Dissociative Amnesia

What is Dissociative Amnesia?

What is Dissociative Amnesia?
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Dissociative Amnesia is one of the Dissociative Disorders and it is characterized by the inability of the person to recall important personal memories. The impairment is greater than just due to forgetfulness.  The condition is often brought on by a traumatic event which the person blocks out of their consciousness.

Dissociative Amnesia: What Does It Mean?

Dissociative Amnesia means that the sufferer cannot remember periods of their life. This is sometimes known as autobiographic memory, and it includes everything important that has happened to the person throughout their life.

The condition can present itself in five different ways.

  • Localized amnesia is a clearly marked life period during which the person has no memory. It can range in time from seconds to decades and frequently corresponds to a period of abuse or trauma. This type of Dissociative Amnesia occurs usually hours or days after the traumatic event and can be repeated several times throughout the person’s life.
  • Selective amnesia is when the person only forgets part of the things that happened during a certain period. Localized and selective amnesia can occur simultaneously.
  • Generalized amnesia is much less common, but the effects are more evident and all-encompassing. Sufferers cannot remember their own history or identity, and they can also forget skills that they previously had and their global knowledge.
  • Systematized amnesia is when the person loses their memory of a specific person or group of people.
  • Continuous amnesia is the term used for when the person has no memory of each new event which they experience.

Amnesia Definition

Amnesia is defined as an inability to recall past events. It is normally caused by physical factors whereas Dissociative amnesia does not have a physical cause but a psychological one.

Stats: How Many Suffer from this Disorder?

Exact figures for the number of suffers of Dissociative Amnesia are difficult to obtain as it can often go undetected. It is thought to occur in about 2-percent of the population, with women being more likely to suffer from the condition with 2.6-percent, compared to one-percent of men.

It is thought that nearly half of the adult population in the US experiences a period of a dissociative disorder at some point in their lives.

The incidence of Dissociative Amnesia increases in war zones or areas where a natural disaster has occurred indicating environmental influences.

What Causes Dissociative Amnesia?

Dissociative Amnesia may be genetically inherited, as sufferers of this condition often have close family members who suffer from other dissociative conditions.

Psychogenic Causes

An extremely stressful or traumatic experience is usually the cause of Dissociative Amnesia. This could be being present in a situation such as a war, a natural disaster, or observing a genocide. A personal experience, such as rape, physical or sexual abuse, or the death of a loved one can provoke the condition. Less commonly, unresolved internal conflicts such as a profound feeling of guilt, criminal activity, or tormented personal relationships, can be the cause of Dissociative Amnesia.

Acquired Brain Injuries

Memory loss can occur when the brain is damaged by a physical occurrence such as a trauma, infection, disease, stroke, or toxicity through drugs or alcohol. With these types of acquired brain injuries, the amount of memory lost depends on the severity and extent of the damage to the brain.

Signs and Symptoms of Dissociative Amnesia

Dissociative Amnesia can often go undiagnosed as the sufferer may not present any tangible evidence of their condition.  The sufferer, is usually, totally unaware of both the existence of the memory loss and of the suppressed memories that caused it. The condition is often noticed when other people who were present during the period reveal that the person has no recollection of the events that occurred. In severe cases of Dissociative Amnesia, the memory loss is more likely to be noticed by others, although the sufferer is usually unaware of the problem.

What are the Common Behaviors/Characteristics?

A person suffering from severe Dissociative Amnesia is unable to remember important personal information, sometimes to the extent that they cannot recall their own name, where they live, or what they do. Some people respond to this with anxiety, but most seem to be indifferent.

Many people returning from a war zone or a natural disaster block out the traumatic memories of what they saw during this time. They can be depressed or agitated prior to the onset of the condition.  Sometimes a personal event such as rape, abuse, or an attack can cause Dissociative Amnesia. In these cases, it can be the time-period in which the event took place which is forgotten, or the place where it occurred, or the people involved in the act.

Dissociative Amnesia usually develops soon after a traumatic event but may not be diagnosed until much later, if ever. Sufferers may display odd behavior related to the event without having memory of the event itself. For example, a person may have a fear of heights caused by having observed someone jump to their death from a high building. However, they have no recollection of the actual details of the occurrence, but the traumatic experience manifests itself in an irrational fear of heights.

The onset of a period of Dissociative Amnesia usually occurs rapidly and it can last from just a few minutes up to hours or days. In rare cases, the time that the Dissociative Amnesia lasts can extend to months or even years. Recurrent periods are quite common.

Sometimes people suffer from flashbacks or brief glimpses of the forgotten period. This can cause confusion, and many people exhibit symptoms of depression or anxiety.  Frequently when the amnesia abates, self-destructive and suicidal behavior are observed as the person tries to come to terms with the past.

The condition is often diagnosed after the person has been referred for treatment of another psychological condition.

Testing: What are the Diagnostic Criteria Per the DSM 5?

The diagnostic criteria for Dissociative Amnesia according to the DSM 5 are-

  1. “An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Note: Dissociative amnesia most often consists of localized or selective amnesia for a specific event or events; or generalized amnesia for identity and life history.
  2. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  3. The disturbance is not attributable to the physiological effects of a substance (e.g., alcohol or other drug of abuse, a medication) or a neurological or other medical condition (e.g., partial complex seizures, transient global amnesia, sequelae of a closed head injury/traumatic brain injury, other neurological condition).
  4. The disturbance is not better explained by dissociative identity disorder, posttraumatic stress disorder, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder”

Dissociative Fugue

Dissociative Amnesia with Dissociative Fugue has a separate code in the DSM 5 listings where the diagnostic criteria are defined as-

“Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information.”

Very occasionally, Dissociative Fugue accompanies Dissociative Amnesia. The person’s lack of memory causes a complete loss of personal identity. This can cause some people to wander aimlessly with no idea of who they are or where they are going. Others, however, set up a whole new identity. They deliberately move to another place, invent a name, get a new job, and begin to create a new life. Sometimes this new life is only detected by others when an event occurs that reveals the lack of physical evidence to back up the person’s identity. People with dissociative fugue usually believe that their new life is the one that they have always led and that they are the person they claim to be. Sometimes the memory of their original identity returns, and they manage to get back to their real life.

Dissociative Amnesia and Other Conditions

Dissociative Amnesia vs Dissociative Identity Disorder

All of the Dissociative Disorders are characterized by an involuntary escape from reality. Sufferers of Dissociative Amnesia manifest this by erasing memories, while sufferers of Dissociative Identity Disorder do it by creating multiple personalities. Each personality is called an “alter,” and the different “alters” are not usually aware of the existence of the others.

Dissociative Amnesia in Adults/Children

Dissociative Amnesia can present itself at any time of life. In children, Dissociative Amnesia is almost always associated with a traumatic event, such as abuse, however, the condition may not be identified until adulthood. When these memories return, either spontaneously or due to therapy, the experience of remembering the painful details of the event can be very distressing for the person.

It is possible for a person to experience multiple periods of Dissociative Amnesia throughout their life.

Example Case of Dissociative Amnesia

“Dorothy” was discovered wandering aimlessly along a country road. She had a disheveled appearance, and when questioned about her identity she was unable to give her name or address. She was admitted into hospital where tests failed to reveal any organic or medical reason for her amnesia. As she had no identifying documentation on her and was obviously confused and distressed by her lack of memory, she was admitted into a mental health unit.

Here, she was treated with minor tranquilizers to alleviate her anxiety. She began a course of psychotherapy which demonstrated that her memory loss was very extensive, and she was given the diagnosis of Dissociative Amnesia with Dissociative Fugue

After two months of therapy “Dorothy” did not show any improvement in her memory. She remained quiet and detached but became agitated at times when pressed to try and recall events from the past.

It was decided to treat her with hypnosis therapy to which she responded very well. Under hypnosis, she revealed that she had been the subject of prolonged sexual abuse by her step-father. She had no recollection of these events when not under hypnosis. With supportive therapy, she was slowly able to confront these memories and she began to recall her past. She remembered running away from the family home and establishing herself in a small town where she worked as a waitress. During this period her Dissociative Amnesia prevented her from recalling the painful memories, but she remained aware of her identity.  She recalled seeing her step-father enter the café and this caused her to enter into another period of Dissociative Amnesia, this time with Dissociative Fugue and she effectively wiped-out all memories of her past life.

Now Dorothy has pieced back together the memories of her life and after many months of therapy decided to visit the family home. Here, her mother received her with great joy, and she learned that her step-father had recently passed away. Her mother had no idea of the abuse that she had suffered and together they are now receiving family therapy to help them both to deal with the past and to build a better future.

Dissociative Amnesia

How to Deal/Coping with Dissociative Amnesia

Family support and assistance in rebuilding memories is important for the rehabilitation of people with of Dissociative Amnesia.

Look out for These Complications/Risk Factors

Families should take note of any evidence that someone does not remember some part of their past or identity. Dissociative Amnesia can become evident on occasions such as family reunions when people are recalling past events that the sufferer does not remember.

Unusual behavior or a phobia can sometimes be a sign of Dissociative Amnesia if the person can not offer a reasonable explication for their comportment or fear.

After being subjected to a traumatic event, such as being in a war zone, a disaster, or suffering an attack of some kind, early professional help can aid in reducing the risk of Dissociative Amnesia developing by facing and dealing with the unpleasant memories.

After the amnesic event, the person should be closely observed for signs of suicidal tendencies or self-harm, which can occur as the person tries to deal with the traumatic situation.

Dissociative Amnesia Treatment

Dissociative Amnesia responds well to treatment and the prognosis for most sufferers if good. Response to treatment depends on the nature of the trauma that caused the condition, the duration of the amnesia, the person’s overall mental condition, and the support that they receive from family and professionals.

Possible Medications for Dissociative Amnesia

Anti-depressant or anti-anxiety medication may be used in patients presenting symptoms of these conditions.

No medication is indicated directly for alleviating Dissociative Amnesia. However, benzodiazepine or barbiturates are sometimes employed to create a drug-induced semi-hypnotic state used in therapy. This, and hypnosis must be performed by a very skilled therapist to avoid the risk of creating false memories.

Psychotherapy is more commonly used to help the person to recover from Dissociative Amnesia.

Home Remedies to help Dissociative Amnesia

The most effective home remedy for helping a person with Dissociative Amnesia is to provide a safe and caring environment for their recovery. Meditation and yoga can be of help in some cases. Encouraging them to eat a healthy balanced diet, take regular exercise, and to develop relationships, can all help them towards a complete recovery.

Living with Dissociative Amnesia

Mild cases can pass unnoticed or not have much effect on the person’s life. Some severe cases can persist and are unresponsive to treatment, and the person will require continued family and professional support.  Dissociative Amnesia can recur if the causing factor is not identified and remedied. However, many people make a complete recovery.

Insurance Coverage for Dissociative Amnesia

Psychotherapy, group, personal, and family therapies are considered as outpatient mental health treatments and so are covered by many health insurance policies. Talk with your supplier to see if you are covered.

How to Find a Therapist

Ask your healthcare professionals to recommend what type of therapy would best help the sufferer and to provide you with a list of possible therapists. Therapies may include Personal therapy, Family therapy, Cognitive therapy, and Hypnosis.

What Should I be Looking for in an LMHP?

Make sure that the chosen therapist has current professional qualifications and experience in dealing with people with Dissociative Amnesia. If possible, check out their website to learn about the therapies they offer. Choose someone with whom the sufferer feels comfortable with, as trust and confidence are very important in these kinds of therapies.

Questions to Ask a Potential Therapist

  • How long would therapy be needed before memory returns?
  • How many sessions per week?
  • Does the family need to come along to the sessions?
  • How does therapy help the sufferer not to experience another period of Dissociative Amnesia?

As the causes of Dissociative Amnesia are now better understood, many people who are exposed to traumatic situations receive the supportive therapies necessary to prevent the development of the condition. Most people who do suffer a period of Dissociative Amnesia will be able to achieve a complete recovery with the correct support and treatment.

Dissociative Amnesia Resources and Support Helpline

-National Institute of Mental Health: https://www.nimh.nih.gov/index.shtml

-National Alliance on Mental Health: https://www.nami.org/Find-Support/NAMI-HelpLine 1-800-950-NAMI (6264) or [email protected]

-National Rehabilitation Information Center: https://www.naric.com/?q=en/content/resources-specific-disabilities

-National Suicide Prevention Lifeline:  https://suicidepreventionlifeline.org/

1-800-273-8255 available 24 hrs a day

Crisis Text Line: Text “home” to 741741
-Substance Abuse and Mental Health Services Administration (SAMHSA)- National Helpline:

1-800-662-HELP (4357)

https://findtreatment.samhsa.gov/

Resources

  1. https://my.clevelandclinic.org/health/diseases/9789-dissociative-amnesia
  2. https://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-amnesia
  3. https://www.psychologytoday.com/us/conditions/dissociative-amnesia
  4. https://www.webmd.com/mental-health/dissociative-amnesia#1
  5. https://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders
  6. https://www.sciencetheearth.com/uploads/2/4/6/5/24658156/dsm-v-manual_pg490.pdf
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