The Nocebo Effect and What You Can Do About it

A man involved in a recent clinical study became impulsive.

He decided one morning during the study to take all his pills for the study at once.

Overcome with fear, he called his friend and pleaded with him to take the man to the hospital.

At the emergency room, the man collapsed. The medical staff found the man’s blood pressure to be incredibly low. And his heart rate to be dangerously high.

They revived him with lots of fluid in an IV that helped to control the blood pressure.

When the hospital staff contacted the people in charge of the trial, they confirmed that the man was in the placebo group. In other words, he overdosed on sugar pills.

There were no drugs ingested.

After the man heard he was in the placebo group, all his vital signs quickly returned to normal and he was quickly discharged.

What happened to this man was the ‘Nocebo’ effect. It is the opposite of the ‘Placebo’ effect.

If you believe something you do will be harmful, chances are it will. Your brain will cause physical changes in your body. Some of the signs that the Nocebo effect is happening include:

• Making treatments more painful

• Making treatments less effective

• Worsening symptoms

• Causing more side effects

The Nocebo effect is the result of your body’s fight or flight mechanism. If someone credible tells you there is someone coming over to your home that wants to kill you, you start preparing for their arrival.

Likewise if someone tells you, or you believe yourself, that you just did something bad to yourself, your body gears up to fight it. Regardless of whether it actually happened.

I believe this effect is a lot more prevalent today than people think. Remember Covid? How they put the daily death counts on everyone’s TV screen. Do you think that might influence how people think about their symptoms?

Or social media. We hear about monkey pox, Ebola, the rates of increase of all chronic diseases and the bad effects of medications.

Do you notice sometimes when you read about a disease or health problem you start thinking to yourself “wow I think I may have those symptoms”?

All of this can contribute to the Nocebo effect.

How do you combat this effect?

The Mayo Clinic put out an interesting article with some tips.

Start by educating your medical providers about the Nocebo effect. People in positions of authority such as doctors can have a very strong influence. Explain to them that you are a bit concerned and to try to remain upbeat when discussing medical conditions.

If your doctor doesn’t comply, find another doctor. Just by empowering yourself to take charge of your health decisions may reduce the chances of the Nocebo effect.

You can also think of your doctor as more of a consultant than an authority figure. Think of them as offering input. You’re the CEO of your own health and the final decision is yours.

Also try to relax. If something bad happens, take some deep breaths. Meditate. Pray. Try to relax. Obviously if it is time-critical take care of the problem first. But relaxing your body may calm the fight or flight response.

I try to do Bible study with some of my residents to help them relax.

Hopefully just being aware of this effect can prevent unnecessary health outcomes in your life.