a factor that increases that individual’s risk for having amnesia again as an adult. Trauma at any time in life is a risk factor for dissociative amnesia, but childhood trauma is a bigger factor.
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Because dissociative amnesia is associated with trauma, there may be co-occurring trauma disorders, such as post-traumatic stress disorder, or PTSD. Living with amnesia, and having memories return suddenly, can be distressing. Many people will suffer from depression or anxiety disorders. Suicidal and self-destructive behaviors are also not uncommon.
Treatment and Prognosis of Dissociative Amnesia
Treatment is important for dissociative amnesia. Treatment can help patients feel more comfortable and safer. It can guide them to help rediscover their memories and help them repair relationships and restore normal functioning. Additionally, treatment is important for helping someone with this condition face the trauma they experienced and learn healthy ways of coping with it.
Overcoming trauma and restoring memories is challenging, and most patients with this condition do best in a residential treatment setting where they are safe and can focus on getting better. The foundation of treatment for dissociative amnesia is therapy. Psychotherapy and behavioral therapies can be used to help change negative thinking patterns and behaviors and to help a patient open up about traumatic experiences.
For trauma, patients may benefit from a type of therapy called eye movement desensitization and reprocessing. It uses eye movements and recollections of the trauma to desensitize the painful memories. It helps patients experience the memories less vividly and reduces negative emotions associated with them.
In addition to these therapies, a patient in residential treatment may also benefit from working in group therapy settings, family therapy, creative therapies, and holistic health approaches such as diet, exercise, and alternative medicine. Medications may or may not be used for patients with dissociative amnesia. Some may benefit from antidepressants or anti-anxiety medications, but there are no drugs specifically for this condition.
The prognosis for dissociative amnesia is generally positive. Most patients respond well to treatment and will eventually regain memories. How quickly or completely they return depends on many factors, including a person’s current environment and level of support, overall health, and severity of the trauma. Most people recover but some will never get all of their memories back. Getting treatment for amnesia as soon as possible is important and improves treatment outcomes.