Mind Over Matter: How Placebos Can Enhance Health

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One day not long ago, 40 freshly heartbroken 18- to 28-year-olds gathered in a lab clutching photos of the exes who scorned them. Through the lens of an imaging machine, researchers watched similar areas of their brains light up when they were physically hurt with something hot and emotionally hurt with the photos.

Then, the research team gave the students a nasal spray, telling some of them that it was “a powerful analgesic effective in reducing emotional pain,” although it was really just a saline solution. Mercifully, it worked: When shown the photos again, the lovelorn not only reported feeling better physically and emotionally, but their brains also showed it to be true. Specifically, areas associated with rejection turned dim and areas involved in modulating emotions – including those that control painkilling chemicals and mood-boosting neurotransmitters – glowed.

In other words, people’s perceptions of some treatments – no matter their actual contents or lack thereof – can affect how their brains interpret pain, both physical and emotional, for the better. This is empowering news for anyone concerned with health care costs, medication side effects or the opioid epidemic.

“[Placebo] research offers this perspective that pain can be both real – physically, chemically real – and generated in part by your brain in ways that you can potentially work with and control,” says Tor Wager, director of the Cognitive and Affective Control Laboratory and professor of psychology and neuroscience at the University of Colorado–Boulder, who was an author of the study, which was published in March in the Journal of Neuroscience.

While his team’s research was the first to look at how placebos can work to heal heartbreak after being dumped, plenty of other research has demonstrated their power to help ease a variety of mental and physical health conditions including depression, migraines, insomnia and irritable bowel syndrome. One study even found that patients with knee osteoarthritis who thought they underwent arthroscopic surgery, but really just received the small incisions, improved just as much as patients who had other, more invasive variations of the actual surgery. At various periods post-surgery, the placebo group even did better.

“Thoughts and beliefs,” Wager says, “can impact our bodies and brains in a way that matters for health.”

Perhaps most surprising is that, in some cases, people don’t even have to believe the placebo treatment is a “real” treatment for it to have some benefits. One study, for instance, showed that giving people with irritable bowel syndrome sugar pills labeled “placebo pills … that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes” improved their symptoms. Another study found that a migraine “medication” blatantly labeled “placebo” was 50 percent as effective as the actual drug.

“Everyone said if you knew you were taking a placebo you wouldn’t get a placebo effect, but we talked to patients and we saw [that wasn’t true],” says Ted Kaptchuk, director of the Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center and Harvard Medical School, who was involved in both studies.

Of course, placebos have limits: An operating table probably won’t heal a broken bone and a broken condom won’t prevent pregnancy – nor do they work equally well for all people. Dr. Jon-Kar Zubieta, chair of the department of psychiatry at the University of Utah and psychiatrist-in-chief of the University of Utah Neuropsychiatric Institute, has found that people’s personality traits and genetics can influence how they respond to placebos for conditions including depression.

“The idea is to try to enhance our own internal systems of resiliency non-pharmacologically,” he says. “You promote the things that work well for you even more.” Here’s how he and others say to use research on the placebo effect to your health advantage:

1. Find a provider you trust.

A key reason placebos seem to work in a clinical setting is the context: Going to a doctor’s office and receiving attention can alone make a difference in the treatment’s effectiveness. “It’s ultimately about mutual trust and support – it’s about caring,” says Kaptchuk, also a professor of medicine and of global health and social medicine at Harvard Medical School.

That benefit might be lost, however, if you don’t jibe with your provider or believe he or she has your best interests at heart. In fact, a sort of reverse phenomenon known as “white coat hypertension” can come into play too, when people appear to have high blood pressure in the presence of a physician but not in the comfort of their own homes. “If you don’t feel comfortable with your provider, get another one,” Kaptchuk says.

2. Be cautiously hopeful.

Contrary to popular belief, the placebo effect isn’t about deception, ignorance or false expectations. But it is about hope. “Be open to the possibility of change,” Kaptchuk says. “That openness is not really expecting to get better, it’s about being able to live with hope and knowing that there’s a lot more to get done.” The opposite – say, telling yourself that nothing or no one can help you heal – in some ways increases the likelihood that you’re right. “It’s helpful for many to realize that the future isn’t set in stone and when things seem bad, there might actually be positive future effects,” Wager says.

Another factor that can enhance the power of placebos is people’s past experiences – that is, if something has worked for them in the past, they’re likely to believe it will work for them again, which can help make that belief true. “People can capitalize on that by developing rituals and signs and things for them that have positive meaning that are associated with positive states of mind,” Wager says. Sitting cross-legged can relax you if your brain expects you to meditate, for example, and just going into the bedroom can make sleep easier if your brain recognizes that location as a place where you rest – rather than where you watch TV, work or scroll through Instagram. “You put yourself in a certain environment that activates a number of processes in your brain that are real,” Wager says. “That’s why baseball players have all these rituals.”

If the feeling of being cared for is part of what brings about some benefits of placebos, why not do that for yourself? Just taking action to pursue a healthy lifestyle – whether by scheduling a doctor’s appointment, shopping for more vegetables or downloading a meditation app – might be enough to boost your health. “It’s not about believing you’re going to get better,” Kaptchuk says, “it’s about doing something; it’s engagement.”

11 Simple, Proven Ways to Optimize Your Mental Health


You know you best.

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Only you truly know the unique triumphs and travails of living in
your own head. If you experience ongoing depression, anxiety or other symptoms,
“Seeking professional help as early as possible, rather than waiting, can be
critical,” says Dr. Robert Klitzman, a professor of psychiatry at Columbia University in New York City. However, you needn’t be diagnosed with a mental health
condition to benefit from taking steps to improve your psychological well-being. Here are some ways you
can get a mental edge.

 The payoff could include everything from a happier, healthier, longer life to better relationships.
Get moving.

Get moving.

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You might not want to sit down for this. “Physical
exercise is very important in preventing or reducing mental health problems,” Klitzman says, which include depression. “When we exercise, our body releases endorphins – natural
opiates that improve our mood and make us feel good. Exercise can also
help cognitive functioning – how well we think.” 

Watch your weight.

Watch your weight.

'Overweight man sitting on couch with belly bulging in gray t-shirt, holding TV Remote.unfit couch potato.'

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Being sedentary, by contrast, can prove a double whammy,
since we don’t get the mental jolt from exercise – and we’re more likely to pack on pounds. Putting on extra weight, research shows, can weigh down our mental
health, too. Obesity and diabetes increase the risk for depression, says psychiatrist
Dr. Mahendra Bhati, an assistant
professor of clinical psychiatry in the Perelman School of Medicine at the
University of Pennsylvania in Philadelphia.

Be careful what you consume.

Be careful what you consume.

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Your diet – whether predominantly plant-based with healthy
greens, nuts and other lean proteins (good), or laden with saturated fat, processed
foods and sugars (not so good) – can impact mood and anxiety levels. So, too,
can other things we put in our body to get by in the moment, from
tobacco and alcohol to recreational drugs.
Better to avoid the feel-good momentary fixes, Klitzman says, and spare yourself
the crash later.

Stay in the moment.

Stay in the moment.

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We all sometimes seek to avoid
uncomfortable situations, either by physically removing ourselves or checking
out mentally. “That’s normal … it’s just
that when you do that very chronically and habitually, it could develop into
significant problems with anxiety and depression,” says psychologist Brandon Gaudiano, an associate professor of psychiatry
and human behavior at Brown University in
Providence, Rhode Island. Experts recommend practicing mindfulness instead to help deal with difficult circumstances and emotions. “It’s
paying attention to the present moment and what your experience is,” says Gaudiano,
noting that approaches vary. “Bringing awareness, acceptance, self-compassion,
curiosity and just noticing non-judgmentally those internal experiences as
they’re arising.”

Meditate about the ones you love.

Meditate about the ones you love.

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Want to get even more from that wonderful vacation or visit
with family? Focus your mind on it. In researching different forms of meditation, Barbara Fredrickson, a professor of psychology and neuroscience at University
of North Carolina–Chapel Hill, has found that so-called kindness meditation or loving-kindness
meditation can improve a person’s emotional well-being and reduce symptoms of
depression; she adds that other researchers have found it eases anxiety. “It’s
a very simple meditation based on … sending well-wishes to yourself or others,”
Fredrickson says, describing it as somewhat similar to mindfulness meditation. 

Keep a journal.

Keep a journal.

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Just as mindfulness can help a person recognize and cope
with difficult thoughts and emotions in the moment, experts say it’s important
to have outlets to process complex experiences. Journaling, or expressive
writing, allows a person to put negative thoughts, feelings, aspirations and
anything else that might be going through their mind to paper – and, Gaudiano
says, to get some mental distance from those experiences. “It has
been [shown to be] very helpful in some of the research I’ve done as well for
[addressing] anxiety and depression,” he says.

Stay socially connected.

Stay socially connected.

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Social support plays a vital role in helping optimize our
overall mental well-being, Klitzman says. He recommends “surrounding
ourselves with supportive people – loving friends and family – and avoiding, if
we can, ‘difficult’ people who may bring us down.” By contrast, a lack of
social connectivity can put us at risk for health problems that affect body
and mind and contribute to premature death. “Lack of socialization is …
the leading cause of geriatric depression,” Bhati says.

Prioritize – and schedule – positivity.

Prioritize – and schedule – positivity.

Using a checklist throughout high school will help students determine their strengths and build strong applications.

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Pay bills, do work, spin wheels. Check, check, check. Lunch
with a friend? Not on the list. “Basically when people make their ‘to-do’ list,
they are often thinking of achievement, as opposed to scheduling something in
their day that they know is a boost to their positive emotions and their mood,”
Fredrickson says. But her own research finds
those who prioritize positivity, such as allotting time to visit loved ones or engage in a beloved hobby, tend to be mentally healthier.  

Assess your stress.

Assess your stress.

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Avoiding high levels of stress and finding ways to cope can
make a big difference. “Many times, we can actively avoid difficult, stressful situations,”
Klitzman says, When we can’t, “framing our experiences positively, and trying
not to worry (especially about things you can’t change) can also be beneficial
– focusing on the positive, not stewing about the bad things that may occur.”
Under such circumstances, he adds: “Mindfulness – relaxation or meditation –
can also help.”

Sleep on it.

Sleep on it.

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Whether you’re wrestling with serious mental anguish or just smelling
the roses, it’s important to get ample rest and practice proper sleep hygiene
room-darkening blinds in the bedroom, TV out. “Poor sleep wreaks havoc on the brain
and circadian rhythms, [and it can] alter brain function and gene expression,” Bhati says. In
short, whether you’re predisposed to mental health issues or not, skimping on shut-eye can awaken psychological problems that make it even harder to
function during the day.

Find purpose.

Find purpose.

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Just as making time to visit with friends can change the complexion of a day, mental health experts say doing something
meaningful and finding purpose can ground a person in psychologically
beneficial ways. “Engaging in activities that give us meaning in our lives can further aid
us,” says Klitzman, in terms of improving mental health. That might include volunteering
to help others, engaging in hobbies as well as doing other things we enjoy, he adds. Bhati echoes
that doing things with a sense of purpose or meaning is a proven way to improve
mental health.

Read More


August 10, 2017 at 09:54PM

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