5 Tips For Comparing Depression Apps
Have you searched “depression” in an app store recently? There are a mind-boggling number of apps to choose from. You may be wanting to give one a try—but how do you know if an app would make you feel better? How do you choose one from the masses?
Then there’s the issue of quality—many apps claim to be able to help you reduce symptoms, but is there real science behind those claims?
Read on to learn the current state of science behind depression apps, get a better idea of whether an app could work for you, and have a list of a few, higher-quality apps to explore like UpLift, our own depression app (full disclosure: we made UpLift and we hope you think it’s the best app out there; this article should still be useful way to discover other apps too).
Why a depression app may help you feel better
Having depression is hard. One of the key symptoms is a lack of motivation. While finding a face-to-face therapist is a worthwhile task (one we recommend you pursue first!), it can take some effort to find someone with whom you’re compatible.
Using a depression app may provide relief while you wait for your first appointment. If you do see a therapist, it can provide added support between sessions. And if the very idea of seeing a therapist is something you’re putting off, an app can be better than receiving no support at all.
People use depression apps for the following additional reasons:
- Convenience: You can use an app around your schedule, when and where it suits you.
- Cost: Typically, costs are significantly lower than in-person therapy (though not always the case with some insurance plans).
- Anonymity: No one has to know you’re using the app but you.
- Lack of in-person therapists: Some regions have a shortage of quality, licensed therapists, meaning you could have a long wait time before receiving any help.
- Supplements in-person therapy: Skills learned in therapy can be strengthened in an app.
- Ease of use: It’s quick and easy to get started.
These benefits are appealing, but not all apps are created equal and not every person benefits from an app.
Tip 1: Check if you’re a good fit for a depression app
Depression apps can be quite beneficial and may even help reduce symptoms of anxiety. However, there are some people for whom these types of apps may be less effective.
Using a depression app may not suitable if you have any of the following:
- Bipolar disorder: An iCBT app may be helpful, but it may not be the most evidence-based option in all cases. Check with a professional to see what types of apps could work for you.
- Severe depression: You may still benefit from using a depression app, particularly an iCBT-based appvii, though some studies have been mixed on whether mobile apps are helpful for those with severe depressionviii. Do consider face-to-face therapy with a trained clinician. Medication is often helpful for those with severe depression.
- Depression from a physical cause: Surprisingly, 10% of people diagnosed with depression are actually suffering from other undiagnosed medical conditions that cause or contribute to depression, such as hypothyroidism, anemia, sleep apnea, and vitamin D deficiency. In these cases, treating depression will be less effective than addressing the underlying issue.
- Suicidal thoughts or behaviors: Suicidal thoughts are not uncommon for people with depression. However, having plans to harm yourself or attempting to do so requires immediate action. Most depression apps are not capable of dealing with crises, or in creating safety plans to prevent them. (If you’re having suicidal thoughts, see the resources at the bottom of this article, including one app that may be helpful).
Additionally, most depression apps are self-paced. This means to unlock the best results, you have to put in the effort. There are some guided apps out there that may help you stick with the recommended tools, but in general you decide when and how often to practice the skills you learn.
Tip 2: Find an app that’s science-backed or better
Unfortunately for those trying to make sense of all the options, a recent study examining 73 of the top-ranking mental health apps in Google Play and iTunes found the science behind apps to be lowi:
- 44% of the apps use scientific language to describe their effectiveness, but 25% of these use at least one “scientific” technique for which evidence could not be found.
- 64% claim to be effective at diagnosing or improving a mental health condition, but only 2 had done their own studies to show that their app works.
The two apps with their own studies were a chat-bot called Wysa and a happiness app called Happify; at the time the paper was written, UpLift, our own depression app, which has conducted its own effectiveness researchvi, had only recently been launched.
That said, more app developers are hard at work to show their apps can be effective. The authors stated that five additional apps had research underway.
So how can you tell if an app has good science behind it and is likely to be effective? The American Psychiatric Association recommends checking for the following things in an app, as best you canii:
- Get some background info: Is it free? If so, how does it support itself? If not, what’s the cost? Who developed it? Is it updated regularly? Will it work with your type of phone?
- Check for evidence: Are there any published studies on the app or the science behind it? Are there positive reviews left by others? Does the content seem valuable?
- Ease of use: Would it be easy to use on a long-term basis? Can you customize it to better suit your needs?
- Sharing with your therapist: Can you share your data with your therapist, if you wanted to?
Using the above model can help you decide if an app is likely to be useful. An app that is based on cognitive behavioral therapy (CBT), described next, is one that is also likely to be higher quality.
Tip 3: Try a CBT-based app, or one with at least some CBT
Cognitive behavioral therapy (CBT) has more evidence that it reduces depression than any other psychological treatment in existenceiii,iv. Unlike traditional talk therapy, which often tries to pinpoint past events that have caused depression, CBT focuses on what’s happening now in your life to maintain depression.
CBT teaches skills like confronting negative thoughts, scheduling enjoyable activities into your day, and problem solving. Compared to other therapies, CBT is typically of shorter duration, between 10 and 20 sessions.
Over the last 20+ years, internet-delivered CBT programs (iCBT) have undergone extensive scientific scrutiny and are regarded as “effective, acceptable, and practicalv.” Outcomes with iCBT programs are comparable to traditional face-to-face CBT.
With an iCBT program, you complete “sessions:” 20- to 60-minute skills-based lessons that you complete on your own and at your own pace. Between sessions you do homework challenges and practice skills learned.
Some countries, such as the UK, Netherlands, New Zealand, and Australia, even provide iCBT programs free for residents (frequently through physician referral). Beating the Blues is an example of such a program. However, Beating the Blues and many similar iCBT programs are available for web browsers only rather than apps, and are not optimized for smartphone browsers.
Many apps contain some elements of CBT. Currently though, UpLift is the only consumer mobile app based on a complete course of CBT. It models itself off the first wave of iCBT programs while being far more advanced and interactive. A pilot study with 120 participants found that users who completed UpLift had depression scores fall by 50% in one month, with improvements maintained 6 months latervi.
Tip 4: Compare different types of depression apps
When comparing apps, consider which type is likely to work for you. The most common depression app types are listed below, along with some higher quality examples.
- Complete CBT course: Modeled off the highest-quality science of work works for fighting depression. Example: UpLift
- Chatbots: Have a conversation with a bot that can also guide you through techniques or meditations. Examples: Wysa and Youper
- E-therapy/text therapy: Connect with a licensed therapist and communicate primarily via text, with some phone or video time. Examples: BetterHelp and Talkspace.
- Mindfulness apps: Focus your attention while acknowledging and accepting negative thoughts and emotions. Examples: Headspace and Sanvello
- Mood trackers/thought diaries: Track your moods to better notice patterns in your ups and downs. Examples: Moodnotes and MoodTools
- Peer support: Connect with others working toward improving their mental health. Example: The Mighty (for web, but also available on iOS)
- Suicide prevention: Make a plan to stay safe and define who you can reach out to when you’re having thoughts of suicide. Example: MY3
- Other: Not primarily for those with depression, some apps involve well-being techniques and goal setting that may be helpful. Examples: Happify and SuperBetter
Consider how important it is for you to connect with a real person (as opposed to a bot), what your budget can afford (e-therapy is the most expensive of the above), whether you want methods that have stood the test of time (CBT) or want to explore newer ideas (like chatbots), and what kind of activities you’ll be doing (recording your mood, meditations, talking with peers or a therapist, multiple types of activities in the case of CBT, and so on).
Tip 5: Don’t let an app replace professional care
Medication and therapy are highly beneficial to many people and are options worth seriously considering, particularly from a CBT-based practitioner (check out the Academy of Cognitive Therapy or the Association for Behavioral and Cognitive Therapies to find a CBT practitioner).
An app isn’t meant to be a substitute for professional care. And you definitely shouldn’t alter your therapy or medication on account of starting an app.
If you don’t have a formal diagnosis, it’s also worth noting that you won’t be able to receive either a diagnosis or medication through an app (including the e-therapy apps listed above). If you’re unsure if you have depression, a trained professional can help you rule out physical causes of depression, check for co-occurring issues such as anxiety, and set you up with a treatment plan that works best for you.
While most depression apps lack scientific backing, there are a few quality options out there. In particular, iCBT programs have a mounting body of evidence to suggest they work as well as, or nearly as well as face-to-face therapy.
However, do first consider more traditional forms of care such as in-person therapy, particularly if you have severe depression, bipolar disorder, suicidal thoughts, or believe your depression symptoms have a physical cause.
To give a depression app a try, receive the first session and tool of UpLift for free. Get started here.
- Call 1-800-273-8255; it’s the number for the National Suicide Prevention Lifeline.
- Text START to 741741, the Crisis Text Line.
- Download the MY3 app to plan a way to stay safe when you’re having thoughts of suicide.
- For emergencies call 911.
- Visit Befrienders Worldwide for hotlines and other resources available throughout the world.
- Use your local emergency services.
- i: https://www.nature.com/articles/s41746-019-0093-1#Tab3
- ii: https://www.psychiatry.org/psychiatrists/practice/mental-health-apps/app-evaluation-model
- iii: http://www.ncbi.nlm.nih.gov/pubmed/16199119
- iv: http://www.ncbi.nlm.nih.gov/pubmed/18752112
- v: https://www.ncbi.nlm.nih.gov/pubmed/29422409
- vi: Liu, E., & Pluta, A., & Dobson, K. (2018, November). Pilot Study on UpLift---A Computerized Cognitive Behavioral Therapy Mobile App for Depression. Poster session presented at the 52nd Annual Convention for the Association for Behavioral and Cognitive Therapies (ABCT), Washington, D.C.
- vii: https://www.jmir.org/2018/11/e10113/
- viii: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608852/