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Time spent on smartphone and GPS location sensor data detect depression

NORTHWESTERN UNIVERSITY

CHICAGO — You can fake a smile, but your phone knows the truth. Depression can be detected from your smartphone sensor data by tracking the number of minutes you use the phone and your daily geographical locations, reports a small Northwestern Medicine study.

The more time you spend using your phone, the more likely you are depressed. The average daily usage for depressed individuals was about 68 minutes, while for non-depressed individuals it was about 17 minutes.

Spending most of your time at home and most of your time in fewer locations — as measured by GPS tracking — also are linked to depression. And, having a less regular day-to-day schedule, leaving your house and going to work at different times each day, for example, also is linked to depression.

Based on the phone sensor data, Northwestern scientists could identify people with depressive symptoms with 87 percent accuracy.

“The significance of this is we can detect if a person has depressive symptoms and the severity of those symptoms without asking them any questions,” said senior author David Mohr, director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine. “We now have an objective measure of behavior related to depression. And we’re detecting it passively. Phones can provide data unobtrusively and with no effort on the part of the user.”

The research could ultimately lead to monitoring people at risk of depression and enabling health care providers to intervene more quickly.

The study will be published July 15 in the Journal of Medical Internet Research.

The smart phone data was more reliable in detecting depression than daily questions participants answered about how sad they were feeling on a scale of 1 to 10. Their answers may be rote and often are not reliable, said lead author Sohrob Saeb, a postdoctoral fellow and computer scientist in preventive medicine at Feinberg.

“The data showing depressed people tended not to go many places reflects the loss of motivation seen in depression,” said Mohr, who is a clinical psychologist and professor of preventive medicine at Feinberg. “When people are depressed, they tend to withdraw and don’t have the motivation or energy to go out and do things.”

While the phone usage data didn’t identify how people were using their phones, Mohr suspects people who spent the most time on them were surfing the web or playing games, rather than talking to friends.

“People are likely, when on their phones, to avoid thinking about things that are troubling, painful feelings or difficult relationships,” Mohr said. “It’s an avoidance behavior we see in depression.”

Saeb analyzed the GPS locations and phone usage for 28 individuals (20 females and eight males, average age of 29) over two weeks. The sensor tracked GPS locations every five minutes.

To determine the relationship between phone usage and geographical location and depression, the subjects took a widely used standardized questionnaire measuring depression, the PHQ-9, at the beginning of the two-week study. The PHQ-9 asks about symptoms used to diagnose depression such as sadness, loss of pleasure, hopelessness, disturbances in sleep and appetite, and difficulty concentrating. Then, Saeb developed algorithms using the GPS and phone usage data collected from the phone, and correlated the results of those GPS and phone usage algorithms with the subjects’ depression test results.

Of the participants, 14 did not have any signs of depression and 14 had symptoms ranging from mild to severe depression.

The goal of the research is to passively detect depression and different levels of emotional states related to depression, Saeb said.

The information ultimately could be used to monitor people who are at risk of depression to, perhaps, offer them interventions if the sensor detected depression or to deliver the information to their clinicians.

Future Northwestern research will look at whether getting people to change those behaviors linked to depression improves their mood.

“We will see if we can reduce symptoms of depression by encouraging people to visit more locations throughout the day, have a more regular routine, spend more time in a variety of places or reduce mobile phone use,” Saeb said.

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This research was funded by research grants P20 MH090318 and K08 MH 102336 from the National Institute of Mental Health of the National Institutes of Health.

February is American Heart Month. People with heart disease are at a higher risk for depression. In fact, up to 33 percent of heart attack patients end up developing some degree of depression – three times the rate compared to the general population.

How are depression and heart disease linked? People with heart disease are more likely to suffer from depression than otherwise healthy people. Angina and heart attacks are closely linked with depression. Researchers are unsure exactly why this occurs. They do know that some symptoms of depression may reduce a person’s overall physical and mental health, increasing the risk for heart disease or making symptoms of heart disease worse. Fatigue or feelings of worthlessness may cause a person to ignore their medication plan and avoid treatment for heart disease. Having depression increases the risk of death after a heart attack.

What are the signs and symptoms of depression? Not everyone will experience the same symptoms of depression, but symptoms may include:

• Ongoing sad, anxious, or empty feelings
• Feeling hopeless
• Feeling guilty, worthless, or helpless
• Feeling irritable or restless
• Loss of interest in activities or hobbies once enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or making decisions
• Difficulty falling asleep or staying asleep, a condition called insomnia, or sleeping all the time
• Overeating or loss of appetite
• Thoughts of death and suicide or suicide attempts
• Ongoing aches and pains, headaches, cramps, or digestive problems that do not ease with treatment

Treating depression can help a person manage their heart disease and improve their overall health. Common treatments for depression are psychotherapy, medication, or combination of both.

Visit the National Institute of Mental Health website for more information on depression and heart disease.

To take a free, anonymous mental health self-assessment that screens for depression and other common mental health conditions visit our online screening.

In any given year, 1 in 10 adults in the U.S. are affected by depression. Depression is a brain disorder that affects how you feel, think, and act. People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

>      Persistent sad, anxious, or “empty” feelings

>      Feelings of hopelessness or pessimism

>      Feelings of guilt, worthlessness, or helplessness

>      Irritability, restlessness

>      Loss of interest in activities or hobbies once pleasurable, including sex

>      Fatigue and decreased energy

>      Difficulty concentrating, remembering details, and making decisions

>      Insomnia, early-morning wakefulness, or excessive sleeping

>      Overeating, or appetite loss

>      Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

>      Thoughts of suicide, suicide attempts

There are different treatment options that can help, which may include medication, therapy, or combination of both. With effective treatment, the symptoms of depression will gradually get better.

 

If you are in crisis or thinking about harming yourself, or know someone who is, tell someone who can help immediately.

>      Do not leave your friend or relative alone, and do not isolate yourself.

>      Call 911 or go to a hospital emergency room to get immediate help, or ask a friend or family member to help you do these things.

>      Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.

 

For more resources and information on depression and other mental health disorders, please visit:

Online Mental Health Screening

The Mental Health Association of Minnesota has partnered with Screening for Mental Health, Inc. to provide free online screening for mood and anxiety disorders. This anonymous online assessment screens for depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder. This screening is not a substitute for a diagnosis, but it will help determine whether or not a consultation from a health professional would be helpful. If you want to follow-up with a health provider, but have limited or no health insurance, MHAM can help find a sliding fee clinic or other medical coverage options. To speak with an advocate, call 651-493-6634 or 800-862-1799.

https://mentalhealthmn.org/be-informed/education-programs/online-screening-for-mood-and-anxiety-disorders

Get Help. Get Well.

Get Help Get Well helps people understand what to expect when seeking mental health care for the first time. Get Help Get Well includes information on…

>      The first steps to obtaining care; healthcare providers to see initially; and factors to consider when seeking a healthcare provider.

>      What may occur in the initial appointment; questions that may be asked by the health professional; and questions the patient may want to ask their health provider

https://mentalhealthmn.org/be-informed/get-help-get-well

Depression and Bipolar Support Alliance

The Depression and Bipolar Support Alliance (DBSA) is the leading peer-directed national organization focusing on the two most prevalent mental health conditions, depression and bipolar disorder. DBSA provides online resources and peer support groups.

http://www.dbsalliance.org/site/PageServer?pagename=home

Support Groups in Minnesota

You are not alone out there. Utilize support groups to share mental health needs and concerns affecting your life and the lives of others.

MHAM Sponsored Support Groups: DBSA Support Groups (Depression & Bipolar Support Alliance)

https://mentalhealthmn.org/mental-health-advocacy/individual-advocacy/access-to-health-care-and-community-services/support-groups/dbsa-support-groups

Other Minnesota Support Groups and Activity Centers

https://mentalhealthmn.org/find-support/resource-list/support-groups-activity-centers/all-support-groups

National Institute of Mental Health

The National Institute of Mental Health (NIMH) provides the latest research and information on depression and other mental health conditions.

http://www.nimh.nih.gov/health/topics/depression/index.shtml

MentalHealth.gov

MentalHealth.gov provides information and resources on mental illness for people experiencing a mental health disorder, family and friends, and other members of the community.

http://www.mentalhealth.gov/index.html

 

In any given year, about 7% of the U.S. adult population experiences a major depressive episode (MDE). In a recent issue of The NSDUH Report from the Substance Abuse and Mental Health Services Administration looked at combined data from the 2008 to 2012 National Surveys on Drug Use and Health (NSDUH) that showed that more than one third of adults with past year MDE (38.3%) did not talk to a health professional or alternative service professional during the past 12 months. Of those who did seek help, 48% consulted with a health professional, 10.7% percent talked to both a health professional and an alternative service professional, and 2.9% talked to alternative service professional. The report suggests that primary care providers should consider using screening tools to identify patients that may be experiencing depression.

To view the The NSDUH Report: http://www.samhsa.gov/data/spotlight/spot133-major-depressive-episode-2014.pdf

For information on resources and the latest news and research on depression, please visit the MHAM website at https://mentalhealthmn.org/be-informed/mental-health-resources/depression

Recently, SMCPros featured the work of individuals and organizations in the community.  We had an entry posted there, but we wanted to share it here as well.

Every day of the week, I find a call for help in my inbox.  The people who write are unflinchingly honest about emotional breakdowns, job losses, and medical nightmares.  They found a form on our website or our general email address, and sent something in the hopes that there is some help on the other end.  Even though they have no idea they are writing to me, they are honest and candid to a degree that awes me.  Because I forward these emails directly to our client advocates, Anna and Tom, almost none of them ever hear from me at all.
But nonetheless, they have come to the right place.  In a system that still tends to treat people as less than, and with an illness that can make even the smallest obstacle too much to handle, they have run into a group of people who are dedicated to understanding their needs and helping them find their way.  I work for a small non-profit, Mental Health Association of Minnesota.  For over 70 years, we have helped people with mental illness be heard.

We don’t focus on what we think is important, we ask them what their goals are.  For one client, it was making copies of correspondence without feeling like the hospital staff were looking over her shoulder.  For Amanda, it was just sorting through the paperwork that meant the difference between a stable home and living on the street.  For Kevin, it was trusting group home staff enough to tell them about his nutritional goals.  It all matters because the person behind it matters.

Believing that we’re important and that we can take a concrete step towards recovery is absolutely necessary.  Time becomes a real enemy when I feel depressed or anxious.  I lose my sense of what things are like without that cloud hanging over me, much the same way that you might forget how good a full, deep breath feels after a long bout of the flu.  Without hope and help, everything is too much, and every set back feels like the end of the world.

More than a decade ago, I was a patient at Abbot Northwestern, hospitalized a handful of times for suicidal behavior and thoughts.  I was not responding well to medication, and every change in my prescription added another 15 or 20 pounds to my frame, until I could barely recognize myself in the mirror.  In a matter of months, I had gone from zero involvement in the system to a head-first dive.  It was frightening and lonely, full of people who didn’t believe me or listen to what I thought might help.  I was on a unit with all kids, but many went days or even entire stays without seeing family.

I got daily visits from family.  There were cards from my friends waiting for me when I got home.  My internship supervisor came to the unit to make up for a lunch we were supposed to have.  She even arranged a get-well call from her boss’s boss, a guy named Paul Wellstone.  And from working in his office, I knew that it took phone calls all the way up the chain of command, and a scheduling effort.  Far from taking away from the impact, it doubled it.  You see, the point is that it’s not about one person who cares, it’s about entire families, communities, workplaces that do.

Mental illness is often chronic.  It can be extremely painful and damaging.  It is also true that people recover, leading wonderful and meaningful lives.  They do so every day, but they almost never do it without support. MHAM takes phone calls and emails from anyone who is living in Minnesota or is concerned about a Minnesota resident who is having a hard time navigating the mental health system.  We connect people with needed services, teach skills for self-advocacy and wellness, helping them live into their recovery.

I wanted to share this story with you so that you know two things.  First.  If you have a mental illness, and you don’t know where to turn, there is help. If it’s 2 AM when you’re reading this, and you’re in crisis, please call 800-273-TALK. It’s a different organization, but they are ready to connect with you, and believe me that it is worth it.  But the next morning, I hope you email us at [email protected], or give us a call at 651-493-6634/800-862-1799.

Second.  Whether or not you are living with a mental illness, do you agree with me that recovery shouldn’t be luck? There are plenty of ways for you to help.  Drop us a line to find out more about volunteer opportunities, how to contact your legislators about life changing community mental health services, or our wellness education program. And yes, consider a donation.  Our services may not be the easiest to fund in today’s economy, but that voice of hope is worth something.  Personally, I think it’s worth quite a lot.

Ben Ashley-Wurtmann

Policy and Outreach Associate

Recovery is a journey and often involves several components. One essential component is support from others. Support from family and friends and can play an integral role. Connecting with others that are experiencing a similar health condition can be important too. Support groups can provide a positive environment to share these experiences. Support groups are not group therapy or a substitute for medical treatment, but a place where people can connect with others and to find mutual support.

The Minnesota Chapter of the Depression Bipolar Support Alliance (DBSA) – a program of MHAM since 2004 – has provided a platform for people to share experiences, personal feelings, information, and strategies for living successfully with mood disorders. DBSA support groups can:

> give you the opportunity to reach out to others and benefit from the experience of those who have been there.
> motivate you to follow your treatment plan.
> help you understand that a mood disorder does not define who you are.
> help you rediscover strengths and humor you may have thought you had lost.
> provide a forum for mutual acceptance, understanding, and self-discovery.

DBSA support groups are free and open to individuals who have depression or bipolar disorder, or for their loved ones. Meetings are facilitated by trained volunteers and meet at several locations within the Twin Cities area and parts of Greater Minnesota.

Check the current listing of DBSA meeting locations and times on the MHAM website. At some meetings, there are specific support groups for depression, bipolar disorder, and family issues. Please contact the facilitator directly for more information. If there is not a meeting location in your area or you are looking to attend a different type of support group, please check our listing of other sponsored support groups on our website. If you are interested in starting and facilitating a DBSA group in your area, please contact Tom Johnson at [email protected] or 651-493-6634 / 800-862-1799.

For general information about DBSA support groups, please visit the DBSA website. Also, check out DBSA on the Not Alone radio program, airing on KKMS-AM (990), August 4 at 1pm and August 5 at 11:30 am. DBSA leadership will be talking about peer support through DBSA.

For the past six years, the Mental Health Association of Minnesota has partnered with Screening for Mental Health, Inc. to provide anonymous online screening for mood and anxiety disorders. Just in the last year, nearly 1,000 assessments were completed. This free online assessment only takes a few minutes to complete and screens for depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder. At the end of each screening, a post-assessment is provided for the individual to review. Though not a substitute for a complete evaluation, it does help determine whether or not a consultation from a health professional or clinician would be helpful. For those who have limited or no health insurance, MHAM can help find a sliding fee clinic or other medical coverage options. To speak with an advocate, call 651-493-6634 or 800-862-1799 between 9am and 4:30pm, Monday through Friday. To take this mobile-friendly screening, visit the MHAM website.

In the coming weeks, college students will be returning home for the holidays. For many, this break provides a time to catch up and relax with old friends and spend some quality time with family; yet for some, deep sadness and emptiness prevents them.

A recent national study conducted by the American College Health Association-National College Health Assessment (ACHA-NCHA) reported that 31 percent of college students reported feeling “so depressed that it was difficult to function” at some time in the past year. In 2009, 8 percent of 18-25 year olds had a major depressive episode, but less than half received treatment according to a national survey.

Everyone feels sad or down from one time to another, but for individuals affected by depression, the symptoms are serious and long lasting. A person with depression may feel: sad, anxious, empty, hopeless, guilty, worthless, helpless, irritable, and/or restless. They may also experience one or more of the following:

• Loss of interest in activities
• Lack of energy
• Problems concentrating, remembering information, or making decisions
• Problems falling sleep, staying asleep, or sleeping too much
• Loss of appetite or eating too much
• Thoughts of suicide or suicide attempts
• Aches, pains, headaches, cramps, or digestive problems that do not go away

Depression is common and for most people, depression can be treated successfully. If you feel that you may have depression, try to be seen by a health professional as soon as possible. If you are a friend or relative encourage your loved one to seek help. It may be necessary to make an appointment and to go with them. If you have no insurance, having trouble finding a health professional, or need additional resources accessing treatment, please contact MHAM at 651-493-6634 or 800-862-1799 to talk with an advocate.

If you or someone you know is in crisis, get help quickly.
• Call your doctor.
• Call 911 for emergency services or go to the nearest hospital emergency room.
• Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

For more information and resources on depression, visit the National Institute of Mental Health (NIMH) website or click on the selected NIMH publications below:

Depression
Depression in Women
Men and Depression
Depression and College Students: Answers to college students’ frequently asked questions about depression

According to a 2008 study conducted by the RAND Corporation, many returning veterans that had been deployed to Iraq or Afghanistan as part of Operations Enduring Freedom and Iraqi Freedom had significant mental health issues. Of the 1,945 that were surveyed, 14% met the criteria for post-traumatic stress disorder (PTSD), 14% met the criteria for major depression, and 19% had a probable traumatic brain injury (TBI).  About one-third of these returning veterans had at least one of these conditions.

Last year, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) launched the Real Warriors Campaign directed towards service members, veterans, their families, and health professionals. The goal of the campaign is to reduce stigma associated with psychological health problems and traumatic brain injury. The campaign encourages and supports service members to seek help through the many resources that are available to them and their families. Along with helpful resources and a 24/7 information and help line, the Real Warriors campaign’s website draws upon the courageous stories of service members and veterans that found the strength to seek help and how it made a positive difference in their lives.