Ardesheer Talati, Ph.D.
Assistant Professor of Clinical Neurobiology in Psychiatry at Columbia University and New York State Psychiatric Institute
For all the high-tech medical gadgetry, the thermometer remains among the most remarkable medical devices: safe, easy to use, reliable. Pop it in, and out comes a number (body temperature) that can be used to make a number of important decisions related to our physical health. If only there was something analogous that could read our mental temperature. While we aren’t there yet, there is a device that can tell us more about our mental well-being than we might think. Like a thermometer, it is easy to use and present in most households.
I’m talking about smartphones
Smartphones already collect a vast amount of health-related information. They monitor our fitness levels, document how many steps we walk a day (have you reached 10,000?), and calculate how many calories we burn. Wearable devices like AppleWatch® and Fitbit® extend these functionalities further. But the information in our smart phones doesn’t just have to inform our physical health: it can speak volumes about our mental well-being too. And forget all the apps that help track mood and emotions (that’s another whole conversation); I’m talking about the very A-B-Cs of our relationships with our phones.
A phone is like a dear friend: it knows a lot about us. It knows how many calls we make and how long we spend on each; how many texts we send and receive; how long we spend surfing the web or on social media. It knows how often it was held, how far it was traveled with. The reason that this seemingly mundane information is relevant is because mental health problems are frequently associated with changes in such parameters of day-to-day functioning. So big changes in usage, just like a big change in a thermometer reading, could be a marker of a problem.
Let’s consider clinical depression, a chronic and distressing disorder that often onsets in teen years. Symptoms include weeks of sadness, irritability, loss of interest and concentration, and change in sleep. It turns out much of this information is actually measured – directly or indirectly – by a smartphone. Take sleep: when we go to bed, our phones essentially go to sleep too. Thus, a marked increase or decrease in continuous hours that a phone remains untouched can be a marker of sleep disturbance. Loss of interest in social engagement, another hallmark of the depressed state, is also captured by the phone. Studies show that teens with depression are less likely to post or respond to posts on social media; when they do, they’re more likely to do so at irregular hours, use first-person pronouns (i.e., talk about themselves), and use emotion-laden language. In the case of bipolar disorder, where periods of depression alternate with mania, surges in phone use and text frequency, or erratic typing, are reliable predictors of an oncoming manic episode.
Smartphones tracking mental health data
While the utility of smartphones for tracking physical health is well documented (e.g., Fitbit), their implications for mental health can be even more compelling. Here are three reasons why.
- They’re everywhere: This sounds obvious, but the fanciest technologies are useless if they’re not easy to access. More than 3 in 4 households in the U.S. already have at least one smartphone.
- The data are objective: Think about it: when we place a thermometer under our tongue, it tells us our temperature. It doesn’t ask us to report what we think our temperature is. Yet, many mental health problems have traditionally been recognized based on reported symptoms. But smartphone data aren’t filtered through a subjective lens and can provide more unbiased assessments on some mental health measures.
- They’re in real-time: Many mental health problems are episodic: that is, symptoms come and go. While that’s true of other medical conditions as well, here’s a key difference. Unlike say heart disease, where we’re more likely to seek medical attention when we’re in greatest pain, being in the throes of an episode of a mental illness may make us less likely to seek help. Thus, many may not receive treatment at precisely the time they would benefit most. This is where the ‘real-time’ quality of smartphone data can potentially be helpful. If connected with the right healthcare interface, changes in data can automatically trigger an alert at the doctor’s office and the doctor can proactively check-in with the family and follow up as necessary. This model also makes the patient-doctor interaction more efficient, being guided by real-time needs rather than conventionally scheduled appointments.
Technology companies look at mental health
This isn’t fanciful thinking. Technology companies are rapidly picking up on the utility of smartphone data for enhancing monitoring and delivery of mental healthcare. HealthRhythms, Priori, Biaffect, Monarca, and Illumivu are just some of the exciting platforms (I hold no financial or other interests in any). To be sure, these technologies are still new. As they evolve, issues of consent and privacy will need to be woven into the discussion to ensure that users are adequately protected. This is far from trivial, and an accompanying piece in this series will address concerns. There’s also the accompanying worry that such platforms can lead to over-diagnosing of normal behavioral variation into psychiatric problems.
Parents can learn from their children’s smartphone usage
But in the interim, there’s another closer-to-home beneficiary of this technology: parents. Discussion about parental monitoring of child use of mobile technology invariably focuses on safety. Yet, embedded within that same technology is a wealth of data that parents may not be thinking about but could serve an important purpose. To be clear, I’m not advocating that parents encourage their child’s smartphone habits simply for this monitoring purpose. But that train may have already left the station— today’s adolescents spend an increasing proportion of their time digitally anyway— so why not travel along and observe? Think of the smartphone data as a mental health thermometer through which parents can better gauge and follow their child’s mental temperature.
Ardesheer Talati is an Assistant Professor of Clinical Neurobiology in Psychiatry at Columbia University and New York State Psychiatric Institute. A psychiatric neuroscientist and epidemiologist by training, his research focuses on studying brain and behavioral abnormalities that predispose to various psychiatric illnesses. He also studies the effects that fetal exposures to substances (via maternal use during pregnancy) have on long-term brain and behavioral development. Dr. Talati has been funded by the National Institute of Mental Health, National Institute on Drug Abuse, the Brain and Behavioral Research Foundation, the American Foundation for Suicide Prevention, the Sackler Institute for Developmental Psychobiology, and the Templeton Foundation. He also writes for the Huffington Post on relationships between mental and physical health and illness.