A guide to HPPD treatment
How to help HPPD
Developing HPPD can be an incredibly frightening and overwhelming experience. Many people say that HPPD is incurable and there is nothing sufferers can do. This is not true. There is plenty you can do to support your own HPPD recovery.
Relaxation exercises: The core priority is reducing the distress. This is what defines HPPD, and makes it different from merely experiencing perceptual changes in general, which don’t have to be stressful.
Meditation, yoga, deep breathing exercises and other techniques are known to lessen stress and anxiety. Meditation can also help to break the cycles of fixation that feed anxiety and the intensity of visuals.
If you developed HPPD after a bad trip, however, or are experiencing dissociation, meditation can be dangerous. Trauma-sensitive mindfulness practices may be recommended in this case.
Re-framing your thoughts and attention through Cognitive Behavioural Therapy and Attention Training, or other kinds of general therapy to process the meaning of your HPPD and how it may be related to general anxiety and stress - especially from the drug experiences that may have provoked the HPPD. You could find a good care professional on our Specialists Directory.
The schema below may provide a useful summary for you in how HPPD and distress can be maintained in vicious cycles. People with HPPD tend to report consistent patterns of destructive and automatic thoughts and behaviours that keep them miserable. What’s great is, these patterns aren’t guaranteed! Mindfulness can work well with CBT here, which encourages people to observe and challenge their thoughts, re-frame them, and stay grounded in their bodies and the immediate environment to really feel and process the anxiety.
For instance, in the past, I would sometimes look around to see a wave of visuals and worry that this made me a kind of a freak - or that the LSD trips I’d taken had never really worn off. That was pretty worrying!
But I reassured myself by realising that many people I know and value (and love) are aware I have HPPD, and do not believe I am a freak. I remembered that I had often viewed myself in that self-hating way even before I ever developed HPPD, so it’s not just about the condition. It’s about a core belief that has now been filtered through and enflamed by the prism of HPPD.
I also remembered that LSD does not stay in the body. While the drug may have left certain imprints, that does not mean I am actually still tripping - or at least in such a way that I am at all dysfunctional. I’ve managed to finish my undergraduate degree, launch a career, and complete most of my Master’s (still ongoing) while living with these symptoms. It doesn’t mean the end!
Exercise: As well as its more general benefits, exercise may specifically counteract (through ‘synaptic pruning’) visual change at the level of the brain.
Healthy diet: As well as the ‘low hanging fruit’ of cutting out fast food, reducing sugar intake, and drinking plenty of water, you may benefit from paying particular attention to how your visuals relate to specific foods. Some report success from elimination diets in overcoming a related condition known as Visual Snow Syndrome.
Stabilise and recover sleep: Fatigue is strongly-associated with more intense visuals.
Supplements: Some HPPD patients report success with supplements like: Magnesium, Lion’s Mane mushroom extract, N-Acetylcysteine (NAC), Vitamin D & Fish oil
But these supplements have also been reported to make some HPPD patients’ symptoms worse, and it’s encouraged that people do not go down a ‘rabbit hole’ of fixating on supplements
Abstinence: If you want to be risk-averse - and you’re committed to eliminating your visual changes - it will not hurt to stop consuming some or all psychoactives.
Continuing to take drugs, at least in the short-term after the onset of HPPD, is often risky - though some do report overcoming their visual changes with psychedelics (perhaps wait for dedicated research if you want to explore this possibility).
Some report success from ceasing caffeine and alcohol, too. Alcohol can lessen visuals in the short-term, but they can bounce back even harder with hangovers.
Re-framing: It may be helpful to learn that many people are not troubled by their perceptual changes. Again, they can be just a ‘thing’ - how one sees now - that’s different, and not necessarily bad.
Other people actively enjoy their visuals or view them in a spiritual way - such as glimpsing auras, having broadened the possibility of the mind, or in seeing the intrinsic shakiness of ordinary experience.
Without a deep, embodied grounding for your re-framing, though, it can be hazardous. Make sure the frame is not just ‘in your head’, but truly held across your entire mind and body in a felt way. Don’t gaslight yourself into ‘enjoying’ your visual changes if they are actually disturbing you.
When really overwhelmed, avoid enclosed and dark environments: Visuals are made more intense when your vision is constrained, as with a small room versus a wide-open horizon. If you can, raising the light in an environment can be useful, because the dark provides greater contrast for visuals to appear.
At the same time, it is best not to make a habit of avoiding certain environments and stimuli because of HPPD. Avoidance of this kind can be part of the maintenance cycle for anxiety.
Sunglasses: Some people report real success in wearing shades - especially special tinted blue or orange glasses.
See a clinician and ask for advice on medication: If you are experiencing great distress, it may be advised to begin a course of psychiatric medication, in particular Lamotrigine (an anti-epilepsy drug) and Klonopin (a benzodiazepine). Many HPPD patients report success in reducing the intensity of their visuals and the associated anxiety, but this isn’t the same for everyone.
Side effects and withdrawal symptoms may be experienced, too, and there have been no controlled trials on the efficacy of these drugs (only case reports and anecdotes).
