What Is Hallucinogen Persisting Perception Disorder (Flashbacks)?

Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesTypesTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Symptoms

Diagnosis

Causes

Types

Treatment

Coping

Flashbacks are common among people who use hallucinogenic drugs, and while drug-related flashbacks have a reputation for being disturbing or just the result of a “bad trip,” not everyone who experiences flashbacks finds them troubling.

But sometimes, these flashbacks can be intense, unpleasant, and frequent, even if the person experiencing them is currently abstaining from drug use.

Flashbacks that continue to occur after the original drug effects have worn off are a medically recognized phenomenon, which is documented in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5-TR) as hallucinogen persisting perception disorder (HPPD).

A drug-related flashback is the sensation of re-experiencing the effects of a drug after the true effects of the drug have worn off. Most often, this type of flashback is associated with the re-experiencing of the effects of ahallucinogenic drugsuch asLSD (“acid”)ormagic mushrooms.

Flashbacks typically happen in the days or weeks following ingestion of the drug but can happen months or even years after the drug use has been discontinued.

Flashbacks are not usually as intense or long-lasting as an actual drug experience, usually lasting just seconds or minutes, and are easier to control mentally than intoxication or a bad trip.

Symptoms of hallucinogen persisting perception disorder (HPPD) include:

Occasionally, people or situations may seem bizarre or ridiculous, or the person experiencing the flashback may feeldissociated. When this happens in a social situation requiring self-control, it can be embarrassing or scary for the person experiencing it.

What an Acid Flashback Is Like

Often diagnosed in people with a history of substance use, HPPD can occur even after the one-time use of triggering drugs, which include LSD, phencyclidine (PCP),methylenedioxymethamphetamine (MDMA), andcannabis (marijuana).

The following co-occurring mental illnesses are also common in people with HPPD but not required to make a diagnosis:

If you or someone you care about is experiencing intense and frequent flashbacks, you should visit your healthcare provider. It’s important to be honest about your current and past drug use, as well as any history of mental illness.

Remember, the doctor is not there to judge you but to help you find the right treatment to ease your symptoms.

According to the American Psychiatric Association, to be diagnosed with HPPD a person must:

Flashbacks can come on unpredictably or in response to a trigger, such as tiredness, anxiety, or stress. Triggered flashbacks can be especially difficult as the person may already be feeling vulnerable due to the trigger, which can make the out-of-control feeling of the flashback all the more confusing and upsetting.

While we don’t know a lot about what causes HPPD, we do know whatdoesn’tcause them, including the following:

The Short and Long Term Effects of Hallucinogens

There are two types of HPPD:

Flashbacks usually subside on their own after the drug use has been discontinued, over the course of a few months, and most experts agree about the importance of abstaining from drug use for recovery.

Therapy

Amental health professionalcan help to treat the anxiety that can accompany flashbacks, giving the person more of a sense of self-control.

If the person has no insight into the drug-induced nature of their symptoms or if these experiences persist or cause significant distress, however, they should seek a psychiatric assessment to determine if there is another mental health issue involved, such aspsychosis.

Medication

Anti-seizure and epilepsy medicines like Klonopin (clonazepam) and Lamictal (lamotrigine) have been used in the treatment of HPPD, however, there is no recognized medical treatment for flashbacks.

Other drugs that have been studied in the treatment of HPPD include:

Having a flashback can be distressing, but calming or self-soothing activities likedeep breathing, grounding techniques, andmindfulnesscan ease the psychological discomfort and help you to stay in the moment. It’s also important to learn your triggers so you can do your best to avoid them and better manage them when they do occur.

For example, if stress is a trigger for you, work on practicingstress management. If fatigue is a trigger, take steps to get adequate sleep and rest when you need to.

Whether you turn to a loved one or a mental health professional, know that you don’t have to deal with HPPD and drug-related flashbacks alone. Getting help and seeking support is a great first step toward overcoming the disturbing and frequent visual disturbances of HPPD.

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3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed., Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Martinotti G, Santacroce R, Pettorruso M, et al.Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives.Brain Sci.2018;8(3). doi:10.3390/brainsci8030047Hermle L, Simon M, Ruchsow M, Geppert M.Hallucinogen-persisting perception disorder.Ther Adv Psychopharmacol. 2012;2(5):199-205. doi:10.1177/2045125312451270

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed., Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Martinotti G, Santacroce R, Pettorruso M, et al.Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives.Brain Sci.2018;8(3). doi:10.3390/brainsci8030047Hermle L, Simon M, Ruchsow M, Geppert M.Hallucinogen-persisting perception disorder.Ther Adv Psychopharmacol. 2012;2(5):199-205. doi:10.1177/2045125312451270

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed., Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Martinotti G, Santacroce R, Pettorruso M, et al.Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives.Brain Sci.2018;8(3). doi:10.3390/brainsci8030047Hermle L, Simon M, Ruchsow M, Geppert M.Hallucinogen-persisting perception disorder.Ther Adv Psychopharmacol. 2012;2(5):199-205. doi:10.1177/2045125312451270

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed., Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

Martinotti G, Santacroce R, Pettorruso M, et al.Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives.Brain Sci.2018;8(3). doi:10.3390/brainsci8030047

Hermle L, Simon M, Ruchsow M, Geppert M.Hallucinogen-persisting perception disorder.Ther Adv Psychopharmacol. 2012;2(5):199-205. doi:10.1177/2045125312451270

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