Community Psychiatry’s Rashmi Parmar, M.D. was featured in The Healthy discussing Dissociative Amnesia.
Dissociative amnesia can steal memories from parts of your life or sometimes your whole autobiography. Here’s how it differs from dissociation and how unraveling the trauma that underlies the memory loss may help you get your life and your memories back.
Dissociative amnesia: A loss of memory
Imagine looking in the mirror and not recognizing the person staring back. Or imagine not being able to recall basic information about your life and lifestyle, like where you live or your partner’s name.
Sound like something out of a suspense novel or thriller? What’s known as dissociative amnesia is more than just a plot twist. At its most extreme, the condition can rob you of all your memories.
Or it may prevent you from recalling specific periods of your life or parts of a traumatic event. Most of the time people with dissociative amnesia have a history of physical, sexual, or emotional abuse, according to the National Alliance on Mental Illness (NAMI).
“Dissociative amnesia, also known as psychogenic memory loss, is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, which cannot be explained by normal forgetfulness,” says Rashmi Parmar, MD, a psychiatrist with Community Psychiatry in Newark, California.
Dissociative amnesia vs dissociation
Dissociation is feeling disconnected from your environment and the world around you. You can feel like you are detached from or even outside your body, or things around you aren’t real.
Dissociative amnesia is a type of dissociative disorder. People with a dissociative disorder can feel disconnected from the present world for hours or days. In rare cases, it can last as long as weeks or months.
These memory lapses are in stark contrast to episodes of dissociation that may occur in otherwise healthy people, Dr. Parmar says. “An easy example is when a person drifts into a daydreaming episode and loses track of time.”
With dissociative amnesia, however, the memory loss typically comes on suddenly and may last minutes, days, or even longer, she says.
Most people (75 percent) experience at least one dissociative episode in their lifetime during which they zone out or feel detached from their body. Of these, just two percent will go on to be diagnosed with a dissociative disorder such as dissociative amnesia, according to NAMI. Women are more likely to be diagnosed with a dissociative disorder than men.
In general, the symptoms of dissociative disorders can include an out-of-body experience, such as feeling like you are watching yourself in a movie (known as depersonalization); a sense of detachment or emotional numbness; a blurred sense of identity; and feeling like the world around you isn’t real (known as derealization).
The other main types of dissociative disorders include dissociative identity disorder (previously known as multiple personality disorder). This is marked by the emergence of distinct personalities that take over.
And depersonalization-derealization disorder is characterized by the persistent feeling that you are detached from your body and watching things unfold from the outside.
This involuntary response to emotional stress can also cause depression, anxiety, and other mental health problems.
Types of dissociative amnesia
There are three types of dissociative amnesia:
Localized: You’re unable to recall events that took place at a specific time.
Generalized: You experience complete memory loss and are unable to say who you are or recall anything that’s happened in your life. These cases are rare.
Fugue: You may leave your home and set out for parts unknown and forget your personal information. In cases that last weeks or months, you may assume a new identity.
When dissociative amnesia is accompanied by dissociative fugue, people may flee from their usual environment—home, school, or job.
“This is characterized by amnesia with [the] inability to recall one’s past and the assumption of a new partial or complete identity,” Dr. Parmar says. “It also sets in suddenly and often involves complicated travel.”
What causes dissociative amnesia?
Anyone can experience dissociative amnesia, but it’s more likely in people with certain risk factors than others. “It can occur in all age groups, but it’s harder to elicit in younger kids due to their limited ability to verbalize subjective experiences,” Dr. Parmar says.
When a person with a history of post-traumatic stress disorder (PTSD) is reminded of a past trauma, that can bring them into a dissociative state that resembles the one they experienced during the initial trauma, says John H. Krystal, MD, professor of translational research and chair of the department of psychiatry at Yale University School of Medicine in New Haven, Connecticut.
These reminders come in the form of flashbacks that often occur with PTSD.
Or “sometimes these individuals seem to be more sensitive to life’s stresses or unclear reminders of the trauma,” explains Dr. Krystal, who is also chief of psychiatry at Yale New Haven Hospital.
Dissociative amnesia and the brain
Exactly what goes on in the brains of people with dissociative amnesia is not fully understood. But studies of drugs that cause memory loss and other symptoms of dissociation have shed some light on the matter, Dr. Krystal says.
There appears to be a disconnect between the brain’s frontal temporal lobe and other parts of the brain. The temporal lobe controls the creation and preservation of memory. (This is what your brain looks like with PTSD.)
“With dissociative amnesia, you can’t access a memory that is so upsetting,” he says. “Even though you wish you could, at another level, you are avoiding it.”
There are times when people can remember parts of a story, but not the whole narrative, Dr. Krystal adds. “What you can’t remember can really prevent you from moving forward, and instead you are a victim of fragments of memories.”
For example, someone who was sexually abused may not recall the entire narrative, just bits and pieces. Because of this, “they may have lingering mistrust of romantic or sexual partners, and for reasons that they don’t understand, are extremely uncomfortable in a romantic situation,” Dr. Krystal says. This likely poisons relationships and stops them from going any further, he says.
Diagnosing and treating dissociative amnesia
These people may seek help because of memory issues, anxiety, and depression that can accompany them, or even problems in relationships that they can’t overcome, Dr. Krystal says. Making a diagnosis involves ruling out other potential physical causes of the lapses such as brain trauma, the seizure disorder epilepsy, stroke, or medication side effects, he explains.
Treatment typically involves a combination of psychotherapy and antidepressants or anti-anxiety medications, Dr. Krystal says. There is no specific drug treatment for dissociative amnesia. “Time is helpful and so is therapy,” he explains. Sometimes relaxation methods such as hypnosis or meditation can help people feel safe enough to access these painful memories.
Dr. Parmar says there are also specific forms of therapy that can help people overcome dissociative amnesia and prevent it from coming back. “Cognitive behavioral therapy may play a role in helping the person identify and address underlying cognitive distortions,” she says. This time-limited type of therapy helps change how you deal with stress and stressors.
Some people may recover spontaneously, she says. “Removal from the triggering stressor and provision of a safe environment to process the trauma or conflict can aid early recovery,” Dr. Parmar says. “In dissociative fugue states, the person will be able to remember their past and resume their original identity once recovered.”
The last word
With dissociative amnesia, you forget who you are. It can last for hours or—in rare cases—months. People with a history of trauma or abuse, especially as a child, face a higher risk of developing the mental illness. Overall, the outlook for people with dissociative amnesia is good. They’re able to recover their memories often without treatment. If you’re experiencing episodes, speak with a doctor about what course of treatment may be best for you.
Click here to read the entire article on The Healthy.