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The Placebo Effect2024-08-12

What is Placebo?

Clinical trails for medications, especially antidepressants, have led to the observation that patients get better, at least short-term, just by believing that the medication will help them, even when they are in the control (sugar-pill) arm. Belief can harness limited biological resources towards repair and getting better in the expectation that the cavalry (external help) is coming. The opposite is also true, but less known, the nocebo effect.

Underlying Biology

This type of reaction has real biological underpinnings, driven at least in part by dopamine. Writ large, these placebo mechanisms are also involved in “active longevity”, whereas people with good mental health, optimistic outlooks, and reasons to live, do live longer.

Practical Uses

How can this be harnessed in medicine, and daily life ? First of all, the placebo effect kicks in if a patient thinks their clinician is competent, so clinicians should use that. I wear a white coat in clinic, as a measure of respect to the profession and to my patients. There is a reason uniforms are won in the military, in martial arts, in sports in general. Second, clinicians should encourage patients to expect to get better from treatments that they administer, so healing kicks in earlier. There is nothing unethical about that. Third, promoting optimism as a philosophy of life, in schools, universities, and other settings, can have massive societal healthcare effects. Optimists are more likely to do something about things, and to expect those actions to succeed. Our Life x Mind app nurtures optimism through the morning Self Therapy four questions, and the evening Self Improvement four questions. Each set of four questions takes one minute. Two minutes a day to better health, and transformational effects on society way beyond that!