Depression: A Coming Out Story

A wonderful and courageously honest blog post from Shira Renee Thomas on the experience and stigma of clinical Depression. The personal (and economic) burden of psychological disorders is profound, and greater than that of any other type of disease – including diabetes, cancer, and cardiovascular illnesses! Over 350 million people worldwide suffer from Depression. Yet, we’re only now waking up to the importance of thinking of Depression and other psychological diseases as a public health crisis that requires much, much more awareness and many more resources to reduce stigma and help alleviate individual suffering.

sally brampton quote

Why Digital Mental Health is Like the Wild West

Why Digital Mental Health is Like the Wild West

When I talk to people about the digital health space – specifically digital mental health – I often say, “It’s the Wild West!” and everyone nods. But then I stopped to think about what I really mean by the Wild West. I realize that the metaphor holds up very well.

wild west

There is a gold rush. The California Gold Rush began on January 24, 1848. News of the gold brought some 300,000 people to California from around the world. They were called forty-niners in reference to the year the fever really hit, 1949. Tens of billions of today’s dollars in gold was recovered. The gold rush transformed the economy of California and economies all over the world.

The financial opportunity – and temptation – represented by the digital mental health revolution is similarly profound. Americans alone spend over $148 billion annually on mental and emotional health. Moreover, more than half of people suffering from emotional and mental distress will never seek treatment – meaning there is a huge, unmet need. Of these who don’t seek treatment, over 45% cite price as a barrier, and over 40% cite stigma as a barrier. Digital health tools, like mental health apps, address these barriers by being highly accessible and highly affordable. They also have the potential to neutralize stigma because, as I’ve argued before, mobile devices are the hub of our lives and thus what we do on them automatically gains an aura of “good.”  Digital health therefore represents a perfect marriage between social good and economic potential, and there are plenty of forty-niners who see this opportunity and want to cash in.

There are snake oil salesmen. Indeed, many companies are jumping on the wagon and digging for digital health gold (to keep the Wild West metaphor going). Some of these companies offer great, beneficial products, but others are “snake oil salesman.” Snake oil is an old-fashioned term that tends to refer to fraudulent health products or unproven medicine, but in general refers to any product of questionable quality. A snake oil salesman is someone who knowingly sells these fraudulent products. You see these guys as comic relief in Western movies all the time, usually a traveling “doctor” selling fake medicines, who leaves town before customers realize they have been cheated.

One way for us to get around the risk of snake oil is to elevate the dialog around digital health and develop ways of evaluating the scientific quality of what’s out there, since none of this is regulated (yet). This will help us look past the shiny bottles of alluring medicines that are actually snake oil, and find the real healing agents. Psyberguide is one organization I came across that appears to be trying to do just that.  If we don’t push ourselves as an industry to meet standards, we risk becoming comic relief rather than a true paradigm shift. We also risk repeating the failures of the analog healthcare system, just making them digital.

There are pioneers.  I believe that a science-backed digital health revolution will be the single most important paradigm shift in the failing mental health industry. This revolution will allow people to promote their personal wellness like they do their physical wellness and fitness. It will allow people to access treatments that are effective without being too expensive, burdensome, or stigmatizing. We need to think outside of the box for a true paradigm shift to occur in how people access support for their emotional and mental health – whether that’s the transformation of how patients access their health information through electronic medical records, how health information is collated to lead to better diagnosis and treatment, how health information is gathered through tests done on mobile devices, or how interventions are accessed, through mobile health apps and digital brain training. Pioneers in digital health are rethinking how to empower the individual to promote their own mental and emotional wellness, to use personal health information to actually improve our lives, not just be monetized by big companies mining our big data.

I firmly believe that destigmatizing mental illness and emotional distress will be the linchpin in this paradigm shift. Mental health – when we say those words, we think illness, not health. We think of people being crazy, despondent.  Why is that? It is because Psychology and Psychiatry have failed to make mental health a positive goal like physical health and fitness. When we struggle emotionally, we feel broken. Treatments are burdensome, hard to access, and stigmatizing. We need to be on the vanguard of a paradigm shift away from stigmatizing, expensive treatments emerging from the “if we build it they will come” mentality, and towards a new vision in which people are empowered to personalize their mental wellness through tools that work for them, when and where they want them.

If pioneers brave the Wild West that is the digital health field of 2015, we have a chance of creating something that transcends our humble beginnings to actually make a difference.

What It’s Like to be Blind in the Age of the Internet

A fascinating thought piece on being blind in the digital age.  Technology can be both beautiful and terrible.

The Ultimate Empathy Machine

Chris Milk TED TalkI just watched Chris Milk’s recent TED talk about virtual reality. He calls virtual reality the ultimate empathy machine. I see the vast potential of virtual reality – its use in therapy for psychological conditions like PTSD, gaming, education, and as a tool to help people create beautiful experiences. But I have to admit, my gut also has told me that virtual reality has more costs than benefits, more risks than payoffs. Perhaps I’ve read one too many future dystopia sci fi novels, but I have often thought that the temptation to reside in an artificial, constructed world of our own choice and design is too tempting for most of us; that eventually, when virtual reality is sophisticated enough, it will keep us from engaging in the “real” world in the ways we need to in order to have have substantial and lasting happiness. Think the creepy, organic virtual reality game consoles called “game pods” from the 1999 David Cronenberg film eXistenZ, and that’s where my mind goes.

treachery of sanctuaryBut Chris Milk might have just convinced me to question my gut, to think more of the artistic and humanitarian potential of virtual reality. Watch the talk to hear more about the amazing work he’s doing with the UN to vividly portray the plight of refugees to policy makers and the public through virtual reality. He also showed a film of the interactive art installation he created called The Treachery of Sanctuary. A boy stands in front of the piece, becoming a bird on the screen that he is viewing ….until all of sudden he takes flight to join the flock. I have to ask myself, why did that bring me to tears? Chris Milk believes that virtual reality is a machine that makes us more human. Perhaps the benefits could outweigh the risks.

Just Do It: A Conversation with a Shaolin Monk

What is going on in this picture? I’m the one on the right.

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Well, I was having a special moment with Shifu Shi Yan-Ming, a master of the Shaolin Kung Fu tradition. Our conversation was part of the Rubin Brainwave festival. I was fascinated to hear about his life, from the age of 5, as a Shaolin monk, training in the most rigorous Kung Fu discipline. The title of our conversation was “Discipline as Art” and as was obvious from his demonstration on stage, his physical prowess is impressive and beautiful. You can sense the focused energy he devotes to his art, the discipline of Kung Fu.

In many ways, my conversation with Shifu (an honorific indicating a master in martial arts) was an action meditation, an illustration of how he thinks about his place and relationship with the world.

Me, asking about his feats of Kung Fu training: “Why did you learn to break a brick with your head?”

Shifu, with a laugh: “Someone asked me to!”

Me: “How do you talk to your students about overcoming obstacles in their life, about dealing with emotional challenges?”

Shifu: “I tell them to just do it!”

Like Kung Fu, his philosophy is action-oriented and full of focused energy. When facing obstacles in your life – just do it. Nobody changes you, you change yourself.

Improv for Scientists

Science has serious PR problems, and at their root are scientists themselves! We scientists often don’t know how to communicate with non-scientists without a whole lot of jargon and obscure words. Brevity is also difficult for many of us, so the art of effective sound bites and elevator pitches remains a mystery. Yet, those of us who go into academia are, despite first impressions, passionate people. We are in love with ideas, with teasing apart mysteries. So, we have the potential to be incredibly powerful advocates for science, translating the knowledge we generate in our labs into real world applications. If only we could stop putting our audiences to sleep…

Then, along comes Alan Alda, who for decades has been a curious, charming, and enthusiastic advocate for the popularization of science. He excels at translating how fascinating science can be to a wide audience. I just discovered that he founded The Alan Alda Center for Communicating Science back in 2009. The Center teaches scientists media communication skills and how to boil down your research findings into understandable take-home messages and engaging stories. And he teaches them improv! Perhaps this is some of the most important work the Center does, because improv allows scientists to practice being present and telling a human story. Here is a clip of what improv for scientists looks like.

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Thank you, Mr. Alda. If you can cultivate and empower even a few scientists to communicate more effectively and compellingly, the positive impact of our research could reach a whole new level.

The Future of Medicine is in Your Smartphone

Picture by Helen Weinstein

A great essay from the Wall Street Journal on the promise and challenges of the smartphone revolution in healthcare – from mobile physical exams, to merging day-to-day health data from wearables with medical records. A key – and underdeveloped – innovation here will be to integrate health tracking with mobile therapies. This transformation of healthcare – both physical and mental – is going to happen, and it is up to us, as patients and professionals, to make sure that it is done right, with the privacy and well-being of the individual as top priorities.

I’ve been interested in some emerging companies, like Mana Health, that are on the cutting edge of this revolution because they are solving the problem of how to effectively merge clinical data with health data collected in the daily lives of patients, and directly empowering patients to have a clear voice in their healthcare and greater collaboration with doctors.

Making the Most of Your Emotions

I had a great time talking with David Shriner-Cahn of Tend Strategic Partners about making the most of a stressful day and putting your emotions to work for you!

View From Nowhere

A smart commentary on the limits, promise, myths, and challenges of big data.


Could Video Games Help Improve Our Mental Health?

A nice discussion of the promise – and challenges – of using video game to promote health.


Could Video Games Help Improve our Mental Health?


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