Anxiety disorders, alongside depressive disorders and stress have greatly contributed to the increasing rise of visits to the hospital. They are the most common psychiatric disorders, affecting both children and adults, and are found to be even more common among females than males. They include conditions like:
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Phobias
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Panic disorder
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Generalized anxiety disorder.
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Social anxiety disorder
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Post-traumatic stress disorder
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Obsessive-compulsive disorder
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Why Do You Feel Anxious?
The feeling of fear, worry, or unease is referred to as anxiety. You can also feel anxious when you are stressed, causing the release of some hormones such as cortisol and adrenaline. In turn, the presence of these chemicals in your bloodstream leads to some symptoms of anxiety like:
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Increased heart rate
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Sweating
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Difficulty in sleeping
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Always being on the edge
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Inability to concentrate.
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Butterflies in your tummy feeling.
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Increased breathing
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It’s normal to feel anxious every now and then. For instance, feeling anxious before an exam or a presentation can motivate you to prepare harder and leave no stone unturned. But anxiety becomes a disorder when it involves frequent periods of excessive fear and worry or when it becomes long termed.
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It is estimated that the total number of people with anxiety disorders globally is 264 million. In a survey carried out in some regions of America, 7.7% of the female population was discovered to suffer from a type of anxiety disorder while for the males, it was 3.6%. (1)
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Several treatment approaches have been found effective for the management of anxiety disorders. They can be broadly classified into the following categories.
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Medication: This is often used in conjunction with therapy and includes major four classes of drugs such as benzodiazepines, tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors. (2)
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Therapy: This includes procedures such as cognitive-behavioral therapy, exposure therapy, acceptance and commitment therapy, interpersonal therapy, etc.
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Complementary and Alternative Medicine: includes therapies such as acupuncture, homeopathy, naturopathy, hypnosis, chiropractic, etc.
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Technology-based treatments such as smartphone apps, transcranial magnetic stimulation, virtual reality exposure, etc.
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The Need for Technology-Based Treatment Option in Managing Anxiety
Thanks to innovation and continuous advances in digital technologies such as smartphones, computers, and other computerized medical devices, there are newer and promising means of determining and monitoring and managing mental disorders. Anxiety and depression are at the top of this list.
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Also, some hurdles placed by conventional face-to-face therapy such as
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The cost of medical bills
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Cost of transportation
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Misconceptions and stigma surrounding treatment.
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Geographical factors
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Inadequate number of mental health facilities to cater to those living with anxiety disorders have made it difficult to access treatment. A bid to overcome these barriers contributed to an increased interest in the use of technology-based therapy. (2)
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It is also worth noting that situations like the Covid-19 pandemic equally brought about the discovery and use of technology-based therapies. During this time, the UK recorded a high number of people requesting mental health apps. Currently, there is a corresponding increase in demand for these forms of therapy to treat anxiety.
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According to the acting director of medical technology and digital evaluation at the National Institute for Health and Care Excellence, Mark Chapman, eight technologies proved to be promising in providing effective treatment to a lot of people with anxiety disorders, amongst others. (3)
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Application of Technology-Based Therapy
Technology-based therapy, also regarded as e-mental health therapy, utilizes several forms of technology. It can be found in smartphones and computers, where apps are created to provide support and encourage easy accessibility to online consults. Some examples include:
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1. Smartphone Apps
This is the most common type of technology-based therapy. In recent times, smartphone apps have gained popularity posing as a universal intervention approach in the management of anxiety. Also, there is growing evidence of their effectiveness. Several random-controlled trials have indicated that these mental health apps have a high chance of relieving anxiety and symptoms of other common mental issues. In a meta-analysis of smartphone interventions carried out in 2017 on 9 patients suffering from an anxiety disorder, results revealed that when the smartphone apps were tailored for psychological treatments, there was a remarkably decreased level of anxiety among the patients. (4)
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The apps can be classified based on how they work.
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Apps are built to promote mental health through activities that calm the nerves and stimulate a sense of well-being. Such activities include low-intensity aerobic exercises, mood-tracking practices, and meditation.
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Apps that are designed to provide clinical support to its users, either through providing easy access to a health professional to talk to or providing necessary materials on how to overcome anxiety.
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Apps that operate as a chatbox, using artificial intelligence (AI) to engage in conversation with users. This can help to access a user’s anxiety state and offer solutions that can make the user feel better.
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Apps that apply principles based on Cognitive Behavioral Therapy (CBT). This therapy is a type of psychological treatment that focuses on changing the way you think and behave. CBT consists of strategies that help you to be your own therapist. Here, you learn how to face your fears instead of avoiding them, develop a great sense of confidence in your abilities, and how to calm your mind whenever anxiety sets in. (5)
CBT-based apps teach users to manage anxiety by allowing them to track their symptoms, their severity over time, and their progress.
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Examples Of Smartphone Apps include:
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This is an internet-based treatment module for teens (15-18) years old that have symptoms of anxiety. Designed based on traditional CBT, it has several sections that can detect your feelings, understands anxiety, spots your thoughts, and challenges them, and controls your worries. It also provides online support from CBT coordinators and psychologists who check in with your progress during the lessons and send motivational texts after each module.
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B. Online Social Anxiety Cognitive Therapy for Adolescents (OSCA)
OSCA is a cognitive therapy program for adolescents suffering from social anxiety. Here, users are given an individualized set of modules to work through online. A call is also initiated by the therapist weekly to encourage and support the user.
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C. Breathing-focused apps like Breathe2Relax and Breathwrk.
It is quite common to hear one say, ‘Take deep slow breaths’ whenever you feel anxious. Just like their name, these apps employ breathing techniques to help reduce anxiety. They adopt a whole range of one-minute breathing exercises that enables you to calm down and refocus. Breathwrk has the advantage of sending you daily reminders to take slow deep breaths in addition to offering goal-specific breathing exercises. There are exercises targeted at making you fall asleep, while some aim to make you feel energized or feel relaxed. Breathe2Relax is designed by the National Center for Telehealth and Technology. (6)
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D. Headspace
This works primarily by guiding users through meditation sessions. It allows you to practice mindfulness by offering exercise strategies that help you focus on the present and drown out things that trigger your anxiety. Headspace is currently used by approximately 70 million people in 190 countries. This could be attributed to the fact that it can be used by all age brackets. It offers bedtime stories for kids, yoga and mindfulness techniques for teens, and relaxing meditation guides for adults.
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E. Moodnotes
This app helps you manage anxiety by helping you to be conscious of your negative thoughts and track your mood. It gives room for documentation of your anxiety journey, which is the main principle behind the app. Moodnotes offers other options such as recommending exercises to shake off negative thoughts, providing educational materials that assist in calming your nerves and developing a positive attitude, and photoshoots to capture your moody moments and rate your feelings at a certain time.
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2. Virtual Reality Exposure Therapy
Also known as Virtual Reality Immersion Therapy or Simulation Therapy, this technology-based approach is a wholly immersive form of therapy. It artificially generates sensory information that can be perceived as a real-life experience by the user. When an anxious person uses this tool, it helps to regulate the nervous system, switching off the fight-or-flight button and encouraging you to relax.
Research has proven VRET to be successful in tackling different forms of anxiety such as phobias, social anxiety disorder, and PSTD. It was discovered that simulating real-life situations of one’s anxiety triggers aids in easing one’s fears over time.
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This procedure involves placing an electromagnetic coil close to the skull to send magnetic pulses into the brain. The target is to alter nerve activity in the areas of the brain responsible for regulating your mood, thereby managing your anxiety levels. Studies suggest TMS may be effective for treating generalized anxiety disorder.
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4. Bilateral Alternating Stimulating Therapy (BLAST) Devices
This form of therapy involves stimulating the senses to activate the right and left hemispheres of the brain. It includes techniques such as alternating stepping on your left and right feet, rocking to and fro from your left to right sides, using headphones that are structured to alternate listening to music between ears, and eye movements that involve following a light bar from left to right.
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BLAST is a key element of Eye Movement Desensitization Reprocessing and has been found to help relieve anxiety and soothe the nervous system.
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It is most popular for using external stimuli to address unresolved traumas, hence it’s highly effective in treating post-traumatic stress syndrome.
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Some devices have been designed to provoke different methods of BLAST when worn by the user. Examples include headphones for auditory stimulation and Tappers for tactile stimulation.
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5. Gaze-Contingent Music Reward Therapy
GC-MRT is a novel development pioneered by Tel Aviv University, Israel. In a new clinical trial conducted at the university, it was discovered that this therapy proved to be as effective as the SSRI class of antidepressant drugs used for treating anxiety. This therapy involves a combination of eye-tracking and a musical reward. Since people with social anxiety disorder are prone to obverse and focus on threats or negative facial expressions, GC-MRT aims to reduce the threat-dwelling time and divert the patient’s gaze toward neutral stimuli. This helps to reduce symptoms of anxiety over time.
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6. Other Brain Recording and Stimulation Devices
These also claim to reduce anxiety and improve mood. Formerly used by by only researchers and clinicians, they can now be bought directly by the users. An example is the Portable EEG device that is worn during meditation to record the electrical activity in the brain. This is transferred to a smartphone app for translation into a sensory signal that guides the users as they meditate.
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7. Online Communities.
Recently, there are several online communities that have been created to provide support to people suffering from anxiety disorders. Here is where you meet people with similar experiences who share tips and hacks that helped them overcome anxiety. They can be found on different social media platforms. Some operate through online discussion forums, while others offer one-on-one chat rooms or virtual meetings.
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This form of technology-based therapy is great for those who can’t access other mental health services. Examples include Support Groups Central and the Tribe.
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Although technology-based therapy for managing anxiety is still in its nascent stage, it is rapidly gaining popularity with the results presented so far. This can also be attributed to their flexibility (higher reach to geographically insulate locations, time-saving, relative cost-effectiveness, and comfort), individualized mental health support, and the insights they offer about the user’s general well-being. With its wide options, more people can start therapy and effectively manage their anxiety.
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Despite its promising future, there are concerns about its safety of care, data privacy, and security. Therefore, further research is ongoing to establish the absolute safety of these apps and tools.
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Reference
(1) World Health Organisation. (2017). Depression and Other Common Mental Disorders Global Health Estimates. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf
(2) Maher, A. R., Apaydin, E. A., Raaen, L., Motala, A., Baxi, S., & Hempel, S. (2021). The Use of Technology in the Clinical Care of Anxiety: An Evidence Map. Psychiatric Services, 72(2), 195–199. https://doi.org/10.1176/appi.ps.202000178
(3) Bailey, M. (2023, March 1). New digital therapies recommended to treat depression and anxiety. Health Europa. https://www.healtheuropa.com/new-digital-therapies-recommended-to-treat-depression-and-anxiety/121614/
(4) Firth, J., Torous, J., Carney, R., Newby, J., Cosco, T. D., Christensen, H., & Sarris, J. (2018). Digital Technologies in the Treatment of Anxiety: Recent Innovations and Future Directions. Current Psychiatry Reports, 20(6). https://doi.org/10.1007/s11920-018-0910-2
(5) American Psychological Association. (2017, July). What Is Cognitive Behavioral Therapy? American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
(6) Illinois Library. (2023, April 4). LibGuides: Anxiety Disorders: Common Assistive Technologies. Guides.library.illinois.edu. https://guides.library.illinois.edu/c.php?g=498026&p=3409717
(7) Lee, M. (2019, April 29). These Are the Best Anxiety Apps for 2022. Healthline. https://www.healthline.com/health/anxiety/top-iphone-android-apps#how-to-choose
(8) Donnelly, M. R., Reinberg, R., Ito, K. L., Saldana, D., Neureither, M., Schmiesing, A., Jahng, E., & Liew, S.-L. (2021). Virtual Reality for the Treatment of Anxiety Disorders: A Scoping Review. The American Journal of Occupational Therapy, 75(6). https://doi.org/10.5014/ajot.2021.046169
(9) Lazarov, A., Pine, D. S., & Bar-Haim, Y. (2017). Gaze-Contingent Music Reward Therapy for Social Anxiety Disorder: A Randomized Controlled Trial. American Journal of Psychiatry, 174(7), 649–656. https://doi.org/10.1176/appi.ajp.2016.16080894
