What Is the Placebo Effect?
Key takeaways:
Taking a placebo (sham treatment like a sugar pill) can have some real health effects — even if you know it’s a placebo.
The opposite, the nocebo effect, can also have real effects, where negative thoughts about a treatment can make it not work as well.
There may be ways to use the placebo effect intentionally in your daily life to improve your health.
When it comes to symptoms like pain or insomnia, popping a fake pill might still help you feel better. It turns out, sometimes it’s your thoughts and beliefs about a treatment that make it work. The placebo effect shows that there is a powerful connection between your body and your brain. Read on to learn more about the placebo effect.
Where is the placebo effect most often found in healthcare?
The placebo effect won’t always cure a condition, but it can help with symptoms that may go along with it — like pain, fatigue, or anxiety.
A placebo can even work when you know it’s a placebo. A 2010 study looked at patients with irritable bowel syndrome (IBS) and saw improvement in symptoms even in people who knew they received placebo pills.
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How is the placebo effect used in clinical trials?
Placebos are often used in clinical trials when some get treatment while others get a placebo (the “control” group). Then, researchers can compare the two groups to see if the treatment works. The placebo treatment may be an inactive pill or a fake injection.
Are alternative treatments, such as CBD or acupuncture, placebos?
Maybe. We don’t fully understand why some alternative treatments are effective. Some, such as acupuncture or herbal supplements, may work through the placebo effect. Some treatments, like CBD, have been shown to have some health benefits, such as pain relief. Other studies have shown that some of this can be explained by the placebo effect.
How does the placebo effect work?
We don’t completely understand how the placebo effect works. It may have something to do with how it changes neurotransmitters in your brain, such as opioids and endorphins. We also know that the placebo effect can actually change the way your brain functions. A meta-analysis showed that placebo treatment led to decreased brain activity in areas associated with pain.
The placebo effect may also work through classical conditioning, where you associate a response with a stimulus. For example, you may associate taking a pill with your headache improving. It could also have to do with having positive expectations associated with getting medical treatments, the ritual of seeing a doctor, and being listened to.
If something only has a placebo effect, is it not a good treatment?
If symptoms improve with a placebo, it still means symptoms improve. Believing in something is powerful and is an example of the benefits of positive thinking. How we think and what we believe might change how we experience sickness or disease. When it comes to treatment, it can be hard to know how much of its positive effect is due to the placebo effect.
Is there a reverse placebo effect?
In the same way that positive thinking can be helpful, negative thinking can be harmful. It turns out, there is also a reverse placebo effect: the “nocebo” effect. The nocebo effect is when having negative beliefs about a treatment leads to undesired side effects or negative outcomes.
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Researchers have observed the nocebo effect in clinical trials, such as when patients receive a placebo medication and then report side effects. Symptoms related to the nocebo effect include fatigue, nausea, headaches, and dizziness.
Interestingly, a recent meta-analysis suggests that the COVID-19 vaccine has a nocebo effect. More than 30% of people who got a placebo vaccine reported adverse side effects.
Some factors that could lead to a nocebo effect include a patient’s expectations about the medication, how a healthcare provider talks about it, or concern about potential side effects. Factors could even include the cost of the treatment.
Can you leverage the placebo effect to improve your health?
It might be possible to use the placebo effect to your advantage. Even if you know that something is a placebo effect, it can still have benefits. Changing your mindset about something may change how you experience it. Knowing that the placebo effect can be real, there may be some ways to leverage it and create positive health effects. For example:
When you take a medication, think about and visualize how it will help you.
When caring for others, such as your children, talk about how the medication or treatments will help them.
Visualize your health goals and how you want to feel.
Think about rituals that can help you feel healthy, such as exercise, healthy dietary habits, meditation, or good sleep hygiene.
The bottom line
Fake treatments can have real effects on your health. Placebo medications can improve symptoms like pain and fatigue. Your mind matters, and the way you think about a treatment has effects on how well it might work for you. Knowing this, there may be some steps that you can take in your daily life to harness the power of placebo.
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References
Colloca, L., et al. (2011). The nocebo effect and its relevance for clinical practice. Psychosomatic Medicine.
De Vita, M., et al. (2021). The effects of cannabidiol and analgesic expectancies on experimental pain reactivity in healthy adults: A balanced placebo design trial. Experimental and Clinical Psychopharmacology.
Haas J., et al. (2022). Frequency of adverse events in the placebo arms of COVID-19 vaccine trials: A systematic review and meta-analysis. JAMA Network Open.
Kaptchuk, T., et al. (2010). Placebos without deception: A randomized controlled trial in irritable bowel syndrome. PLoS One.
Mitsikostas D. D., et al. (2011). Nocebo is the enemy, not placebo. A meta-analysis of reported side effects after placebo treatment in headaches. Cephalalgia.
National Health Services. (2018). Complementary and alternative medicine.
Wager, T. D., et al. (2015). The neuroscience of placebo effects: Connecting context, learning and health. Nature reviews, Neuroscience.
Zunhammer, M., et al. (2021). Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data. Nature Communications.
