Can You Treat Depression with an App?
With the proliferation of health tracking apps, it’s no surprise to see dozens being offered to help treat people with depressive symptoms. (No app has been FDA-approved or scientifically proven to actually treat depression.)
The New York Times asks four experts and researchers in this area whether you can treat depression with an app in their latest Room for Debate. It’s an interesting discussion worth the read.
There are two primary ways to address the rising trend of more people being diagnosed with depression or who are at-risk for a depressive episode. We can develop and implement preventative measures to head-off depression before it becomes a full-blown condition. And we can implement easily-accessible, free self-help programs that have a good research base (such as Australian National University’s popular MoodGYM cognitive behavioral therapy (CBT) program for depression).
I believe that apps can fall into both of these categories, if well done and carefully thought-out. If your app simply tracks moods without offering educational advice — based upon CBT techniques or the like — it’s not well done.
I believe Matthew Hertenstein, an associate professor of psychology and director of the Touch and Emotion Lab at DePauw University, offers the best insight into the current state of mental health apps available:
The apps vary in function but most fall in line with the current zeitgeist of Track Thyself (whether it be calories, weight, steps or depression). The good news is that these kinds of apps increase access to health support and that access is portable. But their use should be supplemental, rather than a primary therapeutic avenue.
I would say that if you’re currently in treatment, such apps should be supplemental. But I think it’s either naive or short-sighted to believe that everyone is or can be in treatment of some sort for depression. The fact is, a significant number of people will never seek out treatment for depression (some suggest the number is nearly 80 percent!). Should we not try and help them in some other way?
David C. Mohr, a professor of preventive and behavioral medicine and the director of Northwestern University’s Center for Behavioral Intervention Technologies has one possible answer — through the apps they’ve been developing:
For example, our Daily Feats app provides checklists with successive goals to activate people who are depressed. Another app, Aspire, helps people identify personal strengths and values, and prompts them to begin acting with a greater sense of meaning and purpose. The Thought Challenger app uses cognitive behavioral techniques to challenge negative thinking.
Even though apps like Daily Feats are specifically designed to help “activate people who are depressed,” user reviews suggest it isn’t quite there yet: “Wasn’t very well designed, there’s nothing to do other than picking tasks and the reminder times” and “I have it set to notify me and it never does.” Thought Challenger has fared better in user reviews. The apps are also oddly unavailable for the iPhone.
Galit Atlas, a faculty member in New York University’s postdoctoral program in psychotherapy and psychoanalysis, disagrees:
This is the greatest danger of seeking help through an app: It could prevent a patient from getting the actual help they need. Insurance companies will jump at the chance to cut costs, reduce spending and limit mental health benefits. As a result, people may find themselves alone, without human contact when it’s needed most. And there is no adequate substitute for human interaction dedicated to the very real task of healing psychological suffering.
There is something to be said in Atlas’s point — an app is usually a poor replacement for actual face-to-face psychotherapy. Sure, it may help reduce depressive symptoms in some, but for others, it may set themselves up for another failure — which will only drive a person deeper into depression. Since most apps don’t screen for whether a person will benefit from using it or not (and frankly, most app makers don’t know the answer to that question), there’s no good way to filter out those who may get worse using an app.
Finally, we have Dror Ben-Zeev, an assistant professor of psychiatry, leads a research group that studies the effects of mobile phone applications on mental health at Dartmouth College. He makes a salient point:
The key is to offer mental health apps that are based on sound research. Those that are the product of trial-and-error and close consideration of the intended user group’s needs and preferences, are often better than those marketed in the commercial app world. The public should know that most apps are made available with little to no research examining their effectiveness or safety. Glossy looks and inflated claims of potency are typically marketing strategies, not indicators of demonstrated effectiveness.
And that’s the real problem — anyone can create and publish an app today and put in Apple’s or Google’s app stores. It could be the most popular and downloaded app available but still have zero research behind it (or worse, the guise of research which wasn’t actually done on the app available, or studied a tiny or non-generalizable sample population). There’s no filter in the app stores that requires a medical or health app to have any research, so most do not.
Read the full debate: Is Depression Treatable with a Mobile Phone App?
Grohol, J. (2018). Can You Treat Depression with an App?. Psych Central. Retrieved on February 23, 2020, from https://psychcentral.com/blog/can-you-treat-depression-with-an-app/