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'''Hallucinogen persisting perception disorder''' (abbreviated as '''HPPD''') is a psychiatric disorder characterized by the persisting presence of sensory disturbances, most commonly visual, that resemble those that are produced by the use of [[hallucinogenic]] substances. Previous use of hallucinogens is necessary, but not sufficient, for diagnosis of HPPD, and the symptoms cannot be due to another medical condition. HPPD is distinct from flashbacks by reason of its relative permanence and the degree to which it interfere's with one's social and occupational functioning; while flashbacks are transient, condition-specific manifestations of a [[hallucinogenic]] state, HPPD is characterized by its persistence.
'''Hallucinogen persisting perception disorder''' (abbreviated as '''HPPD''') is a psychiatric disorder characterized by the persisting presence of sensory disturbances, most commonly visual, that resemble those that are produced by the use of [[hallucinogenic]] substances (typically [[serotonergic psychedelics]]). Previous use of [[hallucinogens]] is necessary, but not sufficient, for diagnosis of HPPD, and the symptoms cannot be due to another medical condition.  


==HPPD subtypes==
HPPD is distinct from flashbacks by reason of its relative permanence and the degree to which it interfere's with one's social and occupational functioning; while flashbacks are transient, condition-specific manifestations of a [[hallucinogenic]] state, HPPD is characterized by its persistence. According to a 2016 review, there are two subtypes of the condition: individuals with Type 1 experience HPPD in the form of random, brief flashbacks while Type 2 HPPD takes the form of ongoing changes to their vision, which may come and go.<ref>{{cite book | vauthors=((Halpern, J. H.)), ((Lerner, A. G.)), ((Passie, T.)) | veditors=((Halberstadt, A. L.)), ((Vollenweider, F. X.)), ((Nichols, D. E.)) | date= 2018 | chapter=Behavioral Neurobiology of Psychedelic Drugs | title=A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD | publisher=Springer | series=Current Topics in Behavioral Neurosciences | pages=333–360 | url=https://doi.org/10.1007/7854_2016_457 | doi=10.1007/7854_2016_457 | isbn=9783662558805}}</ref>
According to a 2016 review, there are two types of the condition:<ref>https://link.springer.com/chapter/10.1007/7854_2016_457</ref>
 
===Type 1 HPPD===
This is where people experience HPPD in the form of random, brief flashbacks.
 
===Type 2 HPPD===
People with this kind of HPPD experience ongoing changes to their vision, which may come and go.


==Symptoms==
==Symptoms==
[[Image:Red-blue-noise.gif|frame|HPPD noise simulation, often referred to as visual snow]]
[[Image:Red-blue-noise.gif|frame|HPPD noise simulation, often referred to as visual snow]]


There are a number of perceptual changes that can accompany HPPD.  Typical symptoms of the disorder include: halos or auras surrounding objects, trails following objects in motion, difficulty distinguishing between colors, apparent shifts in the hue of a given item, the illusion of movement in a static setting, air assuming a grainy or textured quality ([[visual snow]] or static, by popular description, not to be confused with normal "blue field entoptic phenomenon"), distortions in the dimensions of a perceived object, intensified hypnagogic & hypnopompic hallucinations, and a heightened awareness of floaters.  The visual alterations experienced by those with HPPD are not homogeneous and there appear to be individual differences in both the number and intensity of symptoms.{{citation needed|date=September 2011}}
There are a number of perceptual changes that can accompany HPPD.   
 
Typical symptoms of the disorder include: halos or auras surrounding objects, trails following objects in motion, difficulty distinguishing between colors, apparent shifts in the hue of a given item, the illusion of movement in a static setting, air assuming a grainy or textured quality ([[visual snow]] or static, by popular description, not to be confused with normal "blue field entoptic phenomenon"), distortions in the dimensions of a perceived object, intensified hypnagogic & hypnopompic hallucinations, and a heightened awareness of floaters.  The visual alterations experienced by those with HPPD are not homogeneous and there appear to be individual differences in both the number and intensity of symptoms.{{citation needed|date=September 2011}}


Visual aberrations can occur periodically in healthy individuals – e.g. [[after images]] after staring at a light, noticing floaters inside the eye, or seeing specks of light in a darkened room.  However, in people with HPPD, symptoms are typically persistent enough that the individual cannot ignore them. {{citation needed|date=September 2011}}
Visual aberrations can occur periodically in healthy individuals – e.g. [[after images]] after staring at a light, noticing floaters inside the eye, or seeing specks of light in a darkened room.  However, in people with HPPD, symptoms are typically persistent enough that the individual cannot ignore them. {{citation needed|date=September 2011}}


There is some uncertainty about to what degree visual snow constitutes a true HPPD symptom. There are many individuals who have never used a drug which could have caused the onset, but yet experience the same grainy vision reported by HPPD sufferers. There are a few potential reasons for this, the most obvious of which being the theory that the drug usage may exaggerate the intensity of visual snow. Another theory is that instead, there may be no change in the severity or magnitude of the visual snow, but perhaps the drug usage opens sensory pathways that result in the individual becoming more aware of any visual disturbances that may have simply not been noticed before the incidence of substance use. As for root cause of visual snow, some theories suggest that it is the result of thermal noise in the visual cortex or in the 'Optic Pathway' (encompassing photoreceptor cells on the retina, the optic nerve, and the optic chiasm)<ref>Baylor, D. A., Matthews, G., & Yau, K. W. (1980). Two components of electrical dark noise in toad retinal rod outer segments. The Journal of Physiology, 309, 591.</ref> as eye tests for individuals who experience visual snow often reveal that physically, the eye is perfectly normal, and in many cases the individual still maintains 20/20 vision.
There is some uncertainty about to what degree visual snow constitutes a true HPPD symptom. There are many individuals who have never used a drug which could have caused the onset, but yet experience the same grainy vision reported by HPPD sufferers. There are a few potential reasons for this, the most obvious of which being the theory that the drug usage may exaggerate the intensity of visual snow.  


HPPD usually has a visual manifestation. Drugs affecting the auditory sense, like [[diisopropyltryptamine]] ('''DiPT'''), may produce [[auditory hallucinations|auditory disturbances]], though there are few known cases. Some [[Hallucinogens|hallucinogenic substances]] can produce temporary [[tinnitus]]-like symptoms as a side effect.<ref name="tihkalweb">Shulgin, A., & Shulgin, A. (1991). [https://erowid.org/library/books_online/tihkal/tihkal36.shtml Erowid Online Books: "TIHKAL" - #36 - 5-MeO-DET]. Retrieved April 14, 2017.</ref><ref>Erowid. (2003). Erowid Experience Vaults: DiPT - More Tripping & Revelations - 26540. Retrieved from https://www.erowid.org/experiences/exp.php?ID=26540</ref>
Another theory is that instead, there may be no change in the severity or magnitude of the visual snow, but perhaps the drug usage opens sensory pathways that result in the individual becoming more aware of any visual disturbances that may have simply not been noticed before the incidence of substance use. As for root cause of visual snow, some theories suggest that it is the result of thermal noise in the visual cortex or in the 'Optic Pathway' (encompassing photoreceptor cells on the retina, the optic nerve, and the optic chiasm)<ref>{{cite journal | vauthors=((Baylor, D. A.)), ((Matthews, G.)), ((Yau, K. W.)) | journal=The Journal of Physiology | title=Two components of electrical dark noise in toad retinal rod outer segments. | volume=309 | issue=1 | pages=591–621 | date=1 December 1980 | url=https://onlinelibrary.wiley.com/doi/10.1113/jphysiol.1980.sp013529 | issn=00223751 | doi=10.1113/jphysiol.1980.sp013529}}</ref> as eye tests for individuals who experience visual snow often reveal that physically, the eye is perfectly normal, and in many cases the individual still maintains 20/20 vision.


It also should be noted that the visuals do not constitute true hallucinations in the clinical sense of the word; people with HPPD recognize the visuals to be illusory, or pseudohallucinations, and thus maintain the ability to distinguish what is real (in contrast to some mental illnesses such as [[schizophrenia]]).<ref>Moskvitin, J. (1974). Essay on the origin of thought. Athens: Ohio University Press.</ref>
HPPD usually has a visual manifestation. Drugs affecting the auditory sense, like [[diisopropyltryptamine]] ('''DiPT'''), may produce [[auditory hallucinations|auditory disturbances]], though there are few known cases. Some [[Hallucinogens|hallucinogenic substances]] can produce temporary [[tinnitus]]-like symptoms as a side effect.<ref name="tihkalweb">{{Citation | title=Erowid Online Books : “TIHKAL” - #36. 5-MEO-DET | url=https://erowid.org/library/books_online/tihkal/tihkal36.shtml}}</ref><ref>{{Citation | title=DiPT - Erowid Exp - “More Tripping & Revelations” | url=https://www.erowid.org/experiences/exp.php?ID=26540}}</ref>
 
It also should be noted that the visuals do not constitute true hallucinations in the clinical sense of the word; people with HPPD recognize the visuals to be illusory, or pseudohallucinations, and thus maintain the ability to distinguish what is real (in contrast to some mental illnesses such as [[schizophrenia]]).<ref>{{cite book | vauthors=((Moskvitin, J.)) | date= 1974 | title=Essay on the origin of thought | publisher=Ohio University Press | isbn=9780821401569}}</ref>
 
==Literature==
* Halpern, J. H., Lerner, A. G., & Passie, T. (2016). A review of hallucinogen persisting perception disorder (HPPD) and an exploratory study of subjects claiming symptoms of HPPD. In Behavioral Neurobiology of Psychedelic Drugs (pp. 333-360). Springer, Berlin, Heidelberg. https://link.springer.com/chapter/10.1007/7854_2016_457


==External links==
==External links==
* [https://en.wikipedia.org/wiki/HPPD Hallucinogen persisting perception disorder (Wikipedia)]
* [https://en.wikipedia.org/wiki/Hallucinogen_persisting_perception_disorder Hallucinogen persisting perception disorder (Wikipedia)]
* [https://erowid.org/psychoactives/health/hppd/ HPPD (Erowid)]
* [https://erowid.org/psychoactives/health/hppd/ HPPD (Erowid)]
<!-- Added to these articles: Hallucinogen_persisting_perception_disorder, and Network -->
* [https://www.perception.foundation/hppd-self-assessment Do I have Hallucinogen Persisting Perception Disorder — Perception Restoration Foundation]
* [https://psychophysics.qri.org/ Qualia Research Institute's Tracer Replication Tool]


==References==
==References==
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Latest revision as of 17:16, 2 June 2024

Hallucinogen persisting perception disorder (abbreviated as HPPD) is a psychiatric disorder characterized by the persisting presence of sensory disturbances, most commonly visual, that resemble those that are produced by the use of hallucinogenic substances (typically serotonergic psychedelics). Previous use of hallucinogens is necessary, but not sufficient, for diagnosis of HPPD, and the symptoms cannot be due to another medical condition.

HPPD is distinct from flashbacks by reason of its relative permanence and the degree to which it interfere's with one's social and occupational functioning; while flashbacks are transient, condition-specific manifestations of a hallucinogenic state, HPPD is characterized by its persistence. According to a 2016 review, there are two subtypes of the condition: individuals with Type 1 experience HPPD in the form of random, brief flashbacks while Type 2 HPPD takes the form of ongoing changes to their vision, which may come and go.[1]

Symptoms

HPPD noise simulation, often referred to as visual snow

There are a number of perceptual changes that can accompany HPPD.

Typical symptoms of the disorder include: halos or auras surrounding objects, trails following objects in motion, difficulty distinguishing between colors, apparent shifts in the hue of a given item, the illusion of movement in a static setting, air assuming a grainy or textured quality (visual snow or static, by popular description, not to be confused with normal "blue field entoptic phenomenon"), distortions in the dimensions of a perceived object, intensified hypnagogic & hypnopompic hallucinations, and a heightened awareness of floaters. The visual alterations experienced by those with HPPD are not homogeneous and there appear to be individual differences in both the number and intensity of symptoms.[citation needed]

Visual aberrations can occur periodically in healthy individuals – e.g. after images after staring at a light, noticing floaters inside the eye, or seeing specks of light in a darkened room. However, in people with HPPD, symptoms are typically persistent enough that the individual cannot ignore them. [citation needed]

There is some uncertainty about to what degree visual snow constitutes a true HPPD symptom. There are many individuals who have never used a drug which could have caused the onset, but yet experience the same grainy vision reported by HPPD sufferers. There are a few potential reasons for this, the most obvious of which being the theory that the drug usage may exaggerate the intensity of visual snow.

Another theory is that instead, there may be no change in the severity or magnitude of the visual snow, but perhaps the drug usage opens sensory pathways that result in the individual becoming more aware of any visual disturbances that may have simply not been noticed before the incidence of substance use. As for root cause of visual snow, some theories suggest that it is the result of thermal noise in the visual cortex or in the 'Optic Pathway' (encompassing photoreceptor cells on the retina, the optic nerve, and the optic chiasm)[2] as eye tests for individuals who experience visual snow often reveal that physically, the eye is perfectly normal, and in many cases the individual still maintains 20/20 vision.

HPPD usually has a visual manifestation. Drugs affecting the auditory sense, like diisopropyltryptamine (DiPT), may produce auditory disturbances, though there are few known cases. Some hallucinogenic substances can produce temporary tinnitus-like symptoms as a side effect.[3][4]

It also should be noted that the visuals do not constitute true hallucinations in the clinical sense of the word; people with HPPD recognize the visuals to be illusory, or pseudohallucinations, and thus maintain the ability to distinguish what is real (in contrast to some mental illnesses such as schizophrenia).[5]

Literature

  • Halpern, J. H., Lerner, A. G., & Passie, T. (2016). A review of hallucinogen persisting perception disorder (HPPD) and an exploratory study of subjects claiming symptoms of HPPD. In Behavioral Neurobiology of Psychedelic Drugs (pp. 333-360). Springer, Berlin, Heidelberg. https://link.springer.com/chapter/10.1007/7854_2016_457

References

  1. Halpern, J. H., Lerner, A. G., Passie, T. (2018). "Behavioral Neurobiology of Psychedelic Drugs". In Halberstadt, A. L., Vollenweider, F. X., Nichols, D. E. A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. Current Topics in Behavioral Neurosciences. Springer. pp. 333–360. doi:10.1007/7854_2016_457. ISBN 9783662558805. 
  2. Baylor, D. A., Matthews, G., Yau, K. W. (1 December 1980). "Two components of electrical dark noise in toad retinal rod outer segments". The Journal of Physiology. 309 (1): 591–621. doi:10.1113/jphysiol.1980.sp013529. ISSN 0022-3751. 
  3. Erowid Online Books : “TIHKAL” - #36. 5-MEO-DET 
  4. DiPT - Erowid Exp - “More Tripping & Revelations” 
  5. Moskvitin, J. (1974). Essay on the origin of thought. Ohio University Press. ISBN 9780821401569.