Smartphone psychiatry: How doctors are harnessing tech to fight depression, anxiety

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While some may blame the rise of smartphones and other connected devices for an uptick in mental health conditions such as anxiety and depression, a growing number of researchers are seeking to harness such technology to help spot when vulnerable people are slipping into darkened moods that could threaten their wellbeing — and even their lives.

Known as digital psychiatry, such efforts are seen as being on the vanguard of mental health research.

Scientists at the Toronto-based Centre for Addiction and Mental Health (CAMH), for example, are currently developing a Fitbit-like wristband as a tool to help young adults fight depression. The electronic device measures physical activity and sleep habits while a companion mobile app tracks social engagement and prompts users to complete an “electronic diary” about their mood, health, routines and daily life events in order to document changes in their overall wellbeing.

Dr. John Strauss is a clinician scientist in CAMH’s Child, Youth and Family Program and is part of the team that is leading what is being called the “Depression Early Warning study.”

“The idea is, at least in part, to use technology that young people use ubiquitously, kind of every day in their regular life to do these measures,” he told CTV News. “We’re using mobile and wearable devices to gather data from young people with a history of depression between the ages of 12 and 21. We’re gathering this data over a period of time so we can predict when their depression will come back.”

Any significant changes in diet and activity, Strauss says, can be seen as red flags for recurring depression.

“Depression is pretty common in teenagers,” he explained. “By the end of adolescence, about 20 per cent of young adults will have had depression. And so if you think of a high school classroom, that can be the entire back row. Of those young people who have depression, we know that within two years of recovering, somewhere between 30 and 70 per cent will have yet another episode, so it is a very common problem.”

‘TECHNOLOGY-BASED, PREVENTION PROGRAMS’

Similar technology is being tested around the world.

Laurel Foster, for example, is a 15-year-old high school student who has been using an app developed by researchers at Stanford University in California that prods her with questions three times a day about things such as her mood, sleep habits and daily activities.

“Half of my grade has struggled with depression,” she recently told The Associated Press. “I mean, at age 15, I feel like that’s not very good. And pretty much all of my friends have pretty bad anxiety, like moderate to severe.

For Foster, being part of this test group for teens considered at-risk because of things such as school stress, bullying and life crises has made her more open to talking about her mental health.

“It made me feel pretty good because I feel like a lot of teens don’t acknowledge their emotions,” she said. “I feel like actually seeing them and saying; ‘Okay, I am stressed, what can I do about that?’”

Stanford University psychologist Ian Gotlib is part of the team directing the study that Foster is participating in.

“There are estimates that 25 to 30 per cent of adolescents will experience a major depressive disorder, that’s a psychiatric diagnosable disorder,” Gotlib said in an interview with The Associated Press. “If we can have an algorithm that in kids predicts the onset of depression by a change in their smartphone usage or mobility or how they’re responding to certain pushed questions on a smartphone, then we have an opportunity to start to develop, again, technology-based, prevention programs.”

A recent study from the University of Vermont, moreover, says that wearable sensors could be an important tool for detecting hidden anxiety and depression in young children.

“Children with anxiety disorders need an increased level of psychological care and intervention,” the study’s co-author, clinical psychologist Ellen McGinnis, said in a statement. “Our paper suggests that this… can help us identify those kids and get them to the services they need.”

‘EVEN BETTER THAN SEEING A HUMAN’

The Canadian-developed Mind.me app is already being used by about 1,000 adults struggling with depression. According to Mind Mental Health Technologies, the Montreal-based company behind the app, Mind.me is a “passive application” that monitors “behaviour online, offline, as well as the user’s interaction with the world and people around them.” When the app’s algorithm detects “early indicators of an upcoming depressive episode,” it contacts the people listed in the user’s “circle of trust,” which could be friends, family members or care providers. Such warnings can thus provide a glimpse into a person’s state of mind more quickly than if one had to wait for a medical appointment.

Dr. Roger McIntyre serves as Mind Mental Health Technologies’ chief medical officer. He is also a professor of psychiatry and pharmacology at the University of Toronto as well as the head of the Mood Disorders Psychopharmacology Unit at Toronto’s University Health Network.

“This has implications for how we manage depression,” McIntyre said. “It also has implications for safety in case someone is experiencing thoughts of suicide, so that we can enact the appropriate resources immediately.”

Preliminary studies, McIntyre added, show that such services can be just as accurate, if not more so, than a traditional human assessment.

“What we’ve now determined through a very large study that’s been completed is that the use of this passive, ambient technology — what I would call digital fingerprinting of your depression — is in fact as good, if not better than seeing a family doctor,” he said. “We often say that the rate of detections is in the range between 50 to 80 per cent. But with this tool, we’re able to detect it as high as 90 to 93 per cent — even better than seeing a human person as your care provider.”

‘CONSTANT SURVEILLANCE’

While such devices and apps are being touted as a way to help those struggling with depression, having one’s digital behaviour being constantly monitored creates some obvious privacy concerns.

David Ryan Polgar is a U.S.-based writer, speaker and self-described “tech ethicist.”

“The thorny, ethical issue that we’re really going to have to work out to determine, what is that teen’s right to their freedom of mind? Do they have a right — and I think they do — to not be under constant surveillance?” he told The Associated Press. “I think one of the issues that we’re going to start discovering over the coming years is the idea of what are the ramifications for being under constant surveillance?”

Proponents, however, say that patients would have to consent to their information being tracked and shared. The apps and their effectiveness also likely need years to be tested, studied and implemented.

Researchers like Strauss, moreover, say that privacy concerns ought to be balanced with the potential this kind of technology has to save lives by using the devices we carry with us every day.

“The point of gathering the data is to put together an algorithm: a method by which we can predict when a young person will have a depressive relapse so we can intervene early and prevent that relapse from happening,” Strauss said. “It’s easier to treat an illness early… and depression is one of them.”

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