Placebos reduce stress, anxiety, depression -- even when people know they are placebos

A study out of Michigan State University found that nondeceptive placebos, or placebos given with people fully knowing they are placebos, effectively manage stress -- even when the placebos are administered remotely.

Researchers recruited participants experiencing prolonged stress from the COVID-19 pandemic for a two-week randomized controlled trial.

Half of the participants were randomly assigned to a nondeceptive placebo group and the other half to the control group that took no pills.

The participants interacted with a researcher online through four virtual sessions on Zoom.

Those in the nondeceptive placebo group received information on the placebo effect and were sent placebo pills in the mail along with and instructions on taking the pills.

The study, published in Applied Psychology: Health and Well-Being, found that the nondeceptive group showed a significant decrease in stress, anxiety and depression in just two weeks compared to the no-treatment control group.

Participants also reported that the nondeceptive placebos were easy to use, not burdensome and appropriate for the situation.

"Exposure to long-term stress can impair a person's ability to manage emotions and cause significant mental health problems long-term, so we're excited to see that an intervention that takes minimal effort can still lead to significant benefits," said Jason Moser, co-author of the study and professor in MSU's Department of Psychology.

"This minimal burden makes nondeceptive placebos an attractive intervention for those with significant stress, anxiety and depression."

The researchers are particularly hopeful in the ability to remotely administer the nondeceptive placebos by health care providers.

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Placebo reduces feelings of guilt

People don't always behave impeccably in relationship to others. When we notice that this has inadvertently caused harm, we often feel guilty. This is an uncomfortable feeling and motivates us to take remedial action, such as apologizing or owning up.

This is why guilt is considered an important moral emotion, as long as it is adaptive -- in other words, appropriate and in proportion to the situation. "It can improve interpersonal relationships and is therefore valuable for social cohesion," says Dilan Sezer, researcher at the Division of Clinical Psychology and Psychotherapy at the University of Basel.

Whether feelings of guilt can be reduced by taking placebos is something that researchers at the Faculty of Psychology at the University of Basel have been exploring. Their findings have now been published in the journal Scientific Reports.

Open-label placebos work

In order to arouse feelings of guilt, test subjects in the study were asked to write about a time when they had disregarded important rules of conduct, or treated someone close to them unfairly, hurt or even harmed them. The idea was that the study participants should still feel bad about the chosen situation.

Participants were then randomized to three conditions: Participants in one group were given placebo pills with being deceptively told that this was a real medication while participants in another group were told that they are given a placebo. Both groups were told that what they had been given will be effective against feelings of guilt. The control group was given no treatment at all. The results showed that feelings of guilt were significantly reduced in both placebo groups compared with those without medication.

This was also the case when the subjects knew they had been given a placebo. "Our study therefore supports the intriguing finding that placebos work even when they are administered openly, and that explanation of the treatment is key to its effectiveness," states the study's lead author, Dilan Sezer. Participants in this study were all healthy, had no psychiatric disorders and were not being treated with psychotropics.

Clinical applicability not yet proven

Where feelings of guilt are irrational and continue for longer periods of time, they are considered maladaptive -- in other words, disproportionate. These emotions can affect people's health and are also, among other things, a common symptom of depression.

Scientific studies have shown that placebo effects can be powerful in treating depression. But the finding that open-label placebos can also be useful for such strong emotions as guilt is new. It stands to reason, says Dilan Sezer, that we should try to harness these effects to help those affected. "The administering of open-label placebos, in particular, is a promising approach, as it preserves patient autonomy by allowing patients to be fully aware of how the intervention works." The results of the study are an initial promising step in the direction of symptom-specific and more ethical treatments for psychological complaints using open-label placebos, Sezer continues.

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