Given the recent news about antidepressants and the ‘placebo effect’ I thought I’d go there first before folks get themselves all in a lather about those medications and their usefulness treating dogs with fear, phobias and anxiety disorders.
That there are other ways to treat mild depression other than medication is not news. Research demonstrating the ‘placebo effect’ in patients suffering from depression dates back to the 1990’s. That antidepressants have been and continued to be used to help modify behavior in dogs is also not news, nor should it be discounted as the flood of critics of big Pharma (of which I wouldn’t label myself a fan) and medication add the newest studies to their quiver and take aim at medications being used to help dogs.
More accurately the ‘placebo effect’ should be called the ‘placebo effects‘. Placebos don’t all work in the same way. Research into the neurobiology of placebos have been able to identify changes in brain functions. Placebos can work because they help lower the anxiety a sick, or depressed person is experiencing. The possibility and expectation of being healed, along with the attentions of a healer, can be very soothing. Kissed any boo-boos lately to stop the sobbing of a child, hurt and scared by their injury? This lowering of anxiety sets a chain of biological responses in motion, ultimately leading to the patient feeling and being better. That anxiety plays such an important role in healing should be noted by those of us living with fearful dogs. Unfortunately for us and our dogs the attention we give them often contributes to their anxiety rather than lowers it.
Along with the lowering of anxiety there is also the anticipation of a reward, in this case the reward of feeling better. Those of us who use reward based training understand how powerful the ‘expectation’ of a reward is. Our brain’s reward system goes into action even before we receive a reward. The chemicals released in our brains when we anticipate a reward help us begin to feel better. Essentially we create the reward ourselves. The difference between humans and dogs is that we know that the pills hidden in the cream cheese are going to make the dog ‘better’. The dog may not even know they are there at all and does not understand the association between pills and what she experiences in the future.
Placebos also work because medications have taught our brains and bodies how to feel better. If we have daily headaches and take aspirins and an hour later we feel better, we might also feel better if after enough experience with real aspirins we take pills that look like aspirins because our brains learned to do whatever aspirin does that makes us feel better. The medications ‘taught’ our brains how to make the changes necessary for relief. How to apply this to our dogs is a challenging proposition.
A common belief held about placebos is that if they work as well, or can work with a significant portion of the population, it must mean that the drug it is being tested against, doesn’t work. That placebos can work as well as an antidepressant in some people does not mean that the drug is not working at all.
We want to be aware of the potential side effects of taking a medication compared to no treatment at all. Risks needs to be weighed. That the early vaccine for polio caused polio in some instances was not a case against vaccines, but one for a safer vaccine. That the risk of being vaccinated against polio by a safer vaccine was less than the risk of contracting polio is evident today in the absence of polio in most developed countries. The interesting side effect of this success is that there are some who did not grow up during the polio epidemic, and have no experience with the risks of the disease, and eschew the use of vaccines.
If people can grow it or make it we can figure out ways to abuse it. We can use use the things we make or grow inappropriately and suffer and die because of them, or at best, gain no benefit from them. Before you toss the baby out with the bathwater when it comes to using behavioral medications, including antidepressants and anxiolytics to help our fearful and anxious dogs, do your research. That there are other ways to treat fear and anxiety in dogs is not a reason for an owner to discount the use of medication for their dog.
We need to lower the constant stress and anxiety our dogs are experiencing in order for them to be able to learn new skills and responses. If you are not able to do this by managing their environment and teaching them skills that help them cope with the stress they do experience, consider the harmful effects of constant stress on a body and brain. When you don’t see results from alternatives to medications don’t wait for gangrene to set in and lose the limb- talk to your vet about the drugs available to help your dog.