What is HPPD?
Hallucinogen Persisting Perception Disorder (HPPD) is a condition where visual disturbances continue or return after the drug has worn off. People often describe trails, halos around lights, static or “visual snow,” color shifts, afterimages, and objects that seem to breathe or ripple. For some, these moments are brief and rare. For others, they linger and interfere with school, work, sleep, and driving. HPPD can show up after a single use, repeated use, or a difficult “bad trip.” It can affect anyone, even people with no prior mental health history.
Why does HPPD happen?
Scientists are still working on the full picture. The leading idea is that hallucinogens temporarily change signaling in the visual system and related brain networks. In HPPD, some of those changes may stick around, leaving the brain “over-tuned” to certain patterns of light and motion. Risk appears higher with high doses, mixed substances (like LSD plus cannabis or stimulants), sleep loss, anxiety or panic during the trip, and using in unsafe or stressful settings. Caffeine, cannabis, and stress can make symptoms flare even months later.
Symptoms to watch for
Common visuals include halos, starbursts, trails behind moving objects, floaters, grainy “snow,” flashes of color, and afterimages that last longer than they should. Some people also feel derealization (the world feels unreal) or depersonalization (feeling detached from yourself). Anxiety often rides along, because the visuals are confusing and hard to predict. Many report eye strain, headaches, light sensitivity, and trouble seeing well at night.
How HPPD is diagnosed
There’s no single blood test or scan for HPPD. A clinician makes the diagnosis by listening to your history and ruling out other causes (eye disease, migraines with aura, seizures, head injury, medication side effects). Be honest about any substance use—your provider’s job is to help, not judge. Bring notes about what you see, when it happens, what makes it worse, and how it affects daily life. That detail speeds up the right plan.
Treatment and recovery options
Good news: many people see improvement over time, especially when they stop all hallucinogens and reduce triggers. A helpful care plan often includes:
Education and trigger management. Learn your personal triggers. Common ones are bright lights, screens at night, loud clubs, caffeine, cannabis, stress, and sleep loss. Use blue-light filters, dim screens after dark, wear sunglasses outdoors, and set a steady sleep schedule.
Therapy for anxiety and stress. Cognitive Behavioral Therapy (CBT) and mindfulness skills lower the fear around visuals and reduce panic spikes. If you have trauma, trauma-informed therapy (e.g., EMDR) may help.
Medications (when appropriate). There’s no one “HPPD pill,” but clinicians sometimes use targeted medicines for anxiety, sleep, or migraine-like symptoms. Do not start or stop medicines on your own—work with a prescriber who understands visual disorders and substance use.
Lifestyle supports. Regular exercise, hydration, balanced meals, and daytime sunlight exposure improve sleep and mood. Many people benefit from limiting night driving until symptoms settle.
Avoid “retesting.” Using hallucinogens again to see if things get better almost always makes symptoms worse. Give your brain a stable, calm environment to heal.
Hallucinogen drugs people abuse (for awareness)
LSD (acid, tabs, blotter, windowpane)
Psilocybin mushrooms (shrooms, boomers)
DMT (Dimitri), Ayahuasca (brew containing DMT)
Mescaline from peyote or San Pedro (buttons, cactus)
NBOMe series (25I-NBOMe, 25B-NBOMe; often sold as “acid”)
2C family (2C-B, 2C-E)
Salvia divinorum (salvia)
PCP (Angel Dust, sherm), Ketamine (K, Special K), DXM in cough meds (skittles, robo)
MDMA (ecstasy, molly) can cause perceptual changes and anxiety, especially at high doses or when adulterated
Note: Many street drugs are mislabeled or contaminated. A tab sold as “acid” may be an NBOMe with very different risks. This is one reason HPPD can appear after what someone believed was a low, “safe” dose.
Living with HPPD: practical tips
Build a calm routine: regular sleep/wake times, meals, movement, and time outdoors. Use screen hygiene at night—warm color temperature, lower brightness, and frequent breaks. Try visual grounding: look at a fixed point, blink slowly, and breathe from the belly when halos or trails rise. Keep caffeine low for a few weeks and see if symptoms drop. If you use nicotine or cannabis, track whether they make visuals worse; tapering often helps.
Tell a trusted friend or family member what you’re experiencing so they can support you during rough moments. Share any safety limits you’re setting, like avoiding night driving until symptoms settle. If anxiety spikes, have a short plan ready: step away from bright lights, sip water, take slow breaths, and text someone on your support list.
When to seek professional help
Get help if visuals or anxiety interfere with school, work, driving, or sleep; if you have panic attacks; if you notice mood changes like depression; or if you have any thoughts of harming yourself. A clinician who knows HPPD can tailor a plan, check your eyes and nervous system, and treat co-occurring issues so you feel better faster.
You’re not alone—help starts today
HPPD symptoms can be scary, but many people recover or improve with time and the right supports. Search our treatment directory for providers who understand hallucinogens and visual disorders, or call our confidential hotline at (866) 578-7471. We’ll help you build a plan that protects your vision, steadies your mood, and gets you back to life.
