Dissociative amnesia: symptoms, causes and treatment

Dissociative amnesia is included in dissociative disorders. This involves not being able to remember relevant personal information, such as an event or one’s own identity. It usually appears as a result of a very traumatic or stressful event.

There are five different types of dissociative amnesia, depending on their manifestation. In this article, we will know the characteristics of this disorder, its symptoms, causes and possible treatments.

    What is dissociative amnesia?

    Dissociative amnesia is a type of dissociative disorder that appears as such in the Diagnostic Manual of Mental Disorders (DSM). It only takes one episode of amnesia to diagnose it (although more may appear).

    Dissociative disorders include a number of psychological alterations that involve a disconnection or disruption in the processes of memory, identity, perception and / or consciousness. In other words, they imply a lack of continuity in some (or between some) of these aspects or processes of the person.

    symptoms

    The main symptom of dissociative amnesia is a significant impairment in the ability to remember important personal information. One or more episodes may occur, although only one is needed to diagnose dissociative amnesia.

    Usually, forgotten information is traumatic or stressful in nature. This inability to remember is too broad to be explained by ordinary or “normal” forgetting. The symptoms cause the person significant discomfort or interfere with their life and functioning.

    In addition, in order to be able to make the diagnosis, this alteration that occurs in the ability to remember, it does not occur exclusively in another mental disorder, Such as dissociative identity disorder, dissociative leakage, post-traumatic stress disorder (PTSD), somatization disorder, etc.

    Amnesia is also not caused by the direct effects of a psychoactive substance (drug) or medication, nor is it explained by any medical or neurological disease.

      Characteristics

      The information “lost” or forgotten in dissociative amnesia is usually part of a person’s conscious awareness, that is, it is their autobiographical memory that is affected. However, even if the person is not able to access this information, it can continue to influence behavior.

      For example, think of a woman with dissociative amnesia who was raped in an elevator and cannot take it back even though she is unable to remember the event.

      The 12-month prevalence of dissociative amnesia is approximately 1.8%; it is more common in women (2.6%) than in men (1%).

      the causes

      Dissociative disorders are usually the result of a reaction to an extremely stressful or traumatic situation (trauma); they emerge as a defense mechanism for the person (albeit inadequate), to “protect” him from memories that are too traumatic or difficult to process.

      These are reactive responses to external situations, but taken to the extreme and dysfunctional; thus, when these responses become troubles, they logically become maladaptive responses.

      Thus, dissociative amnesia it usually occurs due to highly traumatic situations that the person lives and is unable to functionally process. These traumatic or stressful experiences may be experienced directly (eg, sexual abuse) or may simply be observed.

        type

        Dissociative amnesia can be of five types: localized, selective, generalized, systematized and continuous.

        1. Localized amnesia

        Localized amnesia involves not being able to remember a specific event or a specific period of time. These are specific gaps in memory and are linked to trauma or stressors. In this case, the amnesia can last for hours, days or more. Usually, the forgotten period varies from a few minutes to several decades, but the characteristic here is that the period is clearly demarcated.

        2. Selective amnesia

        This second type of dissociative amnesia it is a question of forgetting only a few events (Or specific parts of them) over a period of time. It can appear in conjunction with the above.

        3. Generalized amnesia

        Here, the memory problems are much more important and patients may be made to forget their own identity and life history. Some of them cannot even access the skills learned and even lose the information they have about the world. Its appearance is sudden.

        It is less common than previous ones and more common among veterans, sexually assaulted people, and people who have experienced extreme stress or conflict.

        4. Systematized amnesia

        In this case, the person forgets information of a specific category or nature, For example, information about the sound surrounding an event, about a specific person, visuals, smells, etc.

        5. Amnesia continues

        In continuous dissociative amnesia, people forget information from a specific moment to the present (Including the present). That is, retrograde (past) and anterograde (present) amnesia occurs.

        In this case, most patients are aware (or in part) of their memory gaps.

        treatment

        The treatment of dissociative amnesia includes psychotherapy and certain types of drugs (antidepressants, anxiolytics), the latter being complementary to the psychological intervention, ideally they should be used in this way to facilitate the psychotherapeutic work, to which the patient is more quiet to be able to access it.

        Psychological therapy will have as one of its objectives that the person can process and understand what he has experiencedWe will therefore have to work on the event and the psychological consequences it produces.

        People with a picture of dissociative amnesia may appear confused and anxious; others, on the other hand, may be indifferent. It will be crucial to work with empathy and flexibility.

        Bibliographical references:

        • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
        • Belloch, A .; Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.
        • Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Flight. 1 and 2. Madrid. 21st century (chapters 1-8, 16-18).

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