From Hollywood to Bollywood, one can find one too many movies based on characters that have simply loss recall of their identity. In real life, amnesia doesn’t exactly cause one to diminish memory of their own self but, people who suffer from amnesia finds it difficult to recall specific details, places and facts (Mayo Clinic Staff, 2017). Lapses of memory occur in many of us in different ways: tip-of-the tongue phenomenon (a.k.a. blocking), absentmindedness, misattribution, interference, decay and transience are some of the ways we forget information that is natural and is not caused by trauma (Lumen learning). Amnesia can be caused by medical and psychological factors alike. Stroke, encephalitis, coeliac disease, oxygen deprivation, medication, subarachnoid haemorrhage, brain tumour, seizure disorder, ECT and head injuries are a few medical related causes; being a victim of violent crime, sexual abuse, child abuse, victim of natural disaster, victim of terrorist act or being involved in combat can cause psychological trauma leading to amnesia (Barclay, 2017). To all types of amnesia there are a few common symptoms: confused and uncoordinated movements, inability to learn new information, false memories, disorientation, partial or total loss of memory and failure to recognise faces or places.
Amnesia can be mainly categorised into two forms, retrograde amnesia and anterograde amnesia. Recall the scenes from the movie ’50 first dates’ where the main character Lucy wakes up to a new day which in her memory is her birthday. When the day ends, and she slumbers all her memories of that day is forgotten and she rises next day to a repetition of activities done on the previous day. This is a clear case of anterograde amnesia, where hippocampus of the brain is affected by trauma resulting in inability to form new memories (Goodfriend Ph.D, 2012). Alcohol intoxication, medicines like benzodiazepine, inflammation of the brain tissue, strokes, car accidents or sport injuries can lead to brain injury causing damage to areas responsible of forming, encoding and retaining short term memory to long term. Those of whose short term memory is affected has to be monitored closely and need to undergo a battery of tests to observe their improvement as some will have permanent damage to declarative memory where recovery is highly unlikely (Wikimedia, 2020).
Retrograde amnesia is the opposite of anterograde: long term memory is affected where an individual is unable to recall some or most of the memory prior to trauma induced event (Imrpove memory). Episodic memory is mostly affected since trauma can damage temporal lobe and prefrontal cortex. Semantic memory and procedural memory are not affected; therefore, the affected individual is able to recall general information, perform daily functions and carry on with skills. In retrograde amnesia, one is unable to recall memory or incidents that are immediately prior to the trauma causing event, although older memories can be recalled easily than newer ones (The human memory, 2019). Factors leading to the cause of retrograde amnesia are mainly as follows:
- Traumatic injuries – contact sports, blow to the head, brain lesions;
- Psychological trauma – stress or anxiety triggering events;
- Infectious diseases – bacterial and viral infections;
- Surgery – neurosurgery performed to cure other illnesses;
- Electro convulsive therapy;
- Korsakoff’s Syndrome.
Diagnosis of retrograde amnesia can be done by CT and MRI scans to view the damage to the brain structure, EEG to monitor abnormal brain wave patterns and interviewing the patient to retrieve facts on autobiographic memory. Treatment on RA depends on each individual and the severity of each case. Spread of infections can be controlled by antibiotics and antiviral drugs, surgery or anti-seizure drugs helps reduce further damage to the brain and counselling with therapeutic techniques helps a person to recall repressed memories and restore forgotten information (HX Benefit Editorial team, 2012).
Apart from the two main categories of amnesia, there are a few other types namely transient global amnesia, infantile amnesia and dissociative amnesia. In TGA (transient global amnesia), an individual will be quite distressed due to disorientation regarding the place and time of when it occurs; an episode of short-term memory loss will take place without neurological indications; one will remember one’s self as well as family members and will not lose consciousness. A few factors like migraine, hypoxia, epilepsy and stress can cause for TGA to occur where the condition resolves on its own without the need for medical intervention (Genetic and rare diseases information centre, 2016).
Infantile amnesia (a.k.a. childhood amnesia) is one of the most common type that occurs in majority of the people. Average person might not remember autobiographical memory prior to the age of three to four years. Freud’s theory of psychoanalytic approach explains this as a repressed memory situation related to sexual stages of development (Bauer, 2008); development psychology enlightens this as the immaturity of the brain to encode information as well as how early emotional bond (monotropy) is formed during early development (Bowlby, 2017).
Dissociative amnesia (a.k.a. psychogenic amnesia) is generally followed by psychological trauma that occurs due to childhood abuse, stress, being a victim of war as well as due to genetic factors (Grohol, Psy.D, 2020). In psychogenic amnesia, past/personal information cannot be recalled, confusion of identity and place occur as well as anxiety and depression. Information is usually blocked out by the individual him/herself in order to avoid unpleasant memories causing overwhelming emotions. It is not caused by any medical factors and the individual will not be concerned about the loss of memory. Women are more affected by dissociative amnesia than men in general (Cleveland Clinic medical professional , 2016). Dissociative amnesia can present in the following ways:
- Generalized amnesia – forgets own identity including global knowledge;
- Selective amnesia – parts of the trauma induced event is forgotten;
- Localized amnesia – traumatic event is completely forgotten;
- Systematised amnesia – forgets specific individuals;
- Continuous amnesia – forgets each new event.
Psychotherapy, medical hypnosis, meditation and relaxation techniques will assist in treating people with DA which gradually will bring back repressed memory to the surface.