Very good point, RAAS, what I have written is purely subjective, YMMV, consequences of overuse of MDMA or any psychoactive can indeed lead to all of the conditions so nicely described in the media and then “fuck up your brain.” I have come to know too many casualties over the years, people that have gone insane, killed themselves, got jailed and so forth.
Considering that the topic is Long Term damage, the bulk of my MDMA and LSD use was in the mid-late 80’s and early 90’s during university days – and in them thar days of yore, not much info on toxicity in nonclinical users was available. I believe the term “HPDD” was not even coined yet. The acute negative effects of overusing included a lot of lower back pain (the Draining Spinal Fluid theory was big at the time). There were indeed also acute memory effects - studying was not easy, hence I say “managed to get” a few undergrad degrees.
Certainly, I’ve had LSD trips which have forever changed my perception of “normal” reality, but in my opinion normal “reality” is a consensual hallucination geared towards the lowest common denominator anyway, and nothing to treasure or build one’s value systems on. I consider “normal reality” a game of sorts, really.
As far as the emotional / happiness landscape – in 1985 I was 18, an atheist, extremely depressed, violent and generally a very negative person. This all changed after my first drug experience which was a whopping dose of LSD.
Certainly, over the years / doses / peak experiences, I have become jaded as soot, but can still derive extreme pleasure, unaided by drugs, from very simple things – a purring cat, a sunset over the ocean, cooking a good meal, first run of the day on 3 feet of fresh pow-pow, gardening, conversing with the loved one, etc etc.
And at this ole’ age, I don’t have to waste time doing things and spending time with people I don’t like anymore.
Anxiety / depression – certainly happens, but then again, I am alive and most people experience these states, which are usually transient and in my case, caused more by living in a high-stress urban environment, maintained by powers that be, propagating a value system I don’t subscribe to.
Panic attacks - sure, every time I fly off a big mountain, or before a SCUBA dive, or when i see a cop in the rear view mirror...
As far as long term health effects, one of my degrees is in neuropsych, i have an extensive knowledge of my metabolism and psychodynamics and have been taking preventative and protective measures for about the last 15 years - proper nutrition, courses of nootropics, antioxidants and supplements, exercise, meditation, extreme sports etc. And, of course, as I have come to learn, moderation is key.
As for the reasons for former frequent intake of large doses - my use of psychedelics has never been to escape my situation or reality, but rather to explore the various facets in order gain a better understanding of same.
again, this is my case (nut case?) and opinions only.