What we think influences how we feel. In fact, our thoughts can even make us sick – or at least make us feel that way. This is where the so-called nocebo effect comes into play.
You’ve probably heard of the placebo effect, the effect of medication that doesn’t actually contain any active ingredients. We suddenly feel better because we believe that a medicine is helping us – and we don’t even know that it actually has no medical effect. Just the expectation of a positive development is enough to make us feel better.
The nocebo effect works according to a similar principle – it can happen that we suddenly feel symptoms of an illness that we don’t actually have, or side effects of medication that aren’t actually medically there. There are now a number of studies that can prove this effect.
The nocebo effect: a deterioration without any apparent reason
“For example, asthma patients were given a drug that narrowed certain airways in the lungs,” explain Dr. Michael Bernstein, Dr. Charlotte Blease, Dr. Cosima Locher and Dr. Walter Brown in their book The Nocebo Effect: When Words Make You Sick. “The patients were told, however, that the treatment they had received was an airway dilator. The patients then showed airway dilation.” The opposite was also observed: “Patients with asthma showed airway narrowing when the airway dilator they were given was described as an airway constrictor.”
In their book, the authors also describe how the nocebo effect can be seen in Parkinson’s patients: sufferers of the disease often suffer from severely slowed reflexes and movements. A neurostimulator that sends electrical impulses can help here. “In one study, Parkinson’s patients were falsely told that the brain stimulation device was turned off, when in fact it was turned on.” The patients who were told this actually showed slowed reflexes and movements, as if the stimulation had actually been turned off.
Stronger side effects due to the nocebo effect
But the nocebo effect can also be felt outside of such a complex clinical setting. For example, people who believe they have been exposed to a harmful substance can suddenly feel symptoms – even if they have not actually come into contact with it. With vaccinations, too, people can imagine that they are experiencing strong reactions and side effects, even though medically speaking these are not actually occurring.
It can be enough for a doctor to warn us about the side effects of a medication for us to experience them. We then experience headaches, nausea and other possible symptoms, even though we actually tolerate the medicine well.
Our fear is to blame
But what is behind it? How can it be that we feel worse physically even though there is no organic reason for it? According to Bernstein, Blease, Locher and Brown, a hormone is behind it, the so-called cholecystokinin (CKK). This promotes feelings of fear in the brain and also plays a role in temperature regulation. In people who suffer from the nocebo effect, more CKK is released. In short: an effect occurs because we are afraid of it.
But conditioning, social learning and expectations also play a role on a psychological level and can cause us to experience symptoms that shouldn’t actually be there. Perhaps as a child we noticed that our mother always felt bad after eating a certain food – and now we feel the same after eating the same food, even though we actually tolerate it well.
Conclusion
A positive expectation can ensure that a drug works even though it does not contain any active ingredient. But we can also experience side effects or symptoms even though there is no organic cause for them. The hormone CKK plays a role here, but so do psychological processes such as fear and the expectation that a certain effect will occur.
The nocebo effect is further impressive proof of the power of our thoughts. It’s a good reminder to be careful not to let fear win and to practice optimism. Otherwise, we could unknowingly increase the likelihood that what we fear will actually happen.
Sources used: “The Nocebo Effect: When Words Make You Sick” by Dr. Michael Bernstein, Dr. Charlotte Blease, Dr. Cosima Locher and Dr. Walter Brown, mindbodygreen.com