Do you know what the nocebo effect is?

Surely we do not know what the nocebo effect is, and the fact is that the word itself already indicates something related to harmful, and we are not very far off the mark. It is about the dark side of the placebo effect, that effect that we all know and that makes us believe that medicine is working and curing us when in reality perhaps we are taking homeopathy. That effect is real and more than proven, because the same thing happens with nocebo.

It is a very unknown effect, but one that also exists. Throughout this text we will understand what it is, when it occurs and which patient profile is more prone to nocebo.

What is it

In short, that effect is something mental and it is an anticipated rejection of a treatment, whether it is fear, revulsion, anxiety, something that blocks the beneficial effects of the treatment and makes us feel that the treatment is not working .

The mechanisms by which we develop this effect are not exactly known, but as far as scientific evidence has come, it blames the patient for his negative predisposition and believing the idea (in advance) that it will not work. Normally it is based on previous experiences, direct or indirect.

The nocebo effect is not only an idea that we create, but can also be induced by how medical professionals communicate with us. Instead of pointing out the positive, it points out the negative, and the patient may cling, out of fear, to that information and develop the nocebo effect.

Similarities and differences

We already know what the nocebo effect is, and we are more or less clear about what the placebo effect is, but to get into the matter, we are going to explain it anyway and then we will see what differences there are between one and the other, although we have already given some clues, and it is that the nocebo effect is the dark side of the placebo.

The placebo effect is when a patient takes a drug that may not have a curative action, so the state of the disease should not change, but, nevertheless, the patient is convinced that it will cure him and is helping him to improve .

It is a proven psychological stimulus induced after the administration of a drug, medicine or inert substance. If the patient is convinced that it is useful, it will be, hence the nocebo effect is the opposite, as we have already seen.

Regarding the differences, we already know that the nocebo effect is when a patient has negative stimuli towards a treatment and these influence the healing process, while the placebo effect is to awaken positive psychological stimuli, even if homeopathy or some substance is being taken. inert, useless.

Both act in the same brain area and both are influenced by psychological, genetic, cultural factors and biological mechanisms. However, the low knowledge of patients, their expectations, previous experience, their weaknesses, if they suffer from a mental disorder (depression or anxiety), etc. come into play in the nocebo effect.

While the placebo effect is not very gendered, the nocebo tends to be more common in women and with a tendency to pessimism. In addition, the communication between patient and doctor can open the gap of the nocebo effect.

Is this effect useful?

To be honest, it does not have any positive effect, but this type of circumstance is beneficial for medical studies and knowing the patient will allow the medical professional to detect these negative intentions in time and be able to redirect the situation. Some clues are:

• Emphasize side effects.
• Have read the prospectus.
• News read in unofficial communication doctors about that disease or treatment.
• Discussion forums.
• Images from the Internet and social networks.
• Lots of negativity.
• Lack of concrete explanation.

Science warns that there are a series of risk factors that make patients more likely to develop these psychological stimuli and more or less fit this profile of patient or patient:

• Women.
• Pessimistic personality or with a tendency to negativity.
• Depressive or anxious disorders.
• Cultural and religious beliefs.
• Low trust in the doctor.
• Fears and incongruous explanations.
• Verbal and non-verbal communication.
• Negative expectations.
• Suggestion.

How to avoid the nocebo effect

This work is up to medical professionals, but we can also do it with our friend, partner or family member. We are going to see the main aspects to reduce the chances of the nocebo effect making an appearance in our lives:

• We must inform ourselves well, in depth, without leaving us with doubts about the disease we suffer and its treatment, as well as the possible adverse effects. The staff that is explaining must make sure that everything is being understood and that the person who is listening has not been left alone with the negative part.
• The expectations . In life, expectations do a lot of damage, so if we are in the middle of a treatment, we must be realistic, but without falling into pessimism. We have to be aware of the adverse effects and possible failures in previous treatments, but avoid falling into low expectations, and also avoid high ones, so that, in case of failure, the damage is not greater.
• The possible adverse effects must always be shown with reality, but care must be taken with the language and the way in which they communicate, since the vast majority of patients accept and tolerate the treatment without suffering adverse effects, so there is no need to paint black and create fears and indecisions that give rise to the nocebo effect.
• The relationship between the patient and the doctor must be positive, clear, direct, fluid, to avoid mistrust, fear and the like. You have to empathize and talk about changes, opinions, decisions, advice, etc.