The "Nocebo Effect" - Placebo's Evil Twin
Posted: Tue Oct 27, 2009 4:37 am
Fascinating! I don't think I'd ever heard this term until I saw it in the latest Time magazine this morning:
http://www.time.com/time/health/article ... 69,00.html
A quick Google search brought up tons of "nocebo" articles (it's been around awhile), but my workday looms and I don't have time to scan them all. Wikipedia points out that the term is used in lots of different ways, to explain many phenomena.
But...even more interesting than the nocebo drug effect is its effect on a patient's actual illness when they think it's more severe than it actually is - or when they're TOLD it's more severe than it is. Like this great article from 2002, The Nocebo Effect - Placebo's Evil Twin:
http://www.washingtonpost.com/ac2/wp-dy ... -2002Apr29
And the 2nd quote makes me think of my horrible reactions to both meds and supplements. Hmmm, surely my own healthy psyche couldn't possibly allow my physical symptoms to be influenced by the false assumptions of the nocebo effect! (I blame my slow progression on all the recommended changes I made in my diet and supplements since the dx, of course.)
Since I found MS forums, I've been especially concerned about the enormous fear instilled in MS patients, often used to convince them to take scary drugs (sorry, but to me all drugs are scary). I've never quite understood the way patients are taught that MS is a horrible, horrible thing, more like an evil entity than a disease, that is constantly attacking our bodies and that the only reasonable choice is to attack IT back, using the harshest, most horrible drugs we can find, never mind that they basically attack our entire bodies, and that they're proven to have only small, occasional benefits.
By the time of my dx, I'd already accepted that my body did weird things, and figured out dozens of ways to gently coax it into shape. For 30 + years it's NEVER felt the slightest bit like a disease to me.
I have lots more to say, but I'm off to work soon. Anyone else want to share their thoughts? On anything? Lecture me? Criticize my take on it all? I'm game. (I dare you. )
Later.
http://www.time.com/time/health/article ... 69,00.html
A quick Google search brought up tons of "nocebo" articles (it's been around awhile), but my workday looms and I don't have time to scan them all. Wikipedia points out that the term is used in lots of different ways, to explain many phenomena.
But...even more interesting than the nocebo drug effect is its effect on a patient's actual illness when they think it's more severe than it actually is - or when they're TOLD it's more severe than it is. Like this great article from 2002, The Nocebo Effect - Placebo's Evil Twin:
http://www.washingtonpost.com/ac2/wp-dy ... -2002Apr29
That study is a classic in the annals of research on the "nocebo" phenomenon, the evil twin of the placebo effect. While the placebo effect refers to health benefits produced by a treatment that should have no effect, patients experiencing the nocebo effect experience the opposite. They presume the worst, health-wise, and that's just what they get.
It fits right into my own belief that I'm truly fortunate that no one told me until now that I was this "sick" (I still don't consider MS a real "disease"...) or tried to treat me for it. And my own experience that the day of my dx 6 years ago, my main complaint was a tremor in one finger. And now I use a cane (PT showed me that using a cane trained my body that it needed a cane. Now it does.).But for some patients -- depressed, wary of medication or worried about drug side effects -- getting a prescription filled is an angst-ridden experience. And such patients appear even more likely to exhibit those side effects.
And the 2nd quote makes me think of my horrible reactions to both meds and supplements. Hmmm, surely my own healthy psyche couldn't possibly allow my physical symptoms to be influenced by the false assumptions of the nocebo effect! (I blame my slow progression on all the recommended changes I made in my diet and supplements since the dx, of course.)
Since I found MS forums, I've been especially concerned about the enormous fear instilled in MS patients, often used to convince them to take scary drugs (sorry, but to me all drugs are scary). I've never quite understood the way patients are taught that MS is a horrible, horrible thing, more like an evil entity than a disease, that is constantly attacking our bodies and that the only reasonable choice is to attack IT back, using the harshest, most horrible drugs we can find, never mind that they basically attack our entire bodies, and that they're proven to have only small, occasional benefits.
By the time of my dx, I'd already accepted that my body did weird things, and figured out dozens of ways to gently coax it into shape. For 30 + years it's NEVER felt the slightest bit like a disease to me.
I have lots more to say, but I'm off to work soon. Anyone else want to share their thoughts? On anything? Lecture me? Criticize my take on it all? I'm game. (I dare you. )
Later.