Behavioral health interventions are notoriously difficult. They require a grasp of psychology, sure, but they also require a certain amount of flexibility because people’s lives are complicated. Apple’s ham-handed approach to physical health has been bad enough — the idea it is now going to approach mental health does not fill me with confidence. I’m sure there are plenty of people out there who won’t mind letting Apple toy with their emotions. But we’ve got a lot of evidence now that too much screen time is linked to bad health — and for Apple, its entire business is getting you to spend more time with its software and gadgets, not less.
This is a great article, and highlights the problems that stem from tech bros trying to be doctors, or in this case, even psychologists and therapists. Health interventions require a personalised approach, and blanket one-size-fits-all attempts are generally suboptimal. A person with weight issues who happens to perform a physically intensive job will require a different approach than someone with similar weight issues who has a desk job. A generic “move!” on your Apple Watch a few times a day won’t really help either of those people.
This gets even more problematic with mental health issues. A great example of just how counterintuitive health information can be comes from myself – I have a severe anxiety disorder and related mental ailments, and I’ve been trying to learn to live with it since I was a child (there’s probably a genetic element, since similar disorders run in my family). Through a combination of extensive behavioural, cognitive, and physical therapy, a lot of scientific studying with my doctor and other specialists into what, exactly, is wrong inside my brain and body to gain a crystal clear insight into how anxiety fluctuates in my body during the day and what internal and external stimuli affect it, and to cap it off a very small dose of daily anxiety medication (it took me almost two decades to come around to taking medication), I now have my mental health issues well under control.
That being said, I will always have these problems. I manage them every day, and they’re never gone, like someone with chronic back problems, even if I seem completely “normal”. Passively and actively, throughout every day, I manage my anxiety, make sure I keep it in check, and recognise the earliest possible warning signs, all made just a little bit easier by my medication.
When I emigrated to Sweden four years ago to live together with my now wife, we went to IKEA, about a 90 minute drive away on the border with Finland. Since trips like that generally increase my anxiety considerably, I had a few rough days leading up to it, but during the car ride, I finally managed to overcome it and settle down. As we parked, everything was back to my normal levels – a change in venue from e.g. car to destination often works as a “reset button” of sorts – and we were ready to shop and eat meatballs.
And then my smartwatch pinged me in the IKEA lobby. Despite me feeling entirely normal with for me acceptable levels of anxiety, it started telling me I was experiencing the highest level of “stress”. Even though I did not feel any stress whatsoever, such a small thing can be enough to send me into a downward spiral of a panic attack – which I actually do not have very often, maybe once a year or so. Due to having just emigrated thousands of kilometers away to the Arctic, leaving family and friends behind, I was obviously already susceptible, and this stupid digital piece of crap on my wrist telling me I was “stressed” was all it took to trigger a massive panic attack.
I’m used to always having a heightened level of anxiety and associated vitals compared to others, but this watch didn’t know that. It just had some basic data programmed in about what is “normal” for someone of my stature, gender, and age, and didn’t take my personal situation into account at all – because it couldn’t. There are countless little indicators, both internal and external, that come into play in a situation like this, and a smartwatch has no way of learning or disseminating such information. It takes a dumb, standardised, generalised shotgun approach in determining if its wearer is “stressed”, actual, real-world stress levels in the moment be damned.
This is why I am incredibly weary of Apple”s rumoured plans to enter the realm of mental health with its Apple Watch. As the linked article details, it’s already not doing a great job at managing people’s physical health, and I am genuinely afraid of what effects such a crude approach will have on people’s mental health. Shotgun mental health notifications are going to make people obsessive, they’re going to give people anxiety, they’re going to give people panic attacks, they’re going to give people depressive episodes, they’re going to disturb people’s sleep, they’re going to worsen or even cause eating disorders, and much more.
Mental health is not something you should leave to Silicon Valley tech bros – you should leave it to your doctor, trained medical personnel, licensed psychologists and therapists, other specialists, and science, not to a glorified wrist calculator.
holy crap – i just wanted to say thanks for sharing your story, i’m sure it wasn’t easy, but you are absolutely right about this. i don’t experience these problems and i think that sharing your experience like this really sends home how much this is something that should be handled by mental health professionals and not a tech company. had no idea they were going to do this until now!
My wife has panic attacks too and they make her feel helpless because they just happen and we don’t know why. She says she feels like her heart’s failing. She went to the ER one time and after extensive tests they all came back negative. $7k hospital bill later after health insurance (seriously fuck the US healthcare system) going back is a really tough decision if we don’t know when it’s real. She still gets the panic attacks though and waits them out, what else can you do. A sleep study didn’t reveal anything and medications haven’t stopped the attacks. This week her co-worker’s spouse died of a heart attack and my wife is terrified that it’ll be her and she won’t know the difference.
Sorry if I’m rambling. I’m not really going anywhere with this, but I thought I’d share.
Check blood pressure and sugar.
smashIt,
Yeah, I’m pretty sure every doctor she’s been to has.
They should have, but I wouldn’t trust them.
The biggest issue is that the people who use these services actually mostly need therapy to stop thinking that they’re mentally ill because they’re just stupid and egoistic instead.
There use to be huge rows of people waiting on who will buy iPhone first. That too wasn’t something demonstrating strong health. I agree that big international monopolies that mostly sell gadgets or word processors should be kept away from health. And not what we are seeing now, that is under some false pretense of AI, to just give public health to this charlatans on a platter. That can’t end good. You don’t need artificial intelligence to figure that one out.
IF they wanted to help, they should make tools which allows doctors to help people, not whatever they are doing which as Thom made clear is very unlikely to work
Appreciate the bravery and honesty in telling a story such as this, and I don’t want to dismiss it at all; but this reaction is similar to the one people try and have with BMI for physiology. 90% of the time BMI is a decent attempt at letting someone know about their weight. It’s not great, but it does well enough. Is it perfect and does it have many exceptions? Yes, and every rugby player the world over will tell everyone else who isn’t built for playing rugby how it doesn’t apply to them.
I don’t think anyone is suggesting that an Apple user should ignore doctors and psychologists and other professionals, but people with access to those professionals are few and far between. These tools by “tech bros” (nice negative framing) may in turn be useful for everyone else and help draw attention to needing to consult a professional or seek some other help and advice.
This is a sensitive topic as it’s highly charged, so let me draw an analogy:
Everyone who needed complex device security in the past had “complex device security”. Apple (and the rest of the “tech bros”) came up with a fingerprint scanner that in no way could make up for “complex device security”, but did drag everyone else into helping secure their devices more than they were before. The world became a slightly more secure place such that within a decade it’s rare to see people on a phone WITHOUT a passcode/fingerprint-scanner/face-scanner.
If these initiatives have the same widespread effect on people’s awareness of their own mental health then I say “bring it on”.
Yeah. And with PIN number, compared to fingerprint scanner, we really had it bad. So lets give Apple, Microsoft, Google, TikTok … our health. They for sure will cure us all. Considering they didn’t even underwent study in this direction. As they make electronics and word processors.
Its the constant problem of tech trying to find extra markets within the health related industry as its a (unfortunate) gold mine.
I shudder to think what companies like Palantir will start doing with A.I. and patient data.
“But we’ve got a lot of evidence now that too much screen time is linked to bad health — and for Apple, its entire business is getting you to spend more time with its software and gadgets, not less.”
Apple has “Screen Time” which tells you how much you are using your device and OFTEN tells you to USE LESS. So how are they telling you to use more? That is just totally out of whack with everything that Apple stands for.
Apple isn’t the only company where their fitness app is a “One size fits all” so to brand them as make it appear that they are an outlier to every other company is absolutely BS.
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On a different note. I have diabetes. But I also have other medical issues that make living in my body be a very unpleasant experience also. I’m sorry that you are going through what you are going through. I really am. There are no buts about that. I wish everyone (that isn’t an a**hole selfish person that is harmful to others) were in perfect health. For the a**holes, I wish them the worst health possible.
You do NOT appear to be one of those people. I hope they find a solution to your issues.
Apple is not the cause nor the solution for you. For a lot of people that just need to get out of their chairs and move more, the application helps. For other people it doesn’t. To assume that Apple is going to be able to write an app that helps everyone is naive. Use what works for you and ignore what doesn’t. You have a choice as to what device to use or what apps to pay attention to and what apps to ignore. Just like you have the choice to change the channel on your TV or watch different videos on your computer or read different articles or listen to different podcasts. Apple never claimed their health app is for everyone. They are doing what they can but they aren’t a medical company though that is becoming part of their DNA.
What Apple stands for? Got me laughing there. Strictly speaking Apple likely could be blamed for some induced mental issues. Just like the rest. But i agree that Apple can at best be considered as a charlatan. When it comes to helping people with mental issues.
This might help =with anxiety, it might be worth a go.
My wife, who is a complimentary health worker, is a strong proponent of some called EFT. It seems to really help with interrupting and resetting those mental and emotional loops that underlie problems like anxiety. There’s more information here;
https://www.healthline.com/health/eft-tapping?cmdf=what+is+eft#What-is-EFT-tapping?