At the time of writing, the US is about to have a presidential election. Most of our readers are Americans, and in any case, what the US does tends to affect most of the world, so certainly many readers in other countries will be experiencing stress and anxiety about it too.

We’re a health science publication, not a political outlet, so we’ll refrain from commenting on any candidates or campaign policies, and we’d also like to be clear we are not urging you to any particular action politically—our focus today is simply about mental health.

First, CBT what can be CBT’d

Cognitive Behavioral Therapy (CBT) is far from a panacea, but it’s often a very good starting point. And when it seems the stakes are high, it’s easy to fall into such cognitive distortions as “crystal ball” and “catastrophization”, that is to say, predicting the future and feeling the impact of that (probably undesired version of the) future, and also feeling like it will be the end of the world.

Recognizing these processes and how they work, is the first step to managing our feelings about them.

Learn more: The Art of Being Unflappable (Tricks For Daily Life)

Next, DBT what can be DBT’d

A lot of CBT hinges on the assumption that our assumptions are incorrect. For example, that our friend does not secretly despise us, that our spouse is not about to leave us, that the symptoms we are experiencing are not cancer, and in this case, that the election outcome will not go badly, and if it does, the consequences will be less severe than imagined.

But… What if our concerns are, in fact, fully justified? Here’s where Dialectic Behavior Therapy (DBT) comes in, and with it, what therapists call “radical acceptance”.

In other words, we accept up front the idea that maybe it’s going to be terrible and that will truly suck, and then either:

• there’s nothing we can reasonably do about it now (so worrying just means you’ll suffer twice), or
• there is something we can reasonably do about it now (so we can go do that thing)

After doing the thing (if appropriate), defer processing the outcome of the election until after the election. There is no point in wasting energy to worry before then. In a broadly two-party system where things are usually close between those two largest parties, there’s something close to a 50% chance of an outcome that’s, at least, not the worst you feared.

Learn more: CBT, DBT, & Radical Acceptance

Lastly, empower yourself with Behavioral Activation (BA)

Whatever the outcome of any given election, the world will keep turning, and the individual battles about any given law or policy or such will continue to go on. That’s not to say an election won’t change things—it will—but there will always still be stuff to do on a grassroots level to make the world a better place, no matter what politician has been elected.

Being involved in doing things on a community level will not only help banish any feelings of despair (and if you got the election outcome you wanted, it’ll help you feel involved), but also, it can give you a sense of control, and can even form a part of the “ikigai” that is often talked about as one of the pillars of healthy longevity.

Learn more: What’s Your Ikigai?

And if you like videos, then enjoy this one (narrated by the ever soothing-voiced Alain de Botton):

Watch now: How To Escape From A Despairing Mood (4:46) ← it also has a text version if you prefer that

Take care!

Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago

The placebo effect is a well-known, well-evidenced factor that is very relevant when it comes to the testing and implementation of medical treatments:

NIH | National Center for Biotechnology Information | Placebo Effect

Some things that make placebo effect stronger include:

• Larger pills instead of small ones: because there’s got to be more going on in there, right?
• Thematically-colored pills: e.g. red for stimulant effects, blue for relaxing effects
• Things that seem expensive: e.g. a well-made large heavy machine, over a cheap-looking flimsy plastic device. Similarly, medication from a small glass jar with a childproof lock, rather than popped out from a cheap blister-pack.
• Things that seem rational: if there’s an explanation for how it works that you understand and find rational, or at least you believe you understand and find rational ← this works in advertising, too; if there’s a “because”, it lands better almost regardless of what follows the word “because”
• Things delivered confidently by a professional: this is similar to the “argument from authority” fallacy (whereby a proposed authority will be more likely trusted, even if this is not their area of expertise at all, e.g. celebrity endorsements), but in the case of placebo trials, this often looks like a well-dressed middle-aged or older man with an expensive haircut calling for a young confident-looking aide in a lab coat to administer the medicine, and is received better than a slightly frazzled academic saying “and, uh, this one’s yours” while handing you a pill.
• Things with ritual attached: this can be related to the above (the more pomp and circumstance is given to the administration of the treatment, the better), but it can also be as simple as an instruction on an at-home-trial medication saying “take 20 minutes before bed”. Because, if it weren’t important, they wouldn’t bother to specify that, right? So it must be important!

And now for a quick personality test

Did you see the above as a list of dastardly tricks to watch out for, or did you see the above as a list of things that can make your actual medication more effective?

It’s arguably both, of course, but the latter more optimistic view is a lot more useful than the former more pessimistic one.

Since placebo effect works at least somewhat even when you know about it, there is nothing to stop you from leveraging it for your own benefit when taking medication or doing health-related things.

Next time you take your meds or supplements or similar, pause for a moment for each one to remember what it is and what it will be doing for you. This is a lot like the principles (which are physiological as well as psychological) of mindful eating, by the way:

How To Get More Nutrition From The Same Food

Placebo makes some surprising things evidence-based

We’ve addressed placebo effect sometimes as part of an assessment of a given alternative therapy, often in our “Mythbusting Friday” edition of 10almonds.

• In some cases, placebo is adjuvant to the therapy, i.e. it is one of multiple mechanisms of action (example: chiropractic or acupuncture)
• In some cases, placebo is the only known mechanism of action (example: homeopathy)
• In some cases, even placebo can’t help (example: ear candling)

One other fascinating and far-reaching (in a potentially good way) thing that placebo makes evidence-based is: prayer

…which is particularly interesting for something that is fundamentally faith-based, i.e. the opposite of evidence-based.

Now, we’re a health science publication, not a theological publication, so we’ll consider actual divine intervention to be beyond the scope of mechanisms of action we can examine, but there’s been a lot of research done into the extent to which prayer is beneficial as a therapy, what things it may be beneficial for, and what factors affect whether it helps:

Prayer and healing: A medical and scientific perspective on randomized controlled trials

👆 full paper here, and it is very worthwhile reading if you have time, whether or not you are religious personally

Placebo works best when there’s a clear possibility for psychosomatic effect

We’ve mentioned before, and we’ll mention again:

• psychosomatic effect does not mean: “imagining it”
• psychosomatic effect means: “your brain regulates almost everything else in your body, directly or indirectly, including your autonomic functions, and especially notably when it comes to illness, your immune responses”

So, a placebo might well heal your rash or even shrink a tumor, but it probably won’t regrow a missing limb, for instance.

And, this is important: it’s not about how credible/miraculous the outcome will be!

Rather, it is because we have existing pre-programmed internal bodily processes for healing rashes and shrinking tumors, that just need to be activated—whereas we don’t have existing pre-programmed internal bodily processes for regrowing a missing limb, so that’s not something our brain can just tell our body to do.

So for this reason, in terms of what placebo can and can’t do:

• Get rid of cancer? Yes, sometimes—because the body has a process for doing that; enjoy your remission
• Fix a broken nail? No—because the body has no process for doing that; you’ll just have to cut it and wait for it to grow again

With that in mind, what will you use the not-so-mystical powers of placebo for? What ever you go for… Enjoy, and take care!