Posted by Sue Landsman on Jul.22, 2009

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Most people know about the placebo effect: if you take a pill thinking that it will help you it just might, even though it might contain no medically active ingredients whatsoever. Maybe your headache goes away, or your digestive problems clear up, because no one told you you’re taking sugar pills. This is in fact an important factor in testing new medications; you need to be able to discern any improvement due to the medication from the therapeutic effect caused by people just thinking they’re receiving a medication.

What might surprise you, and what many people don’t think about, is that the flip side of this is also true. Thinking you’ve taken something bad for you, or being told there’s something wrong with you even though there isn’t, can harm you. Just as you can make yourself healthy by believing you’re being treated, you can damage your health by the sheer power of your own belief.

Voodoo is clearly the extreme case of this. As much as people don’t believe in it, or think it’s a joke, there have been plenty of cases where “hexed” people fall ill until they’re “cured.” In one case described in the New Scientist, a man almost entered the hospital at death’s door believing that a witch doctor cursed him. He was cured by an imaginative doctor who told him that he was being eaten alive by a lizard the witch doctor had caused to grow inside him. The doctor gave him an emetic, produced a lizard from his bag by sleight of hand, and pronounced him cured.

This sounds ridiculous. But the “nocebo” effect, as it’s called, works in our daily lives, too, and is important enough to merit mention in the Journal of the American Medical Association and Harvard Magazine. In Latin, “placebo” means “I shall please,” while “nocebo” means “I shall harm.” Just as many people think they’re being helped by a placebo, many others feel worse. Some people invent strange side effects or amplify any issues they’re having because they feel a medication they’re taking is causing them. This can be a problem in drug development, as well as for the individual. A patient might give up on a useful treatment because they’re afraid it’s harming them, or might require additional treatment for these new symptoms.

In addition, the nocebo effect can have more serious consequences. Studies have shown that women who believed they were more susceptible to heart attacks than others were about four times more likely to die from heart conditions than other women with similar risk factors. People who are told they are at high risk for a disease are more likely to develop symptoms. People who believe they’re dying often do. Often when given a diagnosis of a fatal disease, people will not question it and act as if they are dying. This is significant in cases of misdiagnosis or even in true cases of life-threatening conditions

How can you avoid the nocebo effect? Before you start a course of treatment for anything, review your health status and pinpoint any chronic symptoms you may be experiencing. This gives you a better chance for identifying any true side effects of medications you may need to take.

Also, if you’ve been told you have a medical condition it’s vitally important to make sure you haven’t been misdiagnosed. If your diagnosis is accurate, it’s important to find a doctor who won’t just tell you the worst, but who will work with you to maintain your health and your optimism. Bedside manner isn’t just a nice extra bonus to find in a doctor. A good doctor treads the difficult path between giving you accurate information but still being careful to minimize your expectations of sickness and decline.

The bottom line: you aren’t just what you eat. You’re what you think.

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Posted under Health & Fitness, Health Alerts.