KevinMD January 19, 2025
Richard A. Lawhern, PhD

As a health care writer and patient advocate for over 27 years, I have interacted with thousands of patients who experience chronic severe pain, caregivers who support struggling family members, and clinicians who treat painful conditions. Depression and anxiety are very common in these patients and may significantly complicate treatment. Untreated depression – or under-treated pain – can cause increases in healing times, suicidal ideation, and even suicide itself.

On the other hand, we know patients’ expectations that a treatment will help them and may improve some patients’ symptoms even when they are given an inert sugar pill (“placebo effect”). Positive doctor-patient relationships and mutual respect tend to promote better outcomes. Negative relationships are associated with worse outcomes (“nocebo effect”).

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