Know the Nocebo Effect

Note: Originally, I wrote this of "ehow"; however, "ehow" decided it did not meet their increasingly mysterious criteria. (Perhaps an unfair characterization – if you can show me clear ehow guidelines, I would be grateful.) Your ehow "thing you need" is the ability to forget about the nocebo effect as easily as you get to know the nocebo effect.

The "nocebo" effect is basically the opposite of the placebo effect. Like the placebo effect, the nocebo effect is a "self-fulfilling prophecy," only the nocebo is a belief that some ailment will appear or get worse, rather than disappear or get better. For example, if patients are warned about nausea as a side effect of their medication, they are, according to documented scientific research, three times as likely to experience nausea as those not warned. So, how do you tell if you are experiencing a nocebo effect?

1. Have you experienced side effects from medicine in the past? If so, you are more likely to expect side effects from your current medication, and that expectation can increase the chances of a nocebo effect.
2. Are you an anxious person, prone to depression? Anxiety and depression can cause physical symptoms. This can be a self-perpetuating cycle. Anxiety and depression can lead to medication, which can lead to the expectation of side effects, which can produce side effects, causing more anxiety… Insurance companies and doctors are quick to prescribe pills but not the therapy that is usually also required. And patients are quick to swallow pills because its conceivably more private than therapy, less time consuming, and easier to get insurance to pay.
3. What color is your pill? Even the color of the pill can cause patients to have varying reactions. If your pill is blue or green, you might experience a depressant nocebo effect… sleepiness, fatigue, and so on. If your pill is red or orange, you will experience a stimulant nocebo effect.
4. Have you had this symptom before? How often? If you’re sick, you are hyper-attentive to physical symptoms. A previous mild symptom like itchy skin, burning feeling, and aches morph in your mind to "incurable neuropathy" caused by your medicine, or worse.
5. Do you trust your doctor? If you believe your doctor, then you are more likely to experience symptoms, or not, depending on what the doctor says.
6. Are people around you experiencing similar symptoms? Many studies have shown "group effects," "mob mentality," and "mass hysteria." If you are around people who experience your symptoms, your are more likely to experience them yourself. On the other hand, of course, knowing that you are not alone can help ease your anxiety, and thus reduce symptoms. Know the difference between hysteria and commiseration. Online discussion forums can be helpful, but one-on-one personal interaction seems better, as long as you are both trying to lift each others spirits and are trying to overcome the nocebo effect.

If you suspect you are experiencing a placebo effect, think about something else. Distract yourself. Don’t question anything and forget about researching your condition. Try to enjoy feeling good.

Doctors, traditionally reluctant to accept or try to use the placebo effect, are not keen to recognize the nocebo effect. Imagine being sued for not telling a patient about possible side effects. Then being sued for telling a patient about possible side effects.