On the TV show “60 Minutes,” psychologist Irving Kirsch once reported that placebos and antidepressants had nearly the same effect on most individuals.
While research indicates that many study participants improve when taking fake medication, or a placebo, this does not mean the medications are useless or that symptoms are imagined.
5 Reasons For Improvement on Placebos
There are a few reasons why people’s symptoms may diminish with a placebo medication. Researchers are testing these reasons for validity, and hoping to understand the science underlying the placebo effect.
- Symptoms of a mental disorder frequently fluctuate. Some research participants improving while on a placebo might have improved on their own.
- Mistakes are part of life, including research. Any errors in the measurement of disorder symptoms could contribute to the appearance of a placebo improvement where none exists.
- Though not well understood, the placebo effect is powerful. The human brain seems to have circuitry for healing that is stimulated by positive expectation. Receiving treatment, even a pretend one, can trigger the expectation. This is similar to the process of cognitive behavioral therapy that helps by emphasizing life-enhancing positive thought patterns.
- Earlier research found the placebo effect generates measurable alterations in brain chemistry. For example, the brains of people on placebo pain medication actually increased production of natural pain reducing chemicals. Some Parkinson’s patients experienced a lessening of tremors when their brain released extra dopamine after a placebo treatment.
- The participant-researcher relationships that occur during a drug study seem to enhance the placebo effect. When mental health patients join a clinical trial they go to the lab each week, often after being isolated or inactive. They talk with research personnel who show interest in them. A compassionate clinician frequently meets with participants to assess how they are doing. This is more patient-caregiver interaction that many distressed people typically receive.
So, if a medication is doing as well as a placebo in a drug trial, it does not mean the medication is doing as well as nothing. Positive expectations, brain alterations, and individual interviews - all part of placebo studies - are each something real. Understanding them better may improve many lives.
Sources: Child Mind Institute; Columbia Psychiatry
Photo credit: Leo Watson / flickr creative commons