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Mind Over Matter: How Placebos Can Enhance Health

One day not long ago, 40 freshly heartbroken 18- to 28-year-olds gathered in a lab clutching photos of the exes who scorned them. Through the lens of an imaging machine, researchers watched similar areas of their brains light up when they were physically hurt with something hot and emotionally hurt with the photos.

Then, the research team gave the students a nasal spray, telling some of them that it was “a powerful analgesic effective in reducing emotional pain,” although it was really just a saline solution. Mercifully, it worked: When shown the photos again, the lovelorn not only reported feeling better physically and emotionally, but their brains also showed it to be true. Specifically, areas associated with rejection turned dim and areas involved in modulating emotions — including those that control painkilling chemicals and mood-boosting neurotransmitters — glowed.

In other words, people’s perceptions of some treatments — no matter their actual contents or lack thereof — can affect how their brains interpret pain, both physical and emotional, for the better. This is empowering news for anyone concerned with health care costs, medication side effects or the opioid epidemic.

“[Placebo] research offers this perspective that pain can be both real — physically, chemically real — and generated in part by your brain in ways that you can potentially work with and control,” says Tor Wager, director of the Cognitive and Affective Control Laboratory and professor of psychology and neuroscience at the University of Colorado–Boulder, who was an author of the study, which was published in March in the Journal of Neuroscience.

While his team’s research was the first to look at how placebos can work to heal heartbreak after being dumped, plenty of other research has demonstrated their power to help ease a variety of mental and physical health conditions including depression, migraines, insomnia and irritable bowel syndrome. One study even found that patients with knee osteoarthritis who thought they underwent arthroscopic surgery, but really just received the small incisions, improved just as much as patients who had other, more invasive variations of the actual surgery. At various periods post-surgery, the placebo group even did better.

“Thoughts and beliefs,” Wager says, “can impact our bodies and brains in a way that matters for health.”

[See: 11 Ways to Cope With Back Pain.]

Perhaps most surprising is that, in some cases, people don’t even have to believe the placebo treatment is a “real” treatment for it to have some benefits. One study, for instance, showed that giving people with irritable bowel syndrome sugar pills labeled “placebo pills … that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes” improved their symptoms. Another study found that a migraine “medication” blatantly labeled “placebo” was 50 percent as effective as the actual drug.

“Everyone said if you knew you were taking a placebo you wouldn’t get a placebo effect, but we talked to patients and we saw [that wasn’t true],” says Ted Kaptchuk, director of the Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center and Harvard Medical School, who was involved in both studies.

Of course, placebos have limits: An operating table probably won’t heal a broken bone and a broken condom won’t prevent pregnancy — nor do they work equally well for all people. Dr. Jon-Kar Zubieta, chair of the department of psychiatry at the University of Utah and psychiatrist-in-chief of the University of Utah Neuropsychiatric Institute, has found that people’s personality traits and genetics can influence how they respond to placebos for conditions including depression.

“The idea is to try to enhance our own internal systems of resiliency non-pharmacologically,” he says. “You promote the things that work well for you even more.” Here’s how he and others say to use research on the placebo effect to your health advantage:

1. Find a provider you trust.

A key reason placebos seem to work in a clinical setting is the context: Going to a doctor’s office and receiving attention can alone make a difference in the treatment’s effectiveness. “It’s ultimately about mutual trust and support — it’s about caring,” says Kaptchuk, also a professor of medicine and of global health and social medicine at Harvard Medical School.

[See: 10 Lessons From Empowered Patients.]

That benefit might be lost, however, if you don’t jibe with your provider or believe he or she has your best interests at heart. In fact, a sort of reverse phenomenon known as “white coat hypertension” can come into play too, when people appear to have high blood pressure in the presence of a physician but not in the comfort of their own homes. “If you don’t feel comfortable with your provider, get another one,” Kaptchuk says.

2. Be cautiously hopeful.

Contrary to popular belief, the placebo effect isn’t about deception, ignorance or false expectations. But it is about hope. “Be open to the possibility of change,” Kaptchuk says. “That openness is not really expecting to get better, it’s about being able to live with hope and knowing that there’s a lot more to get done.” The opposite — say, telling yourself that nothing or no one can help you heal — in some ways increases the likelihood that you’re right. “It’s helpful for many to realize that the future isn’t set in stone and when things seem bad, there might actually be positive future effects,” Wager says.

3. Embrace rituals.

Another factor that can enhance the power of placebos is people’s past experiences — that is, if something has worked for them in the past, they’re likely to believe it will work for them again, which can help make that belief true. “People can capitalize on that by developing rituals and signs and things for them that have positive meaning that are associated with positive states of mind,” Wager says. Sitting cross-legged can relax you if your brain expects you to meditate, for example, and just going into the bedroom can make sleep easier if your brain recognizes that location as a place where you rest — rather than where you watch TV, work or scroll through Instagram. “You put yourself in a certain environment that activates a number of processes in your brain that are real,” Wager says. “That’s why baseball players have all these rituals.”

[See: Mantras That Get 11 Diet and Fitness Pros Through Their Toughest Moments.]

4. Practice self-care.

If the feeling of being cared for is part of what brings about some benefits of placebos, why not do that for yourself? Just taking action to pursue a healthy lifestyle — whether by scheduling a doctor’s appointment, shopping for more vegetables or downloading a meditation app — might be enough to boost your health. “It’s not about believing you’re going to get better,” Kaptchuk says, “it’s about doing something; it’s engagement.”

More from U.S. News

10 Questions Doctors Wish Their Patients Would Ask

When Health Treatments Go From Hospital to DIY

11 Simple, Proven Ways to Optimize Your Mental Health

Mind Over Matter: How Placebos Can Enhance Health originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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