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Alina Ivan

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Nov 11, 2021, 5 min read

​​Can smartwatches and fitness trackers augment therapy?

You’re in the therapy room and the therapist asks you how you’ve been feeling since your last session. If you are anything like me, you may struggle to remember what you had for dinner two days ago, let alone to recall events and feelings that you’ve experienced over a longer number of days or how you've been sleeping.

Smartwatches and fitness trackers can track large amounts of information in a continuous, real-time and convenient fashion. Can these data reflect how we feel and can we use them to improve our mental health?  

Can smartwatches and fitness trackers give an insight into mental health?

Take depression as an example. When someone is depressed, their sleep changes; they sleep less or more, or sleep more poorly. They also exercise less, or experience changes in heart-rate.

Can we use data from wearables to depression? While research is still ongoing, recent findings from King’s College London have shown that sleep measured with the FitBit correlates with depression scores, as well as heart rate and physical activity.

And a large proportion of clinicians are already using information from patient's devices to provide care for people with depression.

Studies looking at the use of wearables to track mental health are promising - and they go beyond depression. Wearable devices also have the potential to track ADHD and bipolar disorder, among mental and physical health conditions.

How can smartwatches and fitness trackers be used in therapy?

Building self-awareness

Having access to one’s data can also help one better understand their mental state and communicate it to others. Katie White, who works on the study at King’s College London said: “One of the things that stood out to me most during my experience with participants in the study was their feedback on how remote symptom monitoring helped them to process and understand their depression. Participants told us that seeing their FitBit data alongside completing questionnaires prompted self-reflection, self-awareness, and enhanced their ability to identify patterns in how they were feeling. Many found this empowering.They were able to use this knowledge to communicate with loved ones, or with a medical professional. There is also evidence that symptom monitoring increases emotional self-awareness.

A memory aid

It can be difficult to remember one's mental journey or day-to-day activities. Wearable devices can record useful information continuously and passively, which can be used as a prompt to recall mental states, feelings and events. For example, seeing how many hours someone has slept over two weeks could help them understand how or even why one’s mood might have varied.

Building healthy habits

Smartwatches and fitness trackers could also remind one of the importance of building exercise or other activities into their routine. People with depression who used a FitBit for up to three years as part of a research study and were able to see their data during this time explained that wearing the FitBit reminded them of how important it is to exercise regularly. This increased how much they exercised and improved their mood. Seeing one’s sleep pattern could reveal whether one may benefit from better sleep hygiene. Research has shown that improving sleep hygiene can reduce low mood. Seeing these data and receiving notifications was found to motivate people with mental health struggles to build habits that serve them better.

Enjoyable and convenient

Participants living with depression who used wearables found them easy to fit into their lifestyles and considered them to be a useful addition to their lives, appreciating the comfort and the appearance of different wearables. The fact that the devices were not specifically designed for mental health was also a plus for many, as it did not directly invite questions about their mental health from others.

Click here to watch a 3-minute hand-drawn animated video produced by Alina Ivan in collaboration with the Biomedical Research Centre, showing how depression was understood in the past and how we might manage symptoms in the future.

Are there any risks?

Data accuracy and interpretation

While these devices can offer data suggestive of one’s mental health, they are yet to be classed as medical devices. Also, the terms and conditions of data provision often state that algorithms used to calculate the data, which could leave a chance for rendering research findings inaccurate.

Research is still examining what combination of biomarkers is necessary to predict one’s clinical state, hence the data needs to be interpreted with caution.

One thing’s certain –  subjective accounts remain very important to understand the information that wearable devices provide.

Calorie counting and eating disorder behaviours

Some studies have shown that self-monitoring of someone’s calories and exercise levels through fitness trackers and smartwatches can encourage eating disorder behaviours. This highlights the importance of being able to remove access to some of the data, or working with a specialist to interpret one’s data and track progress.

Kit Norman, founder and CEO of Augmentive, says:

“I love supporting our specialists in applying cutting-edge technologies that enable them to provide personalised support to their clients. This balance of humans and technology is the future of mental health and the practitioners we work with are perfectly placed to ensure these innovative tools are used both responsibly and effectively.

The human side of mental health will always be critical, people want to be heard and to feel an emotional connection. That being said, technologies such as artificial intelligence and automation need to be applied to mental health as they are in medicine to improve the efficiency, efficacy and accessibility.

The automatic collection of personal data through smartwatches is a classic example of this. While there are risks in terms of ethics and privacy, there are huge opportunities to gain a much deeper understanding of the individual and to analyse the efficacy of specific support across similar people.

I use an Apple Watch and love it, primarily for the health and digital wellbeing insights. However, my engagement dropped off pretty quickly and I struggle to use the information in any meaningful way. So I really see the benefit of a professional working alongside it to set both clear and healthy paths forward.”

Also if you're a practitioner looking to to incorporate smartwatches to support your clients, please get in touch!

Disclaimer: Alina Ivan works for both Augmentive and the RADAR-CNS study at King’s College London, which looks at the use of wearable devices to track and predict symptoms of depression. The views presented in the article belong to the author.

At Augmentive, we have a community of practitioners from different areas of mental health and wellbeing who. You can start your journey with improving your mental health by booking an initial consultation to find out what’s right for you.