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Cogntive impairment caused by derealization


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#1 tdmonster99

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Posted 18 September 2009 - 02:25 AM


I'm not sure how familiar you guy are with the hallucinogen DMT, but it is an exceptionally potent hallucinogen. I have used the drugs a few times but after my last trip I experienced chronic depersonalization/derealization. I've been experiencing symptoms for about a year now and thankfully they have lessened but derealization still persists. The main line of treatment for this condition has been the conjunction of an SSRI with a benzodiazpene, primarily clonazepam. I currently take clonazepam at 1mg/day. The derealization causes chronic anxiety and clonazepam has been a life saver in this regard, but the side effects of drowsiness and emotional blunting are starting to take a toll.

The point of this thread is that since that last trip, my memory has become impaired along with focus to some degree. I am currently a senior in college, and my grades are fine, but my mental capacity just isn't what it was pre-DMT. My recall is very spotty and my verbal fluency can be poor at times. It is not horrendous but, for example, I'll try think of an an actor's name or movie title and it just won't come to me. When I speak, words sometimes come out funny or not pronounced properly. Sometimes I'll have a minor stutter, something that wasn't too common for me pre-DMT.

Also, recently, my sleep patterns have been awful; they always were but moreso now. I am very sleepy if I don't get a solid 8+ hours of sleep. There is no way I can go through a day without a nap. I probably only get 5-6 hours of quality sleep. I am just curious if the mechanism of DMT can lend any insight into a course of treatment; I know that DMT is a serotonergic compound. As additional information, I also have episodes of depression which has persisted since I was a freshman in Highschool. Essentially what I'm asking is how should I treat the issues with memory, verbal fluency, etc. Could treating the depression be an underlying factor? One weird thing, I was into nootropics before I tried DMT and had some success. However, certain nootropics that were helpful before, such as bacopa, now either have no or negative effects. Thanks for any insights.

#2 csrpj

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Posted 18 September 2009 - 05:41 AM

interesting read. sorry, don't have any helpful advice. i've had a lot of depersonalization after a few bad acid and mushroom trips about a year ago, though now it's better. i've done DMT once, and plan on doing more in the near-future... what about the trip caused it? was it a "bad trip"? did you take too much?

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#3 acantelopepope

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Posted 18 September 2009 - 06:21 AM

interesting read. sorry, don't have any helpful advice. i've had a lot of depersonalization after a few bad acid and mushroom trips about a year ago, though now it's better. i've done DMT once, and plan on doing more in the near-future... what about the trip caused it? was it a "bad trip"? did you take too much?



What is this "depersonalization" you guys speak of? Is it like "ego death"?

Some of my strangest depressions have come after shroom trips....

#4 csrpj

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Posted 18 September 2009 - 06:44 AM

interesting read. sorry, don't have any helpful advice. i've had a lot of depersonalization after a few bad acid and mushroom trips about a year ago, though now it's better. i've done DMT once, and plan on doing more in the near-future... what about the trip caused it? was it a "bad trip"? did you take too much?



What is this "depersonalization" you guys speak of? Is it like "ego death"?

Some of my strangest depressions have come after shroom trips....


different from ego-death.

http://en.wikipedia....personalization

#5 Zoroaster

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Posted 18 September 2009 - 07:40 AM

My understanding is that the mechanism of DMT is largely unknown. So unfortunately I don't think your going to get much help from anyone here from that angle. Are you sure the tiredness and mental confusion aren't from the clonazepam? I used to take that stuff but the sides were too much for me. Perhaps talking to your doctor about switching up your meds would be a good idea. Perhaps meditation could help get you back on track?

#6 tdmonster99

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Posted 18 September 2009 - 07:52 AM

The trip I had was brutally intense psychologically and ultimately was mentally scarring. Yes, some of the fatigue is attributed to clonazepam but I only started using clonazepam about a month ago, whereas the other problems have existed since my last DMT trip.

#7 sunshinefrost

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Posted 18 September 2009 - 12:15 PM

i don't think your symptomes are abnormal.. i've never done dmt but i need more than 6h of sleep, i need 8. i also forget al lot of stuff including actor names that i really shouldn't forget. But its NORMAL so don't worry too much ! The brain is amazing and if you use it alot(hebbs) it will use its plastic abilities.... There are worst things, like concussions and strokes.

I'm a bit like you, when i drink a lot or party too hard, i always think my brain will not recover. i currently take noots that encourage plasticity to be proactive. of course moderation and no drugs is better.

Just keep concentrating hard and it will come back, it will be even better if you are persistant with concentration.

Edited by sunshinefrost, 18 September 2009 - 12:17 PM.


#8 lynx

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Posted 18 September 2009 - 01:44 PM

I'm not sure how familiar you guy are with the hallucinogen DMT, but it is an exceptionally potent hallucinogen. I have used the drugs a few times but after my last trip I experienced chronic depersonalization/derealization. I've been experiencing symptoms for about a year now and thankfully they have lessened but derealization still persists. The main line of treatment for this condition has been the conjunction of an SSRI with a benzodiazpene, primarily clonazepam. I currently take clonazepam at 1mg/day. The derealization causes chronic anxiety and clonazepam has been a life saver in this regard, but the side effects of drowsiness and emotional blunting are starting to take a toll.

The point of this thread is that since that last trip, my memory has become impaired along with focus to some degree. I am currently a senior in college, and my grades are fine, but my mental capacity just isn't what it was pre-DMT. My recall is very spotty and my verbal fluency can be poor at times. It is not horrendous but, for example, I'll try think of an an actor's name or movie title and it just won't come to me. When I speak, words sometimes come out funny or not pronounced properly. Sometimes I'll have a minor stutter, something that wasn't too common for me pre-DMT.

Also, recently, my sleep patterns have been awful; they always were but moreso now. I am very sleepy if I don't get a solid 8+ hours of sleep. There is no way I can go through a day without a nap. I probably only get 5-6 hours of quality sleep. I am just curious if the mechanism of DMT can lend any insight into a course of treatment; I know that DMT is a serotonergic compound. As additional information, I also have episodes of depression which has persisted since I was a freshman in Highschool. Essentially what I'm asking is how should I treat the issues with memory, verbal fluency, etc. Could treating the depression be an underlying factor? One weird thing, I was into nootropics before I tried DMT and had some success. However, certain nootropics that were helpful before, such as bacopa, now either have no or negative effects. Thanks for any insights.

I sympathize with you.

I would like to know how old your are. Specifically because if you are in your 20's or teens then this symptom may not have been caused by DMT. I am not denying their co-occurence, just the causality may not be so clear.

#9 StrangeAeons

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Posted 18 September 2009 - 02:00 PM

Doesn't sound all that severe, you might have caused a little excitotoxicity while tripping and now your brain's trying to rebuild those connections. If the "derealization" sensation becomes severe and you start feeling like you're truly losing your grip, naltrexone may be of some benefit.

#10 tdmonster99

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Posted 18 September 2009 - 02:23 PM

In response to lynx, I am 21 now, I was 20 when the derealization occurred. And in response to StrangeAeons, I agree that it isn't too severe because I have seen recovery even before I started medication. However, it seems like I have hit some plateau in terms of recovery. But I am most certain I will fully recovery over time. I liken my final DMT experience to having your whole life's worth of emotional trauma crammed into 5 minutes. So obviously it may take a while for the brain to heal.

#11 punkideas

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Posted 18 September 2009 - 02:48 PM

As far as the mechanism for DMT, it is a 5HT2-A and 5HT2-C agonist. These could have been overloaded if the dosage was too high, and the sensitivity of these receptors could be severely reduced, causing the symptoms.

#12 tdmonster99

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Posted 18 September 2009 - 06:16 PM

So in terms of possible treatments, I read that inositol increases the binding affinity of serotonin, something that could be helpful in treating the symptoms. Also, would agonists of the 5-HT2a and 5-HT2c receptors increase their sensitivity over time? Agomelatine is a 5-HT2c antagonist and is a medication I have considered trying. The improved sleep quality that comes with agomelatine would also be a benefit.

#13 lynx

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Posted 18 September 2009 - 07:57 PM

As far as the mechanism for DMT, it is a 5HT2-A and 5HT2-C agonist. These could have been overloaded if the dosage was too high, and the sensitivity of these receptors could be severely reduced, causing the symptoms.

So then Tianeptine might be the way to go. Theoretically increasing serotonin reuptake would cause sensitivity to serotonin to increase.

#14 Mixter

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Posted 18 September 2009 - 08:10 PM

You're talking about http://en.wikipedia....eption_disorder, which is a specific set of conditions (ICD-10 F16).

Sure, experimenting with further drugs/psychoactive nootropics might do the trick, but I would really suggest against it since it is what caused your HPPD in the first place (at least, only at your own risk and if everything else fails to fully eliminate your problem for years).

The best way would be to find a doctor who really has a lot of experience with treating this specific condition, HPPD after using hallucinogens, you could try querying doctor's associations/directories for that, perhaps worldhealth.net or another directory, and calling them if you don't find the right practitioner online.

#15 Algear Linebra

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Posted 18 September 2009 - 08:37 PM

I seriously doubt your problems are related to excitotoxicity. This is more likely a case of PTSD.

EDIT: Don't overlook my post because it's short. It's the truth, plain and simple.

Edited by Algear Linebra, 18 September 2009 - 08:48 PM.


#16 tdmonster99

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Posted 18 September 2009 - 09:21 PM

There is a chance that I have an incredibly mild case of HPPD, in which case levitaracetam (Keppra) has been the most effective treatment. I just dont buy that I have full blown HPPD; I don't have any afterimages, visual snow, floaters etc. DP/DR most closely fits my symptoms. I am more than content to let time heal this disorder. And to Algear Linebra, I don't think what I have falls under the classical definition of PTSD. But like you said, I wouldn't rule it out since DP/DR shares many of the same neurological symptoms as PTSD.

#17 Algear Linebra

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Posted 18 September 2009 - 09:50 PM

Yeah, but the source of your problems is still a mental trauma.

I just want to point out that you DO NOT have brain damage directly caused by dimethyltryptamine, the PTSD or whatever we want to call it might have caused changes, but thats another story, and calls for different kind of treatment.

Edited by Algear Linebra, 18 September 2009 - 09:52 PM.


#18 StrangeAeons

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Posted 19 September 2009 - 03:38 AM

who says that the excitotoxicity and mental trauma are mutually exclusive? I'm talking about a physiological event, you're talking about a psychological experience; the one could be perceived as the other, and the emotional trauma described in the trip sounds like a pretty massive spike in neural activity.

#19 Algear Linebra

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Posted 19 September 2009 - 11:07 AM

Are you saying that the PTSD-symptoms of (for example) a guy who have been buttraped by a gang of steroid pumped mexicans comes from acute excitotoxicity during the "act"? :)



who says that the excitotoxicity and mental trauma are mutually exclusive? I'm talking about a physiological event, you're talking about a psychological experience; the one could be perceived as the other, and the emotional trauma described in the trip sounds like a pretty massive spike in neural activity.



#20 tdmonster99

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Posted 19 September 2009 - 09:52 PM

And as a side note, since this summer I've been having a noticeable increase in intracranial pressure. There was a peak during the summer where it was unbearable, around June, but since then it has leveled off and got better since using clonazepam. However, the degree of pressure fluctuates and hasn't gone away. What would be a good way to diagnose this issue, maybe seeing a osteopath or neurologist?

#21 StrangeAeons

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Posted 19 September 2009 - 10:40 PM

Are you saying that the PTSD-symptoms of (for example) a guy who have been buttraped by a gang of steroid pumped mexicans comes from acute excitotoxicity during the "act"? :)



who says that the excitotoxicity and mental trauma are mutually exclusive? I'm talking about a physiological event, you're talking about a psychological experience; the one could be perceived as the other, and the emotional trauma described in the trip sounds like a pretty massive spike in neural activity.



Really, Mexicans? I find the racial comment unnecessary.
As per your question, yes that's kind of the point. What do you think is happening in that person's brain when one incident of emotional trauma causes lasting damage? Obviously certain areas of the limbic system are firing off the charts, though the memory/flashback aspect of the PTSD is a bit different.
Still, that's not the whole truth in this case either. There was emotional trauma but there was also chemical insult; I wouldn't write off the cognitive damage as being entirely due to PTSD. Why this time and not the times before? There are a lot of variables and I can't answer that, though previous trips may have "primed" the pathways for this incident.
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#22 StrangeAeons

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Posted 19 September 2009 - 10:44 PM

And as a side note, since this summer I've been having a noticeable increase in intracranial pressure. There was a peak during the summer where it was unbearable, around June, but since then it has leveled off and got better since using clonazepam. However, the degree of pressure fluctuates and hasn't gone away. What would be a good way to diagnose this issue, maybe seeing a osteopath or neurologist?


Are you sure it's actually intracranial pressure, or are you just feeling pressure in your head? Increased ICP is a serious medical condition that often results in brain herniation and stroke; I think you might be getting some kind of stress headache instead (given your response to anxiolytics). Definitely don't see an osteopath, they'll just do craniosacral manipulations; anybody with a lick of medical sense knows that stuff is bunk.

EDIT: Granted there are osteopaths who practice real medicine, but specifically seeking one out for some sensation in your head, you're more likely to get the quackish variety. A neurologist might do an MRI to check for a tumor causing the pressure, although I'm pretty skeptical. Certain tricyclics like amitryptiline have been known to do wonders for certain headaches and neuralgias, though, and are far less damaging/addictive than benzodiazepines.

Edited by StrangeAeons, 19 September 2009 - 10:49 PM.


#23 Algear Linebra

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Posted 20 September 2009 - 12:18 AM

Hey, i don't have anything against Mexicans, i just tried to spice up the example bit. :) It would be strange if i did, given that there's not many of them here in Sweden..


What do you think is happening in that person's brain when one incident of emotional trauma causes lasting damage?

I think it's a slow process that follows the emotional trauma, just like with physiological changes that occur in brains of ppl suffering from depression. I find it really hard to believe that getting raped will instantly fry your brain.


I wouldn't write off the cognitive damage as being entirely due to PTSD.


Now that sounds better than

Doesn't sound all that severe, you might have caused a little excitotoxicity while tripping and now your brain's trying to rebuild those connections.



#24 togameru

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Posted 20 September 2009 - 01:33 AM

Um... Really? Is not a one of you aware of this? Benzodiazepines cause cognitive decline! They also interfere with sleep architecture, increasing the number of awakenings (even if they are not remembered) and preventing one from reaching deep recuperative levels of sleep.


http://www.ncbi.nlm..../pubmed/8159265

Under barrier condition and with ad lib access to food and water, 20 Fischer-344 rats were chronically treated for 10 months with the benzodiazepine (BDZ) antagonist, flumazenil (FL; 4 mg/kg/day in drinking water acidified to pH = 3.0), beginning at the age of 13 months, while the group of 20 control age-matched rats received plain acidified water. The life span of the first 8 deceased rats treated with FL was significantly longer than that of the first 8 deceased rats in the age-matched control group. In tests for spontaneous ambulation and exploratory behavior in the Holeboard apparatus, conducted during the 3rd and the 8th month of treatment, the FL group, relative to controls, had significantly higher scores for the ambulation and exploratory behavior. In tests for unrewarded spontaneous alternation in the T maze, conducted at days 7, 39, 42, and 47 through 54 after drug withdrawal, i.e., at the age of 24-25 months, the FL-exposed group, compared to age-matched controls, showed a significantly higher percent of alternating choices, a behavior that was statistically comparable to that of the "young" 6-month-old controls. In the Radial Maze tests conducted 2 months after drug withdrawal, the FL group made significantly less "working memory" errors and "reference memory" errors, relative to the age-matched 25-month-old control group, a performance that was comparable to that of the young 7-month-old control group. In conclusion, chronic FL significantly protected rats from age-related loss of cognitive functions. It is postulated that the age-related alterations in brain function may be attributable to the negative metabolic/trophic influences of the "endogenous" benzodiazepine (BDZ) ligands and/or those ingested with food. A BDZ/GABAergic hypothesis of brain aging has been formulated which assumes that age-related and abnormally strong BDZ/GABAergic influences promote neurodegeneration by suppressing trophic functions of the aminergic and peptidergic neurons through opening of chloride channels in soma membrane and axon terminals, causing excessive hyperpolarizing and depolarizing inhibition, respectively. The review of human clinical and animal data indicates that FL has nootropic actions by enhancing vigilance cognitive and habituation processes.



DO NOT TAKE FLUMAZENIL, ESPECIALLY IF YOU ARE CURRENTLY USING BENZODIAZEPINES, AND EVEN MORE ESPECIALLY IF YOU HAVE DEVELOPED A DEPENDENCY! I shouldn't need to say that, but you never know. If you go ahead and try it anyway, the consequences you'll reap will most probably be one or more of the following: excitotoxicity, convulsions, panic, anxiety, hyperhidrosis, tachycardia, hypertension, paranoia, confusion, depression, mania, psychosis, insomnia, and so on...

If you want to treat your depersonalization/derealization, try naltrexone, but only after you've withdrawn from clonazepam and are in fairly good spirits.


This one does not concern the long-term cognitive decline caused by benzodiazepines and is only tangentially related but it's interesting nonetheless.

http://www.ncbi.nlm..../pubmed/7644474

We report here on the ability of IDRA 21 and aniracetam, two negative allosteric modulators of glutamate-induced DL-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor desensitization, to attenuate alprazolam-induced learning deficit in patas monkeys working in a complex behavioral task. In one component of a multiple schedule (repeated acquisition or "learning"), patas monkeys acquired a different four-response chain each session by responding sequentially on three keys in the presence of four discriminative stimuli (geometric forms or numerals). In the other component (performance) the four-response chain was the same each session. The response chain in each component was maintained by food presentation under a fixed-ratio schedule. When alprazolam (0.1 or 0.32 mg/kg p.o.) was administered alone, this full allosteric modulator of gamma-aminobutyric acid type A (GABAA) receptors produced large decreases in the response rate and accuracy in the learning component of the task. IDRA 21 (3 or 5.6 mg/kg p.o.) and aniracetam (30 mg/kg p.o.) administered 60 min before alprazolam, having no effect when given alone, antagonized the large disruptive effects of alprazolam on learning. From dose-response studies, it can be estimated that IDRA 21 is approximately 10-fold more potent than aniracetam in antagonizing alprazolam-induced learning deficit. We conclude that IDRA 21, a chemically unrelated pharmacological congener of aniracetam, improves learning deficit induced in patas monkeys by the increase of GABAergic tone elicited by alprazolam. Very likely IDRA 21 exerts its behavioral effects by antagonizing AMPA receptor desensitization.


Unfortunately, the IDRA-21 would probably abolish the anxiolysis of your clonazepam.

Edited by togameru, 20 September 2009 - 01:40 AM.


#25 StrangeAeons

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Posted 20 September 2009 - 07:59 AM

I'm not picking up on the distinction linguistically, Linebra. A trip is regarded as the correct term for the use of hallucinogens, and is not pejorative. There are several aspects to PTSD, and the consolidation of memory is part of it (which is why sleeping shortly after the incident helps) but it still centers around a single, brief event. Keep in mind there's a good deal of plasticity up there, so "fry" is somewhat of a relative thing. I'm not professing to be an expert on the matter, though, I just think PTSD (alone at least) isn't the best-fit explanation.

As per the benzos: It's a valid point that I should have mentioned.
I didn't miss that aspect, actually I was thinking about suggesting tapering off of them but I realized that would do more harm than benefit. The other thing to consider is that the clonazepam is being taken to treat the anxiety associated with this condition, whatever you may call it. There is also a therapeutic benefit to sleep-pattern disturbance in psychiatry, counterintuitive though that may sound.

I would recommend the OP double-check their chronology and see if the cognitive impairment and sleep problems were present before the benzos-- sometimes it's tricky differentiating symptoms from side effects in psychiatry. Obviously there's got to be a risk-benefit calculation going on with the Klonopin, and being aware of the side-effect profile should inform your judgment.

#26 tdmonster99

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Posted 20 September 2009 - 07:38 PM

The memory issues did not exist prior to trying DMT but manifested directly afterwards. For example, I'd walk to my kitchen and forget why I went there. The memory issues have worsened since using clonazepam. I am fully aware of the side-effects of clonazepam such as amnesia and cognitive decline, but it has been an efficacious treatment for reducing DR and the anxiety that goes with it.

Unlike the memory issues, sleep has been a problem since I was a kid. It has been hard for me to sleep soundly on a consistent basis for as long as I can remember. I may have a few weeks without problems, but overall sleep has been a problem.

To StrangeAeons, you are right, I didn't mean ICP. My head feels like a there is mild pressure, like a mild headache. It usually corresponds with how much anxiety I am feeling. When it was really bad aspirin relieved the symptoms a bit.

Naltroxene seems like something I would try for the DP/DR because it has studies that back its effectiveness for treating DP/DR but the anecdotal reports don't seem to place this treatment above benzodiazapenes. However, if it is just as efective as clonazepam without the drowsiness and memory problems, I would be all for it.

#27 christopherforums

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Posted 26 March 2010 - 02:32 AM

Agreed on the benzo's,
they will make you retarded. (Clonazepam.....)

Get off the benzo's try meditating and researching that. If you forget something make yourself remember it. Your memory will work the more that you use it. (Your brain will work better the more you use it..)

Go towards the fear man.

#28 winston

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Posted 26 March 2010 - 03:59 PM

I think DMT can be definitely ruled out as having directly caused any physiological mental problems. Did the stress/trauma of the bad trip cause any permanent physiological problems quickly enough that they were evident right after your trip? I don't know enough about PTSD to say.

I think it's likely that the psychological stress and the derealization were the cause for all of the symptoms that you noted shortly after the trip and before spending much time on any medications. I think you should primarily deal with the derealization, not your various symptoms, weather through drugs or therapy.
I've dealt with a little bit of derealiztion from a bad trip on Salvia. I would recommend doing your best to rationalize your way out of it. Remind yourself every day that it's just bullshit, a condition that you have, and notice that each day you get up the exact same world is there to greet you.

#29 Animal

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Posted 26 March 2010 - 07:24 PM

...or accept that regardless of whether the reality you're currently perceiving is 'real' or not, you can only respond to stimuli you are aware of and so interacting with this reality is mandatory.

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#30 winston

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Posted 26 March 2010 - 09:18 PM

Yeah, but believe me it's still pretty disconcerting and scary under that mindset. Hard to find meaning or care for anyone in a world that you aren't sure is real.
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