All the information from your eyes, ears, and other senses tells you that you are living through an event for a second time. However, in HPPD, they tend to be less intense — it is mostly vision that is affected, rather than the other senses.
They can be frustrating if they occur frequently. To date, scientists still do not know exactly how or why they occur. Researchers are still working on the question. Some people with HPPD experience visual disturbances alongside other symptoms. These may include:. Depersonalization disorder is a mental health condition where a person may feel like:. Researchers do not fully understand how these conditions relate to HPPD, but many report that they experience them alongside visual disturbances.
Researchers believe that people are at risk of experiencing HPPD if they take hallucinogenic drugs recreationally. However, they do not yet understand the type or frequency of drug use that causes it. There are also reports of people who have only used hallucinogens once or twice experiencing similar symptoms. HPPD is not caused by brain damage or a mental disorder.
There are some other conditions that could be the cause. As such, the doctor may ask a number of questions to reach a diagnosis. It is important to be open and honest about any past drug use, to help the doctor reach the correct diagnosis.
The doctor is there to provide the best course of treatment and not judge lifestyle choices. Most doctors do have an awareness of HPPD as a condition. Fatigue and stress may also trigger an episode. Talk therapy could be a helpful coping option. A therapist or psychologist can help you learn how to respond to stressors when they occur. HPPD is rare. Not everyone who uses hallucinogens will actually develop HPPD. Some people experience these visual disturbances only once after using hallucinogenic drugs.
For others, the disturbances may occur frequently but not be very bothersome. Learn more: A breakdown of microdosing. Some people who take LSD enjoy and relish the unpredictable nature of the drug's effects. Others prefer knowing exactly what to expect.
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Individual or family histories of anxiety and pre-drug use complaints of tinnitus, eye floaters, and concentration problems may predict vulnerability for HPPD. Future research should take a broader outlook as many perceptual symptoms reported were not first experienced while intoxicated and are partially associated with pre-existing psychiatric comorbidity.
Abstract Hallucinogen persisting perception disorder HPPD is rarely encountered in clinical settings. Other, non-visual symptoms can include recurrent synesthesias, dissociation, auras, depersonalization, and derealization [3]. Accompanying these hallucinations and sensory disturbances, the patient may report severe anxiety, which can escalate to full blown panic attacks [1].
There is usually a latent, asymptomatic period following the initial intoxication, before the onset of returning visual disturbances and other hallucinations. This latent period could range anywhere from minutes to years [11] [18]. The persistent hallucinations tend to be extremely long lasting, with waxing and waning intensity over a course of months to years [11] [18].
Patients may be distressed or anxious. The various aspects of HPPD are largely self-reported by the patient that is presenting. Importantly, other etiologies of this distress such as post-traumatic stress disorder, depersonalization, derealization, etc. Other causes of visual disturbances such as anatomical lesions, epilepsy, and schizophrenia must also be ruled out. Finally, an association between the first intake of the hallucinogenic drug and the onset of the HPPD symptoms must be established [19] [20].
The mainstay treatment of HPPD is pharmacologic management. These are generally considered to be the first line medications for treatment of HPPD. Second line medications include naltrexone, calcium channel blockers, and beta blockers [11]. Non-pharmacological management could include brain stimulation treatment, but this has not been fully substantiated or investigated.
The disease course is usually benign, non-distressing, and limited both in time course and severity. It may require treatment with medication, but the outcomes are generally very good. Some patients fail to adapt to the presence of these long-lasting, recurrent visual and sensory disturbances [11] [18]. There is a consistent subgroup within those patients with HPPD II that require constant pharmacologic intervention [11] [18].
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