Types, causes and treatment of amnesia

Amnesia is a disease in which symptoms of memory impairment are clearly observed, in which a person is often unable to remember part of the events or information from the past. Amnesia manifests itself mainly in the partial loss of memories, and not in complete, when a person is not even able to remember who he is.

With amnesia, a person has difficulty remembering any new information. The disease can appear suddenly and is often temporary. Memories gradually begin to return to the patient in chronological order. Memory loss that preceded amnesia usually does not return.

Today, there are quite a lot of cases registered when a person purposefully wants to get rid of some memories from the past. Before answering the question of how to cause amnesia and what provoking factors can cause it, first let’s look at how the types of amnesia exist today.

Types of amnesia

1. Retrograde amnesia
   - the patient does not remember events that occurred before the onset of amnesia.
2. Anterograde amnesia
   - the patient loses the ability to remember events that occur after the onset of the disease (provoked, for example, by trauma or stress). At the same time, he can remember everything that happened before.
3. Anterograde amnesia
   is a combination of anterograde amnesia and retrograde amnesia. The patient may suffer from both retrograde and anterograde amnesia due to damage to the middle temporal zones and especially the hippocampus.
4. Fixation amnesia
   is a memory impairment for current (more than a few minutes) events. A component of Korsakoff's syndrome.
5. Congrade amnesia
   is complete or partial amnesia, which is limited only to events during the acute period of the disease. Occurs in oneiric syndrome, some forms of delirium, coma, stupor, stupor.
6. Korsakoff's syndrome
   is a severe fixation, anterograde and retrograde amnesia due to a lack of vitamin B1 in the brain, combined with other symptoms. The cause is most often alcoholism, although other causes, such as severe malnutrition, can lead to the same syndrome.
7. Dissociative amnesia
   - amnesia, in which facts from personal life are forgotten, but memory for universal knowledge is retained. Dissociated amnesia is usually the result of mental trauma.
   Localized amnesia
   is a memory impairment of only one modality, all others remain intact. Such disorders arise as a result of damage to the corresponding part of the brain. For example, with agnosia, recognition of previously familiar objects is impaired, with apraxia, previously acquired motor skills are impaired, and with aphasia, memory for words and speech is impaired.
8. Selective amnesia
   - the patient forgets some of the events that occurred during a limited period of time, but retains memory for universal knowledge. As a rule, such cases are associated with mental trauma received as a result of these events.
9. Generalized (global) amnesia
   - the patient forgets everything that happened in a limited period of time and some events that happened before that.
10. Continuous amnesia
    - the patient stops remembering new events, and also forgets some of the old ones. This is extremely rare with dissociative amnesia.
11. Dissociative fugue
    is a more severe disease than dissociative amnesia. Patients with dissociative fugue suddenly leave for another place and there completely forget their biography and personal data, even their name. Sometimes they take on a new name and a new job. The dissociative fugue lasts from several hours to several months, occasionally longer, after which patients just as suddenly remember their past. At the same time, they can forget everything that happened during the fugue.
12. Childhood amnesia
    is the inability to remember events in infancy and early childhood, common to all people. The reasons are probably the underdevelopment of the corresponding areas of the brain.
13. Post-hypnotic amnesia
    is the inability to remember what happened during hypnosis.
14. Catathymic amnesia
    - the patient forgets only certain persons and events that are associated with special experiences.
15. Progressive amnesia
    is amnesia that spreads from later to earlier events.
16. Retarded amnesia
    is “delayed” amnesia, when events that took place do not disappear immediately, but only some time after the illness.
17. Stationary amnesia
    is a persistent memory loss that does not change over time.

Step-by-step diagnostic algorithm

Many experts believe that the most effective way to bring back the memory of the previous evening is to completely immerse the patient in hypnosis. However, not all individuals succumb to it.

Speaking about clinical methods, the following tests and procedures for recording alcoholic amnesia are distinguished:

1. The patient's blood is analyzed for the amount of ppm alcohol.
2. Vitamin B1 helps restore memory in weak cases.
3. To diagnose alcohol amnesia, a specialist must make sure that the drinker has no previous head injuries and does not have dementia.
4. The duration of drinking alcohol-containing drinks is specified.
5. The doctor uses special questionnaires to rule out prolonged and extensive amnesia. These could be questions about relatives, school curriculum, what year it is, the president, date of birth, etc.
6. In particularly complicated cases, brain tomography and duplex scanning are performed.

A detailed blood test for toxins , which can also show the presence of drugs or narcotic substances, can give an accurate answer about amnesia.

Much also depends on the age of the patient. People over 50 years of age are more prone to memory loss after alcohol intoxication.

Diagnosis is individual for each patient; it is impossible to talk about exact steps. It is usually diagnosed by a psychiatrist, neurologist and narcologist.

Psychogenic amnesia

They do not have an organic basis and arise as a result of the action of protective mechanisms.

• Post-hypnotic amnesia.

• Hysterical amnesia - the development of the concept of hysterical amnesia is associated with the names of Jean-Martin Charcot, Pierre Janet, Joseph Breuer and Sigmund Freud. It is necessary to distinguish between hysteria of traumatic origin (caused by mental trauma or experiences of extreme stress) and hysteria as a transference neurosis associated, according to early psychoanalytic concepts, with internal structural conflict and regression of libido to objects of the oedipal phase of development. Hysterical amnesia of a traumatic nature is caused by the action of the protective mechanism of dissociation. Amnesia in hysterical transference neurosis is caused by the action of repression aimed at representatives and derivatives of the conflict drive.

According to the concept of Charcot and Breuer, when experiencing a traumatic situation, some people experience a so-called hypnoid state - a state of self-hypnosis. In this altered state of consciousness, the encoding of memory elements corresponding to the experience of a given situation occurs. In some cases, these memories, which form an independent structure that does not have associative connections with the rest of the system of autobiographical memories, cannot be reproduced arbitrarily. Access to them is possible only in an altered state of consciousness, which is achieved using hypnotic and trance techniques.

Amnesia caused by the action of repression can be overcome, according to psychoanalytic concepts, through awareness of the repressed material. The latter is achieved through the use of the method of free associations in analytical work.

• Fugue amnesia is amnesia of a dissociative nature. This type of psychogenic amnesia occurs during dissociative fugue - a reaction of flight in a situation of mental trauma or extreme stress. The main feature of a dissociative fugue is sudden, unplanned departure. The dynamics of a dissociative fugue are characterized by passing through the double barrier of amnesia. The first amnestic barrier occurs immediately after the onset of the fugue, with important personal information and memories related to the individual's past life remaining behind the barrier. The first amnestic barrier corresponds to a change in the individual’s personal identity. The second amnestic barrier occurs after the cessation of the fugue state, when memories remaining behind the first amnestic barrier return and memories of events that occurred during the fugue state are dissociated. When passing the second amnestic barrier, the “fugue” personal identity is lost and the individual’s previous identity returns.

• Multiple personality disorder is a dissociative disorder whose main etiological factor is chronic childhood trauma in the context of a relationship with a significant adult (usually parents or surrogates). Multiple personality disorder (or DSM-IV dissociative identity disorder) is sometimes misdiagnosed as schizophrenia
  . Multiple personality disorder is characterized by multiple episodes of amnesia both for a number of traumatic situations in childhood and for events that occurred during the so-called switches, that is, when one alter personality ceded control over the individual’s behavior to another alter personality. As with dissociative fugue, amnesia in multiple personality disorder is usually dissociative in nature. Dissociative amnesia in the vast majority of cases (if, for example, they are not accompanied by disturbances in the functioning of the corresponding parts of the brain) is reversible. Recovery of dissociated material is usually complete and occurs either spontaneously or through the use of hypnotic and trance techniques.

Treatment options

Amnesia is treated based on the factors that led to its development. For the organic form of the disease, drug therapy is usually prescribed; for the psychogenic form, psychotherapeutic therapy is prescribed.

1. For organic lesions, vascular agents, antiplatelet agents, and vasodilators can be prescribed. Prescribed to improve cerebral blood flow and tissue supply.
2. Memantines are effective in the presence of Alzheimer's disease.
3. Antioxidants and neuroprotectors are prescribed to optimize neuronal metabolism, increase resistance to adverse effects and hypoxia.
4. Anticholinesterase drugs are prescribed to slow down progressive dementia in older people.
5. Nootropics are prescribed to stimulate cognitive abilities and activate metabolism in cerebral tissues.
6. Psychotherapeutic methods of influence can be prescribed, which are aimed at adapting the patient to the presence of loss of memories. Sometimes hypnosis is used to restore some forgotten events.
7. If there is a cerebral tumor or hematoma in the brain, neurosurgery may be prescribed.
8. If a person has a psychogenic form of amnesia, then therapy can be represented by the following methods:

• creative therapy - suitable for patients who have a closed character, unable to demonstrate their thoughts and feelings, carried out through art and fairy tale therapy;
• drug therapy can be prescribed if the patient has anxiety, restlessness, depression, mental disorders; drugs from the groups of sedatives, antidepressants and antipsychotics are selected individually;
• psychotherapy - a cognitive-behavioral form is used (communication with a person in order to adapt to memory problems).

Impact on culture

Amnesia is often used as a plot device in works of fiction. The vast majority of cases describe retrograde amnesia. As a rule, portrayals of amnesia in films and fiction are unreliable: the hero loses memories of his personality, but retains skills and the ability to communicate.

Rare examples of characters with more or less reliably shown anterograde amnesia are the main character of the film “Memento” and Dory the fish in the cartoons “Finding Nemo” and “Finding Dory”[3][4]. The melodrama “50 First Dates” also shows anterograde amnesia, but, according to experts, it is unreliable[5][6].

Movies:

• Who am I? (1998)
• Remember (2000)
• Inside My Memory (2003)
• Deja Vu (1989)
• 50 First Dates (2004)
• Man Without a Past (2002)
• The Bourne Identity (2002)
• Before I Sleep (2014)

Anime:

• Ergo Proxy (2006)
• Ef: A Tale of Memories (2006)
• Tasogare Otome x Amnesia (2008)
• Golden Time (2010)

Manga:

• JoJo's Bizarre Adventure: Jojolion (2011 - present)

Video games:

• Arx Fatalis (2002)
• XIII (game) (2003)
• Second Sight (2004)
• Shadow The Hedgehog (2005)
• The Witcher (2007)
• The Witcher 2: Assassins of Kings (2011)
• Amnesia: The Dark Descent (2010)
• Amnesia: A Machine for Pigs (2013)

Prognosis and prevention

The most honest advice for frequent alcohol amnesia can only be a complete abstinence from drinking alcohol. A person should check whether he is suffering from alcoholism if he experiences memory loss after every party. Many patients who end up in drug treatment are not even aware of the presence of chronic alcoholism from their parents.

Memory loss is the first call to consult a neurologist or psychiatrist.

If there are no special problems with the health of the body and psyche, we can highlight a number of the following recommendations :

1. Amnesia occurs after a heavy dose of alcohol, therefore, you should not drink alcoholic beverages quickly. If you can have a drink or two, it's better to do so. The chance of leaving the party consciously doubles.
2. Snack – alcohol is quickly absorbed into the walls of the stomach, so the process should be slowed down by fatty and heavy foods. Fat coats the walls, preventing alcohol from being absorbed.
3. To avoid alcohol poisoning, you need to drink activated charcoal beforehand. A simple drug will help remove the remaining alcohol through the feces, reducing the chance of poisoning. A few hours before the celebration, activated carbon is taken in a dosage of 1 tablet per 10 kg of weight.
4. Tolerance of choice is an important point; in order to avoid poisoning and rapid loss of “oneself”, it is advisable not to mix drinks. The myth about increasing alcohol% has not been proven. Any confusion will lead to amnesia. There is a high probability of poisoning from low-quality alcohol.
5. Consumption control - you can set an alarm when you should stop and stop drinking on time. A good way to control yourself during a fun party, especially if you know your limits.

The limits of alcohol intoxication are different for men and women. The following indicators are distinguished:

1. Women - in order not to cause poisoning, loss of memory and dignity, experts allocate 30 g of alcohol. This is 1.5 liters of beer or 80 g of pure vodka. It is worth noting that if a woman drinks equally with men, she should divide the dose by 2 due to the characteristics of the body.
2. Men - the norm is 60 g of pure alcohol.

The norm may change based on the weight category and characteristics of the body . Drinking alcohol while being treated with drugs is completely dangerous.

Everyone has their own norm, which must be adhered to in order not to lose not only memory, but also dignity.

Alcohol amnesia can be controlled . Following the etiquette of drinking alcohol will help not to lose the memory and appearance of a well-mannered person. Every adult should know about this phenomenon so as not to get into an unpleasant situation.