#114 5 Ways Your Smartphone Can Tell If You’re Depressed

July 27th, 2015 by

5 Ways Your Smartphone Can Tell If You’re Depressed

One in 14 Americans will suffer from depression this year.  Your friends are worried you might be the one.  Can your smartphone diagnose you with depression?

In this article, I share 5 scientifically proven ways your smartphone can tell if you’re depressed.  I also share specific things you can do now to minimize your risk of every suffering from this devastating condition.

Depression Causes Heart AttacksHeart Attack

While most people are aware of the link between depression and suicide, few people are aware that depression causes heart attacks.  For example, in a recently published study of 34,726 American adults from Columbia University Medical School in New York City, the combination of stress plus depression increased the risk of premature death or a heart attack by 48%.

How Can Your Smartphone Tell If You Are Depressed?

You may be wondering how exactly your smartphone can tell if you are depressed.  Rather than creating yet another app that asks you questions to see if you are depressed based on your answers, researchers at Northwestern School of Medicine in Chicago sought to answer this question with more objective data generated by smartphone sensors and GPS data.

In this study, researchers enrolled 40 adults.  With an app to collect smartphone data, Northwestern University researchers were able to diagnose depression with 87% accuracy.

This objective smartphone diagnosis of depression, based on sensors and GPS tracking data, was then compared to the traditional way of diagnosing depression.  Based on the results of this study, here are the 5 ways your smartphone can tell if you’re depressed.

5 Ways Your Smartphone Can Tell If You’re Depressed

1. Your Circadian Rhythm Is Off

Your circadian rhythm is your body’s internal 24 hour clock which is set based on the sun.  Even plants and animals have this same 24 hour internal clock.

In people without a stable circadian rhythm, the risk of cancer and heart attacks are both significantly increased.  Our bodies need to be in rhythm with the sun for optimal health.

In depression, people tend to live lives out of sync with the natural circadian rhythm.  In other words, as people are entering into a bout of depression they may go to sleep much earlier or later than previously or they may have days when they go into work late.

In my case, my iPhone knows I like to go to bed at 10 pm and arise at 5 am.  I leave for the hospital somewhere between 6:30 and 7:30 am and that we keep our bedroom very dark at night and I try to keep my daytime light exposure as high as possible.  My iPhone could also tell you that I get on my treadmill desk or bike desk first thing in the morning and, whenever possible, I try to carve out time to exercise hard outside later in the day.

Through motion detectors, your smartphone can tell if your circadian rhythm is off.  To keep yourself as mentally healthy as possible, try to go to bed and arise each morning at the same time, keep it dark at night and light during the day, and have a set time to eat, work, and exercise.

2. You Stop Going to Your Favorite Places

Through GPS technology, your smartphone can quickly learn where your favorite places are.  For me, my smartphone could learn very quickly that I tend to be happiest when I regularly visit the ski resorts near my home to either ski in the winter or mountain bike in the summer.

People suffering from depression tend to lose interest in their favorite activities.  They tend to stop going to their favorite places.

Where are your favorite places?  Do you have a favorite movie theater, restaurant, or workout location?  Make sure you never withdraw from your favorite places or activities.

3. You Suddenly Start Spending More Time at Home

Your smartphone can also tell if you suddenly start spending more time at home.  People suffering from depression tend to stop going out and isolate themselves at home.

Sure, there could be a change in your life like an injury or a new baby.  However, significant events like these, can also be a risk factor for depression.

In my situation, my smartphone knows that if I am at home I am rarely sitting.  I am either on my treadmill desk or engaged in some sort of activity with my family.

Once again, to stay mentally healthy, don’t suddenly start spending all of your time locked within the walls of your home.  Make sure you are connecting with other people and with nature whenever possible.

4. You Spend More Time on Your Phone

Studies have shown that depressed people tend to spend more time on social media or their smartphones.  Not surprisingly, your smartphone can track how much time you are on it each day.

For example, in this study, depressed people spent an average of 68 minutes playing on their phones while non-depressed people spent a mere 17 minutes on their phones.  Could it be that the smartphone is a distraction from the world for depressed people?

To be honest, I am guilty of spending too much time on my smartphone.  I’m not sure if I am at the 68 minute mark or not but I am certainly spending more than 17 minutes on my iPhone each day.  I have made it a personal goal to only check social media and emails once or twice, at most, each day.

Many of my patients have shared with me that the simple act of unplugging from technology on Sundays helps them to avoid feeling depressed and keep their hearts beating right.  If you are spending too much time on your smartphone you are missing out on your life.

5. You Frequently Reach for Your Phone

As with number 4 above, depressed people in this study were much more likely to reach for their smartphones.  Perhaps these people were worried they might miss the latest Facebook post, that critical text message, or an important work email.

I am guilty of this as well.  Once again, for your health, don’t reach for your phone unless it is absolutely critical.

Can I Get the App?

I would love to have an app, like the one used in this study, running on my iPhone in the background. Then, if my behaviors suddenly start to change, it could ask me if I was OK and whether or not I needed help.

Even though all of the data used in this study is already available from your smartphone, an app like this to gather and analyze these data does not currently exist in the iTunes store.  The only apps currently available rely on self-reported data from quizes or questionnaires to assist in determining if you are depressed or not based on your answers.

An app that actually tracks your behaviors could be very helpful as it provides objective observational data that could prompt you to make an appointment with your healthcare provider to prevent a major bout of depression.  Perhaps if you know a software developer you could encourage them to create such an app.

Final Thoughts

Depression is a serious condition.  Depression can ruin your health, your family, and your life.  If you suffer from any of the symptoms discussed in this article, let your physician know so that you can receive the help you need.

Remember, this was a small study.  The findings of this study cannot be used to diagnose true depression until they are validated in a large group of patients.  Regardless, I found the findings of this study very fascinating and it may open the door to new apps to identify people who need help.

Next Steps

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#094 9 Ways to Stop Being a Night Owl

April 17th, 2015 by

9 Ways to Stop Being a Night Owl

Jeff struggled with weight issues his entire life.  He was a computer programmer and told me, “I do my best work between 8 pm and midnight.”  Does this also sound like you?

The trouble was that he was always hungry late at night, had troubles getting up in the morning, and was now was seeing me for heart problems.  Could his night owl ways be contributing to his heart condition?

One third of all adults are night owls.  Are you one of them?

In this article we will explore what makes people night owls, the health risks of night owls, and 9 ways to stop being a night owl.

Is There a Genetic Basis to Night Owls?bigstock-DNA-molecule-43755316

Some night owls have told me that they are genetically “hard-wired” to stay up late at night.  Could this be true?

Interestingly, researchers have now identified the “Night Owl Gene” or the “CLOCK gene” as it is known in the medical literature.  In the medical studies, night owls are often referred to as the “evening chronotype.”

People with the CLOCK gene have a genetic predisposition to an altered circadian rhythm.  The circadian rhythm is your built in 24 hour clock.  This genetic tendency toward an altered circadian rhythm keeps them up at night unless they are careful to control their environment.

Mice with the CLOCK Gene

Mice possessing the CLOCK gene have been studied extensively.  In these mice, not only is their circadian rhythm out of sync with the sun causing sleep disorders, but they also frequently suffer from mood changes, difficulties with pregnancy, and with obesity.

In humans, studies show that people with the CLOCK gene also frequently suffer from attention deficit disorder (ADD or ADHD).  From these studies, the genes controlling for circadian rhythm are also tightly linked to mood, weight gain, and concentration.

Environment vs. Genes for the Night Owl Syndrome

Even if you have the CLOCK gene, are you destined to be a night owl for the rest of your life?

Many researchers have said that the equation for obesity is really quite simple.  Obesity equals the wrong genes plus a modern lifestyle.  The same could be true of night owls.  The night owl syndrome also equals the wrong genes plus our modern lifestyle.  Let me explain.

In a classic study, researchers at the University of Colorado, Boulder studied this question.  Their study group of people consisted of both “night owls” and “morning larks.”Camping Tents Near Lake

For the first week of the study, they extensively studied these people in their natural “modern lifestyle” sleeping state.  For the second week of the study, they took these people high up in the Rocky Mountains.

There, they camped in a location far away from any light pollution.  Also, as part of the study, all electronic devices or artificial light, including flashlights, were completely banned.  Study participants did have access to campfire light at night.

Interestingly, at the end of the week there were no night owls.  Everyone’s circadian rhythm, or their own internal 24 hour clock, was in sync with sun.  In addition, researchers also found the following:

1. People fell asleep and awoke 2 hours earlier in a natural environment.

2. People were exposed to 4-times more light during the day in a natural environment.

3. Natural melatonin production began at sunset.

4. Natural melatonin production turned off with sunrise.

5. No one suffered from insomnia.

Are There Night Owls in China’s Longevity Village?

An interesting question is whether or not there are any night owls in more natural or ancestral environments.  The answer is generally, “no.”  Based on our study of China’s Longevity Village, until recently there were no night owls.

Electric lighting is a recent phenomenon to this Village.  Prior to electric lights, night owls didn’t exist when all you had were fires or candles.  Modern studies have shown that the wavelength of light from fires and candles is such that it does not activate the brain the same way blue light does from electric lights and electronic devices.

Lessons Learned

What lessons can we learn from the Rocky Mountain Sleep Study and from China’s Longevity Village?  The take home message is that if people are exposed to natural light during the day and have no access to artificial light at night then their circadian rhythm will naturally be in sync with the sun.

The converse is also true.  Locking ourselves up in dark homes or offices during the day and then living by electric light and electronic devices at night will bring out the night owl tendencies in anyone.  This gets back to the equation of a night owl.  A night owl equals genetic tendencies plus a modern lifestyle.  If you take away one component of this equation then the night owls go away.

Health Risks of Night OwlsProtect Heart Healthcare

Does it really matter if you are a night owl or not?  Can this just be a “benign” lifestyle choice?  Are there any dangers of having an altered circadian rhythm?

The most extreme example of night owls are shift workers.  People who work graveyard shifts are the most extreme examples of night owls.  Their nights and days are completely reversed.  What are the health risks of shift workers?

In one of the largest studies ever done, researchers found a 23% increased risk of heart attacks in shift workers in this study of 2,011,935 people.  Not only do shift workers suffer more heart attacks, they also are much more likely to get cancer.

It is not just shift workers who are at risk.  Studies of people who travel and suffer from frequent jet lag have the same risks as shift workers.  For those who just prefer going to bed later, here are the health risks according to published medical studies.  I have hyperlinked each health risk with the medical study supporting this finding.

1. Obesity

2. Cancer

3. Depression

4. Muscle loss or weakness

5. Sleep apnea

6. High stress hormones

7. Cholesterol problems

8. Type 2 diabetes

9. High blood pressure

10. Heart disease

9 Ways to Stop Being a Night Owl

As you can see, the medical studies of night owls don’t look good.  If you suffer from the night owl syndrome, let me give you 9 ways to stop being a night owl and start enjoying better health now.  The old adage, “don’t fight the sun” really is true.

1. Get Morning Sunbigstock-Woman-And-Dog-Running-On-Beach-59456648

If there is one time of the day that is most important to get bright light, it is the first thing in the morning.  This bright and natural morning light will reset your own internal circadian rhythm and get you back in sync with the sun.

The morning sun is also critical to maintaining a healthy weight.  Indeed, studies show that morning light accounts for 34% of our body mass index or BMI.  Thus, if you have been struggling with weight issues your entire life, perhaps the solution is as simple as going outside first thing in the morning for 30 minutes to get some natural morning light from the sun.

Even if you are not a shift worker or suffer from jet lag, just prolonged exposure to artificial light at night may increase the risk of breast cancer.

2. Eliminate Blue Light After DinnerIMG_9021

With work deadlines, kid homework, etc. it can be impossible in our modern lives to eliminate all artificial light at night.  This artificial light, or blue light, throws our circadian rhythm off.

Studies show that even brief exposure to blue light at night can delay sleep by 30 minutes.  Additional research shows that artificial light exposure at night not only delays natural melatonin release but that it also shortens it throughout the night making it more likely that you will wake up through the night.

So how can we survive in this modern world without artificial light at night?  The answer may be as simple as wearing orange glasses after dinner to filter out the blue light.

Yes, this photo shows me sporting my new orange glasses.  Studies support that blue light shielding glasses have been shown to improve sleep. This is what we have started doing at our home.  It does seem to help.

3. Eliminate Electronic Devices After DinnerNo computer, no mobile or cell phone - forbidden, red warning si

While blue light filtering glasses may help, electronic devices are one of the biggest causes of the night owl syndrome.  Indeed, electronic devices may account for 50% of all sleep disorders according to the 2014 National Sleep Foundation Poll.

To stop the evening stress and cortisol stimulation, as well as the blue light stimulation, turn off all electronic devices after dinner.  This includes TVs, computers, phones, iPads, etc.

If you absolutely must use an electronic device at night, then either use blue light filtering glasses or download blue light shielding apps for your computer, iPad, or smart phones.  Here is a blog article to learn more about blue light filtering apps.  I am not aware of any filtering devices yet for TVs.

4. Dim the Lights After Dinner

If walking around your house with orange glasses or goggles on at night to filter out blue light doesn’t sound like something you want to do, a simpler approach is to just dim the lights in your house at night.  Dimming the lights at night can somewhat approximate “sunset” to your body and start to get the natural melatonin production from the pineal gland started.

5. Physical Activity During the Day

Countless studies have shown that maintaining physical activity during the day helps with sleep at night.  Even better would be to exercise outside each day.  This natural light exposure helps with keeping our circadian rhythms in sync with the sun.

6. Natural Light or Bright Office Lights During the Day

To keep our body’s circadian rhythm in sync with the sun, getting as much bright light during the day is critical.  Don’t despair, even if you work in a dark office there are still things you can do.

For example, try taking a walk outside on your lunch break.  Exposure to the midday sun will help to keep your body in rhythm.  Other options include purchasing a blue light device for your office during the day.

7. Maintain a Strict Bedtime Schedule

Because of their genetic tendency, night owls have to be very strict in maintaining a consistent bedtime schedule.  It is so easy to get involved in a task and then discover it is suddenly 1 am!

For most of my patients, they would be much better off to set a bedtime alarm clock instead of a morning alarm clock.  Indeed, for many of these patients, the real reason why they are seeing me in my cardiology practice is because they are chronically sleep deprived.

8. Maintain Adequate Vitamin D Levels

Studies report that night owls tend to have lower levels of vitamin D.  As you know, low vitamin D has been linked with just about every medical condition imaginable.  The cause is probably because they are fighting the sun and are not getting outside enough.

Regardless of the cause, talk to your physician about getting your vitamin D levels tested.  If they are low, get them back into the normal range through natural sunlight in a sun-smart way or through high vitamin D containing foods, like salmon, or through supplements under the direction of your physician.

9. Consider Melatonin Supplements

The data for melatonin supplements as a sleep aid are strongest for people suffering from jet lag.  In these studies, melatonin supplements seem to help them regain their natural circadian rhythm.  While melatonin has not been formally tested in people suffering from the night owl syndrome, anecdotally it seems to help some of my patients.  If you are considering melatonin supplements, please discuss this with your physician first.

Do you suffer from the night owl syndrome?  What have you found that helps you to get your circadian rhythm back in sync with the sun?