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DP/DR - A Closer Look

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Hey there, hope everyone is well.


Well I'll get right in to it, after reading the poll on the percentage of sufferers with DP/DR I deduced that almost as many sufferers experience DP/DR as those who do not, it seems to be pretty much 50/50.

Many questions have arisen from these findings, but most of all, can DP/DR be separated from HPPD or is it simply interlinked somehow?


Exploring this further, I made a thread not too long ago asking if any sufferers have experience remission of DP/DR but not other symptoms such as visuals and all the other nasties we have to endure, what I took from that thread, and also introductions and recovery stories, was that there have indeed been a fair few people who's DP/DR has subsided while their visuals and other symptoms have not.


This leads me to believe that they are indeed separate entities. What they share in common is that the biggest (only) trigger for HPPD is prior ingestion of a hallucinogen, and one of the biggest triggers for DP/DR is prior ingestion of a hallucinogen, whether it be cannabis, LSD, MDMA, or whatever else.


After much research on DP/DR on whatever I could find on the internet, the general consensus of the medical community at large at the present time seems to be that DP/DR results from EITHER:


Unprocessed trauma

A long history of anxiety, such as found in generalised anxiety disorder

Prior build-up of stress


And to a lesser extent, dissociative identity disorder.


Why a hallucinogen would trigger this into a chronic state of dissociation remains largely unknown, but it is well documented that many, many cases of DP/DR are triggered by psychoactives.


As you can see from the list of causes, they all have to do with excitation in the brain. Unprocessed trauma would seemingly cause underlying anxiety and stress, a history of anxiety is, neurologically speaking, a long period of time with an over excited brain. Prior buildup of stress is again, a prolonged period of time with an over excited brain. This leads me to believe that DP/DR is a result of over excitation in the brain, no matter what the CAUSE of that over excitation. 


Us HPPD'ers have over excitation in the brain also, which again, leads me to believe that the mind is responding in the same way as it would to large bouts of anxiety, stress etc. It is dissociating.


Now, what can we conclude from this? Well, being as only half of sufferers experience DP/DR and the other half do not, it would be reasonable to draw upon the conclusion that it is not linked with the pathogenesis of HPPD entirely. I know I only experienced my chronic DP/DR after 2 weeks of constant anxiety and panic when my HPPD first onset, as I had no idea what it was and thought I was losing my marbles. 


HOWEVER, I do indeed have a history of anxiety and stress all the way through my childhood and teen years, and also have a history of abuse. How DP/DR seems to work is that if the history is there, then a trigger will set it off. Whether that trigger is a drug, a panic attack, a stressful life event or anything else. 


Thus, there are only 2 logical explanations for DP/DR in HPPD.


Number 1 - It is a co-morbid disorder and was triggered by the use of a psychoactive substance in the same way it is triggered in 'pure' DP/DR sufferers, it just so happens that we have HPPD on top of that. I think this theory should be explored more, as we now know that 50% of the community suffer DP/DR and the other 50% do not, we also know that people have recovered or 'snapped out' of the DP/DR state while all other HPPD symptoms remain intact. 


Number 2 - DP/DR is directly linked to the HPPD pathogenesis, now there are many sub-theories as to why this would happen, such as:


1) Extreme anxiety/worry over the visuals, and since the brain interprets this as there being a threat in your environment everywhere you go, everywhere you are, there is absolutely no escape from the threat, and so the brain simply disconnects you from your environment as means to cope. This is basically what Complex-PTSD is defined as, and is how dissociation arises in Complex-PTSD, an inescapable threat.


2) The over-excitation in the brain as a result of our HPPD is causing a malfunction of communication between different areas of the brain. If specific areas of the brain are firing too fast then this can interfere with communication between other areas of the brain too. The brain would not know the difference between over-excitation caused by HPPD and over-excitation caused by stressors and anxieties, and since HPPD shows dis inhibition across the whole cerebral cortex, quote:


The cerebral cortex plays a key role in memory,attention, perceptual awarenessthoughtlanguage, and consciousness


Note 'perceptual awareness and consciousness' 


This would also explain why we respond wildly different to medications as far as DP/DR goes. Some people have gotten remission of DP/DR with Keppra, but not others. Some with Benzodiazepines, but not others etc.


Sorry for the huge wall of text, I've forgotten what I've wrote already so apologies if it's a bit rough on the old cognition. Any thoughts and feedback would be more than welcome. Thanks.





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Im going to spew out completely unscientifical opinion.


Maybe it's interlinked to some and not interlinked to some. 


LSD creates new pathways and cut off some to old ones?


Considering that actual tripping on LSD can induce anxiety + DP/DR(bad trip) and the fact that HPPD itself is the remaining of visuals from LSD, I believe there is a good possibility that DP/DR itself can remain in the user. 


I also think that there is a better chance from recovering from DP/DR/Anxiety because we can actively work on those areas using our brain/thoughts and even our sensations like touching/swimming/talking to feel more grounded and fight off DR/DP.


However, with visuals, I think its more complex. We cant really counter visual abnormalities by ourselves like we can counter DP/DR by trying to force emotions and sensations.

We would need the aid of professionals and machines (or research some eye exercises), as it has been mentioned in another thread that behaviour optical therapy has some good potential. 

(again i note that im making this up as I write it, just food for thought)


When I developed anxiety about 2month into hppd, I always thought of it as another symptom of hppd.

I didnt know why I was anxious and although I was new to HPPD, ghosting visuals and the like didnt really phase me at all. I'm hesitant to call it anxiety because I think it had more to do with heartbeat fluctuation and bloodpressure levels, not to mention that medically confirmed of mildly abnormal cranial bloodflow. (maybe i was already subconsciously anxious then?) but its questionable because my phase of anxiety developed after I had visual symptoms and disappeared within 2-3weeks. Maybe I coped fast?

Though things that made me feel better was getting massaged and also visiting family relatives kind of forced me to keep myself in check. 


edit: to clarify, my anxiety and very mild dp/dr didnt start until about 3-4weeks into HPPD and only lasted about 2-3 after that. I now 'worry' about hppd occasionally but i wouldn't call it anxiety at all. I never had a history of anxiety either except for a mildly bad trip once and rough start of a trip once.

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  • 2 weeks later...

I think all of those theories sound equally plausible. 

In my own case I had anxiety, dp/dr, and hppd at the same time right after MDMA.


First the anxiety went, and now the dp/dr is much more transient but the visuals have remained. I am left thinking that the anxiety and dp/dr are related but the visual symptoms are not.


The more and more research I do into these symptoms the more confused I become. Everything overlaps, nothing is concrete and it is all exceedingly hard to diagnose. However, I really don't think dp/dr and hppd are related other than having common triggers.

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  • 1 year later...

but i have read that dp/dr disorder has also static occuring as a symptom so maybe some of us have dp/dr disorder instead of hppd without knowing about it...so far im not even sure if hppd isnt a kind o dp/dr disorder.


and psychedlics may trigger trauma perhaps we have to learn a lesson and face our deficiency to get rid of this shit  i think it is imaginable that psychedelics are able to lock our brain towards new experiences to protect us from going crazy and only if we find a way to process our past and face our trauma our brain will unlock again for new experience...its just a theory but note that the natives who use psychedelics have no such issues and also have no trauma...it could be the key


...you cant imagine how glad id be to know everything about this strange hppd condition... we should look at it as our research topic..finding a solution to wipe out hppd, dp/dr or whatever once and for all...so that we make sure no coming generation has to suffer that much..cause its terrible

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trip into hell, yeah i was thinking about what u said too. the first paragraph. if HPPD is some type of DP/PTSD. 


I also wonder if some of us have different diforders. 


yeah its a strange condition, i agree.... but maybe its not a strange condition? what if its just some part of our vision got unlocked and now we're traumatized by it causing DP, simple as that ?


what if there are different kinds of "HPPD?"


some people have it for life, some people it goes away. Does anxiety about HPPD support the HPPD? 

its weird, because 2 of my friends have "HPPD" - they see tracers and stuff still. 

They got it from Nbome, the research chemicals, which are kinda different than LSD and shrooms. and they both have tracers.



But i got it from shrooms and i see faces and pattern recognition ... So is it just random that we have different symptoms, the same disorder or something different? p.s. , my symptoms seem to be diminishing. probly cuz i quit drugs. could it be related to the meditation?, less obsessing, thinking about symptoms? idk



and some people are on a full-blown acid trip basically.... 


what if some people, the DP is related to the condition and some people not...? idk im just spewing out theories .


I feel if we all compared our symptoms and shit we could proove such theories correct or incorrect. maybe we should make a thread




and then theres people on shroomery with no anxiety, and HPPD, and some continue to trip every week...... like my friends ...

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hm...may it be that there are different types of hppd, different intensities or is it just that we all have the same disorder but experience it in another way because we are all different.


my theory is that our filter is dissolved or lets say the ego psychedelic/shamanic speaking.. and the ego is what protects one from the difficult impressions where the perception of truth/reality can lead to..cause it is scary when you look at it unfiltered not able to sort out what you want to perceive and what not, so the consequences are hppd/dp/dr sufferers have to look at everything the reality consists of, im sure this could trigger panic attacks, unexplained pain, wierd sensations and so on  ..remember some of your psychedelic trips ..what happens to you when for example shrooms are coming on...its mostly a sudden fear..which slowly dissapears (ego dissolution) when the general trip starts..and i think hppd/dp/dr sufferers are kind of stuck in this mad sensation because they permanently lost their ego/filter or lets say reality protector and thats why life is mostly so unbearable for them..i guess 


and the reason why it lasts so long for one and not for other people may be determined by the psychedelic experiences theyve made (frequency/intensity/substance) cause differnt experiences have differnt awakening potential...another possibility is that one has to learn the lesson of his life before hppd/dp/dr is completely fading...


its hard to say i guess some people are also talking bullshit to appear improtant..thiis is hard to prove..if so


and yeah ive got my hppd/dp/dr also from using shrooms and i also see faces out of irregular surfaces, sometimes morphing  and visual snow...and i saw these faces since my third trip and this could have always been hppd but dp/dr and visual snow is what i have since my onset after over hundered psychedelic trips..so i could have dp/dr disorder now and the hppd from my third trip on has never been a problem..so my theory about this is that hppd is more common among psychedelic users and not so much a problem as altered perception...the problem starts when a user aquires dp/dr cause then the nightmare begins.


im sure these are two differnt  conditions but they occur often at the same time and hppd alone is usually not a problem, it wont stop one from enjoying his/her life/drugs and so on and im not sure if dp/dr can be caused by hppd as a result its hard to say though...just as you say we have to compare our symptoms and make statistics to compare and work it out..and the best way to do so is to create a form considering every relevant possability.

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