Dissociative amnesia: causes, symptoms and treatments
Table of content
- What is dissociative amnesia?
- How common is dissociative amnesia?
- What is the most common dissociative amnesia?
- What are the symptoms of dissociative amnesia?
- What effects does dissociative amnesia have on a person’s life?
- What are the risk factors for dissociative amnesia?
- What are the treatments available for dissociative amnesia?
Dissociative amnesia is a type of dissociative disorder that involves memory gaps. It includes a breakdown or disruption in identity, memory, awareness, perception, and consciousness. This forgetting could include much of the patient’s life or it could be limited to a specific area or person.
The causes of dissociative amnesia include abuse, neglect, or traumatic or stressful events. This psychiatric disorder can also stem from problems with past experiences and personal identity.
The symptoms of dissociative amnesia include memory loss. This is the kind of memory loss that’s much more profound than regular forgetfulness and it can’t be explained by a medical illness.
The treatments for dissociative amnesia are psychotherapy, cognitive behavioral therapy, dialectic-behavior therapy, eye movement desensitization and reprocessing, family therapy, and medication.
What is dissociative amnesia?
Dissociative amnesia is a memory disorder. The Psychiatry peer-reviewed journal defines dissociative amnesia as a disorder recognized by memory gaps, often with a stressful or traumatic nature. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) by the American Psychiatric Association classifies dissociative amnesia under the dissociative disorders section.
The dissociative amnesia definition involves one or more episodes of inability to remember important personal information.
There are different types of dissociative amnesia, such as localized amnesia, selective amnesia, continuous amnesia, generalized amnesia, systematized amnesia, and dissociative fugue.
This is a severe form of forgetfulness beyond normal forgetting. It can happen in a patient who witnessed or suffered serious trauma. Dissociative amnesia tends to occur alongside other psychiatric conditions, especially personality disorders like dissociative identity disorder.
Dissociative disorder is both a new and an old mental disorder. The history of dissociative amnesia has a notable impact on how the disorder is treated today. A century ago, Pierre Janet and Sigmund Freud, two influential figures in the history of dynamic psychiatry, were fascinated by dissociative phenomena.
They came up with their own theory of the human mind with very different implications. This helped experts better understand these mental conditions, explains the National Library of Medicine. The term psychogenic amnesia was traditionally meant to describe episodes of retrograde and anterograde memory loss.
But, over the years, experts realized they had to use different categories to capture the impact of amnesic disorders such as dissociative, hysterical, functional, and other amnesic disorders, as seen in 2012 Brain Sciences reports.
So, what is the major difference between dissociative amnesia and retrograde amnesia? Retrograde amnesia is memory loss that happens as a result of a traumatic injury or a serious health complication such as degenerative brain disease, stroke, or seizure.
Dissociative amnesia has a psychological, instead of a neurological cause. It’s been linked to overwhelming stress due to a serious traumatic event. Stress-induced amnesia happens when a person blocks out particular events. This leaves them unable to recall key personal information.
How common is dissociative amnesia?
Dissociative amnesia is a rare psychiatric ailment. Because of the 1.8% prevalence rate, it is the most common dissociative disorder. Many of those affected are between 20 to 40 years old, based on 2020 Cureus reports.
Further research from the Global Emergency of Mental Disorders, suggests that dissociative amnesia is less common in men, at a 1% prevalence rate than in women, at 2.6%. Epidemiological data indicates there is a 6%–7% lifetime prevalence of dissociative amnesia in patients from Canada and Turkey.
The reason why these two countries have a higher dissociative amnesia rate than the U.S. is unknown. On that note, for patients all around the world who are in psychiatric care, the prevalence of dissociative amnesia ranges from 7% to 11%. Memory loss caused by trauma can lead to impaired or fragmented memories.
What is the most common dissociative amnesia?
The most common form of dissociative amnesia is localized amnesia. The failure to recall details from a certain time or event is related to traumatic experiences.
A dissociative memory is localized within a specific window of time. But, the patient’s memories remain intact before and after the occurrence. One dissociative amnesia example is when a person survives a car wreck. They have no memory of that experience, until two days later. It means they are experiencing localized amnesia.
This gap in memory tends to stem from extreme stress or a terrifying experience. While generalized amnesia is a rare form of dissociative amnesia, cases such as these are often recorded in patients with profound traumatic experiences such as childhood abuse, sexual abuse, or prolonged mistreatment.
It refers to an acute onset of complete memory loss about the patient’s life history. Those affected could lose procedural knowledge, semantic knowledge, and/or personal identity, explains Johns Hopkins Medicine. But, dissociative amnesia statistics are lacking since this disorder is not detected in many patients, and its prevalence is not well-established.
At this point, it is not clear why localized amnesia is more common than other types of dissociative amnesia.
What are the causes of dissociative amnesia?
Causes of dissociative amnesia are related to overwhelming stress, but a combination of different factors could play a role in the development of this problem. The causes of dissociative amnesia are listed below:
- Trauma: experiencing or witnessing any kind of traumatic event may lead to dissociative amnesia because a person blocks out certain memories. As a result, they are unable to remember some important personal information. In other words, experiencing a severe emotional shock could create a serious gap in memory. Blocking out certain events in one’s mind is a coping mechanism or the brain’s attempt to protect itself i.e. it occurs due to the inability to process trauma in a healthier manner. The onset of memory loss from trauma is usually sudden. Dissociative amnesia from trauma is not the same as amnesia from brain damage or brain disease. In patients with medically-caused amnesia, recovering the lost memories is rare or takes a long time. Most patients with amnesia dissociative disorder experience short-term memory loss.
- Genetics: evidence suggests that genetics may play a role in the development of dissociative disorders. For example, a review from Dialogues in Clinical Neuroscience reported that dissociation is linked to the interaction of traumatic experiences with specific polymorphisms in genes associated with dopaminergic, serotonergic, and other systems. A lot more research on this subject is necessary, but current evidence shows some people may have a genetic predisposition to develop dissociative disorders, including dissociative amnesia.
- Brain changes and abnormalities: traumatic experiences may interfere with the brain’s ability to retrieve personal information associated with those events, which further contributes to the development of dissociative amnesia. A study from Psychiatry Research found that patients with dissociative amnesia had some functional brain changes. For example, scientists observed significantly decreased glucose utilization in the right inferolateral prefrontal cortex. They explained that hypometabolism in this part of the brain, which participates in the retrieval of autobiographic memories and self-referential processing, could contribute to the development of dissociative amnesia.
What are the symptoms of dissociative amnesia?
The symptoms of dissociative amnesia are listed below:
- Memory loss: it includes forgetting personal information, like your address and name, to blocking particular areas or events that have happened in your life. Someone with trauma-induced amnesia might not remember their coworkers, family, and close friends. The symptoms of generalized amnesia can cause forgetting everything about life and self. Dissociative amnesia with dissociative fugue can lead to symptoms like traveling away from home, confusion, and memory loss. A person can be doing things and not remembering. It can feel like being disconnected from their thoughts or sense of self. Patients may not remember where they were born, grew up, or any general information about their background. Also, they might not remember how they traveled so far away from their home, explains Case Reports in Psychiatry.
- Connection with stress or trauma: dissociative amnesia is often associated with a distinct stressful or traumatic life event like fighting in a war, or witnessing or experiencing physical and sexual abuse. With trauma amnesia, people might not remember information related to the time they went through the trauma. For example, a person can’t remember details from the time when the abuse happened.
- Memory loss is short-term: many dissociative amnesia (DA) episodes are short-term. They can last for a few minutes, hours to a couple of days. Sometimes, in very rare cases, they could last longer. When DA symptoms subside, most patients recover their memories. Also, memories return suddenly and completely in most cases. It’s also possible that therapy or something in a person’s environment triggers memory recovery.
What effects does dissociative amnesia have on a person’s life?
The effects of dissociative amnesia include anxiety, depression, and confusion. According to a review from Lancet Psychiatry, dissociative amnesia is also marked by functional impairment.
Some people with dissociative amnesia can have difficulties taking care of themselves or doing everyday activities such as getting out of bed, grooming, dressing, etc. It can interfere with their work activities, and social, and romantic relationships.
As a result, affected individuals have an increased suicide risk. But, the impact of the disorder varies depending on the causes of dissociative amnesia. When someone experiences traumatic memory loss, that short-term memory loss after trauma comes back.
Many victims of trauma frequently re-live their experiences in the form of intrusive and involuntary recollections. Furthermore, it might be difficult to recall trauma voluntarily. These bits and pieces of memory might be partially or completely inaccessible – a feature found in DA patients.
Patients with PTSD (post-traumatic stress disorder) can have these characteristics, explains the National Library of Medicine. In fact, memory loss and PTSD go hand in hand. When triggered by trauma, PTSD can overwhelm someone’s ability to cope. This could be associated with full or partial memory loss.
The complex link between amnesia, dissociative disorder and PTSD causes profound stress and anxiety for patients who experience both debilitating and frightening conditions.
What are the risk factors for dissociative amnesia?
Risk factors for dissociative amnesia are listed below:
- Sexual, emotional, or physical abuse or assault
- History of previous emotional trauma
- Prolonged trauma or mistreatment
- Witnessing natural disasters such as tornados, floods, earthquakes
- Receiving physical threats
- Participating or witnessing military and war-related activities
- Experiencing or witnessing horrible accidents
- Growing up in an unsafe, dysfunctional environment
- History of mental illness including sleep disorders, personality disorders, depression, PTSD, and anxiety disorders
- Having dissociative identity disorder (DID)
How is dissociative amnesia diagnosed?
Dissociative amnesia is diagnosed by first conducting a physical exam. The goal is to rule out any other potential causes like alcohol, drug abuse, brain injury, or illness. Although there isn’t a specific dissociative amnesia test, the doctor can suggest imaging or blood tests.
If there isn’t a physical cause for the amnesia, then the doctor can refer a patient to a mental health expert such as a psychiatrist or psychologist. To evaluate the amnesia trauma, the mental health specialist does a psychological exam. They collect different information about a patient’s past experiences.
They may ask about a patient’s symptoms, emotions, thoughts, and behaviors. After the psychological exam, the specialist can use other tools to get a proper diagnosis such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or a screening dissociation test for dissociative identity disorder.
The screening test is a questionnaire consisting of multiple questions about daily life and experiences. When answering, a patient needs to determine the level at which the experience described applies to them.
What are the treatments available for dissociative amnesia?
Treatments available for dissociative amnesia, whose goal is to treat trauma and symptoms like memory loss, are listed below:
- Cognitive-behavioral therapy
- Eye movement desensitization and reprocessing
- Dialectic-behavior therapy
- Family therapy
Psychotherapy or talk therapy is a key treatment for dissociative amnesia, according to a paper published in the Indian Journal of Psychiatry. It can help treat a wide range of emotional troubles and mental illnesses. This psychogenic amnesia treatment can manage troubling symptoms so that the patient can function better and improve their well-being.
What makes this one of the most popular treatments for dissociative identity disorder and amnesia is that it can help cope with the impact of trauma, daily life, anxiety, depression, or other mental disorders.
2. Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) can treat a variety of psychological conditions as well as dissociative traumatic amnesia. Cognitive therapists can help patients develop different coping skills, all of which can aid them in overcoming and managing the experience.
CBT focuses on addressing negative behavior and thinking that stem from a stressful and traumatic event. This can help patients overcome the issues surrounding the loss of memory due to trauma.
Through cognitive behavioral therapy, patients can replace and challenge distorted thoughts with constructive thoughts. They can also change the way they behave to a certain trigger. People can get a better understanding of their dissociative behavior and take the necessary steps to change it.
3. Eye movement desensitization and reprocessing
Eye movement desensitization and reprocessing (EMDR) is an individual therapy treatment that takes on a different approach than other treatments for dissociative disorders. Instead of focusing on altering the thoughts, feelings, and responses that result from a traumatic event, EMDR therapy focuses on the memory itself.
The goal of this therapy is to change the way the mind stores that memory thereby removing or decreasing the problematic symptoms. Managing trauma memory loss can take some time. But, this type of treatment is usually delivered 1 to 2 times a week for a total of 6 to 12 sessions.
4. Dialectic-behavior therapy
Dialectic-behavior therapy (DBT) is a type of psychotherapy for patients who experience very intense emotions. It is a modified type of CBT. To help people overcome memory loss trauma, a DBT program can teach them healthy ways to cope with stress.
Patients learn how to live in the moment, manage their emotions, and work on their relationships. The DBT program is meant to treat borderline personality disorder (BPD). But, it could also be a viable therapy for dissociative identity disorder, eating disorders, and mood disorders.
When it comes to trauma-induced memory loss, this therapy can help patients accept and understand their difficult emotions. It can help them acquire proper skills to manage them and make positive changes in their lives.
5. Family therapy
When dissociative amnesia treatment has to take on a different approach, that’s where family therapy can come in handy. This treatment can educate the family about the symptoms and causes of dissociative amnesia disorder.
Both the patient and their family can use this therapy to build empathy as well as reduce conflict, and establish healthy boundaries, communication, and problem-solving skills. The patient should come home to a safe and positive environment. Otherwise, it can hinder their clinical progress.
There is no medication for dissociative amnesia. But patients with dissociative complications or dissociative amnesia disorder could also suffer from anxiety and depression. Anti-anxiety medications or antidepressants can help with that.
When used for PTSD, medications like SSRIs and SNRIs can decrease PTSD symptoms. Some of the most recommended options include Sertraline, Venlafaxine, and Paroxetine. They can help ease the symptoms of patients with amnesia PTSD.
For medical dissociative identity disorder treatment, doctors might offer psychiatric medication. Options like mood stabilizers and antipsychotics might help control the behavior of different identities.