David S. Kozin

HONOLULU -- When the red-hot Japanese economy of the 1970s and 1980s cooled off and a period of stagnation set in, suicide rates spiked, and researchers here suggested the same thing could happen in the U.S. View the full article

HONOLULU -- Almost half of children treated as inpatients for psychotic and mood disorders are given atypical antipsychotics, researchers said here. View the full article

HONOLULU -- About half of medical students see Wikipedia as a trustworthy source of information for helping them prepare for exams, researchers said here. View the full article

Image from Commencement: Image Plan project to be bound and cataloged in the Library includes: Chapter 1 an exhaustive argument and discussion of how the current dx. criteria is neither valid nor stable, and results in harm to pts.. Chapter 2 starts with accounts of flashbacks from an isolated report in late 1800's to the three articles in 1954-1955 and up to present day with new case studies from my work to demonstrate this is a stable syndrome with distinct diagnostic boundaries and a hx. hard to ignore. A focus on development of key findings to work towards creation of etiology and re: nosology. Chapter 3: Redefining HPPD with consideration for DSM-V guidelines, why there is no change, and proposal for first biomarker for the disorder. Included original protocol from independent work at HMS. Chapter 4. The Neurobiology to support an updated theory of HPPD addressing CNS AND the ANS to answer why the disorder breaks conventional ideas. Rationale for biomarker. Chapter 5 is an insider's guide to working at a psychiatric research lab with info on how the research came to be and my experience at McLean Hospital. Original documents included. The HPPD illustrated story from a suffer is included. 100+ pages of single spaced descriptions of HPPD and DP/DR in words from the communities from my research and message board. Copies of publications, original documents. Complete bibliography of HPPD and related subjects with over 100 references. Because of fair use law restrictions, the plan is available only in hard copy in one location. An electronic form updated after my oral examination and approval of Dr. Abraham will be available as soon as edits and deletions are complete. Lastly, included: examination and descriptions of stereochemistry and chemical and electrical signal transduction and my experience and evidence-based recommendations of good/bad psychotherapeutics and pharmacotherapy for HPPD to inform clinical practice. Total 397 pages. Oral And Written Outside Examiner: Henry David Abraham, MD. David

Graduation is over. I like this thread for a few reasons, but I'm typing on my phone so do not have time to address it all. One, there is a class of antibiotics with central nervous system activity (not to alarm anyone, so I will discuss later). Permission problems affect me also. I will be fixing this when at real computer. Dk

HONOLULU--The media frenzy surrounding reports of bedbug infestations in New York may increase acute anxiety and mood disorders. View the full article

HONOLULU--Computer time and video games may explain why John and Jane are sleepy teens, researchers said here. View the full article

HONOLULU -- Although most reported cases of Munchausen-by-proxy syndrome involve children, adults can also be victims, a researcher said here. View the full article

HONOLULU -- Depression screens in patients with chronic physical diseases appeared to reduce subsequent clinic visits -- but, paradoxically, only in those who tested negative, a researcher said here. View the full article

HONOLULU -- The process of revising the Diagnostic and Statistical Manual of Mental Disorders -- the "psychiatrist's bible" -- remains firmly on schedule for its official release in 2013, according to the leader of the effort. View the full article

"You know more about HPPD than anyone on this planet." - Said to me, after the oral examination, from Dr. Abraham. I will be speaking with Dr. Abraham about the text and other issues privately on the phone. Cheers!, David S. Kozin

In a section regarding Treatment and HPPD "Set aside the theories, models, and structured sessions during the first state of treatment. The clinician should first establish a very simple, but neccessary requirement to develop a therapeutic relationship with an HPPD patient: validate their experience. An HPPD patient needs to feel they are not alone, to feel they are not "losing their mind," and to know the clinician accepts the patient's description of their symptoms at face-value."

Going to see my professors now for a 3 hour paper correction and review before sending it off. Here is a section I thought people might have not thought about (writing 200 pages of text now, I am covering it all... ack!) Admittedly, insuring HPPD remains as a psychiatric diagnosis is one of the realities that the DSM-IV will have: this text is not solely driven by science, but also by practical and political issues faced by practitioners in the United States. In this sense, DSM-IV is primarily an American product that at times may have less relevance to international communities that may not share the same health care financing problems as the United States. A cogent argument could be made that if there was no need for a diagnosis to facilitate access to appropriate mental health services in the United States, the need for the HPPD diagnosis in a Psychiatric manual would not exist; indeed members of the HPPD community would prefer this. Nonetheless, the expectation is that the updated definition of HPPD will provide clinicians anywhere to identify the more severely distressed who may benefit from psychiatric interventions that have proven efficacy with HPPD patients.

The Historical Development of the Current Etiology Cooper (1955); Elkes, Elkes, & Mayer-Gross (1955); and Sandison, Spencer, & Whitelaw, (1954) published the first accounts of negative consequences from hallucinogen use. Cooper (1995) described one of patient's aftereffects as “Illusions and misinterpretations.” A patient stating seeing a white unicorn from a plant against a shed in the dark.” Additional descriptions include time distortion or feeling of unreality, which are consistent with often comorbid or hallucinogen-induced depersonalization and/or derealization. Horowitz (1969) described HPPD as a syndrome with specific characteristics and coined the term Flashbacks. The publication included theories to explain HPPD. Horowitz stated listed on theory of HPPD as a “heightened sensitivity to perceptual stimuli as a result of an inability to suppress irrelevant sensory inputs.” Furthermore, Horowitz mentioned the possibility that other sensory modalities are involved, but identified the visual system as most affected. The descriptions from his 1969 paper can be compared with the modern responses given above [note, I include quotes from HPPDonline above]: “halo effects, blurred vision, shimmering, or reduplications of percepts, distortion of spatial places, and changes in coloration.” These are hallmark symptoms with HPPD . Furthermore, Horowitz acknowledged that physical stress and marijuana ares two experiences as precipitants of the symptoms with delayed onset or increase severity by stating, “Marihuana [sic], secobarbital (Seconal), physical fatigue, or stress may produce a state in which flashbacks from previous LSD ‘trips’ are more likely to recur.” Horowitz identifies key features that remain as a foundations for the diagnosis today: common symptoms, the possible delayed onset, cannabis as a trigger, and proposes the first neurobiological explanation involving the “disinhibition” of the process of image formation in the brain. Admittedly this theory is general and intuitive; however, it is contrasted with theories of HPPD such as the view of HPPD as role-playing in individuals who have higher prevalence of fantasy (as suggested by (Horowitz, 1969) and 160 more pages. Working on fixing these types of sections. Can't wait to publish it. It will be in hard bound copies with a total of 300? pages including my research, the symptom description and stories of HPPD individuals in the back. David

Swarm, I want to say a few things not yet mentioned: 1) Avoid Marijuana. Many individuals with minor symptoms will have symptoms exacerbated twicefold and it is a permanent change. I am one of those cases. 2) Unfortunately, there is not "out of the clear" time. During this time, while you are working on managing the symptoms you do have, if you develop a way to accept them you will reduce stress over your vision and consequently reduce the odds of having a stress-induced increase in symptoms. I wish you the best, and it sounds like you are making good choices about your future. Best wishes, David

It is official. Dr. Henry David Abraham will be the formal examiner of my written HPPD research project and the outside examiner present at my oral defense with my professors. The date of the oral examination is Monday, May 9 · 9:00am - 10:00am. This will be the final peace to the completion of this first chapter in my academic life that has taken too long. I hope to have it recorded, and then publish the video or audio on the web site. All my best, David

The American Psychiatric Association produced the DSM-IV with minimal (get citation, and the exact number of studies) empirical research to evaluate the validity of a diagnosis. The limited research conducted focused on measuring and demonstrating inter-rater reliability for a diagnosis. The result was a sacrifice of validity for reliability. With the exception of stating HPPD is a transient disorder, the subjective perceptual experiences of Hallucinogen Persisting Perception Disorder (Flashbacks) are so broadly defined the clinician is to make a judgment about the symptoms and their qualification as similar to hallucinogenic experience. The disorder criteria is absent of items that did exist in the literature (Abraham, 1983) to create a detailed characterization of symptoms required for chronic HPPD, or a description discussion of symptom severity (e.g. inability to drive at night, color impairment), and recognize the critical distinguishing features between these form experienced as differences in frequency and duration of symptoms. In theory, a patient experiencing transient derealization and distorted reality for a ten minute flashback that occurs a few times a year would be clinically identical as a diagnosis to a patient with chronic, unremitting, constellation of altered visual perception, which potentially has lasted for 20 or more years. Case report failing to identify the symptoms and only list the disorder of HPPD is valueless when the patient could be on either end of the spectrum and from the text indistinguishable and similarly diagnosed as HPPD. A clinician listing HPPD as a diagnosis on a patient chart or in a published report affords a reviewer very little except hoping the report paints a detailed presentation of symptoms. The challenge for reviewers seeking evidence based on case reports is the absence of these details. Simply stating the diagnosis without addition information contributes to confusing and diluted literature. LACK OF SPECIFICITY Criterion A includes a few symptom examples exempli gratia of potential perceptual disturbances, but these are neither required nor discussed in the text any further. These examples are taken from Abraham’s (1983) seminal work on HPPD that defined 10 specific symptoms with descriptions from a population of 123 LSD users with lasting perceptual alterations. The chronic form of the disorder is essentially excluded from fitting this strict definition as "transient". Chronic HPPD is observed as the most clinically distressful form of HPPD, and pharmacological treatments for Flashback type are not the same as those for chronic HPPD..{{2288 Strassman 1984;}} describes the disorder’s severity based on temporal experience: “responses to the use of these drugs, sometimes require careful clinical judgment in order to diagnose. These reactions can be effectively classified along a temporal continuum. Acute, short-lived reactions are often fairly benign, whereas chronic, unremitting courses carry a poor prognosis.” Additionally, numerous authors have stated the disorder consists of two distinct entities (Abraham, 1983; Abraham & Aldridge, 1993; Abraham, Aldridge, & Gogia, 1996; Lerner et al., 2002; Lerner et al., 2003). Lerner (2003) provides further clarification of this disorder: “At least two subtypes of this syndrome have been reported (Lerner et al., 2000). The first is a transient, recurrent, spontaneous, reversible and generally visual benign experience. Experienced LSD users generally look at these recurrences as a ‘free trip’, an aspect of the psychedelic dimension, and do not seek psychiatric assistance after experiencing this kind of episodes. The second is hallucinogen persisting perception disorder (HPPD). This is long-term, spontaneous, intermittent or continuous, pervasive and either slowly reversible or irreversible. This phenomenon is entirely different from the benign ‘flashback’.” Henry David Abraham, M.D. is the first to characterize the disorder and served on the Advisory Board, DSM Work Group on Alcohol and Substance Abuse, Committee to Revise DSM-IV, in 1986 and earlier the Committee to Revise DSM-III. Widely considered the leading expert on HPPD, he has authored numerous book chapters on hallucinogen-related disorders, including two widely used texts of Psychiatry including [Cite Tassmen and Current Opionions] and includes these subtypes as distinct entities. Despite Dr. Abraham’s position on the committees addressing HPPD, the criteria fail to match the literature and reality. Why did this patient population become forgotten in the language of the diagnosis? Historically, the creation of the diagnosis was described as flashbacks, and even now the term flashbacks are used to address HPPD. Not addressing this form explicitly denies the evidence and reduces the clinical utility of this diagnosis. The common understanding of the disorder has resulted in a reluctance to address the chronic form directly, and to continue to bundle Flashbacks with a disorder that is contstant and unremitting, and in many cases is a life-long condition. The development of diagnosis over time: Flashback came first. The earliest account of a hallucinogen-induced persisting affect was presented in Ellis (1898); as cited in Halpern & Pope, 2002, who reported a prolonged sensitization, to ‘‘the more delicate phenomena of light and shade and color’.’(Barron, Lowinger, & Ebner, 1970; Cooper, 1955; Favazza & Domino, 1969; Horowitz, 1969; Woody, 1971) were first to address LSD-induced pathology, and Horowitz (1969) is associated with the popular adoption of the term “LSD Flashback” to describe any recurring pathological condition from LSD. The name proved attractive, and was adopted by the drug culture and popular media. The branding of the disorder remains today in the name of the diagnosis despite the confusion this creates for someone trying to understand the HPPD condition. The disorder had no formal diagnosis until 1986, when the American Psychiatric Association’s (American Psychiatric Association, 1986) publication of the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), defined the diagnostic criteria for ‘flashbacks’ under the diagnosis of ‘Posthallucinogen perception disorder’. These criteria were slightly modified for the DSM-IV (American Psychiatric Association, 1994) and renamed Hallucinogen Persisting Perception Disorder (Flashbacks); the former diagnostic name is still used even today (Buzzed by Kuhn and friends, cite). The HPPD diagnosis does not contribute to better conceptualization of the condition or to better assessment and treatment) The goal is that the classification system used matches what exists in nature, which contains the power to predict the maximum possible number of facts that can be gleaned to understand a patient diagnosed with a specific disorder. Relying on the DSM-IV-TR for diagnostic information relies heavily on the clinician’s interpretation of this disorder, their knowledge of the literature or experience, and a patient’s self-report for accurate diagnosis. A clinician or researcher seeking additional information will likely find the first barrier to understanding the disorder at the point of the diagnosis name: Chronic HPPD is not equivalent to flashbacks, and this lingering language used both by researchers and hallucinogen users. The word flashback does not clarify the diagnosis; it simply blurs the boundaries of two different disorders, and expands the range sufficient to meet the threshold for an HPPD diagnosis.. A disorder without precision, characterization, and distinction of two different disorders, each proposed to have distinct etiology, produces an unacceptable high degree of diagnostic errors. On average, Dr. Abraham stated that a person with chronic HPPD will see six different clinicians until receiving the appropriate diagnosis (Personal Communication; www.drabraham.com). The diagnostic language results in clinical errors, miscommunicated research, and ultimately a suffering patient. . The language and criteria in the DSM-IV-TR HPPD diagnosis lacks construct validity, the pairing of criteria and what (Kaplan and sadock's comprehensive textbook of psychiatry (2 volume set) 2009) stated as “experimental confirmation of hypotheses concerning the etiology and pathophysiology of an illness construct, demonstrating that the category represents a real and natural occurring entity with a specific pathological mechanism.” The current HPPD diagnosis lacks validity and consequently results in value-reduced research and poorer patient care and clinical reports. The key concept for evaluating a diagnosis is to determine if the symptoms experienced are represented in the diagnosis. This is a measure of construct validity, the ideal standard for creating independent measurable elements of a diagnosis for often immeasurable experiences and symptoms to form an accurate diagnostic validity. Construct validity is the “experimental confirmation of hypotheses concerning the etiology and pathophysiology of an illness construct, demonstrating that the category represents a real and natural occurring entity with a specific pathological mechanism.”(Cite Text)

This post has been promoted to an article

Hello All, The number of users has almost doubled in the last two weeks. I am asking for prices to order extra hardbound copies of my HPPD text to offer to sell. At about 100 pages, it is the largest single text on HPPD, and will be reviewed and examined by Dr. Henry David Abraham in a formal examination and oral defense examination. I am including a copy of Horowitz's paper on Flashbacks. Can you identify how many aspects of this disorder that were known and published as an accurate portrait of HPPD (chronic visual type)? - David horowitz_flashbacks.pdf

clouded memory, or clouded something, makes explaining anything more difficult because i leave out stuff, like my symptoms -disconnection from my memories, my past, the world around(the present), can't picture how the future will be, not because i'm uncertain i just can't picture anything -static vision -everything i sort of moving, not quite but nothing stands completely still at onset: Everything had a cartoony type look to it Colors brighter than they should be MAJOR floaters shooting everywhere VERY intense trails negative and positive after images ANXIETY ANXIETY ANXIETY halo's around objects static only at nightime..colored static a lot of very detailed CEV'S Objects moving and "breathing" major DR (familiar places seeingly really foreign really bad) Feeling "out of it" or just high all the time..disconnected feelings of desperation, suicidal thoughts joint pain mainly elbows, that showed up at onset..probaby due to being tensed up?...dunno mood swings a slight , very slight body buzz type of feeling, like you get while tripping..(this faded after a few months) Insomnia When walking sometimes it felt like I was walking "downhill" hard to explain most of these faded and/or just became my normal over the years and I was back to 85 -90% symptom free or maybe I got used to them?? OR a bit of both.. now since prozac in november of 2007 Major flaoters again Colors brighter again trails again MAJOR DR again and a lot of emotional instability, up and down, emotions are all over the palce headaches anxiety, major major major anxiety again Insomnia again Halo's around objects again Slight afterimages (they are not as bad this time) -trails -weird street lights and car lights (when dark, especially in the morning, sometimes i see the light of cars stretch about double the car size with a transparent rainbow around, not overwhelming thou) -some color spots appear once in a while, mostly blue -conversations can be uncomfortable because my vision gets weird, sort of out of focus but its clear, damn hard to explain, makes me feel like i'm standing in a weird position or something. -some songs replay in my head, not only after hearing them anymore, reading the name of the song is enough now -irregular heartbeat(went to the doctor when i first got it, turns out i have 3 different heartbeats) -no anxiety -no panic attacks -looking down at my arms and hands, they look weird,arms are long, wrists are small and hands are big (saw a picture of that here, probably why i see it now) -bullshit dreams that don't make sense, at all -head pressure -anxiety -suicidal thoughts & thoughts about harming others -depersonalization -apathy -loss of sensitivity -self mutilation to make life real -host of strange phobias such as fear of choking, getting my neck slit in my sleep, etc. -floaters, static, halos, auras, tunnel vision with micropsia, flashes of light, afterimages, patterns flowing like streams and/or breathing, etc. -electric shocks -tinnitus -massive concentration problems -major depression (i.e. convinced my death will lift a great burden off my family & friends) -racing thoughts - just closed eyed visuals can be disturbing - memories fine, can function fine -color spots, static spots, auras around everything... w/e just makes reality more colorful -can't sleep in dark anymore... need light... -conflicting thoughts... -the power of imagination has a new definition now - stress, temperature affect it... I have to be as positivito as possible.... AFTERIMAGES When looking at somehing shining, bright, then I close my eyes, for a while I only see chaos, then it turns into positive afterimage of what I was looking at (don't have to look at it a long time, just a moment is enough), then it slowly turns into a negative afterimage and slowly fades. Then, when I blink my eyes, the negative afterimage reappears, every time for shorter period of time. I notice this everytime while driving car in the dark and looking at coloured rear lights of a car or a semaphore, when I blink my eyes, I see them right in front of me for half a second or a second. Sometimes annoying, but nothing horrible. RANDOM FLASHES OF COLOR OR SHINING DOTS These appear mainly in peripheral vision, when I notice them and look at it, they disappear. However sometimes these appear right in front of me. Annoying, but getting used to them. DISTURBANCES IN PERIPHERAL VISION These include illusion of movement, perpective distortions and straightforward hallucinations - interpreting some objects as completely different objects, like seeing a giant trash can along the road, then looking at it, and voila - just a bunch of bushes. One night I was driving completly exhausted from work and noticed a giant garbage car just a little to the left from the center of my view. After a sec I realized it's just a house along the road. This is some of the worst visual stuff for me, can be pretty scaring. MOVEMENT WHICH ISN'T THERE I can be looking at any object, and when I move my eyes just a little, while not stopping to look at that object, it seems to me it has changed its location. This is pretty subtle but constant and very disturbing. It's worst with people, when I'm for example in a room full of people, everytime I move my eyes just a little bit, all of the persons seem to change their location a little bit. This was btw. the first symptom I noticed, and the only one that remained from the trip. All the others came later. OVERALL WEIRD VISION The worst and the hardest-to-describe visual symptom for me. Everything I look at seems weird in some way, but I don't know how to describe it. Maybe it's derealization, sometimes I have the feeling of dream-like world around me, but it's not that bad all the time. But this is totally constant, never giving me a break. Maybe it's the changed perception of dimensions of objects, maybe it's peripheral distortion, like moving in an old 3D videogame. I can look at an object for infinite amount of time and absorb the weirdess, it never fades and it stays the same from the first time this symptom started - which was the 3rd day after taking ecstacy post-HPPD (maybe a month after noticing the first symptoms). I will regret taking those pills my whole life. Makes me a little difficulty reading letters on monitor. Sometimes it's like looking at it through binoculars. CLOSED EYES VISUALS This can be pure horror, however this is the only symptom which got better over time. All the others got and are steadily getting worse for me - which can be contributed to my extremly stupid E consumption post-HPPD. I never touch it again. The closed eyes visual range from animated tunnels, circles of color closing and appearing again and closing, to vivid imagery of real things, mostly grotesque human faces, computer screens, crowds of people moving chaoticly and fast. Worse when trying to sleep. Sometimes prevents me from sleeping - I get scared, my heart starts beating very fast - classic anxiety. It was worst the first 3 months, alcohol consumption boosted these for me the next day and night. Sometimes I also see LSD-like imagery, like fractals and all the classic psychedelic CEVs. Only difference from these drug induced - these are ugly as hell, dangerous look and feel, those on LSD and E were pleasurable, beautiful. NON-VISUAL SYMPTOMS (I notice everyday increase in these, and they are starting to be extremly brutal, while the visual symptoms I'm noticing less and getting used to them) - feeling like completly another person - disturbed thinking, more chaotic, out of control sometimes - cycling thougts, simple stupid thought reappearing again and again impossible to stop - some weird body sensations, totally beyond description, when I smoke pot, these can get extreme - I don't smoke that shit anymore - less in contact with reality (can be a symptom of depersonalization), many actions I do - feels like I'm doing it automatically - lack of emotions - pure hell, source of all my depressions about not being able to feel, to fall in love again etc - mood changes, sometimes I feel I am ok, and in terms with all of this, but this feeling mostly measures in minutes, then comes the pessimism, depression and fear 24/7 symptoms, except for the "episodes" Static/Snow vision day and night but worse at night. Halos around objects especially tree tops, more during the day EVERYTHING in peripheral vision is distorted/out of focus and moving. Certain patterns on objects like floors/walls move and vibrate like crazy. Floaters concentration problems "episodes" that make me feel like a zombie "episodes that make me feel like I'm going crazy (probably anxiety) SPACED OUT! but I'm used to that now and don't even remember what it's like to have a clear head. That visual sperm thing (I have a name for it now) If i stare at a face, it will distort within 10 seconds and look weird, like those pictures someone posted. A partial disconnection from myself and my surroundings Mild tracers, except when tired, and then pretty severe After images A few head pressure bouts that made me down right sick! And several other visual things that I cant even explain........um, like sections of static when looking at the sky, and flickering muticolored static within the static, ehhhh.......I just wish I could take a picture of my vision, or actually a video because theres so much movement. HPPD: 100% of the time never goes away Flickering snow or pulsating Halo`s around lights Aura`s around people Negative and positive after images around everything. Moving objects in side vision. Floaters, both kinds. Geometric shapes and colors at night. Closed eye visuals Long after images Occasional visual effects this is the feels like acid/flashback symptoms Room suddenly gets darker and goes negative Lights get over bright Objects look like liquid Breathing -electric shocks i know what you mean with that........i really made a fool out of myself with those....reckoning that it was coming from a a faulty electric meter in my mates flat...but then i got them when outside aswell. this is my first post on this site but i have a hell of alot to say good and bad about hppd but i will do it when the moment takes me. the most worrying parts of hppd for me is [a]memory loss.........sometimes i totally forget where i am when i look out the window[i think this is anxiety based though]and my working memory is terrible and since i run my own business...this can be really embarrassing with costumers and emplyees. i get paranoia too witch really bothers me. heres a list of all my other symtoms DP can't fell my legs moving when i walk panic attacks nervousness twiches...i used to get these alot when i tried to sleep loss of control over my mind intense,surreal vision floaters Anxiety Depression A lot of floaters Trouble Concentrating Halos surrounding objects (mainly when I look into the mirror) When I play a video game for a long time then go to sleep I can see things from the video game still there doing what they were doing in the video game with my eyes closed. Depressing thoughts and that's about it Although many of the following have improved with time, I'll just go through the total inventory: Psychological issues: depersonalization, anxiety, and panic attacks. Visuals: 1) snow and static dispersed through the air, with heavy static covering blank or textured surfaces (especially strong in the dark) 2) flashing in my peripheral vision that resembles a strobe light effect 3) grainy movement in my peripheral vision 4) false perception of movement (e.g. stationary objects looking like they are sliding) 5) various minor distortions (e.g. objects looking like their dimensions are stretching, or bending) 6) derealization, which, as I understand it, entails things generally looking off or strange (e.g. things look cartoonish) 7) a variety of movements with my eyes closed, and continual flashing too. 'm going to go with what visuals I have off of Klonopin, as it makes most of my issues go away: Panic attacks up to five times a day Fear of impending death at any moment Suicidal ideation Somataform sensations all over my body - unrelenting head pressure, a feeling like my head is too heavy for my neck to support it, various aches and pains Massive derealization - everything seems like it's made with bad CGI effects (except for people) Thoughts seem to meld together and "loop". It's like my conscious, subconscious, and unconscious mind have melded together to a slight extent. It doesn't ever relent and it causes massive insomnia. Very vivid, scary dreams Pareidolias - Headlights of cars look like praying mantis eyes, demonic faces in clouds, random imagery popping out vividly, especially from towels and rugs due to their designs. Both positive and negative after-images, but mostly negative after-images People's faces tend to distort and look very demonic. If I'm especially panicky than this will also happen to people on tv. When this happens I get a weird feeling of having double-vision, though I don't actually experience it. Looking through a car window everything looks like it's painted onto the window (2-D) and not actually outside of the car. Mild Macropsia and Micropsia. Tends to be with my arms and hands. Sometimes in the shower it will seem like the shower curtain is towering much higher than it actually is. Halos around objects - Don't really know how to describe it, but someone posted an image in the images thread that captures it perfectly. I also take back what I said there about it only happening to objects. I'm starting to notice it on people now too (but only under fluorescent lighting for some reason). Visual snow - Mild, only when looking at light colored objects. Doesn't bother me, I've had this symptom since I was 14 and took DXM while on an SSRI. Color distortion - Doesn't happen often, but sometimes if I stare at something long enough it seems like the colors intensify. -Obsessive, strange, and irrational thoughts. I never act out on any of them, but some REALLY disturbing ideas pop into my head. Killing my family, for example. -Strange, sketched out feelings when I'm under a lot of anxiety. Feels sort of "boxy" or as if I'm trapped. I have a tendancy to scratch, or rub my face when I'm in this mindset. -Panic/anxiety. Seems to be on and off, and unpredictable. Changes with the wind. -Moodiness; I'm not sure if this is due to HPPD, or being addicted to benzo's, but I'm very irritable, and get upset over small and irrational things. -DP/DR. I feel disconnected from my life, my surroundings, and other people. I can see myself through my own eyes, and I can control myself, but I get a strange sensation that I'm just an observer, and don't really _feel_ my existence. This symptom seems to go away (for the most part) when I keep busy, or socialize. -Tracers. I can watch something create a trail across my entire field of vision, and will last anywhere between 0.5 and 2 seconds. This is a particularily annoying symptom around people who talk with their hands, or if I'm outside on a summer day where birds, and bugs are flying everywhere. -Static, or visual snow. Colorful little waterbug-esque things swim around, particularily on plain, bright surfaces. In the dark, I see colorful static, like a tv, only if the static were colorful. -Warping of objects, size distortion. Things seem to grow, pulsate, and breathe when I look at them. -Tunnel vision. Everything in my peripheral vision disappears, and I can only see what my eyes are directly focused on. -Head pressure, extreme lethargy. ONSET SYMPTOMS: panic/anxiety strong closed eye visuals-swirling color dp/dr strong afterimages of everything felt like walking on a boat peripheral vision movement fast heart rate sinking into bed/floor feeling when laying down wake in nite to strong/fast strobe light effect in room feeling depressed/doomed static vision heavy white visual snow when looking at sky shakiness dizziness intense dreams light sensitive patterns moving items breathing severe headaches/pressure anger/mood swings ONGOING SYMPTOMS: afterimages static vision on surfaces/walls heavy fast white snow when look at sky (seems like I could touch/catch it) anxiety/panic occasionally random dp/dr headaches (especially after deep sleep) occasional strobe effect in night (when deep sleeping) light sensitivity (sun, flouresent) moodswings STUFF related to hppd over 17 years (just learned of hppd past Nov.) panic attacks anxiety OCD due to fear of drug residue or something? anorexia due to unknown food fear (drug tainted?) depression/uncertainty Visual: Static Negative after-images Closed eye visuals Geomatric patterns Movement of objects Collours floating in vision (mostly purple) Floaters Glitters in the sky Seeing the air (you know what i mean ) Non-Visual: Anxiety Depression Disturbed thinking Bad concentration Bad memory Panic-attacks Weird perceptions of reality Derealisation Depersonalisation Mood swings Insomnia I probably forgot some symptoms visual: static, dull grey color, other times it's neon colors floaters everywhere, both kinds halos around whatever color I'm looking at auras around people things breathing and shifting around patterns in carpets colored blobs in my vision when I close my eyes sometimes the room I'm in gets dimmer or brighter suddenly (-) and (+) after-images on almost anything light sensitivity non visual: anxiety head pressure DP/DR, not so much when I'm with people, my mind just gets off it I suppose clouded thoughts bad memory feelings where I want to hurt people or myself depression mood swings dizziness when I get up from sitting/laying down the feeling of impending doom like I'm going to die any second (when major DP/DR sets) my onset symptoms would have been major DP/DR, static, floaters, (-) and (+) after-images that's all at first then one day, wham-o flashing, tracers, melting and breathing environment, closed eye visuals that look like the northern lights, visual snow, visual sperm, halos, starbursts, I feel like im on acid or mushrooms 24/7, nightmares , panic attacks, silver orbs that swim through my vision like tadpoles, racing thoughts, deppression, anxiety, DP/DR, cobweb floaters, scalp crawling and ears errect like when on acid, light sensitivity, see faces and objects form in carpets or walls or the sidewalk, brighter colors like neon looking, a shimmering or vibrating effect when I look at lines or read, afterimages, yesterday feels like it happened last year in a dream, pressure in my head that feels like when I took acid, and over all just zoned out like when your staring off into space on a day dream like being some where else but never snapping back into clarity. well thats all, I can explain alot of the stuff I feel, but theres also alot that I cant even find words for. Hi David, It i am surounded by universes and dimensions and vortexes into other realms All the colours of the spectrum, sphears and very bright stars. After walking inside on a sunny day i am blinded by visuals for up to 10 minutes. Objects moveing, macrascopia, micrascopia..things breathing etc When lights are off i am litrelally lost in space like in some far away cosmic star burst of some shit. Universes in universes. can see the air and every type of geometric patterning within it of all most bright psychadelic colors constantly moveing and changeing.... Glowin halos, things melting into each other...The black and white television affect..particles of my hand lifting up into space. Probarbly not a great description...best i can do 4 now as i am a little unewll. Other things also include Anxietey Depression Not being abble to hold my concentration at times Difficulty conecting with other the way i would like when i am in this other place. Thaught of Overdose to take this shit away at times. Visuals - Static : As described in another post... A good way to describe my static/snow is that it looks like there is a blank white, film strip movie, going on behind everything, and that everything has rips in it, on a different level than physically, and you can see through it and watch the film strip skipping frames behind the world. But the film strip picks up some color, as if the edges of the rips in the world, are transparent World Has a Different Color Scheme : Everything in the world looks very cartoonish. Such as a Anime cartoon, that has darker colors. That is the best way to describe it. Dream-Like Reality : It seems as if you could wake up, and go back to... well I know the exact day it would go back to. November 3rd 2006. Sometime I can see it, I feel like I could really wake up. Depressing sometimes. Brightness : It is much brighter outside. I always have to wear sunglasses while driving. But it's really hard to drive with sunglasses on now. Movement : New - A couple of different situations. Last week I went running on a tread mill at the YMCA, and the first time since hppd. After running a mile and a half at 13mph, when I got off, the entire world was just moving out of place. I found it very difficult to walk. I must have looked like and Idiot. Yesterday I played guitar hero 3 for the first time. After playing for 10 minutes(very focused), I noticed the monitor was stretching upwards. I looked over and my couch was breathing (which I can refer to as we've all experienced it.) I went back to playing, and a few minutes later look over by my computer, and the computer chair is starting to move up above the computer. This morning after playing, I was watching my ashtray move across my kitchen table. It moved about a half a foot. Also the grain in the table was swirling. Rocks - When on break at work in the summer, I would look at the rocks on the ground while I ate lunch (if no one was outside). I would focus on one rock, and all the other rocks would form patterns, and kind of shift into that one rock. The geometric shapes they formed where very interesting. They also would glow a lot. As soon as I would take my sight off of where I was directing focus, it would go back to normal. I would take a full thirty seconds for the rocks to form a very vivid design. Grass does the same thing as rocks. I haven't seen either for a bit since it's winter. Stress and Tiredness makes my visuals much much worse. Mentally - Anxiety : After going to watch a movie at a theater it gets very bad. I don't even want to drive after words, and it is very hard to do so. I will get very bad headaches, and stomach pain. I hate school. I used to enjoy it so much, last semester. Now my anxiety is so bad, every time I have to go to class I freak out. I almost can't take it. My class on Tuesday, I was flipping out so much I wanted to cry, I had a exam to take and I was sure I was going to fail it. I finished first, and got 97.5% on the exam, without studying (normal for me). The best way to explain it is.. I feel like I am at the very edge of the top of a plateau, and someone is standing directly behind me as I look down a half mile to the ground. When my anxiety gets bad, it feels like it is eminent that I am about to die. If you can really imagine yourself in that situation, it's the best way to describe it. Depression : I am very sad, and it is very hard to feel emotion, even when I know I should. Pressure Headaches: I used to randomly get horrible pressure headaches in my frontal lobe. Hasn't beena problem lately. Memory: Short term memory is slightly impared. Visual Static more severe in darkness or blue sky Movement in a static setting, this has been getting better. Increased awareness of Floaters Blood cells in my eyes are noticable on a white/light background Mild Trails Halos around lights Depression Hopelessness Anxiety DP/DR Insomnia I get the exact same feelings with my breathing and heartbeat. Other involuntary body processes that i should not have to think about I end up concentrating on. Blinking, for example, I feel like i'm doing it to much, or i dont know how, or if i shut my eyes i cant keep them closed unless i strain. This can contribute to tearing up or squinting from sunlight and air currents. Just a lot of things with my body seem out of whack and just random aches or pressing sensations in different body parts. Other non-visual symptoms are overwhelming senses of defeat, depression, anxiety. And for those who mentioned APATHY. that is a big one for me and it is really causing problems with school. Visually, everything is so fucked up i could never list it all unfortunately any scantron test or quiz i receive in school with hundreds of little bubbles are impossible. I'm very likely to make stupid mistakes or just give up all together with those. LED lights or bright lights of any kind in a dark setting obscure details of any objects near them. Colorful geometric static is constantly buzzing and clouding my vision, coating everything i see at all times so that it is often unbearable. CEV's are STRONG. Having to stare into neverending vortexes of LSD/phenethylamine-like detail that keep coming and coming and coming at me is horrible. Sleep eludes me. Having my eyes open hurts my head and strains my vision, having them closed is even worse. Reading books takes me longer because i have to concentrate so hard, and i'm tired afterward. I'm an artist and even drawing is hard. The only thing in my life that still comes naturally and easily is writing, it still flows to me and is unhindered by my HPPD. It is my only source of a fleeting solace. I'm only 16 and i've been living with this in all its intensity for about 6 months. Drugs involved in this include 2c-i, LSD, Shrooms, DMT, MDMA, THC, and the list goes on. I didnt even start smoking weed until last year, and intense HPPD suddenly began effecting me during last summer. I'm worried. I dont know how i can go through life with this. There is still so much i want to experiment with, discover, experience, and enjoy. I wonder if all this noble effort will ever come to fruition, or if this HPPD thing is just too fucked up. I am hesitant to hope. I am unsure.

Update: The project is now Four papers that are linked roughly titled: 1. Evidence-based review of Hallucinogen Persisting Perception Disorder (“Flashbacks”) (The thesis will be listed when I publish more) 2. Revision of new criteria for HPPD within the DSM-V Guidelines. 3. The Neurobiology of Hallucinogen Persisting Perception Disorder 4. Unannounced until publication. It will shed some light on questions you may have.

Happy to rediscover psychedelic researcher, highly regarded and author of popular texts on DMT, describes the disorder’s severity based on temporal experience: “responses to the use of these drugs, sometimes require careful clinical judgment in order to diagnose. These reactions can be effectively classified along a temporal continuum. Acute, short-lived reactions are often fairly benign, whereas chronic, unremitting courses carry a poor prognosis.” This quote comes from: PMID 6384428 Journal Article Journal Article Ref Type Journal Article Source Type Print(0) Output Language Unknown(0) Authors Strassman,R.J. Title Adverse reactions to psychedelic drugs. A review of the literature Periodical, Full The Journal of nervous and mental disease Periodical, Abbrev J.Nerv.Ment.Dis. Pub Year 1984 Pub Date Free Form Oct Volume 172 Issue 10 Start Page 577 Other Pages 595 Descriptors Adolescent; Adult; Anxiety Disorders/chemically induced/diagnosis/therapy; Chronic Disease; Hallucinogens/adverse effects; Humans; Lysergic Acid Diethylamide/adverse effects; Panic; Prognosis; Psychoses, Substance-Induced/diagnosis/etiology/therapy; Research Design/methods/standards; Schizophrenia/chemically induced/diagnosis/therapy; Substance-Related Disorders/complications/etiology/therapy Abstract The use of naturally occurring and synthetically derived compounds for their "psychedelic" effects has been a part of human culture for thousands of years. The basic pharmacology of the major synthetic psychedelic compounds (primarily lysergic acid diethylamide [LSD]-25) is described and reference is made to their potentially beneficial psychological effects. Adverse reactions, defined as dysphoric and/or maladaptive/dysfunctional responses to the use of these drugs, sometimes require careful clinical judgment in order to diagnose. These reactions can be effectively classified along a temporal continuum. Acute, short-lived reactions are often fairly benign, whereas chronic, unremitting courses carry a poor prognosis. Delayed, intermittent phenomena ("flashbacks") and LSD-precipitated functional disorders that usually respond to treatment appropriate for the non-psychedelic-precipitated illnesses they resemble, round out this temporal means of classification. The question of organic brain damage as well as permanent changes in personality, attitudes, and creativity in patients and normals who have repeatedly ingested psychedelic drugs is controversial, but tends to point to subtle or nonsignificant changes. Future areas for study of the psychedelics' pharmacological, psychological, and therapeutic effects are suggested. Notes ID: 148; LR: 20041117; JID: 0375402; 0 (Hallucinogens); 50-37-3 (Lysergic Acid Diethylamide); RF: 171; ppublish Place of Publication UNITED STATES ISSN/ISBN 0022-3018 Accession Number PMID: 6384428 Language eng SubFile Journal Article; Review; AIM; IM Created 4/27/2010 3:46:13 PM Local Timezone (GMT -4hr) Last Modified 5/9/2010 5:30:37 PM Local Timezone (GMT -4hr)

I have updated my response to this post in the blog at the top of the page. I believe it to be an error on my part. I have changed the settings back to the original. I have selected to have this topic "watched" and I will receive immediate notification via notifications on my iPhone, so please respond so this web site is up to speed.

Here is my first idea: This occured when the website was upgraded to a new version. The server speed and uptime is fine, but some computers that had previously used the old site are not cacheing this site properly or the cacheing out in other servers is not proper. Here it goes... I am going to clear all caches... I would clear your cookies and internet history too (not a bad idea to do anyway). Someone on here that knows about computers (if you could save me sometime and explain how to do on the major browers that would be great!!!) Let me know if this helps. ALSO: I have disallowed guests from viewing the website because I am developing certain sections that are not available except to users who have demonstrated either in the past or through their use here to be trustworthy and have HPPD. This will allow for some intimate discussions with each other. Post if it helps! - David