Introduction: The nocebo effect refers a negative expectation of a phenomenon causes it to have a more negative effect than it otherwise would. Here, we present a case of medication treatment resistance and review pertinent literature of nocebo effect to explore the unconscious determinants of behavior associated with treatment resistance.
Case Report: Patient is a 38-year-old, college educated, divorced woman with a history of bipolar disorder and childhood sexual trauma. Her first psychiatric encounter was ten years ago when she was treated with lithium. She stopped taking the medication shortly. Some years later, she was restarted on medications for recurrent depression. But she discontinued the medications because "they did not help my
