Last spring, Paul Ford was sick of the self-sabotaging, disparaging voice in his head, so he decided to do something about it. He’d been living with anxiety all his life, but it was getting in the way of his professional career. So Ford, a longtime tech tinkerer, decided to turn his anxiety into a bot that he named AnxietyBox.
Ten times a day, at random he’d receive an email from his Anxiety with subject lines like: “Ask yourself, do you always want to be exhausting to know and undesirable?” The messages were nasty and uncannily channeled that negative voice in his head. “Dear Paul,” one email read. “I heard you when you talked about how you wanted to exercise. Where would you put your chances for success? Zero percent? Greater?”
Psychologists call these negative voices “cognitive distortions”–moments when your thinking goes awry and your anxiety gets the best of you.
Ford was just trying out a silly experiment, yet with a little distance between that negative voice and himself (about as much space as you give yourself from your email inbox), he could see just how disparaging and mean so many of his anxious thoughts were. Suddenly they didn’t have as much power over him. “My thing sends you emails that tell you you’re garbage,” he says. “You start to laugh at how bad your anxiety is.”
When Ford talked about AnxietyBox on the podcast Reply All in January, and the story was rebroadcast on This American Life, he struck a cord with listeners. Clinical psychologists have reached out to him, and more than 7,000 people have signed up for AnxietyBox, a volume that’s currently too big for Ford and his bot to accommodate.
There’s a zeitgeist of self-betterment through technology that our culture is embracing these days. And for good cause. If we were anxious before smartphones, we might be even more anxious with them. Studies have looked at the link between tech use and elevated levels of stress and anxiety. A 2015 research study demonstrated a measurable connection between negative psychological and physiological outcomes and iPhone separation.
But there’s also a growing interest in how technology can actually treat our anxiety. The list of relaxation, mindfulness, and meditation apps is long and growing. With 40 million Americans suffering from anxiety, and the mental health care industry raking in $200 billion in the U.S. alone, it’s no wonder the tech world is scrambling to find a way to digitize the therapy process.
Online therapy programs have been around for years, and they’re becoming increasingly sophisticated and refined in order to work more effectively for users. There are many programs out there claiming to offer relief from anxiety, but their effectiveness isn’t entirely clear. Research out of Sweden, Germany, and the Netherlands has shown that when used properly, online Cognitive Behavioral Therapy, which helps people detect negative thoughts or patterns and learn to redirect them, can be as effective as face-to-face treatment.
A recent New York Times Opinionator piece outlined some of the effective CBT treatments being used, like MoodGYM out of Australia and Beating the Blues, which teach cognitive behavioral therapy skills to help people cope with and prevent anxiety and depression.
More recently, developers have been trying to find ways to merge effective online treatment with user-friendly mobile interfaces. In January, for example, the app Pacifica launched, attempting to offer more than just relaxation tools, but actual ways to use CBT to help treat anxiety. “The mind has a tendency to play tricks on us,” says psychologist Ross Nelson, who serves as a health consultant and adviser to Pacifica. “When we are experiencing anxiety, it’s a series of mind tricks.” The features on Pacifica are offered as tools to “untwist the tricks” of the mind, says Nelson.
The app, designed by 28-year-old Chris Goettel, who says he’s “white-knuckled” his way through much of his life as an anxiety sufferer, includes a mood tracker, a feature that lets you record your voice and listen back for cognitive distortions, relaxation tools, and a community space where users can connect anonymously. Goettel, who’s tried every form of treatment he could over the years, from dietary changes to therapy to meditation, says CBT worked best in treating his anxiety, which is why he wanted to create an app that mirrored its effects using your smartphone.
Pacifica offers a free version with rotating features and a $4 monthly subscription that gives users access to all the app features. Since its launch, the app has signed up 230,000 registered users.
Other app developers are trying to take a less traditional approach, incorporating technology in more unusual ways. A new app called Mentally claims to transform your phone’s camera into a biomedical sensor that can look into your bloodstream when you cover the lens with your finger, offering a stress assessment and five-minute breathing regimen personalized to your own stress level. Whether this kind of thing has any science behind it isn’t entirely clear, but what’s certain is we’ll be seeing increasingly inventive and sophisticated ways in which tech entrepreneurs are attempting to break into the mental health industry.
With so many options available at the swipe of your phone screen, there’s ample room to experiment, see what works best for you, and at the very least, start to isolate that anxious voice. “A lot of people have great intentions in trying to improve upon their anxiety and aren’t really sure how to do it,” says Nelson. With a smartphone at your disposal, you’ve got more options than you imagined.