Coping with stress has never been one of my strengths. As a child, I developed a nervous habit of picking the skin on my fingers, and two decades later, I haven’t been able to stop. After more than a year of pandemic life, punctuated by social unrest, natural disasters, a divisive presidential election and a riot at the U.S. Capitol, my fingers have never looked worse — and I’m not alone in dealing with troublesome nervous habits.
Levels of stress and anxiety in the United States, among other mental health challenges, have increased during the past year, prompting many people, myself included, to seek ways to cope. So when I learned that there were wearable devices intended to help improve your response to stress, I was intrigued. How did this technology work? Was it really as easy as the advertisements made it seem?
To answer these questions, I spoke with experts who specialize in mental health technology and stress, and I took a look at several devices: one that can be worn on your wrist or ankle, a headband and a pebble-like gadget. Although the technologies are different in their approaches, they all make variations of the same promise: With regular use, they can help wearers feel more calm and better control their response to stress.
“There’s a lot of potential in using technology,” said John Torous, chair of the American Psychiatric Association’s Committee on Mental Health Information Technology. “You’re in real time using different sensors and multimodal data to understand someone’s anxiety or stress, and you’re able to respond immediately in a closed-loop intervention.”
The promise of delivering personalized, real-time care for stress and anxiety, Torous added, has “been a goal of the mental health field since forever.”
But although Torous and other experts say that the concept of wearable tech for stress relief is promising, and that many available devices use evidence-based strategies that are generally regarded as safe, questions remain about effectiveness.
“While these devices are based on sound science, there is still a need for data to support that the devices themselves do what they’re supposed to, because theoretical science and applied science in the context of these devices may or may not align,” said Ipsit Vahia, medical director of the Institute for Technology in Psychiatry at McLean Hospital in Massachusetts.
Rajita Sinha, founding director of the Yale Stress Center, agreed. When people build technologies, they often “look for simple things,” Sinha said. “Unfortunately, this is not going to be simple.”
Stress, after all, is complex. The common measures of stress — increased heart rate, perspiration and sleeplessness, among others — can be tracked using technology, but those symptoms don’t always mean you’re feeling stressed or anxious. And feeling stressed isn’t always a bad thing, experts said. Moreover, how people experience stress and find relief are “highly subjective,” Vahia said. “A one-size-fits-all approach toward stress relief is unlikely to work.”
Creating a device that can accurately collect data, interpret that information to correctly identify stress, then deliver the right therapy may be challenging.
None of the devices I checked out claim to be there yet. At this point, most wearables that can be used for stress fall into the following categories: simple activity and heart-rate trackers, devices that use collected data to provide instructions for how the wearer should respond, and technology that delivers a form of therapy when the user activates it. Many of these companies have emphasized that they are not marketing their technology as medical devices or miracle treatments.
“A lot of people, when they think about this kind of technology, they have expectations that this is just like a magic button that’s all of a sudden going to make them feel good, and that’s not really how it works,” said David Rabin, co-founder and chief innovation officer at Apollo Neuroscience, which launched its wearable device, the Apollo Neuro, in 2020. “Just like breathwork and meditation and yoga, the more you use it, the better it gets. It’s not like a one-time thing and then you’re fixed.”
The Apollo Neuro ($349) was one of the three wearables I tried, along with the Sensate 2 ($249) and the Muse 2 headband ($249.99). All three devices are Bluetooth-enabled and designed to be used with companion smartphone apps. The companies have not published peer-reviewed research from large-scale clinical trials yet, but they said research is ongoing and more studies are forthcoming.
I wore the Apollo — a small, slightly curved rectangular box — on my ankle and found it comfortable enough to have on during the day and while I slept. Apollo’s website states that it is designed to deliver “novel touch therapy, felt as gentle waves of vibration,” which are intended to improve heart-rate variability.
The Sensate 2 resembles a smooth river rock, minus the weight. It’s placed on your chest during use and combines vibrations, or “sonic frequencies,” synchronized with specially composed soundtracks to enhance relaxation, according to the company’s website. Stefan Chmelik, the creator of Sensate and co-founder of the U.K.-based company BioSelf Technology, contends that adding a physical sensation to the experience of “neuro-enhancing” sounds could “at the very least double and probably considerably increase” the calming effects a person may feel.
Connecting the devices to their apps was straightforward, and it didn’t take long for me to get used to the vibrations. Sensate sessions could feel intense at times, but I often noticed a pleasant tingly feeling afterward. On the other hand, Apollo’s vibrations were sometimes so subtle that I would check to see whether the device was still on.
For me, the appeal of Apollo was that I could conveniently use it during a busy workday. That wasn’t the case with Sensate. To use Sensate as recommended, I had to recline or lie down, have my headphones on and be in a darkened room with minimal distractions.
I also had to carve out time to try the Muse 2 meditation headband, which has built-in sensors to monitor brain waves. It uses “advanced signal processing” designed to translate brain waves into sounds of weather. During meditation, the more mindful and focused you are, the more you’ll hear calm weather, which can help improve your meditation practice, said Ariel Garten, co-founder of InteraXon, the Toronto-based company behind Muse. “We don’t zap your brain to make you better,” Garten said. “This is teaching you a skill that you will apply in your life.”
Muse’s sleek, flexible, lightweight headband was a major draw, but I struggled with positioning and adjusting it properly on my first use. The meditation practice and subsequent sessions went much more smoothly. Wearing the headband didn’t hurt my head or ears, and the app’s free offerings were enough to keep me, a novice meditator, occupied.(Premium content, which includes hundreds of guided meditations, requires a paid subscription of $12.99 a month or $94.99 annually — on sale for $47.50 annually.) Reviewing the graphs of my brain waves in the app was motivating, because I could see that I appeared to be making some progress.
Overall, I felt some mild benefits from the three devices, and it was fun to experiment with them, but I didn’t experience the immediate and dramatic improvements in functioning that are described by dozens of user testimonials featured on the companies’ websites. (I’m still picking at my fingers.) And I didn’t feel a strong urge to continue using them.
My reaction isn’t unusual, the outside experts said, and it doesn’t mean the devices aren’t helpful for others. Wearable therapeutics may be more helpful to people who have chronic disorders, Sinha said. A device that could “reduce your baseline stress levels or anxiety could be quite useful, because it might actually bring that down so people can function.”
“Things that may not work for everyone can still offer benefits,” Torous added. In the field of mental health technology, “we have to keep an open mind and realize that if something helps someone, that’s important to acknowledge.”
Aside from spending money on a device that you might end up not using, there’s probably no harm in trying wearables if you’re interested in them. But, experts said, you should make educated choices.
Be clear about what your mental health goals are, Vahia said, and look for devices that meet your needs. Torous suggested prioritizing companies that are transparent about their research and data-privacy policies. The American Psychiatric Association has developed a framework of questions to help consumers assess mental health apps that can also be applied to wearables, Torous said.
It’s also critical to remember that most people don’t need wearables or technology to effectively manage stress, Vahia said. Before investing in a device, he and other experts urged people to try well-established, free approaches, such as spending time in nature, exercising, practicing mindfulness and cultivating social interactions.
“We are wired for social engagement and community and taking care of each other and learning from each other,” Sinha said. “Those things we’re not going to get from wearables.”