Living with HPPD: Causes, Challenges, and Coping Mechanisms FHE Health
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Remember, the doctor is not there to judge you but to help you find the right treatment to ease your symptoms. Flashbacks typically happen in the days or weeks following ingestion of the drug but can happen months or even years after the drug use has been discontinued. If you’re somebody with HPPD and would like to help out in an online survey study to understand the nature of HPPD experiences, please visit this page. You may find it helpful to check out the Fireside Project helpline, a charity organisation offering free and immediate peer support for those experiencing difficulties related to psychedelics. “It’s really important that people understand the risks of the drugs that they’re taking whether that be recreationally or therapeutically … and can make informed decisions,” Anneliese McConnell said.
According to DSM-5, Hallucinogen Persisting Perception Disorder is the recurrence of perceptive disturbances that firstly develop during intoxication. The contents of the perception and visual imagery range extensively 17,19. DSM-5 and previous DSM editions report a list of the most common symptoms experienced by HPPD patients, but only a few symptoms have been described in the professional literature. The main group of symptoms reported by Criterion A of the DSM-5 are visual disturbances. In fact, as in the vast majority of induced psychoses, visual hallucinations are notably more common than auditory 3. Regardless, every perceptual symptom that was experienced during intoxication may re-occur following hallucinogen withdrawal.
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A mental health professional can help to treat the anxiety that can accompany flashbacks, giving the person more of a sense of self-control. If you or someone you care about is experiencing intense and frequent flashbacks, you should visit your healthcare provider. It’s important to be honest about your current and past drug use, as well as any history of mental illness.
It is likely that those following the advice outlined in ‘What helps people with HPPD? Dr. Henry Abraham suggested in 2001 that half of people who saw him clinically recovered from HPPD within five years. ‘Folk wisdom’ in HPPD communities suggests that cultivating an attitude of ‘acceptance’ helps to prevent the symptoms overtaking sufferers’ lives. Accepting that the visual symptoms ‘are as they are’ in any one moment may be critical in reducing anxiety.
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It can be treated with a variety of different anti-epileptic and psychotropic drugs, but there are no studies to give a clear evidence base as to how effective the treatments are. Sheree da Costa lost her son Joey to suicide and believes he would still be alive if he hadn’t developed hallucinogenic persistent perception disorder (HPPD) as a teenager. The FHE Health team is committed to providing accurate information that adheres to the highest standards of writing. If one of our articles is marked with a ‘reviewed for accuracy and expertise’ badge, it indicates that one or more members of our team of doctors and clinicians have reviewed the article further to ensure accuracy. This is part of our ongoing commitment to ensure FHE Health is trusted as a leader in mental health and addiction care.
- We know little about how HPPD works and what exactly may be going on in the brain and beyond.
- If your doctor suspects another possible cause, such as side effects of a medication, they may request blood tests or imaging tests.
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You may feel a vague sense of unpleasantness, but the episode doesn’t typically make you lose control or function. Episodes of type 1 HPPD don’t come back as often as type 2 episodes typically do. With HPPD type 1, you’re more likely to have a “warning aura” before your episode. This is a feeling of self-detachment (numbness to your emotions) or confused state that happens before you start having symptoms. Narcolepsy-cataplexy syndrome, a rare type of sleep disorder that can cause hallucinations just before you fall asleep or when you wake up.
- However, more research is needed to understand exactly how hallucinogens work.
- Flashbacks are not usually as intense or long-lasting as an actual drug experience, usually lasting just seconds or minutes, and are easier to control mentally than intoxication or a bad trip.
- This means someone may experience persisting perceptual effects after a psychedelic trip without having HPPD.
- Talking about the experiences can help a person with HPPD process their own feelings and may reduce anxiety and stress about having the condition.
Long-term recovery from HPPD means taking medications that can ease the experience of pseudo flashbacks and engaging in a lifestyle plan that supports mental health and wellness. A dosage of 0.75 mg/die of Clonidine has been evaluated as a treatment option for nine HPPD patients 51,59 Drug rehabilitation (Table 4). The total remission has been reported in a single patient with flashbacks and anxiety treated with 0.25 mg of Clonidine three times a day for two months 59. Lofexidine (0.2–0.8 mg/day) is a sympatholytic centrally acting α2 presynaptic adrenergic agonist that showed similar efficacy in some cases 23,65,66. The physical symptoms of HPPD are a type of “flashback” similar to what you might experience with post-traumatic stress disorder (PTSD), except it’s visual and not always distressing.
A guide to HPPD treatment
Some individuals may have a predisposition to developing HPPD due to their unique neurobiology or genetic makeup. Further research is needed to fully elucidate the causes of HPPD and the factors that contribute to its development. The duration of HPPD varied from less than one year to over 10 years. Many people feel that HPPD is just another myth created by the (failed) War on Drugs. HPPD is not something to be ignored, or swept under the rug, no matter how positive I am about psychedelics personally. HPPD is also treated with several types of medication, through regimens that should be tailored to each individual.
- However, taking certain medications can worsen symptoms in some people.
- Hallucinogen Persisting Perception Disorder is a DSM-5-listed condition in which people experience lasting, debilitating changes to their visual perception after using drugs, especially psychedelic drugs.
- This means that ‘noise’ that would otherwise be filtered out may remain in the field of vision.
- Hallucinogenic persisting perception disorder is characterized by the recurrence of visual phenomena caused by psychedelic drugs for days, months, or even years after the trip.
Most people experience HPPD symptoms as a flashback (a past incidence that recurs vividly in the mind) or a benign re-experiencing of the initial drug-induced experience. Research has indicated a potential correlation between HPPD and other mental health conditions. Conditions such as anxiety disorders, depression, and substance use disorders may co-occur with HPPD.
The frequency of recurrence of perceptual distortions is lower for HPPD I than HPPD II 18. Prior substance users can voluntarily elicit or produce visual disturbances with or without known triggers 4,17,18. After HPPD II onset, hallucinogenic events tend to occur more frequently, and their duration and intensity increase. The distress caused by HPPD can lead to feelings of frustration, hopelessness, and isolation. It is not uncommon for individuals to experience anxiety or depression as a result of their ongoing condition and the impact they have on daily functioning.
Research shows that if you live with depression (with or without anxiety), HPPD symptoms may last longer for you and treatment may not work as well. Researchers are looking into whether brain stimulation may work as a way to relieve HPPD symptoms, but studies are still ongoing. When you have one, the vision or experience of a past event springs into your mind suddenly. Often, these are negative events that feel intrusive, unwanted, and unpleasant.
