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Dissociative amnesia: causes, symptoms, diagnosis, treatment
Last reviewed: 18.10.2021
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Dissociative amnesia is an inability to recall important personal information, and this inability is so clearly expressed that it can not be explained by ordinary forgetfulness. The cause is usually trauma or severe stress. The diagnosis is based on anamnestic information after excluding other possible causes. Treatment consists of psychotherapy, sometimes in combination with hypnosis or medications that facilitate interviews.
The information lost is usually part of the conscious, which can be described as an autobiographical memory; who he is, what he did, where he went, with whom he said what he said, thought, felt. Forgotten information sometimes affects behavior.
The prevalence of dissociative amnesia is unknown, but most often it occurs in young people. Amnesia appears as a result of a traumatic or stressful event that a person (for example, physical or sexual violence, fighting, lack of natural disasters, death of loved ones, financial problems) or an intolerable internal conflict (for example, a pronounced sense of guilt, obviously insoluble internal problems, criminal behavior).
[Symptoms of dissociative amnesia
The main symptom is memory loss. It is characteristic that there are one or more episodes, when some patients forget some events observed in this period of time, but not all; other patients can not remember anything. These periods, or failures in memory, can affect several hours or take several years, even a lifetime. Usually the forgotten period of time is clearly limited. If you observe the patient soon after the development of his amnesia, then he may look confused and depressed. Some patients experience severe anxiety, while others are indifferent.
To accurately diagnose a medical and psychiatric examination is necessary, including blood and urine tests to eliminate the toxic causes of this condition, such as the use of banned psychoactive substances. EEG study helps in eliminating epilepsy. Psychological testing can help in describing the origin of dissociative experiences.
The prognosis and treatment of dissociative amnesia
Most patients recover, and their memory is restored. At the same time, some patients remain unable to recall forgotten events. The prognosis is primarily determined by the life circumstances of the patient, especially the stresses and conflicts associated with amnesia, and the overall mental fitness of a person.
If memory is lost for a short period of time, then of all treatments only supportive interventions are sufficient, especially if the complete restoration of memory for any painful events is not clearly necessary. The treatment of more severe memory loss begins with the creation of a safe and supportive environment. Sometimes these activities are enough for the gradual restoration of lost memory. If this does not occur or if immediate memory recovery is required, then effectively using the patient's questionnaire in a state of hypnosis or less often in a similar hypnosis state caused by medications (metohexital). These approaches are used very carefully, because at the same time, memories are restored of the circumstances that led to the loss of memory, which can be very woeful. The person making the survey should carefully formulate the questions in order not to inspire the existence of any event and to avoid the risk of forming false memories. The correctness of memory recovery under such strategies can only be determined by external confirmation. On the other hand, ignoring the consistency of the presentation, immersion in the memory gap is also probably useful in restoring the continuity of the patient's identity, his self-consciousness and the creation of a cohesive narrative. When amnesia is eliminated, treatment helps assess the underlying conflict or trauma to resolve problems associated with the amnestic episode.