Can your phone cure depression?

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After years of resistance to the smartphone craze, I reluctantly accepted an iphone as a gift last month. I instantly fell in love.

Aside from the obvious convenience of having constant access to email, what I really love are the apps. I love that I can check bus schedules, look up recipes on the go, and take vintage-y looking pictures (thanks Maya!). But as a psychologist, I'm especially excited by the idea that apps can be used in the service of mental health and well-being.

For example:

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1. The Happiness Helper. Dr. Sonja Lyubomirsky, psychologist and author of The How of Happiness, co-developed an app called Live Happy involving activities that research shows contribute to well-being. Users can evaluate and track important goals, envision their best selves, savor positive experiences, and keep a gratitude journal, among other activities. I recently downloaded this app to test it out, and I love the idea, but it was hard to get into the exercises and have the patience to take them seriously. I did appreciate the more interactive elements, such as the ongoing Q & A with Dr. Lyubomirsky, and I do want to try to use the "savoring album" (though that's sort of what my regular album already is).

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2. The Mood Lifter. An app called eCBT for Mood (based on widely-used Cognitive Behavioral Therapy) helps users disrupt the downward spiral of depressive rumination by providing a structure for them to challenge dysfunctional thoughts as they occur. For example, a user might be encouraged to identify the biases processes that give rise to their thoughts, as on the screen to the left. Importantly, this app is intended as an adjunct to therapy and medication, not a replacement. I haven't tried this one out, but I would imagine that, like Live Happy, it would require a high degree of motivation and commitment - though for those who are used to regularly completing CBT homework it may be a more fluid transition, and a more convenient platform than traditional paper/pencil writing exercises. Coming soon: eCBT for dieting, anxiety, pain, binging, and drinking.

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3. The Anxiety Buffer. Research suggests that highly anxious people have an attentional bias that causes them to more quickly perceive negative or threatening stimuli, such as a hostile face. Cognitive bias modification was recently developed as a method for training people to redirect attention away from negative stimuli using simple computer-based tasks, and this approach has demonstrated effectiveness in treating anxiety. A team of researchers at Harvard and Boston University have recently begun testing an app that is based on bias modification for social anxiety. According to a New York Times report, findings from an initial study are mixed: the app was better than nothing but did not beat the placebo condition which involved a non-therapeutic gaze-shifting task. The largest benefits came to those who had first read an article about the program, suggesting that positive expectation might play a role. Stay tuned for more when the paper reporting these results is published. (The app is not yet available.)

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4. The Self-Esteem Booster. Mark Baldwin and his graduate students have developed some great self-esteem games. Unlike overt positive affirmations, which can backfire, these games target people's implicit (i.e., automatic, unconscious) feelings about themselves. Tasks that involve, for example, repeatedly physically linking positive words and images with the self can change these "gut" feelings for the better. And repeatedly focusing on positive social information (e.g., clicking on smiling faces), a task also based on principles of bias modification, is intended to help people learn to ignore rejecting information in their social environments. You can try some of the games here, and they can be purchased at this website. I couldn't help but be distracted and amused by the models' varied takes on hostility, but I assume that over time the routine of the task would set in. This is not an app yet, as far as I know, but I imagine that it will be soon!

While few would argue for mental health apps to replace real-life interactions with trained therapists or supportive loved ones, apps do have the unique advantage of being available at times when other resources may not be, such as right before a stressful exam or presentation at work, after a heated argument, or in the middle of the night. Our phones are our constant companions, the one thing that follows us wherever we go - we may as well take advantage of their potential to make us happier and healthier.

References:

Dandeneau, S., & Baldwin, M. (2004). The Inhibition of Socially Rejecting Information Among People with High Versus Low Self-Esteem: The Role of Attentional Bias and the Effects of Bias Reduction Training Journal of Social and Clinical Psychology, 23 (4), 584-603 DOI: 10.1521/jscp.23.4.584.40306

MacLeod, C., Koster, E., & Fox, E. (2009). Whither cognitive bias modification research? Commentary on the special section articles. Journal of Abnormal Psychology, 118 (1), 89-99 DOI: 10.1037/a0014878