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tlehmbecker

HPPD or just eye problems?

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Greetings,

 

I stumbled across this forum/site while researching some mental issues I was/am having and basically I'm just looking for some answers and guidance. 

 

First and foremost, the already present mental illnesses. Severe anxiety and depression have been a fairly constant presence for me ever since my early high school days. I've managed and dealt with them for the most part, but within the last year they've taken a turn for the worse with almost weekly panic attacks and frequent suicidal ideation. Also, within the last 2 months or so it feels like I've been gradually losing touch with reality in the sense of continually questioning what is real and what is not.

 

Because of this I finally got in to see a psychiatrist. After the visit I was diagnosed with major depressive disorder, panic disorder and probable schizophreniform disorder (probable pending further diagnostic imaging and meetings, though he feels fairly confident that I have some sort of mild psychotic disorder). As a result, he prescribed me escitoprolam and risperidone for my symptoms, both of which I am supposed to start next week with low doses and tapering up to the effective dose over a few weeks (he emphasized that I may not need the full therapeutic doses of either medication if a lower dose is effective).

 

While I did mention my vision problems and illusory hallucinations, he attributed these to the anxiety and psychosis stating that they were my brain trying to make sense of a weird situation.

 

However, I think these visual problems are HPPD and not related to any of the diagnosed illnesses. I say this because a lot of my visual symptoms are similar to those of HPPD. Furthermore, I have experimented with drugs in the past, namely MDMA (100mg one time over this past summer) and THC (45mg orally once this past summer. Not enjoyable at all since I was just launched straight into the worst panic attack I have ever had). I also used to take 50-100mg diphenhydramine 3-5 times a week to help with sleep, something I haven't done since I started having these symptoms of mild psychosis and potential HPPD. These were all mentioned to my psychiatrist. A summary of my potential HPPD symptoms is below:

  • Lights appear to streak/downward beams come from lights, especially at night. Gets better when holding eyes wide open and when in bright areas.
  • Monocular double vision in both eyes (i.e. double vision still occurs when one eye is closed or covered) especially with brightly lit objects and where there is high contrast.
  • Glare, halos and star bursts, especially at night.
  • Blurriness/cloudiness in vision
  • Very mild trailing when moving something across visual field
  • Some distortion of peripheral vision and perception of movement in peripheral vision
  • Walls and other objects sometimes breathe usually after staring at them for awhile

So, are those symptoms consistent with HPPD, or are they just a relatively normal eye problems that I'm getting too paranoid about? If it was HPPD, would the medications I'm supposed to take worsen it? I've been reading stories, articles and studies about how these two drugs interact with HPPD and how they almost universally worsen symptoms. I can deal with where I am right now in terms of VS, but if those get worse, the combination with the other 3 issues may be too overwhelming. 

 

Anyways guys, thanks for reading and I would greatly appreciate any help/advice you can give.

 

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"sense of continually questioning what is real and what is not" - that may be part of DP (Depersonalization) which is rather common with HPPD.  Anxiety is very common was well.

 

Your visuals are quite common with HPPD.  Perhaps your "Monocular double vision" is what HPPDers call 'ghosting'.

 

One thing that will help is seeing how you respond to the meds.  While some HPPDers get help with those two med, by far most have worse visual symptoms.  So be patient, start with low doses and see how you respond.  Your doctor will be looking at this to help with his diagnosing for you.

 

It may help to prioritize you symptoms.  In general, the visual distortions are annoying and can increase worry/anxiety.  But major depression and anxiety disorders are the most debilitating and interfere with trying to live a happy, productive life ... as you already know having suffered for quite some time.  So treatment for them is a priority.  Ideally, treatment should improve all your symptoms, but that usually takes time

 

HPPD in general is a constant 'pre-seizure' state.  The brain is running fast and having difficulty regulating how you feel and process visual input -- "cerebral disinhibition".  So meds that have anti-seizure effect help many.  They also help anxiety.  Klonopin is perhaps the most helpful, but best short term.  Some get help with Keppra.  In more recent years, people have had some help with dopamine boosting meds ... which are the exact opposite of risperidone.

 

You'll have to patiently work through this and with your doctors.  Is your doctor familiar with HPPD?

 

How recently did the visuals start and how quickly did they develop?  Any life events or drug use shortly before they started?

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Taking into account that it appears that there isn't a temporal correlation between your drug intake and the symptoms, and that you have other issues, I would say that it's simply symptoms similar to HPPD, but not caused by HPPD.

 

If one goes to the Internet and goes looking for diseases with have some or less the same symptoms that one is experiencing.. then you can end having brain cancer and.. It's just making oneself hypochondriacs.

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I don't think my doctor is familiar with HPPD, but this is kind of expected as the trend seems to be that most psychiatrists are unfamiliar with the disorder. 

 

The visual symptoms started about 2 months ago and have developed gradually since then. Further, the visuals have been relatively mild and more of an annoyance rather than an impairment. I'm still able to function and ignore the visuals for the most part. The only time the visuals had any sort of impairment was when they first started and worsened my already bad anxiety as I thought something very bad was happening to me.

 

7 months prior to the first visual symptoms I had tried MDMA with a dose of 100mg. It was enjoyable, but I had no desire to try it again and haven't used it since. 6 months prior to start of symptoms I tried a massive dose of oral THC, 45mg to be exact. As stated earlier, all this did was launch me straight into the worst and longest lasting panic attack I have ever had. Because of this, I have absolutely no desire to ever try THC again.

 

A few weeks prior, I also stopped taking my regular 50-100mg dose of DPH for sleep figuring naturally induced sleep was much better than chemically induced regardless of actual quality of sleep. Also, at this time I started a fairly stressful quarter at college with a full course load and my father voluntarily admitted himself to a psychiatric hospital following an extreme depressive episode and for treatment of his alcoholism, after which he entered into an IOP for continued treatment.

 

It should also be of note that eye problems do run in my family with most of my family requiring glasses, the only exceptions being my siblings, mother and one of my aunts. This is what somewhat leads me to believe it's just ordinary eye issues causing these things. 

 

Thanks again.

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I would say that you don't have HPPD. Just some symptoms correlate with HPPD, but HPPD is most probably not the problem.

 

Visual problems appear from a wide range of situations. Taking into account the timing, and that you have other mental issues, you can rest assured (or not) that you don't have HPPD.

 

1 or 2 months have not been unheard before the onset of the HPPD symptoms, but 6 months.. And with that drug consumption? Nah.

 

Have a good day!

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One of the few researcher into HPPD is a Dr Abraham.  He states "Developing HPPD without ever tripping on acid can also happen, but in my experience this is quite rare, and suggestive of another disorder in the nervous system that needs medical attention.http://amrglobal.powweb.com/category/hppd

 

I happen to be one of those "rare" individuals.  Time will tell where you are with it all.  You sound calm in your post, which is good.  Just patiently work with your doc and see how you respond to the meds.  I would suggest you start with just 1 at a time and see how you do ... if you do both at the same time, you won't know which one is helpful or otherwise.

 

As for glasses, if you have an astigmatism, that can cause 'ghosting'.  However, if you didn't already have this symptom, then clearly something changed 2 months ago.  HPPD itself resolves for most people in time.  If you have a "disorder in the nervous system", then it is likely that the symptoms will skim along throughout your life until addressed (if it becomes important enough to do so).

 

More questions: Do you find a correlation with anxiety and your visuals?  Or are your visual issues steady?  24/7?  Since you have suffered depression and anxiety (a hypervigilant state) for a long time, either you got more hypervigilant or something changed a little in your visual processing.

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One of the few researcher into HPPD is a Dr Abraham.  He states "Developing HPPD without ever tripping on acid can also happen, but in my experience this is quite rare, and suggestive of another disorder in the nervous system that needs medical attention.http://amrglobal.powweb.com/category/hppd

 

I happen to be one of those "rare" individuals.  Time will tell where you are with it all.  You sound calm in your post, which is good.  Just patiently work with your doc and see how you respond to the meds.  I would suggest you start with just 1 at a time and see how you do ... if you do both at the same time, you won't know which one is helpful or otherwise.

 

As for glasses, if you have an astigmatism, that can cause 'ghosting'.  However, if you didn't already have this symptom, then clearly something changed 2 months ago.  HPPD itself resolves for most people in time.  If you have a "disorder in the nervous system", then it is likely that the symptoms will skim along throughout your life until addressed (if it becomes important enough to do so).

 

More questions: Do you find a correlation with anxiety and your visuals?  Or are your visual issues steady?  24/7?  Since you have suffered depression and anxiety (a hypervigilant state) for a long time, either you got more hypervigilant or something changed a little in your visual processing.

 

I do notice that during times of high anxiety and stress, the visuals don't seem to get more intense, but I notice them a lot more, probably because of the hypervigiliant state. Other than that, the visuals are a 24/7 occurrence and get much worse at night/in low light areas, which again pushes me more towards believing it's some sort of eye problem, whether that be astigmatism, rare early onset cataracts or something else entirely (Fuch's dystrophy comes to mind).

 

After doing some research, I think it unlikely that I have HPPD and more likely that some yet unknown stressor kicked my anxiety into overdrive, which in turn made me much more aware of already present vision problems. 

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This sounds (to me at least) like a clear case of HPPD or 'visual snow syndrome' (mostly the same symptoms as HPPD but not drug-induced)

 

If this is the case, drugs that aim to increase the availability of serotonin or decrease the availability of dopamine could make your symptoms worse.

 

You would be very unlikely to have a sudden occurrence of astigmatism in both eyes.

 

Some of your symptoms sound very similar to mine. See images:

 

post-904-0-93492500-1427748900_thumb.jpg

post-904-0-69042200-1427748912_thumb.jpg

post-904-0-58067600-1427748913_thumb.jpg

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This sounds (to me at least) like a clear case of HPPD or 'visual snow syndrome' (mostly the same symptoms as HPPD but not drug-induced)

 

If this is the case, drugs that aim to increase the availability of serotonin or decrease the availability of dopamine could make your symptoms worse.

 

You would be very unlikely to have a sudden occurrence of astigmatism in both eyes.

 

Some of your symptoms sound very similar to mine. See images:

 

attachicon.gif2.jpg

attachicon.gif3.jpg

attachicon.gif4.jpg

 

Symptoms are similar to those shown in the pictures, though not exactly. As I understand it, HPPD from MDMA is rare and even rarer for DPH (benadryl), which acts like a deliariant/hallucinogen at very high doses (typically 300mg or more, but my doses were nowhere near that). Which of course leads me to want to believe that I don't have HPPD. The other thing is that there are physical things I can do to alleviate some of the symptoms, such as holding my eyes wide open. Which again somewhat leads me to believe that the vision problems are of physiological origin rather than psychological.

 

But of course, it is known though exceedingly rare that HPPD can result from single doses and regular light dosing. If I do though, my symptoms appear to very mild compared to what others experience. When I see my doc in a couple weeks I'll mention HPPD and see if he's familiar with it. If he is, I'll talk about possible treatments. After reading through this site I'll suggest Keppra and clonazepam if he's familiar with the disorder. 

 

In the meantime, I'll try my prescribed medications at low doses and see how that turns out.

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HPPD from MDMA is not rare. From my interpretation of stories on this site it is on of the leading causes, though that might be because it is probably the most popular 'hallucinogen'. You can hallucinate from it, even though it is not considered a hallucinogen in the strictest sense.

 

My starbursting and ghosting also get better when opening my eyes wide, and they get worse when squinting. This isn't necessarily suggestive of an eye disorder, merely that the light is entering you eye in a different way, and so your brain is interpreting it in a different way. Again, this is similar story with others.

 

Do you experience visual snow/static?

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I don't experience visual snow or static or any other visual disturbance other than the ones described.

 

And please excuse my naivety, until reading through this site more thoroughly everything i had read and came across up until this point suggested that HPPD from anything other than LSD was rare and that it was even more rare for it to occur after a single dose. That being said though, I do think it is somewhat important to distinguish poly drug use from single experimental use. It seems like, to me at least, those who use MDMA are also more likely to use other, more potent hallucinogens which seemingly carry an increased risk of HPPD. But that is a topic for another discussion.

 

Anyways, the depression and anxiety are what gets to me the most since they've been present for much longer than this HPPD. I've been dealing with them since middle school and they took a turn for the worse this summer about the same time when I officially moved away from home. And at least for me, these two things are the most debilitating and therefore the two things I want treated most. The visuals are annoying and contribute somewhat to the anxiety, but I can still function with them. Sure, my eyesight might not be great, but at least I can get out of bed, go to class and go to work. The other two just seek to lock me away in my room, isolated and alone.

 

And I do understand that depression and panic disorder are often co-morbid with HPPD, but they've been around much longer for me.

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I read that HPPD can be caused by brain lesions and that explains the lucid dreaming and stuff.

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