Technology to help the Symptoms of Depression (Next Generation Behavioral Health Podcast)

Technology to help the Symptoms of Depression (Next Generation Behavioral Health Podcast)


[Dr. Christina Armstrong] Hello, and welcome
to “Next Generation Behavioral Health”! [Dr. Julie Kinn] Ten-minute tips for modernizing
patient care. [Armstrong] [music] I’m Dr. Christina Armstrong. [Kinn] And I’m Dr. Julie Kinn. [Armstrong] Today, we’re talking about technologies
to support treatments for depression. So Julie, let’s talk first about the scope
of the problem of depression. [Kinn] OK…and we are going to get into lots
of specific apps and other technology later, right? [Armstrong] That’s right. Yep, that’s probably what people came to hear,
so we’ll definitely get to all that good stuff. [Kinn] Perfect. Yeah, the scope is huge, I mean, we know in
the civilian population that depression is one of the most common behavioral health complaints. But what about in military and veterans? [Armstrong] Military, it is a huge issue as
well. So we know in the civilian population, about
7 percent of the U.S. has had a major depressive episode over the past year. And in the military, it’s about the same for
folks before they’ve deployed…once deployed, we see rates increasing to about 12 percent…and
then, when people come back from deployment, rates are about the same, about 13 percent. How about rates in veterans? [Kinn] [Armstrong]
[Kinn] It’s much higher. It’s about 20 percent, and part of that could
be accounted for by our veterans are older, and we know that as people increase in age,
for some populations, incidence of depression increases too. Right. We’re definitely talking about a topic here
that, any behavioral health provider, you’re going to see all the time, of course. But, other clinicians who aren’t specifically
behavioral health providers — general practitioners out there, family practice — you’re going
to see a lot of depression coming in. Although, it might at first look like just
a sleep problem, or just stress, depression could certainly be a part of it. And so, that’s part of why we want to make
sure you’re aware of some of the evidence-based technology to support your treatment. [Armstrong] The great news is, there are a
lot of really great evidence-based treatments that we know work, both pharmaceutical — although
we are clinical psychologists, so we are not going to discuss pharmaceutical-based treatments
here. However, Julie, can you tell us some of the
behavioral health treatments that we know work for depression? [Kinn] Sure. So yes, the good news. Cognitive behavioral therapy, we know, is
absolutely effective, not 100 percent of the time — none of these treatments are — but
it’s a good solid treatment that would definitely be your first course of action. And I’ll just really quickly list a few others:
acceptance and commitment therapy, other kinds of behavioral therapy, behavioral activation,
interpersonal therapy, mindfulness-based cognitive therapy, and also problem-solving therapy,
which is kind of a newcomer to the block, but I know we use it a lot in the Military
Health System. [Armstrong] Part of what we do is take these
evidence-based treatments that we know work, and we create technologies to support the
delivery of these treatments. [Kinn] So they’re not meant to be used by
themselves. [Armstrong] That’s right. Yes. So none of these technology tools that we’re
going to talk about are meant to diagnose, or treat, on their own. Only a licensed clinical provider can diagnose
or treat. [Kinn] But one cool thing about all the technology
we’re going to mention is that it does help an individual kind of dip their toe in the
water. It’ll give some information about the behavioral
health complaints. In this case, today we’re talking about depression. It’s certainly not going to harm someone to
pick up one of these apps, and flip through it, and look at it, and see, “Hmm, does this
make sense? Does this fit me?” And sometimes that can be the first step before
seeking help from a provider. [Armstrong] Let’s talk about some of the mobile
health tools that have been developed to support the delivery of these treatments. I know in a lot of our past episodes, we’ve
talked a lot about Virtual Hope Box. We talked about the randomized control trial
that was published last year on it, so that is one. And that one is based on cognitive behavioral
treatment. [Kinn] That’s right. You have the Virtual Hope Box, and for this
app — and all the other technology we’re going to mention — of course, the links
are in our show notes, and online. So the Virtual Hope Box, again, it’s based
on the traditional hope box treatment, where you get a box, and fill it with reminders
for living, reminders that will elevate your mood. One of the really neat features of the app
is coping cards, and this is something that you can do with the provider. We use it in group treatment here, and it
helps you actually walk through some of those cognitive behavioral tools. [Armstrong] And not only does it integrate
the coping cards, but it has the relaxation techniques embedded in there too. And so diaphragmatic breathing, progressive
muscle relaxation, mindfulness meditation…it’s really just a fantastic collection of techniques
that are based on cognitive behavioral therapy. Let’s talk about the other ones. A couple of the VA ones are ACT Coach, based
on acceptance and commitment therapy. We also have CPT Coach for cognitive processing
therapy, and a brand new one, which I am just thrilled about, is called STAIR Coach, S-T-A-I-R
Coach, and that’s for skills training and affective regulation, which is an evidence-based
psychotherapy for emotion regulation and relationship issues. Another coach one is Mood Coach, and so this
has all the features all wrapped up together, and helps the provider and the patient work
together through coping with mood. [Kinn] [Armstrong]
[Kinn] It’s a good general coping app, and what I
like about all the VA coach apps is that it can, again, help the patient dip their toe
in and see, “Hmm, this one really appeals to me,” or “These exercises make sense.” Because we know they’re not one-size-fits-all,
and, just like finding the right provider is important, finding the right treatment
is important, and so this is a nice little way to figure out, “OK. What’s going to be the messaging that makes
sense?” For example, for some people, cognitive processing
therapy, and just the metaphors, just really hit the spot, and for other people, not so
much. Right. Can I break in, and talk about LifeArmor and
AfterDeployment? [Armstrong] Yes. Yes. [Kinn] These are more informational. AfterDeployment is a website. It just has a wealth of information about
a whole lot of health topics common to the military community, and LifeArmor provides
some of that same information in a mobile app form. The section on depression is fantastic. It’s one of those really easy-to-read websites
that is just chock full of information written by experts, but in language that’s easy
to understand, and it’s updated yearly. And LifeArmor reflects the same information. [Armstrong] Right. [Kinn] Tell us about Positive Activity Jackpot,
because you worked on that app. [Armstrong] Sure…so, what Positive Activity
Jackpot does is allow people to find activities, positive activities in their area that they
can engage in. And then they go through the process of scheduling
that with somebody. So, let’s say I’m depressed, and I haven’t
gotten out of bed in two weeks. But through this app, what I can do is say,
“Hey, you know what? This week, I’m going to make a point to go
have coffee with Joe on Wednesday.” And I can schedule that through the app, I
can find where I can have that activity, I can reach out to Joe, and schedule that, and
then it helps reinforce those positive behaviors. [Kinn] Yes, we know the research on behavioral
activation shows that even just thinking about planning events like these increases mood. [Armstrong] When you’re depressed, you don’t
want to do anything, and it’s almost impossible, it feels impossible to generate ideas for
positive things to do. [Kinn] Yeah, it’s a fun one. Also T2 Mood Tracker, we’ve got to mention
that one. [Armstrong] Oh, yes, so, T2 Mood Tracker is
just a wonderful way to track any symptoms — it’s called Mood Tracker. So, of course, tracking depression symptoms,
but you can also track anxiety symptoms, pain symptoms, triggers for drinking, anything
at all. It’s really just a tracking shell customizable
for anything people want to track. [Kinn] So, I want to put in a caveat real
quick that we don’t recommend just treatment alone using these apps, I know we said that
before. These apps are meant to be used as part of
treatment with a provider, but of course, medication plus treatment plus exercise plus
mindfulness activities, that’s the real solution here. [Armstrong] If somebody is in immediate danger,
please call 911. We also want to provide the number for the
National Suicide Prevention Lifeline, which is available 24 hours a day, 7 days a week,
and that’s 1-800-273-TALK, or 1-800-273-8255. So, if you or someone you love is thinking
about harming themselves, please, please reach out to the National Suicide Prevention Lifeline. [Kinn] It’s a great helpline, and of course,
you can always press “1” for someone who’s specifically trained in military and veteran
issues. [Armstrong] Thank you for sharing “Next
Generation Behavioral Health” on social media. We’ve seen the increase in the numbers of
our listeners. We’re so happy to see that the message is
getting out, and that you guys are enjoying this podcast. [Kinn] You’re helping us change the face of
health care to include technology. [music] Thanks for subscribing on iTunes or
wherever you get podcasts. [Armstrong] You could connect with us on Facebook
and Twitter @MilitaryHealth. [Kinn] “Next Generation Behavioral Health”
is produced by the Defense Health Agency. [music]

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