What Exactly is Placebo? And Does it Work?

What Exactly is Placebo? And Does it Work?

The term “placebo” is thrown around often in everyday parley to mean something which has a desired positive effect on you, without having any factual or physical evidence to support it. In medical terms, it refers to a pill or drug administered to someone, intended to help in recovery, even though chemically it’s probably nothing beyond a cocktail of sweetened/salted water with a few things thrown in. Either way, whether in medical terms or otherwise, placebo operates on the same principle.

Dr Samir Parikh, Director, Mental Health & Behavioural Sciences, Fortis Healthcare, says, "A placebo is any substance, drug or form of treatment which does not have any identified consequences, but yet seems to be beneficial after its administration."

Placebo primarily delivers psychological satisfaction as opposed to possessing actual physical, therapeutic benefits for a particular condition, says Dr Soumiya Mudgal, Consultant, Psychiatry, Max Hospital, Gurgaon.

Dr Soumiya MudgalThe relief reported by a patient in case of a placebo is relief without any physiological effects or benefits.

She adds that this in turn means that when in doubt about physiological issues or if their origins are psychological, placebo can be used as a tool to differentiate between two.

How Does it Work?

Placebo is simply not a victory of mind over matter or “positive thinking” as this report in Harvard Health points out. Yet, with the right combination and permutation of factors, it can prove to be just as effective as traditional medicine, it says further.

Dr Samir ParekhThe placebo effect has been widely used in medical settings as well in experimental and research fields, in an effort to evaluate the effect of an actual treatment relative to the placebo effect. It works not on the basis of any deception, but the individuals are actually and truly experiencing a change, which is a real experience not being consciously faked or imagined. This can be understood to be a result of multiple factors at an interplay, including the individual's expectations, motivation levels, belief systems as well as the effects of the principles of conditioning.

Placebo and Medical Treatment

Placebo cannot alter physiological symptoms. What it does is address problems that arise in the brain.

As mentioned previously, placebo cannot alter physiological symptoms. What it does is address problems that arise in the brain. This means while it can help reduce problems of insomnia, depression, anxiety, perception of pain and symptoms of a bigger illness, like the nausea and fatigue of chemotherapy, it cannot, for instance, alter sugar or cholesterol levels.

There are reports that draw attention to the efficacy of placebo in treating problems like Parkinson’s disease since the medication helped alter dopamine (the feel-good hormone) levels in the body positively. The same report also mentions the case of a Mr Wright, a man in 1950s who had a back and forth relationship with several cancerous tumours in his body which was directly influenced by his relationship with the placebo medication and whether or not he believed in it. When Mr Wright thought the medication would work, it actually did, and when he thought otherwise, his cancer relapsed. Once again he believed in its effectiveness and he lost all his symptoms.

Having said that, while researchers may not have figured out the exact mechanism, placebo is believed to be beyond the ambit of conscious thought. It is also tied to the subconscious belief and behavioural patterns one may have pertaining to it. The report in Harvard Health elaborates:

How placebos work is still not quite understood, but it involves a complex neurobiological reaction that includes everything from increases in feel-good neurotransmitters, like endorphins and dopamine, to greater activity in certain brain regions linked to moods, emotional reactions, and self-awareness.

The Role of Placebo in Modern Medicine

Placebo helps to address psychosomatic disorders, along with differentiating between physical and psychological causes of an illness. It is also an essential part of studying the efficacy of a drug in modern medication, both doctors agree.The bottomline - placebo is not simply thinking positive thoughts and it cannot be expected to significantly alter physical conditions, barring exceptions (as in the

case of Mr Wright). There is also “no clear correlation between an individual's personality type as well as their susceptibility to a placebo”, concludes Dr Parikh.

Dr Samir ParekhPlacebo effect is often used in modern medication, both in fields of research and medical advancements, in order to assess the efficacy of a substance administration, as well as in an effort towards alleviating patient's psychological or physical distress.

The bottomline - placebo is not simply thinking positive thoughts and it cannot be expected to significantly alter physical conditions, barring exceptions (as in the case of Mr Wright). There is also “no clear correlation between an individual's personality type as well as their susceptibility to a placebo”, concludes Dr Parikh.

(Rosheena Zehra is a published author and media professional. You can find out more about her work here.)