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Psychiatric comorbidity in subjects with HPPD

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Author: Klaus Podoll, Markus Dahlem, Sofia Greene	15. December 2007
Edited by: Klaus Podoll, Markus Dahlem, Sofia Greene

Psychiatric comorbidity in subjects with HPPD

Nirvana lead singer Kurt Cobain, who described HPPD symptoms in his private journals (see here), committed suicide April 5, 1994 (see here)

Of the 30 subjects with a diagnosis of HPPD, 23 or 76,7% reported a psychiatric comorbidity with anxiety (15 subjects), panic attacks (14 subjects), obsessive compulsive symptoms (2 subjects), symptoms of Post Traumatic Stress Disorder (2 subjects), depression (14 subjects) or LSD induced psychosis (1 subject), respectively.

In all these 23 subjects, the aforementioned psychiatric symptoms began after the onset of HPPD. For example: "I've been diagnosed with OCD", wrote Ian (subject #91), "however in my opinion my OCD symptoms were directly triggered by the stress and anxiety related to my visual problem."

I wouldn't have the anxiety or depression if I could see properly

"I too have serious visual snow along with a few other symptoms including minor distorted hearing, anxiety and depression. I wouldn't have the anxiety or depression if I could see properly. It's a pretty terrifying feeling to see static everywhere like you are looking out of a Television set. I found that since I obtained this disorder my thoughts about life have changed dramatically as well."

(1planet1chance [subject #442], Ezboard forum Visual snow or static - Discussion - I officially have Visual Snow, September 14, 2007)

"What I meant is that my perception on life has literally been changed. I'm not sure if it was from the drugs which opened me to a new understanding of reality, but I basically feel like I see things that people aren't meant to see... metaphorically speaking, I almost feel as if I have lost my filter in my mind and now I percieve everything that the filter would normally stop. Almost feel like I am in an illusion and that the world isn't actually real... sounds really strange but it's all very very real in my mind. Because of these feelings I have lost my hope at ever being normal and am extremely envious of dumb people, I have lost the passion to follow any dreams, I feel like life is hopeless and that it is all one big test... almost like an alien ant farm I suppose, like they created us and are all just watching us colonize... To be brutally honest when I watched The Matrix a few years ago it was all too familiar and I almost ended up commiting suicide. All in all I feel that I am not real when I have these damned 'attacks.' My biggest problem is that I am so afraid of having the attacks that I wake up everyday thinking about them wondering when it's going to come. I have to tell myself everyday that 'today will be better and I will be ok'... sometimes it works and sometimes it doesn't. I try to distract myself from these feelings which can leave temporarily, but always within minutes they are right back again. I really don't want to admit that what I have is psychological because then ALL hope of finding help would be lost and I wouldn't be able to go on... Wow that was the most honest I have ever been about my feelings in years. Hope I didn't scare you..."

(1planet1chance [subject #442], Yuku forum Visual snow or static - Discussion - Strange feelings in head, September 30, 2007)

"Thanks so much for your help... I researched [HPPD and] Depersonalization disorder and when I read about it I was in shock... I finally know what I have and am going to be seeking help for it immediately. Again, thank-you."

(1planet1chance [subject #442], Yuku forum Visual snow or static - Discussion - Strange feelings in head, September 30, 2007; additions in square brackets by Klaus Podoll)

Two subjects (#89, #103) reported symptoms of Post Traumatic Stress Disorder (PTSD) related to bad trip and/or HPPD experiences.

PTSD following HPPD

Fockyoumang (subject #89) developed HPPD following smoking pot that was almost certainly laced with LSD. "When I was 11 years old I smoked some pot, or at least what I thought was pot, and I remember how the two older kids, in their late teens, were laughing and then kept asking me if I wanted to drink some liquor, which I thought was odd - how they kept asking and asking... I knew something wasn't right, that night it all happened, and that might have set the stage for everything else to come. And I don't know why the older kids were laughing at me smoking and kept pressuring me to drink that liquor. I'm pretty sure it was LSD because at that time, in the early 1990's, all those kids were doing it." In the further course, after having developed HPPD, "Just smelling pot would make me feel like I was going insane... Then I got these OCD things that I would do; like not touch anything because I was deathly afraid that someone had put LSD on it and it would go through my skin... Thinking back now, I can't believe that I actually lived like that and didn't take my own life. Because for a kid who's only 11 years old, and who didn't tell anyone about what was happening; that is a lot to deal with."

(fockyoumang [subject #89], Ezboard forum HPPD – HPPD – General Support - DO I HAVE HPPD??? I THINK I DO, April 30, 2006)

"I am quite sure I had PTSD for some years", reasoned Victor (subject #103). "My trauma occurred in conjunction with both the 'bad trip' as well as the perceptual distortion that it created. I find it somewhat hard to separate the two. The trip was an absolute nightmare and catalyzed a traumatic episode, there is no question of that, but had I 'returned to normal' the next day, had my vision settled down to the way it was PRIOR to the experience, perhaps - who knows? - I would not have experienced long-term PTSD. The trauma was chiefly connected to perceptual distortion. The psychological or emotional component of the trip itself was a source of extraordinary mental/physical distress, but I believe it was not the primary origin of my trauma. I have already enumerated the contents of my HPPD in my last message."

(Victor [subject #103], Email to Klaus Podoll, May 16, 2006)

"I believe the development of PTSD after a bad trip is a credible claim for anyone to make. LSD in particular is one of the most potent psychoactive drugs known to man, as you are well aware. One must be prepared for it - as I clearly was not. As for whether I developed PTSD or HPPD as a direct consequence of my bad trip, and which of the two led to the other... I strongly believe that the lingering visual effects after the bad trip had instigated the long-term traumatic response. I consider myself a logical person, lucid-minded. My vision never quite returned to normal after the trip, keep in mind... actually, I believe that qualitatively it had remained on the same distorted level... and the experience itself while on the LSD 'high' was highly distressing. Like your participant [subject #89], I, too, had trouble with stimuli reminiscent of the trauma... and not even that, but anything 'psychedelic' in nature, such as certain psychedelic or experimental art or music... I felt like I had to avoid it for several years, adding an additional layer of stress..."

(Victor [subject #103], Email to Klaus Podoll, May 18, 2006; additions in square brackets by Klaus Podoll)

In a sci-fi cartoon drawn by HPPD sufferer SamyFire (subject #268), a policeman reads the suicide note written by a hung visual snow sufferer: "... the snow, the dp/dr, I just can't stand it any longer". The inscription on the wall ("White walls are the enemie!") suggests that he might have gone paranoid before he committed suicide. As a tragic irony of fate, the discovery of a cure (sci-fi!) against "visual snow" is broadcasted via TV news in the very moment that his corpse was found by the policeman. "Sometimes I've got a very very black kind of humor", commented SamyFire on his cartoon which is an emblem involving the three basic components of inscriptio (a title or motto), pictura and subscriptio, a caption that formulates the take-home message of the cartoon: "Do not risk a fatal timing! Stay alive!"

(SamyFire [subject #268], Ezboard forum Visual snow or static – Discussion – Visual snow comic, September 6, 2007)

References

Cobain K. Journals. Riverhead Books, New York 2002.

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