So You Think You Have Hallucinogen Persisting Perception Disorder (HPPD). Now What?
If you’ve found your way here, chances are you’re struggling with strange and unsettling symptoms after a psychedelic experience—visual changes, anxiety, a sense of detachment from reality. Maybe you’ve searched online, read conflicting stories, or even spoken to doctors or therapists who didn’t quite know what to make of it. And now you’re left wondering: What’s happening to me?
If this sounds familiar, please know you’re not alone.
Hallucinogen Persisting Perception Disorder (HPPD) is not well understood. It’s rare, yes—but it’s very real. And for those who experience it, it can be deeply disorienting, frightening, and lonely.
What Is HPPD, Really?
HPPD is a condition that can follow the use of hallucinogenic substances like LSD, psilocybin, or MDMA. It’s defined by ongoing visual disturbances that linger long after the substance has left your body. These can include:
• Visual snow or static
• Light trails or afterimages
• Enhanced or distorted colors
• Halos around objects
• A general feeling that reality is “off” or unreal
These symptoms can range from mildly irritating to profoundly distressing. For some, they fade over time. For others, they persist and affect daily functioning.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines three core features:
• Ongoing perceptual disturbances after psychedelic use
• Significant distress or impairment in daily life
• No other underlying medical or psychiatric explanation
What makes HPPD so challenging is that it doesn’t fit neatly into the usual boxes. It’s not a psychotic disorder, nor is it just anxiety. It lives in the in-between—and that can make it harder to find help.
What It Feels Like
Everyone’s experience is different. For some, HPPD shows up as subtle visual shifts—a bit of static in the vision, slight distortions that come and go. For others, it’s much more intense: hallucination-like visuals, panic attacks, dissociation, or a sense that something is deeply, fundamentally wrong.
It can also stir up existential anxiety—questions about the nature of reality, identity, or perception itself. These are big questions, and while they’re important, they can feel overwhelming when they’re emerging alongside physical and emotional distress.
Why Aren’t We Talking About This?
As psychedelic therapies gain popularity, there’s been a surge of excitement—understandably so. Psychedelics offer real healing potential. But that doesn’t mean we should ignore the risks.
HPPD is one of the few well-documented long-term side effects of psychedelic use, and yet it’s rarely acknowledged. There’s a hesitancy—both in clinical circles and the broader psychedelic community—to talk about what can go wrong. But honest, balanced conversations are necessary if we want to truly support people in these experiences.
What You Can Do
If you’re dealing with HPPD, there are things you can do to support your healing. While there isn’t a one-size-fits-all treatment, many people report improvement over time, especially with a gentle, grounded approach.
1. Care for Your Nervous System
This is essential. Your system is likely overstimulated and on high alert. Start with the basics:
• Sleep: Prioritize rest. If you’re having trouble sleeping, talk to your doctor about safe options.
• Nutrition: Eat regularly and focus on whole foods. Omega-3s, healthy fats, and protein all support brain health.
• Hydration: It sounds simple, but dehydration can make everything feel worse.
If eating or sleeping feels impossible, reach out to a medical provider. Temporary medication support is okay—sometimes it’s necessary.
2. Know When to Ask for More Support
If your symptoms are extreme—if you’re struggling with daily functioning or experiencing suicidal thoughts—please seek medical or psychiatric care. Inpatient treatment can feel intimidating, but in some cases, it can offer essential stabilization.
Even if hospitalization isn’t needed, having a safety plan and support system in place is crucial.
3. Reduce Stress (Even a Little Helps)
HPPD tends to flare when the nervous system is under stress. Try incorporating small, soothing practices into your day:
• Breathwork or gentle yoga
• Walking in nature
• Warm baths, soft lighting, calming music
• Acupuncture, massage, or grounding essential oils
You don’t have to “fix” everything—just find what helps you feel a little more grounded.
4. Avoid Mind-Altering Substances (for Now)
This includes psychedelics, cannabis, stimulants, and sometimes even caffeine. While this doesn’t have to be a forever thing, giving your brain space to recover without additional chemical input is a helpful first step.
5. Consider Therapy
While therapy won’t “cure” HPPD, it can make a meaningful difference. Working with a therapist who understands anxiety, trauma, or psychedelic experiences can help you:
• Manage fear and intrusive thoughts
• Cultivate coping tools
• Reduce avoidance behaviors
• Stay connected to your body and the present moment
CBT, DBT, and somatic therapies can all be helpful depending on your specific symptoms.
6. Put the Existential Questions on Hold
It’s totally natural for altered perception to spark big questions about reality, time, consciousness, etc. But when those questions become obsessive or distressing, it’s okay to gently set them aside. You can revisit them later—when your nervous system feels safer and more regulated. That’s where I can come in.
The Road to Recovery
Healing from HPPD is rarely quick, but it is possible. Some people recover within months. For others, it takes longer—but gradual improvements are common. You may notice some symptoms fading, becoming less intense, or less emotionally charged.
Progress isn’t always linear, and setbacks can happen—but over time, many people find their way back to stability.
You’re Not Alone
One of the hardest parts of HPPD is the isolation. It’s invisible. It’s misunderstood. And sometimes it feels like no one gets it.
But you are not alone. Others have walked this road and found healing. There are online support groups, forums, and growing conversations happening in the psychedelic integration space. Finding even one person who understands can help you feel less lost.
HPPD is real. It deserves more attention, more research, and more compassion. If you’re struggling, take things one day at a time. Support your body, seek connection, and try to be gentle with yourself.
You are not broken. You are not “too far gone.” And while things might feel overwhelming now, healing is possible.
If you’re currently in crisis or struggling to function, I may not be the right fit—but I recommend visiting the Perception Restoration Foundation for resources and support.
If you’re feeling stable but curious to explore your psychedelic experience through a therapeutic lens, I offer psychedelic integration therapy in Oakland and throughout California. Contact me today.