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Apps help COVID anxiety, depression

Free mobile apps – IntelliCare – significantly reduce mental health symptoms
IntelliCare users showed improvement over the course of eight weeks.

Terrified you will contract COVID-19? Feeling down, lonely and wondering when you’ll be able to safely see your friends in person again?

A new Northwestern Medicine collection of mobile apps called IntelliCare — free for downloading in the Apple and Android stores — significantly reduces anxiety and depression, reports a new study to be published May 20 in JAMA Psychiatry.

The apps also have special content to help people reduce the stress and anxiety of dealing with the pandemic.

“These apps offer remote treatment to avoid depression and anxiety during these socially distancing times,” said senior study author David Mohr, director of the Center for Behavioral Intervention Technologies and professor of preventive medicine at Northwestern University Feinberg School of Medicine. “They’re designed to fit easily into people’s lives and to help the millions of people who want support but can’t get to a therapist’s office.”

Prior to the pandemic, more than 20 percent of Americans had significant symptoms of depression or anxiety each year. Now that percentage may have tripled, according to new research. Prior to the coronavirus, only around 20 percent of people with a mental health problem got adequate treatment.

“The number of Americans getting the help they need is certainly lower now than before,” Mohr said.

The multiple apps offer short exercises to de-stress, reduce worrying, methods to help your life feel more meaningful, mantras to highlight your strengths, strategies for keeping up with daily activities and more.

The level of improvement in anxiety and depression – about 60% recovery – was similar to that seen in traditional psychotherapy. While the new study employed coaching along with the apps, previously published research showed the apps alone also reduce anxiety and depression. 

People who received IntelliCare over eight weeks showed significantly greater improvements in depression and anxiety compared to the control group. Once the control group received the intervention, their depression and anxiety decreased, too.

“Participants continued to use IntelliCare throughout the eight weeks of coaching and beyond, which is important because people often stop using mental health apps before treatment ends,” said lead study author Andrea Graham, assistant professor of medical social sciences at Northwestern. 

The IntelliCare project is one of several current efforts led by Northwestern researchers who are on the front lines of the COVID-19 crisis.

This study was conducted as a clinical trial across the internal medicine clinics at the University of Arkansas for Medical Sciences.  People were enrolled in the study if they met criteria for depression or anxiety. They were randomized to receive either IntelliCare or continue with care as usual. Of a total of 146 participants, 74 received IntelliCare, and 72 received treatment as usual from their primary care provider.

How the apps can help

Say you are worried that you are going to get sick with COVID-19.

“That kind of thinking can make you feel anxious and impact your daily activities,” Graham said. “You can go to the Thought Challenger app to challenge the negative thinking and change it into something more positive or realistic. The app helps you question the evidence that your thoughts are 100% true and see if it’s a type of negative thinking pattern. Then, the app may guide you to change your thinking to: ‘There’s a lot I can do to stay healthy like washing my hands’.”

10 tips for good mental health during the coronavirus pandemic

1. Be kind to ourselves

We may experience waves of emotion or negative thoughts. Act in a kind and understanding way toward ourselves.  Remind yourself of the good things you’re doing in this challenging time.

2. Be kind to others 

Social distancing means we are spending more time with fewer people. This can create strain and stress. Notice the positive things those around you are saying and doing. Kindness toward others can help us feel less distressed and more positive.  

3. Do things you enjoy and that make you feel good 

It can be hard to do activities we enjoy in times of stress. But doing enjoyable activities helps us with our mental health by making us feel good! Take time to do the things you enjoy, find meaningful or have fun doing.   

4. Maintain a routine 

This pandemic has caused many of us to have changes to our daily routine. In this time of change, think about how you can create a new routine or adjust your regular routine, so you can have a bit more order to your day.

5. Get enough sleep

When we’re stressed or feeling down, it can be hard to get enough sleep, or we may sleep for longer stretches of time than usual. Try to wake up and go to sleep around the same time each day, on the weekdays and weekends.

6. Keep up with healthy eating and physical activity 

In times of stress, keeping up with balanced eating can be helpful, and taking time to move our bodies also can make us feel good and boost our mood.

7. If you need to, take a break from the news 

In this challenging time, we are getting a lot of information — from the news, social media and talking with friends and family. If you find yourself getting too stressed and worried, see if you can take a break and limit the amount of time you spend with the news. 

8. Challenge your negative thoughts 

Information about this pandemic can lead to negative thoughts, and so can the uncertainty about all that’s happening around us. Negative or unrealistic thoughts can impact how we feel. We can challenge our thoughts and change them to more positive or realistic ones. 

9. Create positive experiences and emotions 

There are many things we can’t control right now. But one thing we can do is create positive experiences and emotions, like remembering positive moments from the day, expressing gratitude to others and doing acts of kindness.  

10. Keep looking forward 

In this challenging time, remember that things will return to normal again, even if we don’t know when. If we can stay hopeful and look forward to better times ahead, it will help us stay positive now. 

Other Northwestern authors include Mary J. Kwasny and Susan M. Kaiser.

This work was supported by grant R44 MH114725 from the National Institute of Mental Health, as well as by the National Institute of Diabetes and Digestive, and Kidney Diseases (K01 DK116925) and the Translational Research Institute (U54 TR001629) through the National Center for Advancing Translational Sciences of the National Institutes of Health.

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