After a gruelling midterm in February, I was talking to a student in my economics class. He had pulled an all-nighter before the exam and could barely get himself to attend school in the morning. He then showed me these caffeine pills he took right before driving to campus, which gave him an instant energy boost. I was curious, so I examined the tiny box. Not even a minute of looking at it, I realised that the pills were decaf. Yet, he felt the boost that prepared him to sit for the midterm.
After researching this anomaly, I discovered an explanation for why your brain deceives you in this manner. The placebo effect explains why people might experience an improvement in their symptoms even after taking an inactive treatment. While the placebo effect will not lower your cholesterol levels or shrink a tumour, it will lessen the symptoms that are controlled by the brain, such as the perception of pain.
It baffles me sometimes how belief can be the sole catalyst behind real physiological responses. University students often have simple wants — get more gains at the gym, get better grades, or be less stressed. When the desire is strong and the belief is unwavering, not much can stand in the way. If my friend really wanted to sit for his exam that day, he only needed a placebo to get him going.
This seemingly magical concept is actually backed by science. There have been numerous studies conducted on this. It turns out that certain regions of the brain light up more when a patient receives a placebo treatment for, let’s say, pain.
One of these regions is the prefrontal cortex. This is the area of the brain responsible for higher-level thinking, which is how it uses contextual clues that a placebo provides. In layman’s terms, if your doctor is very confident, wears a white coat, and has a stethoscope around their neck, you are more likely to trust them than someone who shows up to treat you in a hoodie and sweatpants.
The prefrontal cortex then sends signals to other regions of the brain which are further responsible for producing neurochemicals including dopamine, the feel-good neurotransmitter, and oxytocin, the ‘cuddle’ hormone.
The main player in this game is your brain’s natural production of opioids, which have a strong calming effect.
When responding to the placebo, these neurochemicals are produced at an increased amount, which causes even more opioids to be released by a region of the brain called the periaqueductal gray. The neurochemicals then signal down to the spinal cord as if to say that the pain has been managed. Meanwhile, the hypothalamus is controls the hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol release. A placebo that reduces a patient’s stress level will calm the HPA axis activity, which in turn will lower cortisol levels and improve physiological outcomes.
The mind and the body are deeply interconnected. The placebo effect is a powerful reminder of this fact. Drawing on principles of classical conditioning, the brain ‘learns’ to link certain kinds of treatments with healing effects. With time, the brain recognises these associations so strongly, that even the act of receiving a treatment can trigger biological responses. In this way, placebos are able to stimulate brain regions that are involved in the perception of pain and other emotions, which effectively ‘tricks’ the brain into producing the outcomes you want it to produce.
Placebos can also work in the opposite manner. If one can feel less pain, they can also experience negative side effects to a placebo treatment. This is called the nocebo effect. For example, if someone is told taking a certain medication will give them headaches or nausea, they might start experiencing these symptoms even when taking an inert medication.
An Indian stand-up artist, Samay Raina, once talked about how a lot of his friends quit smoking cigarettes by pretending to smoke one without actually doing it. Since the brain is conditioned to ‘feel good’ when performing these actions, this would cause the brain to release an increased amount of opioids. Something similar happened to my friend’s brain when he took the decaf energy pills instead of regular ones.
There have been several instances where placebos have worked just as well as normal procedures. In the 1990s, Dr. Bruce Moseley conducted a ‘sham surgery’ on about 180 patients with severe knee pain. The reported discomfort was so bad that they had trouble getting out of chairs. He performed real arthroscopies on some patients and only made the sounds of surgery for others, with only a small cut on the knee. While both groups were given painkillers, they were all blinded to prevent fostering biases in their treatments. After being observed for two years, it was found that the fake procedure was just as good for improving pain and function, while being less invasive and posing a lower risk of infection at the same time.
Our brains are wired to respond to expectations by creating physiological outcomes from psychological cues. The instance with my friend’s decaf caffeine pills wasn’t just a funny accident; it was a demonstration of how powerful our perceptions can be. University students chasing fitness goals, high grades, or stress relief, might not necessarily need complex solutions. Sometimes, a lot of what we feel and experience is shaped by our own expectations. Belief alone can be enough to tip up the scales. It might even be possible to placebo yourself into being a morning person.
The placebo effect is not magic – it’s science. It’s a reminder that the stories we tell ourselves matter. When we, or our brain, anticipate feeling relief or success, it sets certain processes in motion that can make those expectations a reality. Simple belief has the power to alleviate pain, so imagine what it could do when paired with action and purpose. Your mind is the most powerful tool you have – and the placebo effect proves it.
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