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Hallucinogen Persisting Perception Disorder (HPPD) Support Forum

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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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The last occasion that I tripped I ate mushrooms, i was at my friends house and we decided to eat 2 grams each, and we were gonna hangout there and smoke all night and just trip, and about 15 minutes after we ate them before we started tripping a group of my friends show up maybe 6-7 of them all telling us to come over to the one kids house to trip with them and party. I myself didn't want to go because i didn't like tripping with more than one or two people at a time, so I was already out of my comfort zone, but I ended up going. We got there and I knew every single person there but I was feeling a little social awkwardness due to the fact that maybe five out of the fifteen people there were tripping, at one point I had a friend come up to me and another kid and asked us if we just wanted to go down and smoke in his house, so we went and I started feeling a lot better. We will call the two friends i was with J and G, me and J get along very well and J was the friend i was with at the beginning of the night, G and I on the other hand don't get along as well but are still friends. We started watching Family Guy and G pulled out his dab rig and took a dab then proceeded to offer both me and J a dab, I of course accepted and this is where my night really started to go south, I started tripping really hard, and none of us were talking we were just watching an extremely old family guy episode, one of the ones where only one character moves at a time, and if they speak only their mouths move, and it just kinda weirded me out watching that, in fact it weirded us all out so we decided to go for a walk, G went back up to the party and me and J accompanied by two more friends who were NOT tripping, and started walking, we will call this friends B and A, so me J B and A were all walking down this back road in some Pennsylvania woods at 3 am. We started walking and B and A started asking me about my life overseas, as I started trying to explain what life was like i began to get stuck, I was trying to describe to them the feeling of being overseas and obviously they weren't able to perceive the depiction that I was providing, I got a little anxious and stopped talking about it, we continued to walk when me and J ended up being about 13 feet behind them, I felt some sort of psychological connection with J, we couldn't telepathically read each others minds or anything but we just felt the fact that we were both perceiving on a completely different level than the others. All the sudden I hear A and B talking, saying things like, "I feel like they are retarded, I feel like im talking to a third grader." and then laughing, I didn't take this lightly and said something like "hey how about you keep your mouth shut and quit talking shit", I really made things awkward now, and there was no talking. When we got back from our walk we were sitting on a few big rocks just hanging out, I had already apologized for my first out lash and everything is back to normal, as we are sitting there B says something very slightly provocative (i cannot remember verbatim what was said" and I snapped out, I couldn't control what I was doing or saying, but I was standing up pointing my finger at B and cussing at him telling him to shut the fuck up or fight me, what was really weird was the fact that I had no control over what I was doing, the whole time I was thinking in my head "what am I doing? Why am I doing this? I need to stop yelling at him and let it go. Whats happening to me. I'm never gonna stop tripping. After that night I was kinda weirded out by the whole incident so I stopped taking any type of psychedelic, after a few months I started noticing that I was tripping constantly, especially in situations that made me nervous, like going to a court hearing, i was looking at the floor and i was seeing waves everywhere and books sliding in and out of the shelves. This constant tripping lasted for a while, I became a different person, It was like i developed ADD and anxiety, and my depression had worsened a lot. Me and my girlfriend broke up while i was going through this as well and it was extremely hard for me, I plummeted into a deep depression and didn't think I had ever truly loved myself. I was a big time party freak before I met my girlfriend and kinda mellowed out the year we were together, so after we broke up I kinda jumped right back into it, I started doing a lot of benzos because they made me feel numb, in the HPPD state I feel everything and the feeling is multiplied, so these were a quick addiction for me, although my HPPD subsided. I continued partying and doing drugs until I went to my freshman semester of college at, you guessed it WVU. As soon as I got down there I made some bad friends and was robbing people and doing pills and smoking like never before, I eventually had a close call and dropped out and returned home, when I got home I did the same old thing, robbed people and did pills, and I really needed something to change my life around quick. Then one night I was staying in a motel with a friend when he pulls out an ounce of mushrooms, Ahhhhh my friends at last. He asked me if he cared if he ate some, and i said as long as I can eat some with you. It had been really long since i tripped and this friend was my best friend for the past two years so I decided i was in a good environment with one friend, fuck it. We started tripping, and it was a trip like I had never had before, I ate 4.3 grams of caps and we blasted off into the unknown, after a while of tripping and happy laughs good visuals, we had to go sell a half ounce to someone about 20 minutes away, so we drove there just talking, no music the whole time. We talked about life and about where we were at and if we were happy. On the way back i started to notice that my eyes were going lazy and i was seeing one road for each eye that I had, So I was double visioned basically. I found it extremely hard to fight this so I just focused on one road and drove perfectly all the way back, when we got there we were still conversing and heading to get food, all the sudden, epiphany after epiphany, my vision closed in and formed one extremely clear picture, like I have never seen anything before and It was while I was saying how I needed to quit doing drugs and focus on my body and spiritual health, My friend says we opened our third eye, and I believed it, my whole life changed that day and i started loving psychedelics again, buying and using daily, I would micro-dose, i would take .5 in the morning and .5 around 3-6 pm, even though i wasn't doing it right i thought i was okay because i was only micro-dosing. I started getting into meditation and yoga and all these spiritual things, I had a few epiphanies while meditating that were very radical, like one was I felt a telepathic connection with the universe and was thinking with consciousness, I say consciousness because the image that came along with the thought was telling me that consciousness is one, we are all the same, so the first thing i thought to ask was whats the point of life? The response; Love, the point of life is to love everything and everyone, because no matter if I am human and dog is dog, we are both alive, thriving on this planet together, so If i have the knowledge to care for life on this planet I must.  This short lived high point in my life quickly faded weeks after when I noticed that I was tripping all the time again... It has been about 4 months since then and I am in the worst place ever, I cannot get myself to work, I cannot eat, I sleep surprisingly well though still. I have had crazy thoughts that pop into my head along with my visuals, like i saw visual snow, and i thought "well what if it is really something out there that I can see but nobody else can.." or "well if i believe that this room is moving then in my reality.. it really is moving.." And i become scared of these thoughts even though I don't believe them, It scares me to know that my brain is thinking them. I have debated suicide many nights, I consider myself a fuck up and a failure for all these evens that have happened, and now that Im thinking so much i begin to debate whether or not I am going crazy, I used to be such a smart kid, being able to off any teacher because I would find ways to prove them wrong, or being able to win any debate with friends because I knew more about the subject, I went from that to being the awkward kid who doesn't really talk a lot and has been sick twice in two weeks so he missed four days of work. I am beginning to fear that I can no longer do this. Hope this story was put together decently for you, I tend to get off topic sometimes, any thoughts comments would be appreciated dearly.   
       
      -E
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