That pop-up message window may be an irritant to many of us, but new research shows it can be used as an aid to getting over depression.
Researchers have found that online talking treatment using instant messaging can help people recover from depression. Accessing treatment online could make psychological therapies more widely available, and help people who find it challenging to visit a therapist.
What do we know already?
Talking treatments have been shown to help people with depression, but a shortage of therapists and long waiting times mean that it's not always easy to get treatment. According to the Mental Health Foundation, it's common for British patients to wait more than a year to get talking treatment, and 78 percent of GPs have prescribed antidepressant drugs through lack of an alternative. In America, drugs for depression are the most commonly prescribed of all medications.
Cognitive behaviour therapy (CBT) is one of the most common psychological approaches to treating depression. It helps you examine how you see yourself and other people, and how your behaviour affects your feelings. It tends to focus on the here and now, looking at practical coping strategies, although it can also involve some discussion of the past.
Even when therapists are available, there can be problems with access to CBT. Some people referred to therapy never manage to attend a single session, and, worryingly, it's often the most severely ill who don't manage to access care. Finding the time and motivation to attend therapy can be difficult for someone with severe depression.
Researchers have explored several ways of using technology to bypass the barriers to treatment and reduce drop-out rates. There are self-help books and computer programmes based on CBT, and therapy has been offered over the phone or by email. Now, a new study has looked at whether CBT can work if it's offered entirely through instant messaging, using a password-protected computer system.
What does the new study say?
The study looked at 297 people, most of whom suffered from anxiety as well as depression. Half had up to 10 sessions of therapy, each lasting about an hour, where they used instant messaging to chat one-to-one with a trained therapist. The other half got the usual care from a GP.
During the study, about 4 in 10 people who had online therapy improved to the point where they were no longer depressed. Only 2 in 10 people recovered with the usual care from a GP. The benefits of therapy lasted at least eight months.
The researchers didn't compare online therapy with traditional therapy, but judging by other studies, both seem to offer similar benefits. The researchers think that for some people it might be easier to write about their problems than talk about them. Another advantage of online therapy is that the computer can save messages, so people can re-read the discussion with their therapist if they need to.
People seemed to get more benefit from chatting online with a therapist if they were more severely depressed to start with.
How reliable are the findings?
People carried on with other treatments for depression during the study, and people having online therapy were slightly more likely to be taking antidepressant drugs. However, the difference was small and is unlikely to have affected the results.
Where does the study come from?
The study included patients from Bristol, London, and Warwickshire. It was published in The Lancet, a medical journal owned by a company called Elsevier.
The study was paid for by the BUPA Foundation, an independent charity that receives funding from BUPA.
What does this mean for me?
Instant messaging therapy offers several advantages. There's no travel time, and if there are no therapists in your area, you can easily chat to someone from further afield. Online therapy could also help people with mobility problems, and remove language barriers by offering access to therapists who speak foreign languages.
Treatment would still depend on the availability of trained therapists, since the care offered still involved full, one-to-one sessions, even though the communication took place online.
An NHS programme aims to train 3,600 new therapists by 2011, although mental health charities are still campaigning for better access to talking therapies.
What should I do now?
If you want to try a talking treatment for depression, ask your doctor about availability in your area. There have been trials of online therapy programmes in the UK, but the service isn't widely available. You could ask your doctor about books, computer programmes, or web sites that are based on CBT principles.