Hallucinogen Persisting Perception Disorder
Hallucinogen Persisting Perception Disorder (HPPD) is a DSM-V disorder with the diagnostic code 292.89. HPPD is categorized as persistent and severely distressing changes in perception following the use of hallucinogenic drugs. These changes are predominantly disturbances in visual processing, although mild disturbances in other sensory perceptions have been reported on rare occasion. Hallucinogen Persisting Perception Disorder is a complex condition that is poorly understood due to a critical lack of comprehensive medical research. As a consequence of medical neglect, misdiagnosis and mistreatment of the patient is a common occurrence. Even when properly diagnosed, the treatment in place for those suffering from HPPD are ineffective, and often anecdotal at best. Patients often suffer from co-morbid ailments such depression, depersonalization, derealization and severe anxiety as result of not perceiving reality correctly. There is blatant stigma attached to the sufferers of HPPD due to a severe lack of awareness, compassion, and understanding of this disorder amongst the medical profession, and society as a whole. There is a strong theme of isolation where patients are left with no answers, no credible solutions and are left to suffer in silence. It has left many sufferers in an extremely difficult and lonely battle, often losing quality of life and sadly, has resulted in many suicides over the years. It is imperative that comprehensive medical research and a widespread awareness campaign is undertaken with immediate effect.
Much credit is to be given to Dr. Henry Abraham who has spent decades in researching HPPD mostly at his own expense and to David Kozin, a pioneer in HPPD study, advocacy and awareness. To learn more about them both please review this feature article published by the one of the most prestigious neurological publications, the Dana Foundation: http://www.dana.org/News/Details.aspx?id=43275
“We should be researching this much more than we do.”
– Keith Laws, Professor of Cognitive Neuropsychology at the University of Hertfordshire
The Diagnostic Struggle
Due to a severe lack of research and awareness, HPPD is often misdiagnosed by medical professionals, with research reporting an average of requiring at least six different doctors’ opinions before a patient’s diagnosis is correctly ascertained. There is a clear distinction of HPPD from ailments which have overlapping symptoms, disorders such as epilepsy, migraines, lesions, dementia, delirium, Parkinson’s, drug induced psychosis, schizophrenia or “flashbacks.” For an individual to be diagnosed with HPPD, these other potential causes must be ruled out. Many medical professionals often misdiagnose Hallucinogen Persisting Perception Disorder as one of the aforementioned disorders. Misunderstanding, misdiagnosis, skepticism and maltreatment of this condition is highly pervasive.
Throughout the years HPPD and the term “flashbacks” has been used interchangeably, leading to much confusion, lumping together an extremely serious condition, with that of a benign and temporary occurrence. There is a clear distinction between flashbacks and HPPD. Flashbacks are a transient and intermittent re-experience of perceptual changes reminiscent of a previous psychedelic state. These occurrences do not happen often, do not last long, and do not produce anxiety or unease in the experience. HPPD conversely, is the continuous and often long term presence of disturbances in visual and sensory perceptions. The visual disturbances experienced, are understood as pseudo-hallucinations rather than the clinical view of hallucinations, as people with HPPD understand what they are experiencing. Sufferers know that their perceptions are a result of alterations in visual processing, as opposed to other mental illnesses whereby the sufferers are unable to discern what reality is.
It is imperative that the dialogue be changed pertaining to HPPD. The stigma and shame associated with victims of drug use must also be cast aside and replaced with compassion and empathy; qualities that are needed from the medical establishment, policy makers and the public if any headway will ever be made in addressing this disease and finding a cure.