A therapist in your pocket
February 8, 2012
Are you depressed, checking e-mail and Facebook, or home alone ruminating for hours?
Cheer up. Scientists are inventing web-based, mobile and virtual technologies to treat depression and other mood disorders at a new National Institutes of Health-funded Northwestern University Feinberg School of Medicine center.
In the works: a virtual human therapist to prevent depression, a medicine bottle that reminds you to take antidepressant medication and tells your doctor if the dosage needs adjusting, and a web-based social network to help cancer survivors relieve sadness and stress.
“We’re inventing new ways technology can help people with mental health problems,” said psychologist David Mohr, director of the new Center for Behavioral Intervention Technologies and a professor of preventive medicine at Northwestern’s Feinberg School. “The potential to reduce or even prevent depression is enormous.” The goal: become a national resource, offering a library of intervention technologies that will be available to other researchers.
The virtual technologies include:
A smart phone spots symptoms of depression by harnessing the phone’s sensor data to interpret a person’s location (GPS), activity level (via an accelerometer), social context and mood. If the Mobilyze! app — which learns your usual patterns — senses you are isolated, it will send you a suggestion to call or see friends.
Tested in a small pilot study, the technology helped reduce symptoms of depression. “By prompting people to increase behaviors that are pleasurable or rewarding, we believe that Mobilyze! will improve mood,” Mohr said. “It creates a positive feedback loop. Someone is encouraged to see friends, then enjoys himself and wants to do it again. Ruminating alone at home has the opposite effect and causes a downward spiral.”
A medicine bottle now being developed will track if you forgot your daily dose of antidepressant medication and remind you to take it. It addresses the common problem of patients who quickly stop taking antidepressant medications prescribed by their primary care doctors.
“People whose depression is being treated by primary care doctors often don’t do very well, partly because patients don’t take their medications and partly because the doctors don’t follow up as frequently as they should to optimize the medication and dosage when necessary,” Mohr said.“
This pill dispenser addresses both issues.”The bottle is part of a MedLink system, which will include a mobile app that monitors the patient’s depressive symptoms and any medication side effects and will provide tailored advice to manage problems. The information is then sent to the physician or health care provider with a recommendation, such as a change in the dose or drug, if necessary.
The MedLink system also will be used to improve medication adherence in patients with schizophrenia and HIV.
A virtual programmable human will role-play with adolescents and adults to teach social and assertiveness skills to prevent and treat depression. A prototype is being developed with researchers from the University of Southern California.“We think this will be especially helpful for kids, who often are reluctant to see a therapist,” Mohr said.
The program will allow them to practice these behaviors in the safety of virtual space. Existing online interventions for teens “look like homework,” Mohr noted.
The virtual human feels like a game, making it more likely to engage them.“Having trouble with those situations makes people more vulnerable to depression,” Mohr said. “When people have the confidence and skills to better manage difficult interpersonal interactions, they are less likely to become depressed.
”Previous research also has shown that intervening early in adolescents who have difficulty with social skills can help prevent the first onset of depression.For example, Web-based content to help cancer survivors manage stress and depression is more effective when a human coach checks in on their progress via a phone call or e-mail.“
People are more likely to stick with an online program if they know that someone they like or respect can see what they’re doing,” Mohr said. His group is creating a closed social network and collaborative learning environment where peers can serve that function for each other.“
People can get feedback from the group, share goals and check in with members if someone has stayed offline for too long,” Mohr said.
Also see: Can Smartphones Cure Depression? Probably Not from Slate: “If you’re already feeling alone and depressed, wouldn’t a text message from your phone telling you to go socialize make you even lonelier?”