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What is HPPD (Hallucinogen Persisting Perception Disorder)?

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Imagine seeing trails of light or distorted patterns long after a party is over and the drugs have worn off. This is what some people experience with Hallucinogen Persisting Perception Disorder, or HPPD. HPPD is a condition where people have visual disturbances even when they are no longer using hallucinogenic substances. In other words, the person experiences “flashbacks” to when they were under the influence. 

In this article, we examine what causes HPPD, its symptoms, how it is diagnosed, and ways to manage and prevent it. Knowing what it is and how to deal with it can help those who are struggling with this disorder.

What Causes HPPD?

Hallucinogens are psychoactive substances that change the way you see, hear, and feel things around you. Common hallucinogens include lysergic acid diethylamide (LSD) and psilocybin mushrooms, affectionately known as ‘shrooms’. These substances can make you see colors and patterns that aren’t really there, and they work by changing how your brain processes information. When you take a hallucinogen, it affects certain chemicals in your brain, like serotonin, which is a neurotransmitter that helps regulate mood, perception, and other functions.

Hallucinogens bind to serotonin receptors, particularly the 5-HT2A receptor, altering the normal activity of your brain’s visual and sensory pathways. This causes the intense and vivid sensory experiences that are characteristic of a hallucinogenic trip. The brain becomes hyperactive, creating and misinterpreting sensory signals, which leads to hallucinations.

Sometimes, these changes can last long after the drug has worn off, leading to HPPD. Scientists believe that HPPD happens because these drugs can cause lasting changes in the brain’s visual system. Prolonged activation and alteration of serotonin receptors may lead to changes in how the brain processes visual information. This means that even after you stop using hallucinogens, your brain might still process visual information differently.

Researchers have identified two types of HPPD: Type 1 and Type 2. Type 1 HPPD involves short, sporadic flashbacks, while Type 2 HPPD is more long-lasting, intense, and troubling–potentially lasting for years after use.

The number of people affected by HPPD is hard to determine because many individuals who have used hallucinogens might not feel comfortable discussing it with their healthcare providers. Additionally, despite being accepted as an actual medical diagnosis in diagnostic manuals and medical curricula, many doctors might not be well-versed in recognizing–let alone treating–HPPD.

Due to the limited number of officially diagnosed cases, research on HPPD is scarce, which means that medical professionals and researchers have a limited understanding of the condition.

Symptoms of HPPD

People with HPPD often face a variety of visual disturbances, such as:

  • Enhanced colors: Objects may appear more vivid and brighter than usual.
  • Color flashes: Unexpected bursts of color may appear in your vision.
  • Getting colors confused: Differentiating between similar colors can be challenging, and sometimes colors may seem switched. For example, something red might look like a different color to you based on what others see.
  • Size distortion: Objects in your side vision might appear larger or smaller than they really are.
  • Halos: A glowing border may form around objects you are focusing on.
  • Tracers: Moving objects may leave behind a trail or afterimage.
  • Geometric or kaleidoscope-like patterns: You might see shapes and patterns that aren’t actually there, like perceiving a grid pattern in the leaves of a tree.
  • Perceiving images inside other images: Seeing things that aren’t present, like spotting snowflakes in a window.
  • Reading difficulties: Words might appear to move, shake, or become scrambled, making it tough to read.
  • Discomfort: You might feel uneasy knowing that what you’re seeing isn’t real, leading to feelings of discomfort or embarrassment.

The exact mechanism behind HPPD flashbacks is not well understood, and they can occur unexpectedly. These flashbacks are typically less intense and shorter than the experiences brought on by the original hallucinogen use.

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Non-visual symptoms include:

  • Depression
  • Anxiety
  • Suicidal ideations

Undoubtedly, these feelings are likely related to the stress of dealing with constant visual changes or worries about mental health.

Diagnosing HPPD

If you start experiencing hallucinations without a clear cause, it’s important to consult a doctor. Any hallucinatory episodes are concerning, especially if they happen frequently. It’s important to differentiate HPPD from other mental health issues. Some conditions, like anxiety or schizophrenia, can cause similar symptoms. 

Diagnosing HPPD involves meeting certain criteria. A doctor will look for persistent visual disturbances that started after using hallucinogens. You’ll usually undergo a thorough medical workup to make sure the symptoms are not caused by another medical condition. They may also perform an electroencephalogram (EEG) to monitor your brain’s electrical activity. Getting an accurate diagnosis is crucial for finding the right treatment plan and support.

If you have a history of using hallucinogenic drugs, it’s essential to tell your doctor. Their primary concern is to help you manage and treat your symptoms, not to judge your past or current drug use.

Preventing HPPD

Preventing HPPD starts with safe practices when using hallucinogens. If you choose to use these substances, it’s important to be aware of potential risks and use them responsibly. Avoid mixing substances, use them in a safe environment, and always have a trusted friend with you.

Mental health awareness is also crucial. Understanding how hallucinogens can affect your brain and mental health can help you make informed decisions. It’s important to be in a good mental state before using these substances, as pre-existing mental health issues can increase the risk of developing HPPD.

If you start to notice symptoms after indulging in hallucinogens, talk to a medical professional about your experiences. Early intervention can help manage symptoms and may prevent them from getting worse.

Key Takeaways

Although it is rare, if you or someone you know is experiencing symptoms of HPPD, it’s important to seek professional help. Additionally, practicing safe habits when using hallucinogens and being aware of pre-existing mental health issues that make you susceptible to unwanted flashbacks can help you make informed decisions. 

Remember, early intervention and a strong support system are key to dealing with HPPD. Stay informed, stay safe, and don’t hesitate to reach out for help if needed.

Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.



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