There might be as many as 1,000 smartphone “biomarkers” for depression, said Dr. Thomas Insel, former head of the National Institute of Mental Health and now a leader in the smartphone psychiatry movement.
Researchers are testing experimental apps that use artificial intelligence to try to predict depression episodes or potential self-harm.
“We are tracking the equivalent of a heartbeat for the human brain,” said Dr. Alex Leow, an app developer and associate professor of psychiatry and bioengineering at the University of Illinois’ Chicago campus.
At least, that’s the goal. There are technical and ethical kinks to work out — including privacy issues and making sure kids grant permission to be monitored so closely. Developers say proven, commercially available mood-detecting apps are likely years — but not decades — away.
“People often feel that these things are creepy,” because of the tech industry’s surreptitious tracking of online habits for commercial purposes, said University of Oregon psychologist Nick Allen.
Using smartphones as mental illness detectors would require informed consent from users to install an app, “and they could withdraw permission at any time,” said Allen, one of the creators of an app that is being tested on young people who have attempted suicide.
Depression affects about 3 million U.S. teens, and rates have climbed in the past decade. Thirteen percent of 12- to 17-year-olds had depression in 2017, up from 8 percent in 2010, U.S. government data show. One in 10 college-aged Americans is affected.
Suicide has risen to the second leading cause of death for ages 10 to 34. Rates among teen girls doubled from 2007 to 2015, climbing to 5 per 100,000. Among boys, rates jumped 30 percent, to 14 in 100,000.
A recent study suggested a parallel rise in smartphone use is likely a contributing factor.
People with mental illness typically get treatment “when they’re in crisis and very late in the course of an illness. We want to have a method to identify the earliest signs,” in an objective way, Insel said.
After a livestreamed suicide, Facebook trained its AI systems to flag certain words or phrases in online posts that could indicate imminent self-harm. Friends’ comments expressing concern about the user’s wellbeing are part of the equation.
The ongoing research includes:
• A Stanford University study involving about 200 teens, including kids at risk for depression because of bullying, family circumstances or other life stresses. As part of the research, teens who have been tracked since grade school get an experimental phone app that surveys them three times daily for two weeks with questions about their mood.
Researchers are combining those answers with passive smartphone data, including how active or sedentary kids are, to identify any changes that might be linked with future depression.
Study participant Laurel Foster, 15, acknowledges feeling stress over academics and “the usual” teen friendship pressures and says depression is rampant at her San Francisco high school. She said using the smartphone app felt a bit like being spied on, but with so many online sites already tracking users’ habits “one more isn’t really a big difference.”
• At UCLA, as part of a broader effort to battle campus depression launched in 2017, researchers are offering online counseling and an experimental phone app to students who show signs of at least mild depression on a screening test. About 250 freshmen agreed to use the app in the first year. Personal sensing data collected from the app is being analyzed to see how it correlates with any worsening or improvement in depression symptoms seen in internet therapy.
Sophomore Alyssa Lizarraga, 19, has had depression since high school in Whittier, Calif. She has worried that she’s “addicted” to her phone and spends a lot of time on social media sites.
But using smartphones in a positive way for mental health might help nudge people to seek early treatment, if they could see how their phone use showed signs of depression, she said.
• At the University of Illinois’ Chicago campus, researchers studying depression and mania in bipolar disorder are using crowdsourcing to test their experimental phone app. Anyone can download the free app, and nearly 2,000 have so far, agreeing to let the researchers continuously track things such as typing speed, number of keystrokes and use of spellcheck.
• Mindstrong, a Palo Alto, Calif., tech health company cofounded by Insel, the former NIH official, is testing a “digital phenotyping” app in several studies. Insel thinks the technology has promise to transform psychiatry, but that the most important question is whether it can be used to improve patient health.