Muriel Cooper
Psychologist in Mornington

Self-image and self-esteem

 
Nurse with a pill

How can I make myself feel better now? It's a question that's been suggested in therapy for eons. Cognitive Behaviour Therapy, Acceptance and Commitment Therapy and many other therapies are all variations on a simple recipe.

  • I accept that I feel bad.
  • I accept the feelings that go along with feeling bad.
  • In spite of feeling bad, I can cope.
  • But what can I do to make myself feel better now?

The last step is important. It's the action part of the formula. If we just accept feeling bad and then don't do anything about it, it prolongs our misery and disempowers us. Taking action though, can come in a variety of ways.

For example thinking differently; re-focusing the brain on something else (action and distraction); learning to regulate distress and negative emotions (the six-second breath is good for this); addressing poor relationships; and paying attention to sleep, diet and exercise.

Sometimes though, taking action might be to try something new. A new doctor who seems to understand us better, a new medication, or a new remedy we see on the internet. We want to try it and hope it will help, so we look it up, only to find there is no scientific basis behind the action, the substance or the medication. It's only a placebo, we're told. It doesn't really work, so we don't try it.

But is that true? That we shouldn't try things just because they're thought to be a placebo or science hasn't proven it?

Pain, including emotional pain, is one of the most researched symptoms in modern medicine. In any clinical trial, half the participants in an experiment are given the actual pain medication, and half are given a placebo (usually an inert pill of some kind). We know that many in the placebo group will find their pain lessens, or in some cases disappears altogether. It is estimated that between 30 and 60 percent of people have less pain after taking a placebo. Yet they may never know, often wanting the pill long after the experiment is over (a disadvantage of being in clinical trials, as when the trial is over, there is often a long wait for the medication to become available).

Some home remedies thought to be placebo, or at least minimally effective, have eventually been found to be so effective that they have been synthesised or copied by large pharmaceutical companies. A couple of examples are Digitalis or foxglove for heart disease and Valerian for anxiety and insomnia.

Here are some fascinating examples of the profound effectiveness of the placebo effect.

Sham surgery

A well-known experiment was conducted on participants who received an arthroscopic procedure on their knee. Although a third of the procedures were fakes, most of them recovered just as well as those who had the genuine procedure.

Anti-depressants

The University of Connecticut found that 80% of the success of these treatments was due to the placebo effect. I have seen this regularly in my practice when clients tell me they feel immediately better after taking anti-depressants for only a couple of days. This is impossible unless it is due to the placebo effect, since these medications take between 2 to 4 weeks to become effective.

The placebo effect may not good news for big pharma or orthopaedic surgeons it seems.

Asthma

In a Venezuelan experiment, children with asthma were given a dose of bronchodilator along with a squirt of vanilla. Later they responded just as well to the squirt of vanilla alone. Did it really matter if it was mind over matter? I don't think so; as long as it provided relief.

Placebo is Latin for 'I shall please', but the reverse can be true too, where the effects are not so benevolent.Participants in one study were told the experimenter was rubbing poison ivy on their right arm. Sure enough, they developed a red soreness and blisters, even though it was a harmless shrub.

Obviously, we don't want what we don't desire and who desires to get a rash from poison ivy? But should we be put off trying something that might make us feel better, because science hasn't proven it to be efficacious?

What we really believe in can be immensely powerful. Here are some common remedies for stress, anxiety and depression that may, or may not, be proven to work, but which have been giving people relief for centuries.

Alcohol

You might be saying right now "You can't put that in there! Alcohol is addictive and bad!" Yet people have been using alcohol as a mild sedative for thousands of years. The bottle of medicinal brandy didn't used to be in the medicine chest for no reason. Now we may feel guilty for having that glass of wine before dinner, thinking it's a slippery slope that will lead to dependence. There is so much evidence either way that you can be excused to being confused. Many say it's healthy in moderation, while others will warn you against even moderate amounts.

As far as it being an aid to relaxation there is one thing to remember:

One glass (or two small ones) may relax you and make you feel better but any more than that will not make you feel any more relaxed than the first glass.

Any more alcohol than that can make you drunk, woozy, affect your sleep, affect your ability to drive or operate machinery and yes – you can become dependent on it.

In the meantime, why not enjoy a wine or two once a day, this is considered low risk drinking. More than four is considered harmful and one or two alcohol-free days a week is recommended.Just be smart about it and be mindful; know what is best for you. If you are depressed, you might want to avoid alcohol (it is a depressant after all).

Analgesics

One commercially produced drug with some sound research behind it is paracetamol, a common pain reliever, which has been proven to dampen emotional pain as well as physical pain and may therefore be useful in relieving Stress, Anxiety and Depression. Obviously you want to stay within the recommended dosages and not abuse it, but it may be helpful.

As far as believing that analgesics can make you feel better, any one of them probably can – so why not; as long as you stay within the recommended dose and do not use them for long periods of time unsupervised.

Herbs

Used for thousands of years. Most popular herbs are Valerian, Kava Kava (from Fiji), Passion Flower, Hops and especially St John's Wort, an herbal remedy widely prescribed in Europe. A review done in 2009 at the Munich Technical University concluded that St John's Wort was more effective than a sugar pill in the treatment of major depression and just as effective as anti-depressants (with fewer side effects).

Aromatherapy

Oils like lavender have been used as a calmative and to induce sleep for many centuries. Scientific evidence is not so evident here, although my opinion is that our limbic/survival brain is soothed by pleasant sensual experiences that indicate the abundance of nature. Pleasant floral and herbal scents might have this effect. The sense of smell can be very powerful, as the results of the experiment with asthmatic children and vanilla spray seems to suggest (above).

Essential oils

The FDA in Australia recently approved the sale of the Brazilian resin oil Copaiba (co-pay-iba). It contains a type of cannabinol found in Marijuana, but the anti-inflammatory and pain-relieving kind used in medical marijuana – not the kind that makes you 'high'. It may be useful in relieving Stress, Anxiety and Depression. Care needs to be taken when taking the oil orally as it can cause digestive problems.

Supplements

See my article on supplements. Recent studies have shown that magnesium complex can be a powerful remedy for S.A.D.

Water therapies

For example warm baths and other water treatments such as mineral spas and even a simple, warm shower.

Exposure to nature

Walking in a park or on a beach (see my article the seas and trees).


The effectiveness of these remedies, scientifically proven or not, can only be enhanced by our desire to believe that they work.

Provided these remedies are used judiciously, as recommended, and remembering that herbs, like any other drug or substance, can have side effects, who are you or I to say that they aren't useful and effective?

In the action part of your four-step guide to overcoming Stress, Anxiety and Depression, if it makes you feel better, consider doing it. Whether it has a direct action, or whether it is a placebo; what does it matter? If it feels good – do it. Be careful though, that you aren't being ripped-off by exorbitantly-priced remedies sold by 'quacks'. You need to do your due diligence.

As usual, check with your doctor before taking remedies (especially herbal ones like foxglove or St John's Wort) and remember that they are active substances and therefore may interact with medications you are already taking. If you are interested in references or further reading, post a comment or make an inquiry.

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