Placebo: What Your Brain Can Do for You

The placebo effect is the measurable, observable, or felt improvement in health not attributable to treatment. This effect is believed by many people to be due to the placebo itself in some mysterious way.

So states this article on placebos and depression from the Skeptic's Dictionary, and appropriate resource. Like this UCLA article about placebo usage, it discusses how, when a patient is told they are receiving a placebo, the effectiveness often goes away. Is this because the treatment was all in their heads? Or that the depression was?

Many studies try to compensate for the "placebo effect." Others, more recently, have specifically studied this factor as a healing process. A study by Dr. Arif Khan showed, according to the New York Times, that:

It turns out that the more severely depressed people are, the less likely they are to respond to a placebo. And people with more mild depressions get better with just about all treatments, including placebos. Since most clinical trials enroll less severely depressed patients, the observed difference between the response to an antidepressant and a placebo can be misleadingly small.

Other studies, including one by Dr. Irving Kirsch, suggest that medications are nearly useless because the placebo effect is so high in depression treatment. Meanwhile, doctors wrestle with the ethics of "tricking" patients with placebos.

I think the point is not quite being realized by the scientific community. Depression is a disease that is has an effect upon the body as well, because the brain controls all things. Placebo is the brain's natural ability to repair damage to all the human systems. This process is easily interrupted by doubts and limiting beliefs. At this point in our development we have identified the process, and we recognize that it can be encouraged by presenting patients with a physical talisman, if you will, of healing; the pill. More severely depressed people need more than a sugar pill because they are so very sick their limiting beliefs extend deep into the unconscious, metastasizing like cancer. They need medications to bring them to the point where the placebo process can recover enough to even try to work.

I foresee a time when the scientific community will focus serious research on placebos, not to remove them as a variable or identify what is "in a patient's mind," but to determine how to harness our own healing ability and hone it. This research will not be conducted by drug companies, because it would not be advantageous to cure such a lucrative market for maintenance medications. It will be research into areas currently sidelined as psychology or superstition, and will tap into the true potential of the human brain.

The lucky depression patients have found other avenues to unlock these secrets, either through sugar pills or prayer or exercise or therapy, and they have been given a chance at true healing, y allowing their brains to overcome depression naturally. It's time the scientific community figures out a way to give the rest of the victims that opportunity.

Medical Reinforcement (sort of)

Dr. Neubauer has located some studies that support what I have stated previously, namely that there are steps you can take to improve your mood and your sense of accomplishment, including caring for pets and exercise. I understand that his training is scientific and so he will only support any treatment option so far as the scientific method can document its success, but I take exception of his downplaying the value of these treatments, as well as herbal remedies like St. John's Wort, which I will discuss more in detail in a future post. For now, suffice it to say that there have been studies that demonstrate this herb's efficacy, just not, apparently, published in any journal the doctor respects.

I'm also not surprised that he does not include such vehicles as prayer and self-affirmation, as these are exceedingly difficult to document in a laboratory. Being unverifiable is not the same is being unsuccessful, however. Expectation is often half the battle.

Gift For a Depressed Person

Holidays can be a very difficult time for the victim of depression. As I've discussed in the last post, it is very easy for well-intentioned holiday activities to completely overwhelm the depressed person. If you know someone who's depressed (some warning signs can be found here if you're not sure), you might want to prepare a gift that takes their disease into consideration. Here are some ideas:

Presence, not presents: present them with an invitation or a certificate that requests that they spend the holiday or a specific time with you. Make it quite clear that no gifts will be exchanged, no food is to be prepared, and nothing special is required. If they tell you, "I'm afraid I won't be very good company," tell them, "That may be true, but I will be." If you sincerely care about this person and are willing to see who dwells beneath the cloud of gloom that their disease has helped them make for themselves, this may be the best gift you could give. If you and they are lucky, they will be able to tell you it made them happy. If not, trust that it did.

Focus on the positive: Put together a photo album, a slide show on a CD, or a letter or scrapbook that centers on positive things you have shared. A well-depressed person doesn't see themselves as having any value, and this kind of effort serves to remind them of things they've almost certainly forgotten. Depression can cause memory loss, and you can bet that the good ones go first. This is a gift that will be cherished.

Ask for help: This may or may not work, depending on the level of the depression. My mother has suffered from depression on and off for most of my life. The holidays have always been important to her, and I knew that being at a loss for things to suggest to her for gift ideas wouldn't sit well with her. Since I didn't have any wants particularly, I requested that she create a needlework piece for me. Mom has always been an avid needlework artist, ranging from knitting to crewel to embroidery to counted cross stitch. Her hands knew what to do even though her mind didn't see the point, so the act of creation served as a reminder of the value she held to me.

Bright Blessings: If you share a religious belief with the victim, or at the very least he or she isn't a diehard atheist, offering a tangible blessing may be helpful. Depressed people have very often lost their faith, and cannot pray for themselves, even if they know that prayer is a very important part of their ability to overcome the disease. Give them a promise, one you intend to keep, that you will pray for them daily or weekly for a set amount of time. Put it in writing. As an alternative, find an appropriate candle and either bless it yourself or have it blessed by someone who has taken religious orders or their equivalent. Specifically focus the blessing on light, be it the Light of Jesus or the return of the sun or the oil that burned for eight days, or whatever makes sense in your tradition. Tell them to burn the candle at their lowest point in the day.

Irony of Prayer

Prayer is a powerful tool for healing, whether it is physical, emotional, or spiritual damage that must be repaired. In the case of depression, what better treatment option can there be but prayer?

Of course, prayer requires faith, which is generally rooted in hope. Depression attacks that hope as thoroughly as leukemia attacks white blood cells. If you're deep in the black pit, there is very little chance that you have any belief in God, by any name. Your pain is so complete that you no longer feel it, and your hope has been replaced, if you're lucky, with a desire to subsist and survive in the dark world you have created for yourself.

Mr. Bloch suggests having others do the praying for you as well as trying it yourself. This is an excellent suggestion, because it removes the victim from the onerous task of having any hope. I never had that idea when I was myself depressed, since that's the nature of the disease. I will expand on his list of services if I find more and varied ones.