We live in a world where smartphones are seamlessly woven into our lives while continually constructing a digital version of ourselves. Unlike their cell phone predecessors, smartphones (e.g., iPhones and Androids) are embedded with sophisticated tools, such as GPS trackers, accelerometers, and voice and ambient light detectors, which can analyze spatial and social dimensions of everyday life.
Smartphones have given us the ability to customize and organize our days based on our preferences, and gather data which reflect our connections, opinions, habits and behaviors. Since people tend to identify with and trust their own devices, a smartphone provides a healthy platform to express and record thoughts privately. They have thus far enhanced human individuality. In some ways, your smartphone is an interesting diary of your life.
It’s fascinating to note that there is now more computing power in the palm of one’s hand than all of NASA had when the first humans landed on the moon!  This may seem inconceivable, but it underscores the rapid technological advances made in recent years. The possibilities for this goldmine of untapped processing power are vast, particularly given the ubiquitous nature of smartphones.
HealthRhythms, the brainchild of Dr. David Kupfer, Dr. Ellen Frank and Dr. Tanzeem Choudhury, is a startup company founded on the evidence-based notion that our mental health is inextricably linked to our everyday life. By leveraging passively collected data from smartphones, HealthRhythms seeks to provide a fluid and clinically grounded understanding of mental health risks associated with daily routines, or “behavioral rhythms.”
Measure (HealthRhythms Inc.) is an app designed to monitor the behavioral rhythms of people with major depressive disorder (MDD). This includes tracking cycles throughout the day and night, such as physical activity, sociability and sleep. Depression is associated with sleep problems, fatigue, loss of interest in social activities and anhedonia (inability to feel pleasure), among other symptoms . Passive tracking of depression symptoms by smartphone sensors requires little to no effort from the individual, is minimally intrusive, and can potentially provide a more reliable picture of depression symptoms rather than depending on individual feedback alone in clinical settings weeks later, which can be prone to recall bias. The app can also collect data via customizable self-report questions prompted at regular time intervals. In sum, Measure is a valuable tool for ecological momentary assessment (EMA)—that is, moment-to-moment assessment of an individual’s behaviors and experiences in real-time and in their natural environments .
Because mood and emotional state can frequently change throughout the day, EMA gathers a continuous and more complete picture of individual’s state. An ongoing pilot feasibility study by CAN-BIND researchers hopes to establish Measure as a usable and acceptable tool for tracking depressive symptoms of patients with MDD.
Identifying symptom improvements can proactively reinforce positive behavioral change, and identifying the worsening of symptoms at the right time allows for early and effective intervention and can prevent immense suffering. Smartphone apps may not be the panacea for monitoring depression but are certainly a leap-forward from traditional methods.
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 American Psychiatric Association. “Diagnostic and statistical manual of mental disorders: DSM-5.” Washington, D.C: American Psychiatric Association. 2013.
 M. Rot, H. Koen, R. Schoevers. “Mood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies.” Clin Psychol Rev. 2012 Aug;32(6):510-23
Author: Yashvi Asher, Summer Student.
Editors: Aleksandra Lalovic, PhD and Janice Pong, MSc