eHealth

What is eHealth for mood disorders?

eHealth is the use of technologies such as online psychotherapy, informational websites, social media, forums, blogs, and video games to educate, provide social support, encourage screening for disorders, offer self-help strategies and psychotherapy, and reduce stigma. By using eHealth technologies, people can access health materials whenever and wherever they like, work at any speed that is comfortable in the privacy of their own home, and play an active role in their health. At this time, web-based eHealth strategies for mental health have more evidence than mobile-based strategies. Further research and development of eHealth strategies for mood disorders is needed. 

Internet and computer-delivered therapy

Internet and computer-delivered therapy is psychotherapy or behavioral treatment that is delivered online or as a stand-alone computer program. These therapies use audio and video as well as interactive features to engage users. There is a lot of research evidence that supports Internet- and computer-delivered therapy in improving depression and/or anxiety outcomes. Since these programs are completely anonymous, you can share feelings that you may feel uncomfortable sharing with a provider.

Online counseling

Online counseling is psychotherapy that is offered via the internet. It may include the use of email, chat rooms/instant messaging, and webcams. The benefits of online mental health treatment include its accessibility, convenience, and affordability. For instance, people who live in rural or remote areas or people with disabilities may find it easier to access online therapy than in-person therapy. Many people may also find online treatment more comfortable and less stigmatizing than meeting with someone in an office.

However, keeping your information private is a concern with this method of treatment. To ensure that your health information is protected in the same way it would be for an in-person appointment, make sure your provider is using a secure, HIPAA-compliant platform to communicate with you. Whenever possible, sit in a private place during the videoconference where no one else can see or hear the conversation. Use a secure, password-protected Wi-Fi network rather than a public connection.

Mental health apps

In recent years, many mental health apps have become available for smartphone users. These apps provide self-directed mental health education, self-assessment, symptom management, coping strategies, and/or supportive resources. They are not intended to replace professional treatment, but may work well in addition to your treatment plan.

At this time, a majority of apps that are available are not supported by research. We provide a list of apps that you may wish to use below. Type in the name of each app to locate and download them on the App Store and/or the Google Play Store. Talk to your healthcare provider before using a particular app.

AnxietyCoach

An app for anxiety that addresses fears and worries using Cognitive Behavioral Therapy (CBT) strategies. Users create a list of feared activities and learn to master them with guidance through the app. The app includes tools for a self-test, anxiety tracking, and viewing progress.

Cost: $4.99

Evidence: This app is currently being tested in a clinical trial(link is external).

CBT-i Coach

An that was designed for those with sleep problems. Users learn how their thoughts and sleep-related behaviors affect their sleep patterns and have access to educational materials about sleep, sleep habits, and how to promote sleep quality. CBT-i Coach is available for Apple mobile devices (iPhone, iPad, and iPod touch) and for Android phones and tablets.

App Website:

https://www.ptsd.va.gov/professional/materials/apps/cbticoach_app_pro.asp(link is external)

Evidence: CBT-i Coach has been shown to be an effective treatment for insomnia in several clinical trials.

Headspace

A mobile app to reduce anxiety and stress and improve attention and awareness in individuals with depression, anxiety, PTSD, and related disorders. This app is useful for starting a regular meditation practice. The app teachers mindfulness, breathing exercises, meditation practice, and ways to increase relaxation and concentration. This app is user-friendly and includes clear instructions, videos, podcasts, and an online forum.

App Website: https://www.headspace.com(link is external)

Cost: $7.92-$14.95/month after free 30-day trial

Evidence: 16 published studies in the leading mindfulness peer-reviewed journals showing the impact of Headspace on health outcomes such as stress, focus and compassion. Other studies are ongoing.

IntelliCare

A suite of 12 interactive mini-apps that work together to target common causes of depression and anxiety such as sleep problems, social isolation, and obsessive thinking.

App Website: https://intellicare.cbits.northwestern.edu(link is external)

Evidence: These apps are part of a nationwide research study funded by the National Institutes of Health.

Medisafe

A mobile app that helps you remember to take your medication.

App Website: https://medisafe.com(link is external)

Evidence: In a retrospective study, Medisafe users showed statistically significant increases in adherence.

MoodKit

An app that uses the principles and techniques of Cognitive Behavior Therapy (CBT) to help users with mood disorders engage in mood-enhancing activities, identify and change unhealthy thinking patterns, rate and track their mood over time, and write journal entries.

App Website: http://www.thriveport.com/products/moodkit/(link is external)

Cost: $4.99

Evidence: Pepperdine University psychologists developed this app(link is external)

reSET for Substance Use Disorders

An app that delivers cognitive behavioral therapy (CBT) to help people recover from substance abuse and increase the rate of people who stay in outpatient therapy programs. reSET includes interventions and assessments for patients. It is indicated as a prescription-only adjunct treatment for patients with substance use disorders.

App Website: https://peartherapeutics.com/reset/(link is external)

Evidence: Data from a clinical trial showed a statistically significant increase in adherence to abstinence in those who used reSET. reSET has received clearance from the FDA to be marketed as the first prescription digital therapeutic with claims to improve clinical outcomes in a disease.

MyMeds

This app is a secure medication management platform. The app sends you daily medication and refill reminders and helps you understand why you are taking your medications. It also keeps your healthcare providers and family aware of what medications you're taking.

App Website: https://www.my-meds.com

Websites

Mental health websites may provide psychoeducation, or information and support for patients and their families to better understand and cope with a mental illness. Websites may also offer cognitive behavioral therapy (CBT) or interpersonal therapy (IPT) for mood disorders.

Some key sites include:

moodgym(link is external)

This Way Up(link is external)

Mental Health Online(link is external)

Beating the Blues(link is external)

Living Life to the Full (link is external)

Social Media

Social media sites such as Facebook, Twitter, or YouTube can be a resource for mood disorder information, or be used to create social connections that promote education, peer support, and stigma reduction.

Internet Forums

Internet forums (message boards, discussion forums, discussion groups) are online discussion sites where you can post messages or questions according to a specific topic and view responses to the messages you leave. You can also choose to just read the posts that other people have left. In order to post a message, users are often required to sign up and create an account and user name.

Blogs

A blog is an online personal journal or diary that is updated on an ongoing basis. Blogs can be used for self-reflection, to educate people about mental health conditions, or to help themselves cope with mental illness. Bloggers may use their blog platform to provide encouragement and exchange support with others coping with similar challenges.

How to assess if the resource is a good option for you?

Has it been updated?

Many websites and resources provide a date that material was created or updated. Even without this information, you can see whether a webpage provides research from within the past 5 years, indicating that it’s relatively new. Not all health information needs to be updated all the time, but it is best to follow the latest guidelines or use the latest mental health apps and tools whenever possible.

Who has created the materials?

Some resources are developed by private companies, some are from individuals with a mental illness, while others are available from the government, non-profit organizations, or educational institutions. Pay attention to who has provided the materials to determine whether it has come from a credible, reliable source.

Do the resources work?

Read reviews of materials carefully to learn whether a particular resource or tool is likely to address your needs. See if professional organizations like medical associations or government agencies have provided an endorsement or certification.

Are the tools or resources easily usable?

Is it easy to search for the information you need on a site? Can you easily understand how an app works and how to use it?

Is your privacy protected?

Resources that collect personal health information can be risky. Make sure there are privacy and security policies that protect your information.

References

Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2016). Mental health smartphone apps: review and evidence-based recommendations for future developments. JMIR mental health, 3(1).

Chan, S., Torous, J., Hinton, L., & Yellowlees, P. (2015). Towards a framework for evaluating mobile mental health apps. Telemedicine and e-Health, 21(12), 1038-1041.

Christensen, H., Choi, I., Deady, M., Glozier, N., Calvo, R. A., & Harvey, S. B. (2017). eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis. BMC psychiatry, 17(1), 310.

Karasouli, E., & Adams, A. (2014). Assessing the evidence for e-resources for mental health self-management: a systematic literature review. JMIR mental health, 1(1).

Lal, S., & Adair, C. E. (2014). E-mental health: a rapid review of the literature. Psychiatric Services, 65(1), 24-32.

Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and evaluation of mindfulness-based iPhone apps. JMIR mHealth and uHealth, 3(3).

Parikh, S. V., & Huniewicz, P. (2015). E-health: an overview of the uses of the Internet, social media, apps, and websites for mood disorders. Current opinion in psychiatry, 28(1), 13-17.

Sander, L., Rausch, L., & Baumeister, H. (2016). Effectiveness of internet-based interventions for the prevention of mental disorders: a systematic review and meta-analysis. JMIR mental health, 3(3).

Stoyanov, S. R., Hides, L., Kavanagh, D. J., Zelenko, O., Tjondronegoro, D., & Mani, M. (2015). Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR mHealth and uHealth, 3(1).