1994. Lanza and some other cool people published an article about this new drug that would help cure ulcer, in this fancy AF medicine journal. People were like, gimme. Besides people given the actual drug, 44 patients got placebo that looked like the real thing. Same diagnosis, tested after 2 and 4 weeks, they were cured like the patients who got Prevacid (shoutout to Prevacid btw).
Placebo is inert, meaning it’s not supposed to do anything, but placebo is a rebel and breaks the rules.
A long time ago, if a monk died (RIP), at 4 pm* the other monks would gather round and read psalm 116: “placebo domino in regione vivorum” aka “I shall be pleasing to the Lord in the land of the living”. Physicians started using the term placebo for every medication given to calm the patient when the doc didn’t know what else to do rather than to cure. Then, placebo got the meaning it has today, actual inert substances instead of no-good drugs.
Including a large range of mental/physical symptoms/disorders, with no known external factors affecting them, patients get better.
The placebo response rate in depression consistently falls between 30 and 40%¹. Now that’s something, right?! Placebo relies heavily on the mind-body relationship and the main theory claims the placebo effects depends on the patient’s expectations. If the patient expects medication to produce change, bodily chemical reactions work in such a way that they produce a similar effect to the actual drug. There was no significant difference between patients with asthma that used a placebo inhaler and the ones using the real thing (I love saying the real thing). Even when asked about perceptions, they reported the same feeling of liberation as the other group of patients. ² You’ve probably heard of IBS. It’s a common problem of a part of the body, with no physical abnormality per se.
Patients received placebo treatment in the form of acupuncture, however, the needles used didn’t pierce through the skin. 44% of them reported symptom relief, 62% if the acupuncturist was caring, engaging and empathetic.³ Even though we have powerful resources to handle the challenges life throws at us, we can’t use them deliberately all the time. Weger asked 40 college freshmen to complete a general knowledge test, with 4 alternative answers to every question they had to pick from. Half the students were told that the right answer appears on the screen for a fleeting moment and even though it was too quick for them to process it consciously, their brain would register it. Hint: that was a lie. If you guessed the placebo students scored higher than the control group, you guessed right. Feeling safe in the knowledge that your brain knows the answer, lowers your anxiety making what you already know more accessible.
To quote Daft Punk, your brain works Harder, Better, Faster, Stronger.
As you might’ve figured by now, placebo practitioners have to use deception as a tool sometimes, and in 2010 an avid lover and connoisseur of the placebo effect, Kaptchuk, had enough and he was like “let’s just tell them they’re getting placebo”. Just like that. However, he did inform patients about the placebo effect and how lots get better after placebo treatment. If you guessed they got better, you’re right (hopefully again). Human brains just want you to get better and seems like they’re all in, even if you’re not giving them much to work with in the first place.
To misquote The Weeknd, just trynna put you in the best mood.
Studies have shown that blocking endorphin release, the placebo effect would also stop; suggesting that it’s similar to that of an active ingredient (API). Apparently, a lot of the present neurotransmitters follow the same neural pathways as marijuana or opium. Our brains are that mighty powerful! Skeptics claim that people suffering from chronic illnesses don’t go to the doctor right away, so there is a chance they get better naturally (for a short period).
Many doctors have been among the skeptics, not very sure what to do with this (relatively new) information. Correlation doesn’t mean causation, so they can’t know for sure yet, but time (well, studies) will tell, hopefully soon enough.
There are two main points we can take away from this. First, that being supportive and providing (psychological and emotional, besides medical) care can’t hurt. If there’s the slightest chance you telling them they’re badasses means they get 0.001% better? I’d say those odds look pretty good to me.
Reminder: kind words cost nothing, BUT they’re invaluable.
Lastly, our brains, ladies and gents. You find snippets of the placebo effect in lots of self-help books, with good reason. I find it magical how our brains know no scientific boundaries when it comes to serving us. Today, I feel grateful for my brain and my body and every little organism inside me working non-stop to keep me here. Here’s my new all-time favorite quote from Thích Nhất Hạnh:
Because you are alive, everything is possible.
*I don’t know why exactly then, #justmonkthings ?
¹ L. Johnston, Sebastian. Asthma: Critical Debates. John Wiley & Sons,2008.
² Brown, Walter A. “Placebo As A Treatment For Depression”, Neuropsychopharmacology 10.4 (1994): 265-269. Web.
³Kaptchuk, T. J et al. “Components Of Placebo Effect: Randomised Controlled Trial In Patients With Irritable Bowel Syndrome”. N.p., 2017.