Can Your Watch Change Your Wellbeing?

As a counselor, to get paid by healthcare insurers, I had to assign a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM). As the DSM has more categories than the Academy Awards and as much scientific validity as a Hogwarts textbook, to lessen the stigma-labeling of my clients, I settled on one of two diagnoses for 90 percent of my clientele — generalized anxiety disorder, and dysthymic disorder (depression). I figured the average person would not equate these common maladies to mental illnesses, but at the same time, covered most people who found their way to counseling. However, (don't snitch to the insurance companies) my definition of depression and of anxiety is different from that in the DSM. I regard depression as viewing one's life as a bummer and feeling helpless to find a remedy. I see anxiety as viewing one's life as a bummer, believe there is a remedy, but can't figure out what it is.

A question for me is, does a wearable monitor such as the Apple Watch have the potential to either alleviate or elevate depression and anxiety? A good guess is that, (as with most things) whether it goes one way or the other will depend on the individual.

Some people are the boy who cried wolf, often regarding common discomforts as potential major diseases or injuries. They take every little pain as if it were a sign of the return of Voldemort. To alleviate their anxiety, they go to the doctor ten times a year. Those visits to the doctor don't really lessen their anxiety, however, because they forget to mention one of their symptoms, or they get a new symptom on their way home from the medical center.

On the other extreme, some people's attitude toward their health is don't ask, don't tell. Not only don't they want to know either the why of that pain in their shoulder, or the lab results on their cholesterol, they may not even want to know if they have six months to live. They go to the doctor ten times in their lives. Most of us live somewhere between these two extremes. Can the smart watch push us into one of the above groups — increasing or alleviating depression and anxiety?

The concept behind the smart watch as health aid makes the assumption that people will use the information rationally. What that would mean is that if your Apple Watch app gives you clues that you're in poor condition, if you're the doctor-going type, you'll follow your physician's advice for change in exercise, diet, and/or medications. If you prefer to trust your own research on health and fitness sites, you'll begin and sustain a diet and exercise routine.

There is a mountain of research that suggests that exercise is at least as effective as medication or counseling for relieving depression, and perhaps for anxiety, as well. For a smart wearable to be effective, it would have to influence users to employ, rationally, the health information that comes from their smart watch, in this case influence users to begin and maintain exercise and diet habits. If it doesn't lead to remediation, having information about ill-health or poor condition can push people to get more depressed and/or anxious. Hence, to be useful, you want your smart watch to not just give you health information, information that might even make your emotional condition worse, you want it to influence you to enhance your health and conditioning.

What we know about human behavior is that prohibition works poorly. You (and me) are less apt to go along with don't eat that donut, and more apt to go along with have some carrots and hummus. We're less apt to respond to an exhortation to "relax!" and more apt to respond to a reminder to practice our yoga, tai chi, or meditation.

Whether the Apple Watch and other smart watches are "health watches" will be determined by whether they can influence us to maintain healthful habits. That the Apple Watch includes an app that directs us to breath (meditate for a minute) periodically, and also includes an activity reminder, is a tiny sign that Apple gets it. Still, developing a partnership with people to change their health habits requires a high level of sophistication — a challenge that's probably harder than developing the iPhone.

Gary Bloom

Counselor/therapist, writer, coffee home roaster, Husband and father.

Greater Seattle http://gebloom.com

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