Review: can wearable tech help my treatment-resistant depression & anxiety?

The World Health Organisation estimates that 350 million people have depression, making it the biggest cause of disability in the world

It’s a bummer having depression and anxiety for sixteen years and counting, not gonna lie. I tried nine anti-depressants, innumerable therapies, and the patience of two psychiatrists before being labelled “treatment resistant” and left to cobble together coping strategies from a mix of yoga, ice cream, cry breaks and that time I spent all my savings going to Florida. OK, two times. (No regrets.)

There are apps designed to help users’ mental health, and I’ve tried them, but mostly they focus on tracking daily moods and then summarising how you feel at the end of each week. (“Bad”). Some give tips for feeling better, mostly involving jogging, but as I also have a disabling physical illness, that grew old fast. A few are based on CBT (Cognitive Behavioural Therapy), where you try to “reframe” negative thoughts, an NHS-approved way of telling you to cheer up love, it might never happen. The main reason I hate this kind of approach is that my depression/anxiety (I can’t prise the two conditions apart) is a physical feeling, like an anchor in my gut constantly pulling me down. Telling me that I could choose to see things differently doesn’t change that, and that’s what makes mental health wearables so appealing.

The idea that a gadget could help me shift my mood without making me analyse it first sounded like a miracle. Of course, the devices that are on the market right now don’t claim to treat depression or anxiety – if they did they’d be subject to stricter regulations and would probably have to be prescribed. But they do tout their mood-boosting effects, and it’s inevitable that those of us who get no benefit from antidepressants (between 50% and 75% of patients, depending on who you ask) will be curious about their potential. So I decided to check some out.

I started with the Pip, which costs £145 and was shortlisted for the 2015 AXA PPP Health Tech & You Awards. Technically, it’s more of a “holdable” than a wearable, although it’s small enough to keep in a pocket. It’s a teardrop- (or I guess, pip-) shaped piece of plastic with a metal sensor in the middle that you hold between your thumb and forefinger so it can measure your stress level. It connects to your mobile device using Bluetooth and works with three free apps: Stress Tracker, where you’re faced with red, orange and green bars (representing stress, stability, and relaxation), which expand or contract depending on how relaxed you are:

The Loom, in which a frost-covered winter field melts into a flower-filled summer meadow as Pip senses you becoming more serene (theoretically – I never quite managed it):

And Race and Relax, where you’re represented by a dragon soaring over a mountain range, but the only way to speed up… is to calm down. Counterintuitive! There’s also a new mindfulness app that costs £1.49 but I eschewed that immediately because I’ve dabbled in mindfulness before and HATED IT (sorry, Buddhists).

I found Race and Relax the most fun, so used it every day, twice a day, for two weeks. I’m not clear on the exact details of the scoring system, but I only got 54% on my first attempt and, the app informed me, didn’t have a single “relaxation event”. A couple of days later I managed one, and after a week I was up to 74% and 18 relaxation events. I can’t say I noticed a difference in my anxiety level throughout the day, but when I was using the Pip, I did feel myself relaxing a bit more easily. I’m sure it would take more than a couple of weeks to feel any long-term changes, and even then, they might not be dramatic, but the Pip seemed to have the potential to reduce my anxiety a little – which when you’re highly anxious, feels like a win.

Next up, I tried out Seqinetic, which looks like the world’s weirdest pair of glasses. Instead of lenses, there are six small lights and a reflector that bounces the light into your eyes, delivering 2500 Lux from 3cm away. It’s a wearable SAD light box, basically, and its makers claim that using it for between 15 minutes and an hour every day can banish the winter blues, boost energy, and make it easier to get out of bed, all for €69 (£50).

I unwrapped my trial unit on one of the dreariest October mornings in living memory, so I was ready to feel its effects. I put it on, switched on the light, and instantly felt like I was being interrogated in an old movie, each eyeball seared by spotlights, everything around me dark and blurry. After a couple of days of squinting, I adjusted, and got into the habit of wearing it for an hour every morning while I worked or caught up on emails. After a week, I enjoyed wearing it: the world looks so much nicer when it’s bathed in light, even fake light. But after a fortnight, I hadn’t felt more than a mild, temporary boost that ended as soon as I took the Seqinetic off. Maybe it works better for people whose depression is seasonal or who just have the “winter blues”, or maybe I’d need more time to feel its effects: I’d definitely be interested to see if it could make February less awful.

What I really wanted, though, was to try out a more hardcore mental health wearable: one that could measure brainwaves. There are two main types, both based on electroencephalography (EEG) technology. This consists of sensors attached to the scalp that record fluctuations in the brain’s electrical activity, and then alert you to changes – so a wearable headband might prompt you to be in the moment in order to reduce anxiety, teaching you to retrain your reactions over time. Devices from Muse, Emotiv, Melon, and Neurosky all fall into this category.

Some wearables use transcranial direct current stimulation (tDCS) to take this idea a bit further, not only measuring brain activity, but giving the prefrontal cortex a tiny electrical shock to change the wearer’s mental state. Moov works like this while Thync uses both tDCS and TENS (transcutaneous electrical nerve stimulation, more usually used for pain relief) so nerves close to the scalp are stimulated as well. Thync has two modes: one for relaxation and one for energy, and some journalists who’ve tried it have reported feeling happier, although Stephanie M. Lee from Buzzfeed said it only gave her a headache.

Unfortunately I wasn’t able to get my hands on/head into any of these devices myself. Muse tried, but got caught up in customs, and other companies were unable or unwilling to part with one. But according to Stuart Black, I might not have missed much. He runs Brain Train UK, a neurofeedback practice that helps people with mental health issues, and says the low number of electrodes in commercially available devices makes him doubt their effectiveness.

“These sorts of gadgets get a decent amount of press but haven’t yet come under a lot of clinical scrutiny. Many are based on hope rather than science.” He’s currently developing a device for home use himself so is probably biased, but he has a point. Earlier this year, research found that tDCS was unlikely to be effective while a recent study found it impaired users’ short-term memory(we don’t yet know what long-term effects it might have). There’s only one brand that Black credits as potentially useful, and that’s Wearable Sensing’s hulking EEG device, which costs $20,000 and is barely portable.

The World Health Organisation estimates that 350 million people have depression, making it the biggest cause of disability in the world. More than half of those people will also experience anxiety, and millions will be unable to tolerate medication for either. That’s a huge crisis – and a huge potential market, meaning it’s just a matter of time before we see medically-approved, therapeutically useful mood-boosting gadgets that we can wear as easily as a Fitbit. But we’re probably going to have to wait a little longer than many tech companies would have us believe.

So where does that leave me? Seeing a therapist, having regular cry breaks and still wishing there was some magical way to zap my brain into behaving better. (And I’m all out of savings, obvs.) I’ve never found a way to escape anxiety and depression, and that’s often made me feel like a failure. But maybe I’m not. With the Pip, I got visual proof that straining to feel differently only made me stressed, while accepting my mental state made it more bearable. Maybe it’s OK to feel bleak, or hopeless, or like you might puke if you have to speak to a stranger. Maybe I just have to keep going.

Main image: Seqinetic