Author: Thom Holwerda
Behavioral health interventions are notoriously difficult. They require a grasp of psychology, sure, but they also require a certain amount of flexibility because people’s lives are complicated. Apple’s ham-handed approach to physical health has been bad enough — the idea it is now going to approach mental health does not fill me with confidence. I’m sure there are plenty of people out there who won’t mind letting Apple toy with their emotions. But we’ve got a lot of evidence now that too much screen time is linked to bad health — and for Apple, its entire business is getting you to spend more time with its software and gadgets, not less. This is a great article, and highlights the problems that stem from tech bros trying to be doctors, or in this case, even psychologists and therapists. Health interventions require a personalised approach, and blanket one-size-fits-all attempts are generally suboptimal. A person with weight issues who happens to perform a physically intensive job will require a different approach than someone with similar weight issues who has a desk job. A generic “move!” on your Apple Watch a few times a day won’t really help either of those people. This gets even more problematic with mental health issues. A great example of just how counterintuitive health information can be comes from myself – I have a severe anxiety disorder and related mental ailments, and I’ve been trying to learn to live with it since I was a child (there’s probably a genetic element, since similar disorders run in my family). Through a combination of extensive behavioural, cognitive, and physical therapy, a lot of scientific studying with my doctor and other specialists into what, exactly, is wrong inside my brain and body to gain a crystal clear insight into how anxiety fluctuates in my body during the day and what internal and external stimuli affect it, and to cap it off a very small dose of daily anxiety medication (it took me almost two decades to come around to taking medication), I now have my mental health issues well under control. That being said, I will always have these problems. I manage them every day, and they’re never gone, like someone with chronic back problems, even if I seem completely “normal”. Passively and actively, throughout every day, I manage my anxiety, make sure I keep it in check, and recognise the earliest possible warning signs, all made just a little bit easier by my medication. When I emigrated to Sweden four years ago to live together with my now wife, we went to IKEA, about a 90 minute drive away on the border with Finland. Since trips like that generally increase my anxiety considerably, I had a few rough days leading up to it, but during the car ride, I finally managed to overcome it and settle down. As we parked, everything was back to my normal levels – a change in venue from e.g. car to destination often works as a “reset button” of sorts – and we were ready to shop and eat meatballs. And then my smartwatch pinged me in the IKEA lobby. Despite me feeling entirely normal with for me acceptable levels of anxiety, it started telling me I was experiencing the highest level of “stress”. Even though I did not feel any stress whatsoever, such a small thing can be enough to send me into a downward spiral of a panic attack – which I actually do not have very often, maybe once a year or so. Due to having just emigrated thousands of kilometers away to the Arctic, leaving family and friends behind, I was obviously already susceptible, and this stupid digital piece of crap on my wrist telling me I was “stressed” was all it took to trigger a massive panic attack. I’m used to always having a heightened level of anxiety and associated vitals compared to others, but this watch didn’t know that. It just had some basic data programmed in about what is “normal” for someone of my stature, gender, and age, and didn’t take my personal situation into account at all – because it couldn’t. There are countless little indicators, both internal and external, that come into play in a situation like this, and a smartwatch has no way of learning or disseminating such information. It takes a dumb, standardised, generalised shotgun approach in determining if its wearer is “stressed”, actual, real-world stress levels in the moment be damned. This is why I am incredibly weary of Apple”s rumoured plans to enter the realm of mental health with its Apple Watch. As the linked article details, it’s already not doing a great job at managing people’s physical health, and I am genuinely afraid of what effects such a crude approach will have on people’s mental health. Shotgun mental health notifications are going to make people obsessive, they’re going to give people anxiety, they’re going to give people panic attacks, they’re going to give people depressive episodes, they’re going to disturb people’s sleep, they’re going to worsen or even cause eating disorders, and much more. Mental health is not something you should leave to Silicon Valley tech bros – you should leave it to your doctor, trained medical personnel, licensed psychologists and therapists, other specialists, and science, not to a glorified wrist calculator.