Dissociative amnesia is a disorder that can be observed by one’s inability to recall personal information; this looks like a loss of autobiographical memory that can impair one’s entire life. Several research studies have observed connections between dissociative amnesia and severe trauma.1 Although treatments for dissociative amnesia are not yet evidence-based, research continues to find therapies that have been found to reduce symptoms.2
What Is Dissociative Amnesia Disorder?
Dissociative amnesia is when a person experiences a significant loss of memory surrounding important personal information. These symptoms of amnesia do not include simple forgetfulness, like not knowing the date. These episodes can begin suddenly and generally last for a short period (e.g., hours or a day) but have also been seen to last for weeks and possibly even years.3
Dissociative amnesia disorder is considered the most common of several dissociative disorders.3 Research completed on a small sample observed dissociative amnesia in about 1.8% of their population (2.6% in females and 1% in males).1,4. Further, the diagnosis of dissociative amnesia is suggested to be lower than the disorder’s actual occurrence.1,4It is important to know that dissociative amnesia does not always cause the same symptoms from person to person.
The American Psychiatric Association notes that dissociative amnesia has several presentations, including:3,4
- Localized: This type of amnesia is characterized by an inability to recall specific events or periods, creating a memory gap of personal details. These memory gaps can include multiple periods of traumatic events or significant stress.
- Generalized: This type of amnesia is rare and usually seen in those who have experienced significant stress, such as veterans who have experienced combat and survivors of sexual assault. Generalized amnesia is when people lose memories of their experiences, identity, feelings, and people and places. It is suggested that this amnesia can lead individuals to lose general life skills.
- Fugue: This type of amnesia is severe, and only .2% of people are diagnosed with it. A dissociative fugue will include memory loss, not recognizing people they formerly knew, unexpected travel, and wandering around in confusion, which can last from hours to months. Sometimes, people will recall their memories after they have started new lives. The ending of these episodes can influence feelings of grief, depression, or shame.
Dissociative Amnesia vs. Amnesia
Dissociative amnesia and medical amnesia are not the same. For dissociative amnesia, a mental health diagnosis is usually diagnosed along with it, ruling out any medical cause on the person’s symptoms and presentation. Research has not conclusively confirmed the connection, but it suggests that the loss of autobiographical memory in dissociative amnesia is connected with severe stress and trauma.5
On the other hand, medical amnesia (i.e., organic, psychogenic, or global) is observed by the sudden onset of general memory loss, not just autobiographical, that can apply to past and recent events. While some may recover memories quickly in global amnesia, other types of medical amnesia can be gradual and symptoms may even come and go.5,6 Further, causes of medical amnesia can be related to physical brain injury or damage.7
Dissociative Amnesia Symptoms
Each type of dissociative amnesia differs, but it is not uncommon for these episodes to happen multiple times.3,4 Lost memories from each can and do return after the episodes of dissociation are over, but not before, causing similar symptoms that present challenges in daily life.
Symptoms of dissociative amnesia can include:1,3
- Confusion
- Depressive symptoms
- Flashbacks
- Difficulty in relationships due to memory loss
- Suicidal thoughts, when memory is suddenly recovered and overwhelming to the individual
Causes of Dissociative Amnesia
Dissociative amnesia is frequently connected with significant trauma and stress. These traumas include significant childhood trauma from physical, sexual, or emotional abuse and significant physical or emotional neglect. Trauma can also be caused by adulthood abuse, surviving a sexual assault, military trauma (combat or non-combat), and even experiencing or witnessing a natural disaster or genocide.1,3,5
In addition to trauma, significant stress or internal conflict may be connected with dissociative amnesia.3 While the cause of stress can differ with each person, internal conflicts could include stress surrounding an interpersonal interaction or fight, a crime, or powerful feelings of guilt. 1
Possible causes of dissociative amnesia can include witnessing or experiencing:1,3,5
- Severe physical, sexual, or emotional abuse
- Severe emotional or physical neglect
- Sexual assault or rape
- Severe interpersonal conflict and stress
- Military trauma, especially combat
- Natural disasters
- Genocide
Comorbid Conditions
Symptoms of dissociative amnesia and its potential causes can be correlated with other mental health disorders, especially for those who have experienced significant trauma or depressive symptoms due to a fugue.
Conditions that may occur comorbidly with dissociative amnesia include:
- Post-traumatic stress disorder (PTSD): Those who experience dissociative amnesia may have experienced significant trauma. Some individuals who experienced dissociative amnesia have reported PTSD flashbacks, and, in addition, some people with DA may go on to be diagnosed with PTSD.1
- Depression: People can experience several emotions, including depression when coming out of a dissociative amnesia episode.1
- Anxiety disorders: As the forgotten memories of the trauma return, anxiety levels may be increased, especially if the individual is experiencing flashbacks, eventually leading to comorbid anxiety disorders.5
- Personality disorders: There have been many clinical observations of a significant correlation between individuals with personality disorder diagnoses and dissociative disorders.8 Most clinicians associate dissociation with cluster B personality disorders (e.g., borderline, narcissistic, histrionic, and antisocial disorders); however, researchers note a correlation between dissociative amnesia episodes and cluster C personality traits (e.g., avoidant, dependent, and obsessive-compulsive disorders).9
- Substance Use Disorders: Substance use disorders can be seen in some individuals who experience dissociative amnesia. Those who experience dissociative amnesia while abusing substances can experience worsening symptoms due to drug impacts on the brain and other financial and interpersonal stress that accompany it.10
- Sleep Disorders: Individuals who experience dissociative amnesia can also experience sleep issues (like insomnia and sleepwalking) and mental fatigue.10,11.
How Is Dissociative Amnesia Diagnosed?
A doctor can diagnose dissociative amnesia by considering the criterion set in place by the DSM-5. This criterion includes the individual’s inability to recall important autobiographical information and their symptoms (e.g., memory loss) impairing the individual in several areas of their life (e.g., occupational, social, etc.).3,4 In addition, there cannot be any other influences on this memory loss, such as medical issues, medications, or substance use.
As a doctor needs to rule out medical influences, the doctor will need to conduct testing before making an official diagnosis. They may need to complete psychological assessments and a physical exam to rule out other mental health disorders or medical causes for the reported memory loss. Sometimes a referral to another specialist is needed if it is not their specialty.
A medical professional may use a combination of these methods to diagnose dissociative amnesia:1,3
- Physical exam: An exam can help rule out any initial physical abnormalities that could influence memory loss.
- Psychological testing: Psychological assessment helps rule out other psychological influences. In addition, it allows the doctor to gain more information about the types of dissociative symptoms and amnesia.
- Blood and urine testing: These can help identify potential medical abnormalities (e.g., increased white blood cells). However, they also help rule out any substance-based influence on memory loss.
- MRI Scans: These can help identify abnormalities in your brain, such as structural differences in memory centers.
- EEG: This testing helps monitor your brain activity. They can help to rule out potential seizure causes for memory loss.
Treatment for Dissociative Amnesia
While treatment is individualized depending on the severity of someone’s symptoms, talk psychotherapy can help create a safe and trustworthy environment for the individual to work on reconnecting with their memories.3 Dissociative amnesia can be challenging to treat, as there are no current approved evidence-based treatments for dissociative amnesia.2 However, this doesn’t mean that hope is lost.
The goals of these therapies, which can be tailored to each person, can be to increase coping skills to process conflict and stress, reduce amnesia episodes, and begin reconnecting with and reframing traumatic memories.1,3,5 While there are no specific medications to treat dissociative amnesia, sometimes anti-depressants and anti-anxiety medications can help manage symptoms that come from memory loss. People can find a therapist who offers these types of therapy through an online therapist directory.
Therapy methods for treating dissociative amnesia may include:
- Cognitive behavioral therapy (CBT): This treatment explores negative and unhealthy thought patterns that can influence unhealthy behaviors and beliefs. By exploring these, people can challenge these thought patterns and learn to engage in healthier thinking. CBT can help address thoughts revolving around their trauma.3,5
- Eye movement desensitizing and reprocessing (EMDR): This treatment can help reduce negative associations with certain stimuli, such as reminders or triggers of one’s trauma. By neutralizing and reframing how the brain perceives stimuli, EMDR for PTSD can help to process emotions and feelings associated with the traumatic event rather than avoid them.3,5
- Dialectical behavioral therapy (DBT): This treatment helps people to learn how to regulate their emotions and challenge black-and-white thinking. In addition, DBT can also help to reduce the risk of self-harm. This treatment can also be used to treat certain personality traits.3,5
- Family therapy: This treatment can help family members to identify harmful interactions and to practice healthy communication patterns. In addition, family therapy can help to educate and support the individual(s) experiencing symptoms.5
- Relaxation techniques: These techniques (such as progressive muscle relaxation) are often combined with other therapies to help provide coping skills and reduce anxiety. They can also help increase self-awareness and ground people, which can be helpful for those who experience dissociation from flashbacks or night terrors.5
- Hypnosis: Although riskier due to the potential of bringing up traumatic memories, hypnotherapy can be used to retrieve lost memories.3
How to Help Someone Experiencing Dissociative Amnesia
Experiencing dissociative amnesia can be difficult, disorienting, and significantly impact an individual’s life. It can be concerning and scary to see a loved one experience dissociative amnesia, especially if they are in a fugue. Rather than avoiding interaction with them, there are ways you can help your loved one in their journey.
Five ways you can help your loved one experiencing dissociative amnesia include:
- Don’t take it personally: Seeing a loved one not remember your shared history can be upsetting. Reminding yourself that your loved one is experiencing an amnesia episode and that they may struggle to stabilize and recover when it is over can help you put things into perspective.
- Offer encouragement and support: While this can look different for each person, knowing they have your support can be helpful. Support can look like maintaining healthy boundaries, encouraging treatment attendance, or even helping access treatment.
- Be open to working on your shared relationship: As one can imagine, the loved ones of someone experiencing amnesia may feel estranged, frustrated, or angry. Allow yourself and your loved one grace, within a healthy boundary, to approach the new relationship with an open mind and to communicate concerns.
- Engage in activities together: By engaging in healthy activities together, you will both be able to access a relaxed environment that can allow for positive communication.
- Attend therapy with them: Attending sessions with your loved one can help provide missing information, foster communication surrounding the symptoms, and allow them a supportive space to discuss their concerns.
Final Thoughts
Experiencing and living with dissociative amnesia may carry many complex emotions, including frustration and depression. Thankfully, you are not alone; others had come before and managed to reconnect with who they once were. Suppose you think you may be experiencing dissociative amnesia. In that case, seeking therapy and building a treatment team with your support system can help you stabilize and recover. There are resources and support groups for those experiencing these symptoms and those whose loved ones are experiencing them.
Dissociative Amnesia Infographics
