For someone dealing with depression or anxiety, regular visits with a mental health professional can often be the best solution. But in-person help isn’t always an option, either because of location, scheduling conflicts, or cost.
Now, a new study suggests that a free suite of mobile apps may also provide relief from depression and anxiety symptoms. The 13 mini-apps, collectively known as IntelliCare, were designed by Northwestern clinicians and based on validated psychology techniques currently used by therapists. They are free of charge and available on GooglePlay; iOS versions will be available soon.
To see how well the apps worked on real-life users, the developers recruited 96 people with elevated symptoms of depression or anxiety. After using the apps for eight weeks, the study participants reported a 50 percent reduction, on average, in those symptoms.
Although the results are short-term and preliminary, the developers say this level of improvement is comparable to what’s expected for in-person therapy or antidepressant medication.
Most apps designed for mental health offer a single strategy for feeling better, say IntelliCare’s developers, or they provide too many features and quickly become overwhelming. But this program, they say, offers easy-to-follow exercises to help users de-stress, reduce self-criticism and worrying, find more meaning in their lives, build confidence, sleep well, and more.
The variety of activities seemed to help users stay engaged: Participants used the apps as many as four times a day during the study period, and some kept using them after the study ended, as well.
"We designed these apps so they fit easily into people's lives and could be used as simply as apps to find a restaurant or directions," lead author David Mohr, Ph.D., director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine, said in a press release.
"Using digital tools for mental health is emerging as an important part of our future," Mohr added. "These are designed to help the millions of people who want support but can't get to a therapist's office."
Programs in the IntelliCare suite include “Daily Feats,” which was designed to motivate users by adding worthwhile and rewarding activities to their day; “Purple Chill,” which includes audio recordings and guided exercises; “Slumber Time,” designed to help users sleep better; and “My Mantra,” which helps users create motivating mantras to highlight their strengths and values.
Gail Saltz, M.D., psychiatrist and author of The Power of Different: The Link Between Disorder and Genius, says the idea of using smartphone apps to treat mental-health issues is a growing trend—largely because they are cost-effective, widely used, and customizable.
“Apps can help bring individual attention to your mental health and coping mechanisms,” says Dr. Saltz, who was not involved in the study. And while smartphones shouldn’t be used to diagnose or treat severe cases of mental illness, she says they can be helpful for people with milder symptoms—and may even prevent their decline into more serious problems.
More than 20 percent of Americans have significant symptoms of depression or anxiety each year, according to the study, but only about 20 percent of people with a mental-health problem get adequate treatment.
Guy Winch, Ph.D., psychologist and author of Emotional First Aid: Healing, Rejection, Guilt, Failure, and Other Everyday Hurts, agrees that apps designed for these purposes have the potential to help many people.
“Many people might struggle to recognize the difference between sadness and depression or between worry and anxiety,” says Winch, who was not involved in the study. “And many depression and anxiety sufferers do not know how to reduce the severity of their symptoms. For them, mini apps like the ones described in the study can be useful for their education value alone.”
But at this point the findings should only be taken with the grain of salt. Dr. Saltz points out that the participants received personal coaching throughout the study, including an initial phone call and two or more text messages per week. “This alone could have an effect on their symptoms,” she says.
Winch also notes that the study, which was published in the Journal of Medical Internet Research, did not contain a control group that received no treatment, or used other smartphone apps instead, to serve as a comparison.
Mohr agrees that participants’ symptoms may have improved for reasons unrelated to IntelliCare’s programming—or simply because they were motivated to try something new. In order to get more definitive answers, he’s launched a 300-person trial that includes a control group.
For now, he says, there’s early evidence to suggest that the apps do work. "They are designed to teach many of the same skills therapists teach patients,” he says. “Different apps are expected to work for different people. The goal is to find what's right for you."
Winch says it will also be important to follow up on participants from the larger study, to see if the apps have actually taught them to think differently or manage their mental health more proactively and effectively.
“If so, people who use them should still show improvement weeks or months after using the app,” he says. “That would be the true test of the apps’ effectiveness and utility—whether they produce an actual change or lasting effect.”