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Mental Health in the Smartphone Generation: I bet there's an app for that

Disclaimer: This article in no way claims that smartphone applications are as effective as or a substitute for traditional forms of therapy. Apps are beneficial for self-care, dealing with daily stressors, monitoring progress and mood, reinforcing what you learn in therapy and relaxation or meditation. However, they show best results when used in conjunction with or in addition to seeking help from a mental health professional.

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With just a few clicks, our smartphones provide us quick fixes for all our concerns. In addition to the introduction of super interactive snapchat filters and multiple ways to stay connected, in recent years, smartphones have also drastically changed the entire landscape of how we approach health and wellness, and Mental Health Care is no exception to this.

The shift in the past decade in how we approach the subject of mental health and the decline in the stigma associated with it, has led to more and more people seeking help. While this is a positive change to witness, one must not ignore the fact that access to adequate and affordable mental health care is still a privilege. Inadequate resources in terms of infrastructure and well-trained mental health professionals, lead to a drastic treatment gap in India. In such a scenario, once again, our smartphones come to our rescue. With a sudden surge in the number of mental health apps at our disposal, therapeutic resources are now more readily available than ever. This cost-effective and portable measure that caters to our well-being, minimises the burden of booking an in-person couch session, that might not work for your schedule or take a huge toll on your pocket.

Which is the Best App for you?

Type in “stress”, “anxiety” or “sleep difficulties” in the search bar of your app store and a myriad of apps will pop up. Some claim to track your mood, while others promise to help you sleep better or ‘cure’ your anxiety. With over 10,000 of these applications available online, we are sure to be hit by the paradox of choice, making it difficult to decide how to decide. To help choose the right app for you and avoid going through the cycle of deleting and re-downloading, here are a few tips that are sure to make that decision easier:

  1. Make a list of symptoms you’d like to target, whether it is low mood, panic attacks or sleep disturbances. Knowing what you require help with can help you filter out the options. Moreover, most of these applications do take into account comorbid conditions, making that search easier. For instance, considering the high rates of comorbidity between anxiety and depression, ‘Moodfit’, a free application available on Google play, not only helps you track your mood and thoughts, but also provides mindfulness guides to deal with the coexisting worry/stress.

  2. Check whether the app uses evidence based therapeutic techniques. There are plenty of applications online claiming that they have the ‘cure’ for depression or bipolar disorder. Don't fall for these marketing gimmicks, since they are sure to fail. A platform which uses well-researched methods like Cognitive Behaviour or Acceptance and Commitment Therapy, is more likely to offer better results than other non-evidence-based techniques. In fact, research has suggested that internet-based CBT techniques are effective (Grist & Cavanagh, 2013). Searching for keywords like CBT, ACT or recommendations from certified Psychologists can assist with finding these.

  3. Look into the apps privacy policy. Usually, once downloaded, apps get access to your phone as well as your personal information. Since mental health is a sensitive issue and you may be discussing private and intimate details about your life on it, it is a good idea to check out the privacy policy and provisions of confidentiality.

  4. Another important aspect is the viability of the app in real time, i.e. whether what you learn from it can be put to use while experiencing a particularly distressing situation. If the app equips you with strategies that you can successfully apply and benefit from during an anxiety provoking situation, the acquired coping strategies will be more effective.

  5. While choosing to use any technological device, user friendliness is always a priority. Same goes for mental health applications. Downloading an app that is easy to navigate, uses simple terminologies, is minimalistic and responsive is beneficial. The idea is to be able to incorporate using the app in your daily routine, just like weekly therapy sessions. If the software is too complicated or time consuming, it is likely that you will get frustrated and discontinue using it; the real-world equivalent of dropping out of therapy. Remember, consistency is key, and a great user experience offers that.

  6. While not 100% reliable, it's always a good idea to check out the rating & reviews section before hitting download. What real time users have to say about their experience offers great insights into what the app holds and how effective it has been for others. Moreover, it also provides a great way to compare different applications offering almost the same benefits, leaving you confused. A rating of 4 and above on the apple app store is usually considered to be good.

  7. Do you like it? Although this seems like an odd tip to help you decide, it is extremely important. No matter how well rated the app is or what it claims to do, if you don’t like the way it looks, the language it uses or the technique it follows, you are less likely to enjoy it and stick to it. It is not necessary that what works for one shall work for all. If you don’t like what you’re using, it’s best to look for something else.

To know more about choosing the right app for your mental health, check out the American Psychiatric Association’s (APA) ‘App Evaluation Model’.

https://www.psychiatry.org/psychiatrists/practice/mental-health-apps/app-evaluation-model

My top 5 recommendations:

1. Calm: Best for relaxation and sleep.

Calm, one of the most popular mental health apps, that claims to be the number one for sleep, meditation and relaxation and has been awarded the best app of the year by Apple in 2017, surely lives up to the hype. It’s extremely user friendly and provides you with the option of choosing what you’d like to focus on (For example, sleep, happiness, anxiety, stress etc.). Once you’ve picked your target area, it offers you a catalogue of both guided and unguided mindfulness sessions, breathing exercises and sleep sounds of different durations. These are super easy to follow and comes with the option of tracking your progress and setting reminders to keep you on track. The USP of the app is that it is suitable for beginners and requires no prior experience in meditation. New programs are regularly developed and added to avoid monotony.

Platforms: iOS, Android and web browsers

Price: The initial 7 days of the app are free. Post this, a few guided and unguided services are still available at no cost, while the premium services can be purchased

2. Mind Shift: Best for anxiety related concerns

Designed specifically for teenagers and young adults experiencing anxiety, Mindshift draws from principles of Cognitive Behaviour therapy, an evidence based treatment for anxiety, allowing users to learn effective coping strategies. With the help of psychoeducation, goal setting and the ‘my situation’ tab that allows you to write about your personal experience, this app allows you to take charge of your anxiety. The app offers an option between ‘Chill out tools’ and ‘Active Steps.’ The former includes guided meditations and relaxation exercises, while the latter focuses on activities that actively offer a distraction or help foster healthier habits. It is easy to navigate through and visually appealing at the same time.

Platforms: iOS and Android

Price: Free to use

3. BetterHelp: Best for those looking for therapy online

BetterHelp is a platform where you can seek therapy from licensed mental health professionals online. This app is best suited for people who are anxious about going in for an in person session or need to talk to someone right after that 2:00 am panic attack. Based on your profile and initial assessment, the app gives you the option of not only choosing your therapist but also the medium through which you’d like to connect with them (Instant messaging, audi/video call). Betterhelp also offers LGBTQIA+ affirmative counsellors, making the experience more inclusive. This sort of flexibility allows you to connect with someone who is sensitive to your needs and concerns.

Platforms: iOS, Android and web browsers

Price: Paid

Mind.fit, part of the cure.fit family is an Indian platform that also operates on similar principles. It might be more useful for those seeking assistance for certain culture specific issues. Available on both iOs and Android.

4. MoodMission: Best for anxiety and depression related issues

Moodmission is based on the extremely effective Behavioural Activation principles that work towards elevating your mood. As the name suggests, the app assigns the user 5 missions on the basis of their current mood state. These can be emotional, physical, thought based or cognitive tasks. Completing these missions lead you to gain rewards, a simple behavioural reinforcement technique. There is also a provision of keeping a log of your completed missions that assist you with tracking your progress. Moreover, research evidence has proves the success of this app in decreasing depressive symptoms (Bakker, Kazantzis, Rickwood & Rickard, 2018)

Platforms: iOS, Android and web browsers

Price: Essentially free with a few in app purchase options.

5. What’sUp: Best suited for depressive symptoms.

Before you confuse this with the most frequently used communication platform, ‘Whatsapp’, What’sUp is a mental health app based on the principles of Cognitive Behavioural and Acceptance and Commitment Therapy. In addition to offering information about depression, the app has many useful features ranging from a mood tracker, interactive games, a list for identification of common thinking errors as well as a chat forum for further discussions. Along with it’s positive and negative habit tracker and the Catastrophe scale, the app puts your thoughts and feelings into perspective.

Platforms: iOS and Android

Price: Essentially free with a few in app purchase options.

References:

Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2018). A randomized controlled trial of three smartphone apps for enhancing public mental health. Behaviour Research And Therapy, 109, 75-83.

Grist, R., & Cavanagh, K. (2013). Computerised Cognitive Behavioural Therapy for Common Mental Health Disorders, What Works, for Whom Under What Circumstances? A Systematic Review and Meta-analysis. Journal Of Contemporary Psychotherapy, 43(4), 243-251.

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