The power of placebo

The mind and the body are complex entities that work both ways — for our benefit and for our detriment. The brain is a complex collection of neurons, neural networks and brain fluids which most likely forms the seat for our memories and thinking processes. The mind is the less tangible of the two. We cannot touch or taste the mind, can we? But none of us would disagree with the fact that we have one. It is the reason for our sanity. We usually associate it with consciousness which facilitates our perception of the world through the five senses.

Scientifically speaking, we can’t accurately define what we mean by a mind or consciousness. We know that it separates us from the rocks, but we don’t know what causes it. Could it be a by-product of the various chemical processes that occur in living organisms? Is it a property of RNA itself? Or is it the act of a god? I don’t know. However, I am interested in a peculiar activity of the mind that also seems to baffle science, medicine in particular.

It is said that our mind can move mountains, and certain questionable movies also portray it as such. But we know that is hardly the case. Nonetheless, our mind does seem to have the capability to affect the physiology of our body. Consider the following example — There are 2 people Harry and Ron. Both are affected by a certain disease. To cure their disease I gave Harry a blue pill and Ron a red pill. The blue pill is a fake, it is filled with water. The red pill is an established cure for the disease. We would expect Harry to not get cured, right?

Physicians found that in many cases even a fake treatment does have the ability to cure a bodily malfunction or a disease threat. This phenomenon is famously known as the placebo effect. The placebo effect has been repeatedly addressed and confirmed in thousands of medical studies. In some cases, the placebo response is so strong that it is impossible to distinguish from the actual cure.

Let’s take antidepressants for example. Antidepressants work on the principle of chemical imbalance. The theory suggests that depression is caused because of an imbalance of a particular hormone called serotonin. So, if we create a balance by giving this hormone artificially, we should be able to cure the depression. As you may have guessed even a placebo pill, i.e a fake pill is just as effective in treating the condition. In a certain case, a patient was given saline water instead of serotonin and she was relieved!

All this is great news. If it works, there is no harm done right? Wrong. The placebo effect is routinely exploited by people who are out there to make a quick buck. Talismans are one example of this exploitation. Haven’t you ever come across people who swear that a magic button is available at a ‘nominal fee’ which cures everything? It is also sometimes said to enhance your happiness, get rid of negative emotions and make life fulfilling. And these people take the credit for their actions by citing examples where the placebo effect was at work. They say, “Here look! This person is happy because of this talisman”. They don’t talk about the others who weren’t cured.

In other cases, the people who prescribe drugs which are no better than placebos do so because they just don’t know about it. Homeopathy is the classic example. Consider this interesting fact about homeopathy. A normal concentration of a drug used in the sugar pills in homeopathy is 15 C. A unit of C stands for 1/100 times dilution. So a 15 C stands for 10 raised to -30! At that concentration, it is quite impossible to have even a single molecule of the drug that was supposed to cure the disease. But homeopaths genuinely believe that reducing the concentration of the drug actually increases its potency because of some myths like water memory. A reasonable conclusion would then be that whoever is getting cured because of homeopathy is either under the placebo effect or just naturally recovers from the disease. Most likely a mix of both.

Now the question arises — how do we actually tackle the placebo problem in medicine? We need to make sure that a cure for the drug is better than a placebo. Medical experts achieve this by performing double-blind tests. If the drug does not pass the test, it is not released to the public. In these tests, neither the test subject nor the experimenters know if a particular pill given to any test subject is a placebo or a real drug. Only after the results are studied, the actual data is revealed. So, in this scenario, we can determine if the drug is better than a placebo by checking for the number of people cured by the drug and the placebo in the blind test. If the number is more or less equal, the drug is no better than a placebo. If the difference is considerable, then the drug may be viable.

To say that the placebo effect is fascinating is an understatement. It is downright mind-boggling. It poses somewhat of a challenge to our current understanding of medicine. As medicine or science, in general, improves it faces newer and tougher challenges. But scientists aren’t dismayed by this fact. They just accept this truth and are willing to work tirelessly to overcome these hurdles.

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