Like most nights recently, Cheryl woke up at 4 AM, heart pounding, mind racing, soaked in sweat. Her night’s sleep was probably over, though the alarm wouldn’t ring for another two hours. She tried to calm her heart rate, her breathing, her desperation and out-of-control thoughts and go back to sleep, but all she could hear was the sound of her own anxiety, buzzing like a bee hive inside her head.
“Cheryl” isn’t a real person; but she’s very real, in that she’s based on dozens of stories we’ve heard from women going through the very real experience of perimenopause and menopause.
Menopause and anxiety are common. Increases in anxiety, depression, and rage are some of the most common and debilitating concerns we hear about from women, and the treatments available for midlife women – usually HRT or antidepressants – come with their own concerns.
Team Gennev was fascinated to hear about controlling anxiety and other mental health problems in menopause with gaming: calming the anxious mind through online games and apps based on brain science and “cognitive training.” A treatment that doesn’t require a lot of time, doesn’t depend on taking medications, is safe, effective, private, and probably already in our pockets? Tell us everything!
To learn more, we spoke with Tracy Dennis-Tiwary, Ph.D., professor of Psychology and Neuroscience at The City University of New York, and Director of both the Stress, Anxiety, and Resilience Research Center and the Interdisciplinary Center for Health Technology and Wellness. Dr. Tracy is also the founder of Personal Zen, one of the companies leading the digital mental health revolution to put wellness back in people’s hands.
As Dr. Tracy says, there are treatments already out there for anxiety- and stress-related disorders. However, these treatments may only help 30 – 50 percent of sufferers over the long term. And they can be expensive, time-consuming, and stigmatizing. Even more, 89.3 million Americans live in federally-designated Mental Health Professional Shortage Areas, meaning they have to travel four or more hours to get help.
These concerns about existing barriers to treatment inspired Dr. Tracy to take the research she was doing on anxiety and create Personal Zen.
Dr. Tracy’s research focuses on anxiety, on trying to understand what’s actually happening – neurologically – when someone experiences anxiety. This knowledge, Dr. Tracy says, can directly inform intervention development. Simply put, once we know where anxiety comes from in the brain, science can target those specific areas, slowing or stopping the processes that cause it.
Personal Zen leverages the knowledge that most people, when anxious and stressed, engage in what’s known as threat bias.
According to Dr. Tracy, threat bias is a habit of paying attention only to what’s negative in our environment and being hyper-vigilant about every potential threat. It sucks up all our attention, and we miss opportunities to notice positives that could offer safety and comfort because we’re focused exclusively on real or perceived threats.
It’s a vicious cycle that can be hard to break: as your attention narrows to the negative, you perceive more threats, which makes you more anxious, causing even more focus on the bad to the exclusion of the good. Once you start loosening up patterns of attention, Dr. Tracy tells us, you can disrupt the cycle – and that’s the promise of these kinds of cognitive training techniques.
Threat bias, says Dr. Tracy, is common across many if not all anxiety disorders (like social anxiety, phobias, panic disorder, etc.) and across stress- and trauma-related disorders like PTSD. It may even be related to other emotional disorders such as depression, making treatments targeted at alleviating threat bias potentially very powerful.
We have to be aware of potential threats, of course; we wouldn’t survive long otherwise. But, Dr. Tracy says, “the problem with threat bias is the focus on threat becomes too rigid, too consistent, and too strong, and we need to increase flexibility.” By disengaging our attention from the negative, we’re able to regain awareness of and benefit from the positive.
Personal Zen directly targets threat bias, rewarding players for focusing on positive images. Two sprites, one smiling, one frowning, tunnel around in tall grass. Players trace the path of the happy sprite, earning purple and gold jewels as they get faster and more accurate at following.
It sounds simple – and it is – but the goal isn’t collecting lots of jewels; instead, you get better at following the more you’re able to ignore the negative sprite and focus on the positive. Within minutes, players report feeling less anxious and more ready to cope with the world.
Even better, that calm lingers. In a study Dr. Tracy conducted with pregnant women, just 10 minutes of Personal Zen a day, a few days a week for one month resulted in less of the stress hormone cortisol. It’s actually possible to build resilience against anxiety, and less cortisol could mean far fewer sleepless nights.
One question we had for Dr. Tracy was if threat bias becomes so habitual over time that it’s more deeply entrenched in those of us over 40. “Habits are supported by neural circuitry that becomes activated over time,” she told us, “so there’s a readiness to activate.” But, she reassured us, there’s still plenty of flexibility in mature brains and therefore plenty of reason for hope.
For women dealing with the additional emotional challenges of menopause, apps like Personal Zen can be a huge help. The hyper-focus on the negative that characterizes anxiety is also present in rage and depression, making Personal Zen a hat trick for women in midlife.
Personal Zen and other cognitive training apps and games can be used alone or as an adjunct to medication, therapy, etc. Dr. Tracy doesn’t advocate ditching your shrink (her term!) for an app, but, she says, there are “so many ways to get at anxiety. Personal Zen is great because it’s based on science, it’s engaging, and it’s brief. We’ve done four clinical studies that show a few minutes a day, a few days a week can really help.”
Because the app is on your phone, it’s incredibly portable. Waiting for the bus? Take 10 minutes to ease some stress out of your day. Nervous about giving a big presentation or making a speech? Fire up your Personal Zen to calm your nerves before you head in to the conference room. (Bonus: Research has proven that this kind of cognitive training reduces anxiety and can improve your performance at scary tasks like public speaking.)
Mix the app up with exercise (a surprisingly effective intervention for multiple mental health concerns), throw in some mindfulness meditation, Dr. Tracy says, and you have really powerful tools for recalibrating your mood.
Ready to find your Personal Zen? You can download Personal Zen for free at the Apple Store. And stay tuned for the release of the next version, coming soon, with even more environments to explore!
Find out more about Dr. Tracy and the science behind Personal Zen on the Personal Zen website and her blog, Psyche’s Circuitry.
Have you tried online games or apps to deal with anxiety, depression, or other challenges? We’d love to hear how it worked for you, so share with the community in the comments below, or fill us in on Gennev's Facebook page or Midlife & Menopause Solutions, Gennev’s closed Facebook group.