Showing posts with label Placebo. Show all posts
Showing posts with label Placebo. Show all posts
Saturday, November 15, 2014
Book Review: The Happiness Advantage
Grade: B
Riveting research gets a little stifled by the author’s pride.
Did you know Shawn Achor went to Harvard?
No really. I’m quite certain of it. He only mentioned it about 27 times in this book, so it was kind of subtle, but if you read between the lines you too can pick up this hidden gem.
I promise not to mention it again – because it was the only glaring annoyance in this otherwise useful book.
This book could also be called: The Placebo Effect.
It is very very VERY real. People dismiss the effect of thought on our physical body – and it’s HUGE.
Thought is what leads to hormone release. Perception of fear releases adrenaline. Perception of happiness releases Dopamine. This book discusses Oxytocin and Cortisol and many other hormones and it points out the absolutely real physiological effects of each.
Doing the exact same physical activity, with the thought that you are exercising – leads to more weight loss and increased muscle gain. HORMONES matter. THOUGHT matters.
Being “happy” can kill pain better than narcotics. Exercising can cure depression better than antidepressants.
Being Happy decreases heart disease, diabetes, high blood pressure, and many other PHYSICAL diseases.
This is not about positive affirmations or “think a happy thought.” This book is not Peter Pan advice to help us fly away from tragic lives.
This book is science. Research study after research study proving that our mental outlook on life makes a HUGE difference in our physical health, our finances, our family, our friends, our entire existence.
This book is very worthwhile – because the author doesn’t just say “Get Happy” – He gives you specific tasks and practices to accomplish it.
My favorite chapter was “Principle #6: The 20 Second Rule”
It talks all about "activation energy."
It takes very little energy to keep a signal running along a nerve. But it takes a burst of energy to start the flow. You have to provide enough “activation energy” to start it. Kind of like getting a car rolling on a flat road. You have to put in a ton of energy to push the car from a dead stop but once it’s going it doesn’t take much to keep it going.
It is the same way with habits. Habits are very hard to start. Forming them can be a nightmare.
The answer – DECREASE the activation energy. Make it as simple as possible to do the habit each day.
What ever you want to do: put it in your natural path. Take away all need for decision making. Make it harder NOT to do the new thing.
If you want to exercise first thing in the morning – sleep in your gym clothes.
If you want to learn to play the guitar – keep the guitar in the middle of the room where you will almost run into it every time you walk through your house.
The same is true for habits you want to STOP. Make it much much HARDER to do the thing you want to stop.
If you check your e-mail WAY too often and you want to stop – delete your shortcut, and don’t let the computer remember your password.
Make it require time, energy, and a whole lot of work to do the WRONG thing.
This chapter is genius. The entire book is good.
I recommend it.
Here are two of my favorite quotes from the book:
"Common sense is not common action." - p. 146
"Coercing employees into awkward icebreakers or forced bonding activities, like making everyone at a meeting share something about their private lives, only breeds disconnection and mistrust. Better that these moments happen organically - which they will if the environment is right. The best leaders give their employees the space and time to let moments of social connection develop on their own" - p. 193
Labels:
achor,
Book Review,
happiness advantage,
Placebo,
research
Thursday, March 29, 2012
Is “Prozac” just “Placebo” misspelled?
A few facts:
In 2010 the top 5 antidepressants were prescribed 115 million times in the USA.
Antidepressants have side effects, the most common being weight gain, sexual dysfunction, and upset stomach. The most severe being suicidal thoughts and fatal birth defects.
Conclusion: These are not benign medications.
About me – I did not read just one article about antidepressants and then write a blog post about it. I have researched this topic. I have read many articles, and read the Newsweek article including the drug companies responses. I have read studies sponsored by drug companies as well as those with no “Pharm” funding whatsoever.
I wrote before about the publication bias in antidepressant research.
If we look at EVERY published and unpublished study submitted to the FDA for a set of antidepressants and compare the drug response with placebo response, guess what we find?
I'll give you a hint...it's depressing.
Everyone in the studies took a "depression rating test" before and after the drug trial.
If patients on Prozac said they got got better by 10 points, those on Placebo got by 8 points. Yes, Placebo had 80% of the effect.
You want the exact numbers?
There is a scale for rating depression called HAM-D which has been used since 1960 for pretty much all antidepressant trials. The higher you score, the more depressed you are.
0-7 = No Depression
8-13 = Mild Depression
14-18 = Moderate Depression
19-22 = Severe depression
>23 = Very Severe Depression
So you take the test before the drug trial. Then you get either an antidepressant or placebo and take it for a few weeks. Then you take the test again. How much lower your score is = your improvement.
Average improvement on antidepressants: 9.6 points (that would move you 1-2 levels up on the scale, like from severe to mild, and from moderate to mild or none.)
So that’s some real improvement
Average improvement on Placebo = 7.8
So the medication works better than placebo – but not much. How do we tell if that difference matters? Does a difference of 1.8 points matter? If you do a statistical analysis – YEP, it’s significant.
If you do a clinical analysis (do the patients notice any real difference?) – NOPE, it's insignificant.
It turns out that to be clinically significant the drug needs to be at least 3 points better than the placebo. (So says the National Institute for Clinical Excellence)
SO WHAT DOES IT ALL MEAN?
Americans are taking drugs for depression and their depression is getting better. If they were getting a sugar pill (but thought it was the drug) they’d do just about as well.
So you tell me - Knowing the side effects and the costs – is it worth it?
Labels:
Anti-Depressants,
Kirsch,
Medical Research,
Placebo,
Publication Bias,
SSRI
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