If you haven’t heard of the nocebo effect, you’re not alone. It’s a relatively new term that doctors are using to refer to negative connotations about concussion treatment and how those may slow down recovery.
With the nocebo effect, recovery is impacted by the original brain injury as well as the misconceptions about concussion symptoms and how much rest is needed. While it used to be normal for people to stay home, stay in a dark room or avoid work or school after a concussion, which may not actually be the best advice.
The nocebo effect works opposite of the placebo effect. Instead of getting positive gains by thinking positively about an injury, illness or treatment, the nocebo effect creates negative and harmful physiological outcomes by creating negative psychological expectations.
What’s an example of the nocebo effect?
One example is how the nocebo effect may impact treatments. It has been found that doctors who warn people about the side effects of a medication increase the risk of those side effects by around three times. This comes down to a psychological expectation of those side effects as well as the potential for them to develop normally.
With head trauma, the same kinds of issues can arise. Anxiety about the potential for lingering effects may make it so someone does connect every symptom back to the concussion even when a symptom isn’t related to it at all. Unfortunately, the nocebo effect worsens symptoms and may result in people resting too much or avoiding exercise when it’s actually needed.
Exercise has been shown to help after a concussion in some cases. In one study, teens who exercised more than 160 minutes a week ended up having fewer post-concussive symptoms one month after the initial injury compared to those who didn’t exercise as much. It was also shown that these individuals who exercised were less likely to develop anxiety, depression, dizziness or issues with their balance.
The nocebo effect is largely psychological, but it can have a major impact on recovery. Those who have suffered concussions should remember to follow their treatment plans and be aware of the risk of negative psychological impacts as they recover.