Tuesday, January 09, 2007

Placebo Deficiency

Is the light therapy working?

I do feel less gloomy and more energetic than I did before. And when I think about how long it will be until the sun really starts making a comeback, that seems like a simple fact; I don’t feel it in my bones.

At first I was thinking it might just be a placebo effect. Then I remembered—I have a serious deficiency: I am immune to placebos. I used to be proud of this, thinking it meant I was less gullible than other people, but over time I have come to realize that it just means I don’t feel as good as other people. Because the placebo effect is a marvelous thing.

I always suspected that I was missing out. I get terrible post-viral coughs, and used to drink gallons of dextromethorphan without noticing the slightest decrease in the hacking. (I continued to take it mainly because the people I lived with got terribly annoyed if I didn’t—as if I were destroying their sleep on purpose.) I felt vindicated when I finally saw data that over-the-counter cough remedies are entirely useless aside from their placebo effect—but the knowledge didn’t help me cough any less.

My first attempt at (illegal) mind alteration was a dud. It was a pretty pathetic scene: three of us huddled around a tinfoil-and-tampon-applicator b0ng containing a tiny dried-up lump of h@shish. J, who supplied the stuff, was an anorexic who consumed only Tab and tiny, strictly measured mounds of trail mix. After a few minutes of inhaling hot cotton shreds, J said, “I feel it! I definitely feel it!” My friend S, a 2-pack-a-day smoker who was fluent in three languages, politely said, “Maybe?” And I said, “Nope. Don’t feel a thing. Let’s go get drunk.” (This non-starter led to unfortunate overindulgence much later on, on the suspicion that I just might need a higher dose; the result was not unlike that described by Feral Mom here.)

The real proof came one evening when I was staying at my sister’s house. She and her (first) husband went to a dinner event without me. I got takeout Mexican and happily sat down with a book and a beer. I didn’t much like the beer—some weird German brand I found in their fridge—but I really felt like I needed a drink that evening. Strangely, after I finished the beer, I still felt like I needed a drink. Must be really stressed, I thought, and cracked open another. But after draining that one, I still felt like I needed a drink. Am I becoming an alcoholic? I wondered. It was not until I pulled the third beer out of the fridge that I noticed the fine print on the label: non-alcoholic. I swore a bit, rummaged around and found a real beer, and was perfectly happy after drinking that one (though a bit bloated by that point).

While others are happily enjoying their buzz or being relieved of headaches and such, I’m moping in the corner wondering how I can get my hands on the good stuff.

I’m always a little amused when people get started on antidepressants and after about four or five weeks say, “You know, I’m feeling a lot better, but I don’t know if it’s really the medication—maybe I’m just snapping out of this!” Not that that could never happen, but it’s interesting that it almost always seems to happen right around the time when one would expect an antidepressant to kick in. And here I am, wondering the same thing about the light therapy.

So, I guess it works.

17 comments:

Anonymous said...

I just got my Appolo GoLite in the mail today and I'm waiting for it to be charged up. I've also been taking Celexa for about a year, and we recently upped the dose (which helped some of my anxiety ALOT). Since I'm in a rush most mornings to get out of the house with my 2 kids, I'm going to have to try to figure out how to get my 15 minutes of therapy in the morning.

Not that I enjoy reading about people going through depression, but it's nice to know we're not alone! Thanks for sharing your perspective with us.

I, too, believe I am immune to the placebo affect. Since I have a master's in psychology/counseling, I believe that as much as I enjoy talking about myself, I can't be "tricked" into feeling better by a therapist. Weird, huh?

Liza said...

Funny you should mention that, because apparently I suffer from the same deficiency. I'm one of those obnoxious people who cannot be hypnotized, refuses to suspend disbelief, and doesn't get a dang thing out of Robitussin either. I bought one of those lamps about the same time you did, and I felt like it was helping me feel better almost immediately. The funny thing is that when I got it I didn't think I was depressed or seasonally affected at all, just stressed out like I am every winter (denial: placebo effect of the Bizzarro world) and hey it can't hurt to try a little drug-free pick-me-up, right? Well, maybe it's not the stress, because I'm still pretty stressed out, but I'm no longer prone to tearing up or making snippy comments to loved ones the way I usually am in the winter time, and I actually enjoyed the holidays this year (usually I dread them and attribute my winter "stress" to them in large part). Yay, happy lamps.

luolin said...

I'm glad the light seems to be working.

I was also very happy when I read that otc cough syrups didn't work, because I hate the taste so much.

In college, a nurse told me that instead of a combo remedy syrup for colds, it was better just to take whatever separate over-the-counter remedies were relevant (sudafed and tylenol were the college health center's favorite meds, but they also got me hooked on cepacol lozenges) with a lot of water for the cough, and a bit of booze if I wanted the soporific effect. I've avoided cough syrup ever since, except for the rare prescription.

ozma said...

I am the queen of the placebo effect. And cough syrup worked for me, the one time I tried it--even though I knew that studies say it doesn't work.

A random question, but I wonder if you are affected by scary movies? The power of suggestion is phenomenal to me. Even the slightest scary movie might give me bad dreams and haunt my thoughts for months. I think there's sort of a strange relationship here between the two things, don't ask me why.

Glad the light box is working!

Anonymous said...

Ah yeah, the hacking cough and medicine. I always refused to take them (and people complained about my cough). What does that make me? Both immune to the placebo effect and peer pressure? I'm intrigued to hear that they really don't help (sans placebo effect).

But, I do wonder if it's made me reject all interventions (except antibiotics, I always liked them).

Is it appropriate for you to point us in the direction of the light therapy that's working for you? That's an intervention I'd like to try.

bj

Rachel Stephanie said...

Okay, I have a few questions:

tampon and tinfoil? that's even worse than a coke can. :-) I guess despereate times call for...creative measures?

Also, it is entirely surprising that cough medicine doesn't work! It always worked like a charm for me. I guess it was all in my head.

Anonymous said...

Thanks.

It has been warmer than normal here in the Northeast. On Saturday it was 72 degrees so I put the top down on the car and drove around and trying to spend as much time out side as I can. It seems to help. When it gets really cold I can be found in from of my SAD lamp.

C.

B.E.C.K. said...

"...over-the-counter cough remedies are entirely useless aside from their placebo effect..."

I knew it!! I've been saying that for a while now, and it's always disheartening when I give my son cough syrup and he continues to hack away. The only thing I've found that has helped my son when he's been sick and coughing all night is to give him an antihistamine (to knock him out) and crank up the steamer to add moisture to the air. The only thing that ever worked for my own cough was the same thing, or a prescription cough syrup with codeine (which knocked me out). I may try booze next time (for myself), though, rather than pay for a doctor visit merely to get a prescription for cough syrup -- unless you have an even better suggestion...

Anonymous said...

I think I need one of those lamps. I grew up in AZ and had never seen snow until I moved to NY to attend Cornell. Ever since then I get depressed every fall. I never understand why most people find fall the best time of the year, the time when they feel energized and want to "go out" and "do things". Fall leaves me dreading the first snow, dreading the change in the daylength, even dreading the time change and the holidays.
Spring, however, get's me so excited I can hardly contain myself. The moment the first crocus pops a green little leafbud through the snow I'm rearing to go. I bundle up in my winter gear, to the point where I feel completely helpless and look like the stay-puft marshmallow man, and venture out- looking for other signs of spring and GREEN.
I have also learned to loathe evergreens, green portends of spring and the end-of-snow and long days- sometimes I am fooled by an evergreen- seeing the peek of green out of the corner of my eye.

Lo, it's just a damn pine.

I live for green, for summer, for things that aren't senescing or hibernating or going dormant.

Perhaps it's time I ask about a light.

Great post, and I highly deny it is your mind tricking itself. Some of us are just designed for light.

Monica C. said...

LOVE that beer story!

Kris said...

Do you happen to know how I can get my hands on a phototherapy light without having to go through my GP?

I am glad to hear that it is helping you! I live way up North and the lack of light is fairly bothersome...suggestions?

K.

Old MD Girl said...

I usually take Nyquil to sleep when I have a cough -- it TOTALLY knocks me out. It's probably just the booze in it though.

During a sociology class, we read an article entitled, "Learning to be a marajuana user," which was all about the fact that getting high -- on weed anyway -- is a social phenomenon that you learn from your peers over time. Interesting that they didn't entitle their article, "Learning to be a heroin user." Or a light box user. :-)

Anonymous said...

Glad you're feeling better! I can't get my placebo on, either.

Maybe I should try the light box thing. I've looked them up online a couple of time, gulped at the price, and forgotten about them.

But, since the winter pit has me desperately clawing through Kayak and Priceline looking for plane tickets to Mexico, maybe I should reconsider.

~Artemisia

legalmama said...

I did the tampon and tinfoil thing in college too. Didn't everyone?

I've always thought cough syrup was a big waste. It used to drive me nuts when I was going through the infertility thing when women swore that Robitussin made them more fertile by thinning their cervical mucous. If it didn't make my cough any better, I seriously doubt it would work on my hoo-hah. I guess it made them feel better to think so. I thought I read somewhere recently that a lot of cough medicines no longer even contain any real medicine, but they still sell because of the placebo effect.

thumbscre.ws said...

I KNEW dextromethorphan was crap! During a recent up-all-night cough-a-thon, I discovered that the best thing was to down an big ol' slug of booze... don't know whether it made me more relaxed, sleepier or told the "hack up a lung" center of my brain to cut the shit, but I was asleep within half an hour. Alas, the only liquor available was... dun dun DUN! Glenlivet 10 Year, which made that particular home remedy about as expensive as an economy-sized jug of Ineffectussin.

DoctorMama said...

ozma—You are a lucky woman. Go with it. If it works, it doesn’t MATTER if it’s the placebo effect! As for scary movies—I never watch them. Never could. Too scary. So at least for me, it’s unrelated to the placebo effect.

bj—I got this one.

Rachel Stephanie—Like I said to ozma, doesn’t matter if it’s all in your head, as long as it works.

B.E.C.K.—I’ll call in codeine syrup for my patients rather than make them come into the office. It’s a silly loop: you have to go see the doctor to get the good stuff, then when you show up the doctor assumes it’s because you want antibiotics and writes for them to avoid an argument … as for whether codeine suppresses cough, that’s a little up in the air too, but you at least can go to sleep.

Anonymous—“it's just a damn pine”—too funny.

Kris—you don’t need a script; you can order them all over the web.

Old MD Girl—It’s probably mostly the diphenhydramine in the Nyquil that helps you sleep.

Artemisia —They are a pretty penny; I hesitated myself.

legalmama—“if it didn't make my cough any better, I seriously doubt it would work on my hoo-hah”—amen.

thumbscre.ws—you’re right, it IS as expensive as good Scotch. What a crappy deal.

Elizabeth said...

Artemisia, I got my lightbox on Craigslist for less than half of list price - it's worth a try.