Amnesia

A character developing amnesia in the middle of the plot is a favorite trope in both television and literature alike. Almost every major drama has had an episode (or an entire season) centered around a character who forgets major things about their life, such as who they are, where they live, who they love, and what their goals are (think *Bones*, *Charmed*, *Doctor Who*, etc.). In most stories, however, this amnesia is short-lived and always resolves by the end of the arc—but is that realistic?

Short answer: not really. Amnesia is a lot more complicated than most storytellers make it seem. It can have a myriad of different causes, and it can be long-term or even lifelong. Every person’s experience with it will be different, but it rarely has a convenient solution.

## What is Amnesia?

Amnesia is a condition that affects memory—namely, the partial or complete loss of memory.

However, most people assume amnesia *only* describes the loss of memory. There are many different types of amnesia, and many different ways it can affect diverse individuals. In some cases, it can also result in an inability to make new memories.

Amnesia can impact large parts of a person’s identity and personality or it can be a mere inconvenience at worst, depending on the severity and type the person experiences. It can be temporary, permanent, or progressive.

## Types of Amnesia

Contrary to popular belief, there are actually many different types of amnesia.

Here are the most common types of amnesia:

* Retrograde Amnesia
* Anterograde Amnesia
* Dissociative Amnesia

Each type of amnesia can vary in severity and duration. Sometimes amnesia will go away without treatment as the body and brain naturally heals, but sometimes it’s permanent. For one person, amnesia might be debilitating and pervasive, but for someone else, it could be hardly more than an inconvenience. It depends on the trigger, the type of amnesia, the individual, and the treatment and support they pursue after the fact. It’s also possible to suffer from more than one type at a time.

The following sections will define these individual conditions in more depth.

### Retrograde Amnesia

Retrograde amnesia describes a loss of existing memories.

This term applies regardless of if the amnesia happens suddenly and doesn’t get worse, or if it continues to get worse over time (called “progressive amnesia”).

If the amnesia is progressive, the person is likely to forget more recent memories first, while older memories stay intact for longer. However, that doesn’t mean the person is going to forget things in perfect reverse chronological order; more significant memories, such as a wedding day, a meaningful trip, or an incredible party, tend to be harder to forget.

### Anterograde Amnesia

Anterograde amnesia describes the inability to form new memories.

In many cases, anterograde amnesia is temporary. After a traumatic injury or other amnesia-inducing event, the brain requires time to heal. During this time, it may not be able to store new memories, thus leading to the person not being able to remember things following the event. This can last for weeks, and it can affect anywhere from a few memories to absolutely everything the person experiences after the event.

Permanent anterograde amnesia can be debilitating, but it is possible for characters to lead independent lives with this condition. They may simply make notes for themself often, set reminders and timers, and establish a support network with friends and loved ones. This, of course, depends on the severity of their amnesia.

### Dissociative Amnesia

Dissociative amnesia describes the loss of memories about the self and personal experiences, following a traumatic event.

Dissociative amnesia is an umbrella term used to describe many different ways amnesia can manifest as a result of emotional trauma or severe and debilitating long-term stress, such as abuse, war, natural disasters, accidents, and assault. It is possible for someone to experience more than one type at a time.

Here are the most common subtypes of dissociative amnesia:

* Localized amnesia: This describes a subtype of dissociative amnesia in which a person loses all memories relating to a specific event or period of time. The stress of the triggering event may cause that entire period of the person’s life to be forgotten, leaving a huge gap in the person’s memory.
* Selective amnesia: This describes a subtype of dissociative amnesia in which a person loses some memories relating to a specific event or period of time. If someone experienced a difficult childhood, they may remember some elements of their childhood (like neutral or good memories) but forget other moments that may have been traumatic.
* Generalized amnesia: This describes a subtype of dissociative amnesia in which a person loses memories about themself and who they are. They may forget their name, their history, their family, and anything else about their own identity. They may lose skills they previously had, such as the ability to paint or play an instrument. They may even lose basic life skills such as how to drive, cook, or tie their shoes.
* Systemized amnesia: This describes a subtype of dissociative amnesia in which a person loses all memories relating to a specific person, place, or concept. They may lose all memories relating to a place in which they were hurt, or they may lose all memories relating to a person who hurt them in the past.
* Continuous amnesia: This describes a subtype of dissociative amnesia in which a person has no memory of anything that takes place after a specific traumatic event. They will remember everything up to that point, such as important details about their own identity and history, but they will continuously lose new memories they make. This memory loss often includes the traumatic event itself, so the person forgets the trauma and everything that comes after it. This is the only type of dissociative amnesia that is anterograde in nature, with no significant retrograde amnesia accompanying it.

Dissociative amnesia operates like the brain’s self-defense mechanism against memories and experiences that are too difficult to manage, so it will always relate to the triggering event in some way. Sometimes, a person’s identity is so inextricable from the trauma that they experienced that elements of their personality can be forgotten as well.

## What Can Cause Amnesia?

As stated above, there are many different things that can cause amnesia. Some are more severe and permanent than others, but each one has the potential to result in that wrenching plot twist in which the hero forgets who they are.

### Injury

Injuries are the most likely cause of memory loss, and, understandably, the most often portrayed in media.

When a person sustains a Traumatic Brain Injury (TBI), they may get what’s known as post-traumatic amnesia, which can manifest as both retrograde and anterograde amnesia. If the injury isn’t severe, then the person’s memories will be restored once they have had the chance to recover. However, they will likely never remember the actual events that resulted in the injury, or those immediately preceding or following the injury.

However, it’s not just head injuries that can result in amnesia. Injuries that result in a lack of oxygen getting to the brain, such as being strangled or bleeding out, can also result in temporary amnesia. If the lack of oxygen is sustained enough to result in brain damage, then the amnesia can be permanent.

Additionally, the stress of being injured in any way can result in amnesia as well, even if the brain isn’t the part being damaged. A person may forget things about how they sustained the injury, like where they were, what they were doing, and how it felt. This is often for the best, however, and generally doesn’t interfere with a person’s life. It can, however, complicate an investigation if this character is a primary witness to a crime.

### Illness

Amnesia often manifests as a symptom of another condition, rather than being recognized as an illness in itself.

Epilepsy, dementia, Dissociative Identity Disorder (DID), stroke, tumors, encephalitis, and any other condition that affects the brain can result in periods of amnesia. Radiation poisoning can also result in amnesia (along with many other unpleasant side effects).

If you want to design your own illness with amnesia as one of the symptoms, you might enjoy reading another one of my articles: How to Create a Fictional Illness for Your Story.

### Medication

Sometimes, medications used to treat some illnesses can have amnesia as a complication or side effect. The most common culprits are antianxiety, antidepressant, antiseizure, antipsychosis, and antihistamine medications, along with narcotics and sleep medicines.

With most medications, the amnesia is anterograde, beginning from the moment the person starts taking the medication. It is also possible for the amnesia to be retrograde, slowly causing the deterioration of old memories the longer the person is on the medication.

Medications are unlikely to cause a sudden onset of amnesia, however, unless they are specifically designed to do that (such as anesthetics). Other times, serious complications of medications can result in amnesia, such as hypoxia, seizure, or stroke.

### Brain Surgery

Brain surgery is another favorite choice for writers who want to give their character amnesia. It’s inherently dramatic, given the high stakes of such a dangerous surgery, so it’s an excellent choice for anyone who needs to amp up the drama of whatever they’re writing.

After brain surgery, as with any surgery, there is likely to be some swelling around the site of the incision. This swelling causes pressure on the brain, which often results in temporary amnesia in the weeks following the procedure while the brain heals. This is so common, in fact, it’s expected and not inherently alarming.

It is possible that a certain degree of memory loss (both retrograde and anterograde) can persist long after the person recovers from the surgery. However, it is going to be less severe than the initial amnesia the person experienced in the first few days after the surgery.

Nothing even has to go wrong with the surgery for the amnesia to be permanent. If the character has a brain tumor, for example, some parts of the brain may need to be removed for the surgery to be successful.

### Stress

Both acute and sustained stress can result in amnesia.

A single traumatic event can trigger a person to dissociate, leading them to block the traumatic event and surrounding details from their memory. This is subconscious, and not in any way a deliberate choice on their part.

Similarly, prolonged stress, coupled with lack of sleep and other poor habits that develop as a consequence of the stress, can cause a person to reach a psychological breaking point and shut down. This can also result in episodic or long-term dissociative amnesia. In this case, a person has better odds of recovering quickly and completely when compared to someone who experienced severe acute stress—as long as the cause of the stress is remedied first.

### Alcoholism

Blacking out after a night of drinking is actually a kind of acute anterograde amnesia that the vast majority of adults have experienced at least once in their lives.

Alcohol inhibits the brain’s ability to make and store new memories as they occur, and as a person drinks more, this effect becomes more pronounced. Drunk people aren’t very good at remembering things. If you’ve ever had more than a few drinks in a single evening, then this information is probably not surprising to you.

However, chronic alcohol consumption can cause significant and permanent impairments in the brain. Alcoholism can result in brain damage that can cause both retrograde and anterograde amnesia over time. If the person continues to abuse alcohol, then their ability to recall old memories *and* make new ones will continue to deteriorate.

For help writing drunk characters, you can take a look at another one of my articles: How to Write a Drunk Character.

### Old Age

Old age is another major cause of amnesia—and not just because of dementia or Alzheimer’s disease.

As a person ages, it’s normal for them to develop mild memory problems, contributing to forgetful behavior, difficulty learning new skills, and foggy memories. Of course, the extent to which this occurs varies wildly per person, but in most cases, this won’t be the severe and dramatic kind of amnesia that makes for good fiction.

### Magic

As always, if your story utilizes magic in any capacity, you can have a bit more flexibility. A character who has been magically affected or cursed may forget very specific things, but they might have equally magical solutions to their amnesia. This, obviously, is not going to work for every story.

## Is it Possible to Recover from Amnesia?

Ultimately, yes, it is possible to recover from even severe forms of amnesia—but it’s not a guarantee.

A character’s likelihood of recovering from amnesia depends on a myriad of factors.

You should consider amnesia to be a *symptom*, not a condition in itself. The character’s odds of recovering from their amnesia are going to be primarily dependent on what caused the amnesia in the first place. If the underlying condition cannot be cured, then the amnesia it caused is not likely to ever go away completely—but the inverse is also true. If, for example, the amnesia was caused by a tumor in their brain, then they might make a complete recovery once the tumor is removed. (There could also be complications with that as well, but you can read about that above in the “Brain Surgery” section.)

Amnesia might also not go away even when other symptoms of the trauma they endured subside. A character who suffered a severe concussion may recover in some regards, such as no longer having pain, light sensitivity, or bruising, but they may still have brain damage and subsequent amnesia that never goes away.

If you want your character to make a full recovery by the end of the story, you need to be thoughtful about how you give them their amnesia in the first place. If the character sustains a minor injury or undergoes some kind of surgery, then they might be fine if given time to heal. If, however, their amnesia is caused by severe brain damage (from physical trauma, alcoholism, etc) or chronic illness, then they likely *will never fully recover.*

## How to Write a Character with Amnesia

In order to write a character with amnesia well, you have to start with a character who is well established and fully fleshed out. You need to know what the character has forgotten and what that means to them (and the people they love), otherwise, you won’t be able to write about their experiences meaningfully. If you don’t know anything more about the character than what they know about themself, and you think you can just figure it out as you go along, that’s going to reflect poorly on your writing.

Creating a character from scratch is always a difficult thing to do on command, so you can check out my other article, How to Make Characters Interesting, Complex, and Unique, if you want a quick checklist and some pointers.

Once you’ve nailed down all the details of your character’s personality and past, you can move on to figuring out how their amnesia manifests.

### How Did the Character Lose Their Memory?

First things first: you need to decide *how* the character loses their memory. Do they dissociate after a traumatic event? Are they in a horrible accident and end up concussed? Do they develop brain damage as a result of almost drowning? Are they afflicted by some kind of illness that results in amnesia? Remember that the way they develop amnesia is going to influence how they experience it and if they have a chance of recovering from it.

In addition to figuring out exactly what happened, you should also establish *when* it happens. Does the character lose their memory halfway through the story, or does the story start with them already amnesiac? If the amnesia-triggering event took place before the beginning of the story, how much time has passed since then? Does the character (and by extension, the readers) actually know what happened, or is that a mystery to them?

Almost all triggers can result in either anterograde or retrograde amnesia (unless stated otherwise in the above sections), so you have a bit of freedom to decide which one primarily affects your character. Remember that a character can experience more than one type at a time—it’s actually more realistic that way, too.

### What Does the Character Remember; What Do They Forget?

Once you’ve determined the plot behind why the character has amnesia, you then have to decide what parts of their memory are affected. What do they remember? What do they forget? What comes back to them over time? What always feels vaguely familiar yet unknown to them?

If the character experienced a psychological trigger, then you need to determine how their amnesia relates to that particular trigger. Remember that dissociative amnesia is a tactic used by the brain to mask trauma that is impossible to cope with, so the amnesia a person develops as a result of psychological trauma will always relate to that trauma.

The character may forget another person, a place, a period of time, or only specific details about specific things. They may forget details about their own life, their hobbies, their personality, their friends, and their identity if any of that information has a chance of relating back to the traumatic event.

Alternatively, they may remember the triggering event but dissociate from their own identity to make the trauma feel more distant, as if it happened to someone else.

If the character experienced some kind of physical trigger, then the memories affected may be more random or relating to an area of the brain that was damaged. This kind of amnesia is likely to involve short-term memory and procedural memory, and it is far more likely to be anterograde than psychologically-triggered amnesia.

An amnesiac character may also instinctively know what to do with something despite not remembering what it is or that they are familiar with it. They might not remember they ever learned how to play piano, but they could still sit down and play their favorite song just like they always used to. Or, alternatively, they know they learned how to play the piano, but now they no longer remember how to do it.

Of course, physically traumatizing events are often psychologically challenging too, so a character could experience different kinds of amnesia as a result of both physical and psychological trauma from the same event.

It can help to take really extensive notes at this point. Take a look at your character’s backstory and personal information (you should have that written down somewhere. You do… right?). Pick out specific periods of time, details, and other relevant pieces of information you want the character to forget and highlight them. Remember to take notes about which pieces of information you want them to remember later, too. Reference these notes throughout the writing process to help keep the character consistent throughout the story.

### Where is the Character in Their Recovery?

If the amnesia-triggering event takes place before the beginning of the story, you should consider how much time the character has had to recover, and how successful their recovery has been thus far.

How much of their recovery is going to develop over the course of the story itself, and what has already happened? What will they remember over time, and what memories are gone forever? Has their progress plateaued, or are they still making strides with recovery?

It’s also important to consider what techniques the character employs to manage their amnesia. Do they obsess over taking photographs and videos of everyday things? Do they keep a diary? Do they set timers, reminders, and notes to help them remember to do things? Do they live with someone full-time who helps them with their daily life?

And of course, you need to decide: will they ever fully recover?

## How to Write About Amnesia Realistically and Respectfully

Amnesia, especially in its most severe forms, can be a terrifying condition to live with. It can have serious consequences for individual sufferers and their families.

As always, when you’re using a condition like this for your fictional story, you have to consider the ways you are portraying it. It isn’t some cheap trick that can be trivialized or turned into a joke. It’s not something that should be taken lightly.

With that said, good fiction often relies on difficult themes, and you shouldn’t shy away from writing about characters with amnesia. Just try to be conscious and understanding of the real people who suffer from this condition, and do your best not to misrepresent it.

I believe in you!