Brooding in your apartment on Saturday
afternoon? A new smart phone intuits when you’re depressed and will nudge you
to call or go out with friends.
It’s the future of therapy at a new
Northwestern University Feinberg School of Medicine center where scientists are
inventing Web-based, mobile, and virtual technologies to treat depression and
other mood disorders. The phone and similar projects bypass traditional weekly
therapy sessions for novel approaches that provide immediate support and access
to a much larger population.
Also in the works at the National Institutes
of Health-funded center: A virtual human therapist who will work with teens to
prevent depression; a medicine bottle that reminds you to take antidepressant
medication and tells your doctor if the dosage needs adjusting; 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.”
“These new approaches could offer
fundamentally new treatment options to people who are unable to access
traditional services or who are uncomfortable with standard psychotherapy,”
Mohr added. “They also can be offered at significantly lower costs, which makes
them more viable in an era of limited resources.”
The goal is for the center to become a
national resource, offering a library of intervention technologies that will be
available to other researchers.
Among the center’s projects:
A really
smart phone reads your mood
A smartphone spots symptoms of depression by harnessing
all the sensor data within the phone to interpret a person’s location, activity
level (via an accelerometer), social context, and mood.
Are you making phone calls and getting
e-mails, or are you home alone ruminating for hours? If the phone—which learns
your usual patterns—senses you are isolated, it will send you a suggestion to
call or see friends. The technology, which still is being tweaked, is called
Mobilyze! and has been tested in a small pilot study. It helped reduce symptoms
of depression.
The new phone offers a powerful new level
of support for people who have depression and intervenes to help them change
their behavior in real time.
“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.”
You
can’t food this medicine bottle
A medicine bottle now being developed will track if you
forgot your daily dose of antidepressant medication and remind you to take it.
The savvy bottle 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.
Virtual
human coaches teens in social skills
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.
The Northwestern laboratory will be
evaluating a number of different types of social interactions that are hard for
teens and adults.
“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.
Helping
cancer survivors cope with stress
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.