Your brain is superpowered.
It’s so powerful that it can actually convince you not to feel pain.
How’s that possible?
It’s all thanks to something called the placebo effect.
Placebos have been around for a long time. Back in the 16th century, Catholic priests
used fake religious relics during exorcisms to determine if a person was truly possessed
by the devil or not.
But the term placebo wasn’t commonly used in medicine until after 1763, when the physician
Alexander Sutherland used the word to condescendingly describe doctors who only aimed to please
their patients rather than focusing on providing effective treatment.
And “placebo” literally translates to “I will please” in Latin.
Nowadays, placebos are really just treatments that have no true medical effect. You know,
like sugar pills, or saline injections.
With a placebo, you’re mimicking the action of taking a medication or applying a treatment,
but there’s no active ingredient. You’re not really doing anything.
So it’s pretty weird that a lot of the time, placebos actually work.
But if a patient is not getting any medication, or receiving a real treatment, how is that
even possible?
In 1985, psychologist Irving Kirsch guessed that the reason placebos work could be because
of what he called response expectancies.
According to this theory, what a person experiences in any given situation is partially a result
of what they expect to experience.
So if a doctor hands you a pill and tells you it’ll make your pain go away, you expect
that it’ll help your pain, and so you experience pain relief.
Or when your mom kisses your skinned knee and says “all better!”, suddenly it doesn’t
hurt anymore.
Placebos can also work as a result of classical conditioning.
Ivan Pavlov demonstrated classical conditioning back in the 1800’s, when he presented dogs
with food while ringing a bell.
Eventually, the dogs learned that the sound of the bell meant they were about to receive
food, and they would start drooling even when there wasn’t any food present.
In the case of a placebo, because we’ve learned that taking a pill will have a beneficial
effect on whatever ails us, if we swap the “real” pill out with a fake one, our bodies
will still react as if we were taking medication.
Or if a friend drinks non-alcoholic beer without knowing, they may still experience symptoms
of intoxication.
Psychologically speaking, placebos can be very powerful. There’s evidence that
placebos can be up to 70% as effective as taking an antidepressant drug for patients
with depression, and patients taking a placebo for migraines reported at least a 50% improvement
in their pain symptoms compared to no treatment - even if they knew it was a placebo!
And it turns out that those psychological effects may be connected to actual changes
in the brain and body.
In one small study, researchers used positron emission tomography, or a PET scan, to track
glucose metabolism in the brains of patients taking placebos to treat depression.
Because your brain requires lots of energy to function, scientists believe that more
glucose metabolism corresponds to more neuronal activity.
Patients who felt like their depression was improving while taking a placebo showed changes
in metabolism in the neocortex and limbic areas similar to those seen in patients who
were taking the antidepressant fluoxetine - also known as Prozac.
And in another small study, patients with Parkinson’s Disease showed an increase in
dopamine release in the striatum, similar to that seen when patients were given a traditional
L-dopa medication.
Placebos are also known to have an analgesic effect, helping to reduce or eliminate pain
in many different situations. And in cases where placebos do help alleviate pain, they’ve
also been found to have effects in many different associated brain regions, including the prefrontal
cortex, cingulate cortex, and basal ganglia, and even into the brainstem and spinal cord.
Scientists believe that many of the effects of placebos can be linked to top down processing.
Our brains have to do a lot of work to take in, process, and understand all of the information
it receives minute to minute.
So in addition to bottom up processing, where the brain integrates and responds to raw sensory
information, top down processing lets different brain regions give each other feedback based
on our memories and goals.
So essentially your brain is like, “Hey, I remember taking this medication.
It makes me feel better.
I better send a message telling everyone to get to work feeling better!”
This is especially true of complex conditions, like pain and depression. Unlike something
like a heart murmur, which just kinda happens by itself and doesn’t get processed through
the brain, these conditions have a big cognitive component, and require a lot of that top down
processing.
This may be why placebos seem to be particularly effective for those kinds of conditions.
The effects of placebos are a really incredible example of just how powerful our brains can
be. Our minds can actually affect the way that we perceive intense physical stimuli
like pain, increase the effectiveness of medications, and impact how we cope with illnesses like
depression.
But that isn’t to say that these kinds of illnesses are “just in our minds”.
The real takeaway here is that brains are complex, and lots of different approaches,
from therapy to medication to pure mental strength, can be effective and useful when
it comes to these conditions.
Now, don’t you feel better, just knowing how placebos work?
You do, don’t you.
Yeah, you do.
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Until our next transmission, I’m Alie Astrocyte. Over and out!