Apple Watch readings help with Mental Health Care for postpartum depression

Apple Watch Sleep app

Wearables such as the Apple Watch are gaining acceptability among clinicians and medical researchers. Although there have been many studies that have explored the accuracy of the Apple Watch, there is a limited number of studies that have examined some of the correlations between the information collected by the Apple Watch and mental health status.

Unlike Fitbit Sense, the Apple Watch lacks an EDM (Electrodermal sensor). The Fitbit uses an innovative multi-path sensor to detect tiny electrical changes on your skin (electrodermal activity). This is used by the Fitbit Sense and Charge 5 to help detect stress.

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A new study looks at using wearables like the Apple Watch to help treat postpartum depression

The Apple Watch makes up for this shortcoming by providing accurate readings in other areas, a comprehensive symptom tracker, and a powerful health app.

Researchers at the University of North Carolina, Chapel Hill explored app-based assessment to enhance clinical care for postpartum depression. 

Postpartum depression is the most frequently diagnosed complication of childbirth; however, significant gaps in screening and treatment remain.

The 6-week pilot study was used to investigate the clinical utility, predictive ability, and acceptability of using ecological momentary assessment to collect daily mood, sleep, and activity data through an Apple Watch and mobile app among women with postpartum depression.

Results of this new study were published this week in the JMIR Formative Research Journal.

The study concluded that using ecological momentary assessment to track daily symptoms of postpartum depression using a wearable device was broadly endorsed as acceptable and clinically useful by participants and the study clinician and could be an innovative solution to increase care access.

Can the Apple Watch help with gaining insight Into Mental Health Status?

The watch’s ability to track data, including sleep patterns, heart rate, and steps, along with daily logs of mood, anxiety, sleep quality, and medication, increased the participants’ abilities to connect patterns in these factors to their mood and anxiety symptoms. 

Some women participating in the study found that they had not understood the severity of the symptoms they were experiencing before this effort. These data gave participants and providers a tangible picture of symptoms that increased insight into mental health status. 

There was 1 participant who connected her activity levels with the severity of her symptoms. This participant then made efforts to reach out for more social support to increase feelings of security when leaving home with the baby. This data provided insight into how mental health affected other behaviors of other participants.

Data collected via Apple Watch

Apple Sleep app for Apple Watch
Apple Watch Sleep Monitoring

To collect EMA (ecological momentary assessment) data via the PPD ACT app, the researchers created the PPD ACTApple Watch Module using Apple’s CareKit framework, allowing app-based data collection to understand and manage health conditions.

The Apple Watch Module allows women to log their self-reported mood, anxiety, sleep quality, and medication use (if applicable) daily, while using an Apple Watch to passively collect physiological data on their daily activity (steps taken), heart rate (periodic beats per minute), and sleep. 

The Sleep++ app, a third-party app, was downloaded on the Apple Watch and used to log nightly sleep duration passively.

list of symptoms for Apple Health app
Apple Health Symptoms tracker

Although categorized as passive, the Sleep++ app did require participant input to log when they went to sleep and woke up each day.

Mood, sleep, and physiological data were shared with the study clinician via the participant’s PPD ACT app at research visits to provide critical information about the daily experience of PPD outside of the clinical evaluation.

Importance of Wearable data and mental health

Although this was a limited study with only 26 women enrolled, it clearly shows the possibility of using wearables to help with serious mental health issues.

Numerous studies have looked at some of the parameters collected by wearables and their correlation to mental health parameters.

Vallance et al. (1) reported that greater physical activity as measured by an accelerometer was correlated with lower rates of depression.

Other research found that skin conductance, measured by wearable patches, can be a sensitive biomarker for depression (2–4).

A meta-analysis reported that heart rate variability (HRV), defined as spontaneous fluctuations in heart rate mainly reflecting the activity of the autonomic system, is reduced in patients with depression.

References:

  1. Vallance JK, Winkler EA, Gardiner PA, Healy GN, Lynch BM, Owen N. Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005–2006). Prev Med. (2011) 53:284–8. doi: 10.1016/j.ypmed.2011.07.013 
  1. Ward NG, Doerr HO, Storrie MC. Skin conductance: a potentially sensitive test for depression. Psychiatry Res. (1983) 10:295–302. doi: 10.1016/0165-1781(83)90076-8 
  1. Kemp AH, Quintana DS, Gray MA, Felmingham KL, Brown K, Gatt JM. Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol Psychiatry. (2010) 67:1067–74. doi: 10.1016/j.biopsych.2009.12.012 
I am a technologist with years of experience with Apple and wearOS products and have a Bachelor’s degree in Computer Science. In my day job, I advise fortune 500 companies with their digital transformation strategies and also consult with numerous digital health startups in an advisory capacity. I'm VERY interested in exploring the digital health&fitness-tech evolution and keep a close eye on patents, FDA approvals, strategic partnerships and developments happening in the wearables and digital health sector. When I'm not writing or presenting, I run with my Apple Watch or Fossil Gen 5 LTE and keep a close eye on my HRV and other recovery metrics.

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