The fear of getting sick makes you sick. That fear arises from unnecessary X-rays, useless genetic tests and incorrect information in package leaflets. A phenomenon known as “nocebo”, counterpart of the more well-known term “placebo”.
Nocebo, counterpart of placebo
A man named Derek Adams took an overdose of antidepressant pills in an act of desperation. His girlfriend had left him and he never wanted to wake up. The 26-year-old was admitted to an emergency department in critical condition, but doctors were initially unable to stabilize him. Adams had come into possession of the antidepressants as a participant in a study into the effects of medicines. What he didn’t know: his antidepressants contained no active ingredient. He was one of the test subjects who had only received a dummy drug, a placebo. Yet he showed the typical symptoms of an overdose. When Adams was informed about the sham medicine at the clinic, those symptoms disappeared in no time.
Fears that are partly inspired by doctors
This incident, published in 2007, is considered a classic in so-called nocebo studies. Nocebo (Latin for “I will harm”) is the negative counterpart of placebo (“I will please”). In both cases it is about much more than just pills. It is about patients’ expectations, fears and hopes, which are partly inspired by doctors.
Scans and X-rays make you sick
The fact that patients are highly influenced by doctors, media and pharmaceutical manufacturers is no secret. The German neurologist Heier even published a book about it: “Nocebo: whoever believes in it becomes ill”.
Back pain for illustration
Heier had observed one devastating nocebo effect within his own field, in the popular ailment par excellence, back pain. In most cases, no clear cause is found. But there are only four reasons to further investigate such a problem back with scanning techniques: numbness or paralysis of limbs and sudden bladder or intestinal problems. With all these symptoms there is a risk that nerves have been compromised.
But the practice is different: it is almost standard to use X-ray techniques or push people into scanners to produce images. The equipment is simply there and wants to be used. Not only does that cost a lot of money, but according to Heier there is something even worse: the photos make you sick.
“Anyone who sees the images of his abnormalities will never recover”
People with a broken spine from a radiological point of view can go through life completely pain-free. Others, on the other hand, suffer only excruciating pain with a spotless-looking back. Because this cannot be explained with simple scan and X-ray images, increasingly complex ones are being produced. Most people have back abnormalities that may not mean anything. But in those advanced photos they suddenly appear as a possible cause of those hellish pains. And anyone who has seen those abnormalities in their back will never recover from their pain, Heier believes. He cannot get those images out of his head, the pain becomes chronic.
The leaflet can also make you sick
Experiments by researchers have shown that just general formulations that pain may occur, these formulations actually evoke that feeling and even make it last for a longer period of time. Today we know that strong anticipation changes our brain chemistry and often produces the desired effect in the body. The frontal lobe of the brain plays a central role in this.
The package leaflet can also make you sick due to the side effects listed there. Anyone who takes the trouble to read this leaflet thoroughly takes an increased risk of actually developing one of these side effects.
What does “often” or “occasionally” mean?
A number of doctors and therapists therefore want package leaflets to provide more explanation about the risk of side effects. Terms such as often, rarely or occasionally are often misinterpreted by patients. Incidental side effects, for example, occur in less than one in a hundred patients!
read more
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