Episode 11: Adam Chekroud, PhD, Yale Psychologist and Chief Scientific Officer

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Dr. Adam Chekroud has been published in top medical journals for his research on neuroscience, computational data analysis and mental health. Hear Dr. Adam discuss his latest findings on the positive impact of exercise on mental health in a study of over 1.2 million individuals, performed in collaboration with the Centers for Disease Control and Prevention.

Transcript

Dr. Haroon Kazem: Hey guys, Haroon here and thanks for joining us on another episode of the Body Clock Podcast presented to you by Owaves. On this episode, Sohaib has a remote conversation with Dr. Adam Chekroud. He is the co-founder and chief scientist at Spring Health, a behavioral health startup based out of New Haven Connecticut.

Dr. Adam’s work focuses on the treatment of mental illness and how to better deliver quality behavioral health care to patients. I think you’ll really enjoy this episode. And please if you haven’t already, remember to download the Owaves app from the App Store. It’s designed to work with iPhones and the Apple Watch and you’ll love it so it’s free and it’s the number one wellness app on the App Store. So I hope you guys enjoy the show. And thanks as always.

Dr. Sohaib Imtiaz: Not sure if you’ve heard of Owaves before but Owaves is basically a concept slash app which helps you to kind of optimize your health through circadian biology so we all actually focusing at the moment on mental health as one of the main parameters of health and kind of targeting university students.

So Adam I’ve-obviously you’re from Manchester I’m from Manchester. I’ve kind of read a little bit about you. You seem to have an extensive history of, you know, studying at Oxford and neuroscience and experimental psychology as well as going to Yale and doing a PHD. So I mean that sounds pretty awesome that that you’ve had such such ingrained training in such a such a specialist field. Could you tell me a bit more about that?

Dr. Adam Chekroud: Yeah, I think I’ve gotten very lucky at a number of steps along the way. It’s not too often that someone from Manchester ends up at Yale after a little a couple details. It’s been very fun. I’m really glad I had the opportunity to do this kind of work nowadays.

Dr. Sohaib Imtiaz: Yeah I mean doing some exciting things.

Dr. Adam Chekroud: Yeah really it’s not too hard to get out of bed when you get to do the stuff you want to do all day. So, it’s pretty nice.

Dr. Sohaib Imtiaz: So yeah I mean number one thing you’re enjoying it so. So you started at doing neuroscience and psychology or. I’m guessing is a lot of overlap between the two fields.

Dr. Adam Chekroud: Yeah I’ve always kind of been somewhere between the two and then my master’s was technically in neuroscience and before that was student psychology but I’ve always been kind of somewhere between the two.

Dr. Sohaib Imtiaz: Okay so you’ve been quite deep into that kind of mental health focus.

Dr. Adam Chekroud: Yeah I was actually focusing primarily on treatments for mental health conditions so different medications that you can use to treat things, different kinds of therapies that you can use and then trying to understand which ones are most effective in different circumstances.

Dr. Sohaib Imtiaz: Okay. That’s very interesting. So kind of a tailored approach because well one of the kind of articles recently that’s been going on social media has been your article in The Lancet, which recently-in September I think-it was published and it provides quite a lot of insight. Could you could you explain a bit about the main findings of of your research in the article?

Dr. Adam Chekroud: Yeah so, very much like you guys, you know, I’m super interested in and what we can do to change our lifestyle or to change our daily routine to improve our mental health. I mean the grand scheme of things it’s really important because not everyone is ready for treatment, not everyone needs treatment and we always need extra strategies that we can use to try to help people’s mental health. So for me, you know exercise was was a clear area of interest but then when I kind of dove deeper into the to the literature I was kind of surprised that I hadn’t been-there had been a bunch of trials and a bunch of small scale studies.

I was kind of shocked not to find any kind of really big, large scale representative or definitive study and so we were curious whether we could get any data that might help us do that and really speak to this relationship between exercise and mental health. So we actually collaborated with the CDC and the United States and it’s a large survey every year, you know, hundreds of thousands of people and we aggregate all of that data from a few different years and then started to look at people’s mental health depending on the different kinds of exercises that they do. So that was kind of a start of the idea.

Dr. Sohaib Imtiaz: Okay, well it sounds quite-um you had to bring a lot of parties together, it seems, to to make it work.

Dr. Adam Chekroud: Yeah, it takes a village, right?

Dr. Sohaib Imtiaz: Yeah. I mean it’s great that you, I mean, you touched on data because that’s the approach because a lot of the behavior neuroscience side of things, it’s interesting that you’re so data centric with this, because of the variances and variables with kind of mental health because often psychiatrist-who I’ve been in touch with-always say that “every individual is so different. There’s different kind of you you can’t have a tailored approach for each patient.” But I mean you’ve been able to show trends which seem to be applicable for a mass population. Is that correct?

Dr. Adam Chekroud: Yeah it’s super important. Every patient is different and they think that that makes psychiatrists in a really tricky position, right? If they, if every patient is different-and they don’t really know necessarily what’s going to work for who-that it’s really important that we as researchers give them tools that help them understand that so that then when the new patient does arrive in their office they can try to focus in on the information that really matters and then and try and get a sense of, you know, what it is about that person that makes them more likely to respond to exercise or more likely to respond to, you know, citalopram are more likely to respond with cognitive behavioral therapy.

Dr. Sohaib Imtiaz: Exactly. So you have that kind of tool kit ready so you know what what works and what doesn’t or what’s more likely to work in terms of kind of confidence intervals of probability.

Dr. Adam Chekroud: Yeah exactly.

Dr. Sohaib Imtiaz: So your Lancet paper, I mean, what I found very interesting was so, it seemed to show that forty five minutes was the kind of length of time which was best for mental health for combating depression and it was three to four times a week-am I correct, you said?

Dr. Adam Chekroud: Yeah would somewhere between three and five, yeah.

Dr. Sohaib Imtiaz: Three and five. I mean, that kind of kind of getting that kind of data all that kind of conclusion is quite useful because then we tell patients to exercise you feeling down that’s one of the things that’s been longstanding and there’s research that proves that but from a patient perspective as a consumer you don’t know okay you’re feeling down you don’t know how much to do but you’ve kind of quantified that. So if you have a target I think it’s more realistic for you to achieve your goals.

So that’s why I found this paper and that’s why I think some of my colleagues were sharing it because I mean it’s had more of a kind of-not. “it’s nice to exercise it will help” and you use it as an adjunct-but you’re using it as an intervention or intervention in comparison to anti-depressants.

Dr. Sohaib Imtiaz: So yeah I mean I agree with you I agree with you totally I think that there’s a lot of research showing that when people have clear goals and when you really give people tools kind of like the Owaves app itself, like give people tools that help them meet their goals, then I think people are way more likely to be able to achieve those goals.

And I think really really the thing with exercise as well is it’s not like this it’s not like patients when they come to you they don’t want to get better like they they arrive in the room because they want to get better and if they’re not doing what clinicians are telling them or they’re not doing what’s right for them, you know, maybe it’s not because they’re not behaving in a way that you want.

Maybe it’s because you just didn’t convey the values of what you’re trying to get them to do. Like, if you say, “go and exercise,” I mean, someone tells me to do something you know it’s unlikely that I’m going to do it but if someone then helps you understand like, “here’s what you could do and if you do this you’re likely to get this kind of benefit and these are all the reasons why I think could be valuable for you to do that. And you know here is some framework and some infrastructure that helps you you know that helps you do it along the way.” You know, that’s a totally different proposition.

Dr. Sohaib Imtiaz: Definitely. It makes a lot more achievable. I mean, it’s great that that’s what makes your research more actionable, implementable. People can take that and be like, “okay, this is an organized approach for you to actually it’s shown clinical effectiveness to improve your mental health. It’s not trial and error as such.” So you’ve written quite a few other articles as well. I mean, your name pops up on the Lancet quite frequently, which is good. You had a good run.

No, I mean amazing things, it’s quite inspiring. Obviously, you’ve worked to academic institutions, Oxford Yale being some of the kind of elite universities. So any other findings that you feel you could reveal or you’ve discussed in your other papers that you you feel people can do in that from from a lifestyle perspective for anxiety and depression?

Dr. Adam Chekroud: Yeah I would. I actually I guess I maybe like a slightly rogue academic in that sense in that after after spending, you know, a fairly long time in academia and publishing in these kind of papers, I think that you know along the way we also founded this mental health company as well we’ve been working on mental health company in New York and with a goal of mental health. Yeah exactly mental health. So we’re providing mental health care to employees who work at companies that we partner with. So, think companies like Gap or Whole Foods and we partner with those institutions and then we provide mental health care to those employees for free.

So, I’m kind of going through that experience that you maybe really have a much deeper appreciation for product. And so, I would say that honestly I think that’s just the product in itself is like a huge untapped potential in mental health. And I don’t mean in the kind of vaporware sense and there’s a lot of like on validated you know apps like out there. I think I like if people are really awful about design and usability and you know what it is that you’re trying to get the user to do, I think that there’s like a huge amount that can still be done because mental health care is operationally, you know, it’s definitely not a 2018 thing, like we’re back in like maybe 1980. They have to show up, they have to pay for medical records, you know, it takes six weeks to get an appointment, you show up and then they say, “why are you here?”

Dr. Sohaib Imtiaz: A long process.

Dr. Adam Chekroud: Relive all of your stories and then they’re like, “okay, sounds good. I’ll see you next week.” And, you know, and then, you know, no idea what happens in between and like you know you may or may not do your homework in between. So I just feel like there’s so much room for improvement and optimization through product, but through thoughtful, you know, clinically driven product. You know, if anything I would say that that’s where the most bang for our buck is going to be.

Dr. Sohaib Imtiaz: Yeah more value as well. Because there’s so many variables involved as you said, I mean, we’re so reliant on patient empowerment, for them to do it. So, as you say the product if it makes it easier for the patient or empowers them or makes them kind of incentivizes them to follow certain things for their own health benefits and there’s nothing better.

So behavior actually, so you touched upon them some invalidated technologies and apps. Have you heard of, recently in Silicon Valley, there’s been a lot of hype around kind of voice technology and picking up changes in the tone of your voice. Big depression or anxiety to three days before the onset. What are your opinions on that?

Dr. Adam Chekroud: I I would say that it’s still really early days. You know diagnosing depression is not trivial. And you know clinicians regularly disagree over a diagnosis when they both see the same patient on the same day. You know I can totally imagine a world maybe 10, 15, 20 years from now where things like that you do factor into how we make these decisions or maybe they factor into some kind of risk assessment before the clinical diagnosis is made.

But I just think the concept that that is ready for primetime right now is fairly ludicrous. I mean I don’t see any papers in major leading medical journals, you know, showing that they they took 100 people who showed up at primary care and you know they gave them all the app and then they you know all they analyzed all of their voices and then they made predictions about who was going to be depressed and then they had clinicians diagnose those that can patients and then show it’s like, “okay, this is how many of the cases that the algorithm you know caught, this how many clinicians verified it,” whatever.

You know, I don’t see anything like that. Really all you see is like you know a couple of people win a hackathon. They roll out their app. They, you know, like, pull together a couple tool boxes and then they say like “yeah it can work for,” you know, I mean they like show that they can record me saying “imagine your ideal day” and then they say like “yeah, now we’re going to like analyze these voice mechanisms and able to predict who gets depressed and how we’re gonna help them get better.”.

Dr. Sohaib Imtiaz: At a very small sample size as well.

Dr. Adam Chekroud: Yeah.

Dr. Sohaib Imtiaz: So that’s a great that’s a great thing because you’re academic with that evidence base and you know kind of the process of validating. But then you’ve got this kind of startup entrepreneurial vibe and spirit where you do want to make that academia actionable. That’s that fusion which which the healthcare needs at the moment, because the kind of academics are away from the startup entrepreneurs. So if you have that fusion is not perfect using data and kind of innovation to kind of-

Dr. Adam Chekroud: Yeah totally. I think it’s interesting to see sometimes in academia there is this like consensus that people and people in industry are like not interested in validation. And I find that kind of ludicrous because like it’s like speaking personally as someone who is like developing tech and then putting it out there like, if it’s not going to work, I would want to be the first person to know. Like the worst case scenario is if it-

Dr. Sohaib Imtiaz: Exactly.

Dr. Adam Chekroud: -this doesn’t work and I don’t know. And the same is kind of true for like pharma companies right. Like they don’t want to make drugs that don’t work. They want to make drugs that work, right? And if the drug works and it works well then they’re going to get super rich from it. And so if it doesn’t work like they don’t want to waste more money on it like they have plenty of, you know.

And so so I find it kind of weird to see like these kind of things where it’s like small scale validation you know three people like, completely implausible, like they haven’t you know they tested on their three best friends and it’s like yeah I get that you’re trying to show proof of concept and trying to show, you know, gather enthusiasm. But like, I feel like when you see some of this stuff it’s like you wonder like whether people really like deluding themselves, right?

And it’s like, you know, if this is going to really make it, you can be very very critical and drug companies in general like, are very very critical of their own work. And this is you know obviously preapproval-post-approval, you just want to sell it-but like preapproval, they are very very critical. I’ve met a lot of chief medical officers at major drug companies and all of them will 100 percent tell you that if it’s not going to work they need to know as soon as possible.

So these kind of it feels weird to me when I see a small study over fit studies or things that are unlikely to work. You just kind of question like, what is that person’s motivatiom , was it just money? Was it just to publish a paper get a bit of hype and then, because like it because you also probably not going to make money out of it.

Dr. Sohaib Imtiaz: Because it’s not scalable.

Dr. Adam Chekroud: You’re not going to be-you might be able to scam like a little. Yeah exactly right. Like a couple of bucks but you don’t really going to change the world. And if you don’t change the world you’re probably not going to make big money.

Dr. Sohaib Imtiaz: Exactly. The due diligence isn’t there. The kind of long term vision-so, at Spring Health, how have your results been? How long have you guys been operating and what kind of strategies have you been using?

Dr. Adam Chekroud: Yeah. So we we got funded mid 2016. We’ve been growing basically partnering with employers to treat their employees. So we have therapists and we have psychologists and psychiatrists on staff and so when someone needs treatment then we will pair them with a provider. And so we’re doing a lot of a lot of product work around process basically around the way that people receive mental health care the way that we track outcomes.

So I would say that most of our product focus is around screening and accurate diagnosis at the beginning. And so trying to come up with scalable ways is reaching a lot of employees and then accurately figuring out what kind of conditions they have, whether it’s depression or anxiety or maybe other things like eating disorders or bipolar attention problems or suicide risk, whatever that may be. And then-.

Dr. Sohaib Imtiaz: To see the range of mental health problems that you’re dealing with.

Dr. Adam Chekroud: Yeah. We have pretty much the full span of outpatient psychiatric problems, yeah.

Dr. Sohaib Imtiaz: Okay, well so they’re very diverse. Okay. And a diverse team as well. And it seems so, in the kind of behavioral health you’re in the behavioral health space. But more specifically, in this mental health space. So what’s your opinions on what kind of behavioral health strategies?

Do you think technology is the solution? Or should these try to-do you need humans to be enabling- cause a lot of people talk about face to face interaction for CBT-but like, a for for my example, my my opinion is that obviously so many people and so few kind of behavioral psychologist etc can be on that level, that next best option is technology and these interventions are working.

Dr. Adam Chekroud: Yeah. So yeah totally. So I would say, I think we have to embrace technology. I think it’s ludicrous if we don’t embrace technology. I think that you know it is the future and it will help us do what we want to do better. I think for me the technology is like a broad thing, right? If you say, you know, from the spectrum of give someone like a chat bots to put them face to face in front of a therapist, right? I mean, that’s a no-brainer.

I’m not going to do the chat bot, right? But then technology is kind of, there is a lot of things that we could do in the middle, right? So we could start by having still real providers but just have them treat via video. So instead of going and seeing them face to face, you know, you could think about seeing the provider via zoom video or something like that.

And you know, that would solve a lot of, that would actually solve a lot of problems, right? It would help us reach more providers. It would help us get access to care in rural areas in places where providers don’t live. Those patients could still be seeing providers, right? So, you know, without some of those availability issues.

Dr. Sohaib Imtiaz: Yes. You’ve described how.

Dr. Adam Chekroud: Yeah. Go for it. Go for it.

Dr. Sohaib Imtiaz: Yeah. Carry on. Carry on.

Dr. Adam Chekroud: Yeah, and then you could take another step, right? And like what would that look like? Well, it would probably look like still real providers but they just kind of e-mail you homework and you can do CBT through an app or through a website and then the provider is just checking in with you.

Right? So that’s again, another way that we could use technology and it’s still you know you’re still not talking about chat bots, right? But you know you’re still thinking about ways that you can better leverage your provider you know so you and then you could just go all the way to a pure digital CBT, you could go to pure self help, you could go to some kind of you know robot thing like how does that robot whatever way you-

Dr. Sohaib Imtiaz: Very futuristic I like it.

Dr. Adam Chekroud: Yeah. You guys can get the message with like a robot provider.

Dr. Sohaib Imtiaz: Definitely. And then, you basically describes this kind of consumer patient is very lean. Well because I mean I have looked at statistics which say for example people don’t attend a gym more than 12 minutes out of reach for them. So similarly, with mental health, it’s that whole kind of consistency over months to improve it. And the more barriers we can remove like you’ve described remote, for example, interactions make it more likely for people to engage.

I mean it’s and fortunately, that, being able to discuss with someone who’s kind of an expert in kind of neuroscience, mental health, this space and you’re providing some very good insights for our listeners. So would your Moonshot go be to kind of democratize mental health interventions through technology?

Dr. Adam Chekroud: I would say the Moonshot would just be that we don’t guess anymore. That people, that we can know from the very beginning which option is most likely to help a patient get better. So, instead of people having to go through trial and error process of maybe one medication or maybe they try therapy or maybe they try digital CBT or maybe they try to exercise or maybe they just need to go through a sleep program, you know, for me I think that a great goal a great conclusion of the next five maybe 10 years would be that we have assessments of exactly what treatments work.

In the same way that for antibiotics, you know, we could just take a biopsy and then we could run it through some kind of assay and then it was like, “this is the antibiotic that looks like it’s going to work.” I would love if we could have some kind of analogous system analogous system in mental health where we have a patient and we ask them some kind of questions or we take some information from them and then we have tools that help us know exactly what’s going to work from them so that we don’t waste that time, we don’t waste their boss’s time, we don’t waste our insurance companies’ time, you know, we don’t add on this burden to their friends and to their family and we can really just help them get better from the very start.

Dr. Sohaib Imtiaz: I mean, that’s a very noble objective and I would agree. You remove the guesswork and that’s exactly what health care needs at this stage. Why I’d reach in and make it more-making things more objective. And so do you feel that there’s a lot of talk about genomics as well. People have different kind of likelihoods of suffering from certain, according to them, mutations or genetic, certain conditions. Are you, do you have, do you think genomics are important as well?

Dr. Adam Chekroud: I think that, you know, I’m hopeful. I hope that one day we can learn something from that. I think at the moment it’s definitely a little bit too early. I mean, there was a paper in JAMA this week saying that you know from genomic tools are being sold but there’s no efficacy behind them. Favorite JAMA Psychiatry earlier this year.

So there is a lot of you know a lot of of you know clinicians and researchers, you know, consistently showing data that suggests that these things are not working yet but then, you know, that being said like the there’s a clear biological pathway from genetics to biology and so I’m sure that we could probably learn something if we did understand the genome in sufficient detail that would help us understand things like metabolism of the drugs or trying to understand specific biological markers that might inform different treatment strategies. I think it’s just really early.

You know, if you look in other areas of healthcare, things like Huntington’s which is like a single nucleotide issue like have still not been like we still don’t have like gene based home run treatments for that. So to think that we if we can’t do it there-I haven’t seen that we’ve done it there-I find it a little bit challenging to believe that we can already do it here. Version which is like an extremely polygenetic issue and obviously has major environmental factors. So you know I think of all the places we could look for genetic genetic biomarkers you know I would probably think that depression would be the last one to fall.

Dr. Sohaib Imtiaz: Yeah. So we should be looking more downstream rather than upstream before we can solve the first issues and then-and talking about so circadian biology, obviously how you run your day, have you seen any studies any research in the field about mental health that you wake up, sleep times, et cetera.

Dr. Adam Chekroud: I haven’t seen anything specific. I know that there is definitely, you know, research linking sleep and, you know, especially a lack of sleep to higher mental health issues. So I totally understand how getting better control of your sleep patterns. Um, trying to have a bit more structure in your life.

These are all things that clinicians will try and do to help people with mental health conditions so I can totally understand how an app that helps you you know get on top of your sleep and try to structure your day a little bit more and put in things like exercise type of patient and you know taking a break, those kind of thing. All of the data would be valuable for a clinician and helping a patient get better.

Dr. Sohaib Imtiaz: It helps to keep in check. Exactly. So now we move on to how you run your day just to finish off. Obviously you’re a neuroscientist as well as a founder. You must be very busy. You’re writing papers in jump publishing like Lancet etc. so it must consume a lot of your time. I mean how would you like to run your day keep your mental health in good nick?

Dr. Adam Chekroud: I think that exercise is super important. I know that definitely for me it is very important. And I think that as I get more stressed as well I actually get more and more strict about making time for exercise. I think the reality is that like adding more hours of work doesn’t mean you are going to be more productive. So when I feel myself getting more stressed, I kind of take a step back.

I’m like,”okay. Am I stressed about the work or am I stressed because I’m like overworking and I’m not taking time to, you know, taking breaks throughout the day just go for a breather because I’m not eating lunch at my desk I’m not walking I’m not exercising. And so for me it’s all I had to exercise. Like I try and go for a long bike ride over the weekend, you know, I’ll play soccer a couple of times a week. And so-

Dr. Sohaib Imtiaz: Do you stay active?

Dr. Adam Chekroud: Yeah, I mean, for me for me it’s key. I think it helps you control your sleep a lot better, it also helps keep your mind in check, it gives you a break from whatever you’re doing, you’re thinking about something else, time to time to think, get some fresh air. I think there’s tons of benefits for it. So, for me it’s super important.

Dr. Sohaib Imtiaz: Exercise is your main kind of-and you do kind of plan your days ahead or do obviously in such a busy environment you take things how they go and are you quite a plan person?

Dr. Adam Chekroud: I think I have to be nowadays, yeah, kind of religiously have to live by calendars, otherwise I think things will just fall through that.

Dr. Sohaib Imtiaz: Yeah you have kind of organized obviously lifestyle.

Dr. Adam Chekroud: Yeah. Nowadays.

Dr. Sohaib Imtiaz:  And with exercise it’s-do you focus more on cardiovascular or did you find any, was that any kind of research on strength training with cardiovascular or team sports for mental health?

Dr. Adam Chekroud: There is there is the paper that came out earlier this year in JAMA as well specifically on resistance exercise training for depression. For me I just I just don’t find it in the gym that fun, it’s just a preference thing and so I prefer to focus most on cardiovascular things especially team things so if I go cycling at the weekend then I’ll go out with some friends if I-when I play football during the week then, you know, I get to see a bunch of friends I see at football and you go to chat and that kind of stuff.

So for me team sports is team sport slash you know high cardio things that yeah my I mean my preference but I think especially in that paper we kind of showed that you know most sports seem like they do have a benefit. So it wasn’t just things like team sports and cycling, you know, a lot of other sports also carried those people who did them seem to have much better mental health. So I think it’s really what you know whatever it helps people get into exercise or whatever it is that they like doing, like that’s definitely better than nothing.

Dr. Sohaib Imtiaz: Yeah, that’s an incredible point you’ve touched on because if you doing a team sport it takes off the socializing side of lifestyle medicine as well as exercising. That’s what I think the study I looked at where tennis was shown for better health and longevity as well. So that’s quite interesting. But I mean exercising is the most important factor. Know that’s what you found.

Dr. Adam Chekroud: It’s about how, you know, every little bit helps.

Dr. Sohaib Imtiaz: Every little bit, of course helps. And as any parameters you can measure for your mental do you do I mean measure like heart rate variability or cortisol levels, or is it just something you know when you’re feeling down or happy or the mood fluctuation?

Dr. Adam Chekroud: I’m I I I personally  I mean I like that I’m super into data because I’m data.

Dr. Sohaib Imtiaz: We love data here.

Dr. Adam Chekroud: I look at my resting heart rate, I check how much I’m sleeping, I do all that kind of stuff. I don’t measure any biomarkers or anything. I mean, I do check in like every couple of weeks I do like, I mean we have mental systems for tracking every couple of weeks I’ll just you know I’ll just spend two to five minutes just doing a couple of those assessments to just check in with myself and give myself another metric to see how-

Dr. Sohaib Imtiaz: To see how you’re doing.

Dr. Adam Chekroud: Yeah.

Dr. Sohaib Imtiaz: So so are there any actually good assessments are they validated tools that you can do to assess your mood?

Dr. Adam Chekroud: Yeah. So I think things like that the patient health questionnaire nine page nine is very common, depression and there’s a similar one for anxiety called the GAD-7, generalized anxiety disorder seven. So those are both really short.

You know you could deal with them in a few minutes and you can find them online like that they’re public public domain so anyone can access them if you just google those things and you could just do those assessments and you can keep doing them every couple of weeks and you can track your progress and see if it’s going up or down. So yes I definitely do that pretty often and depending on your position as well there are so many different rating scales that you can use in mental health to track you’re-to kind of measure that over time.

Dr. Adam Chekroud: Yeah, it’ll be very useful to listeners because I’m people dealing with mental health issues. I think tracking them is very important. You can see the improvements and went to kind of consult an expert.

Dr. Sohaib Imtiaz: Do you think there’ll be any wearables coming out in this in the mood space to help you assess your mood as well?

Dr. Adam Chekroud: I’ve heard of like kind of stress sensors as you get through your skin. Anything novel that you envision happening?

Dr. Adam Chekroud: Never seen that. It sounds pretty wild. Honestly, I’m like an early adopter and all that stuff. I’d probably try it out. For a long time and every time they make a-

Dr. Sohaib Imtiaz:  Definitely!

Dr. Adam Chekroud: -cell factories and the sensitive stuff.

Dr. Sohaib Imtiaz: I think we’re both like self quantified movement.

Dr. Adam Chekroud: Exactly.

Dr. Sohaib Imtiaz: Okay it’s great talking to you, so much revelations. Very interesting. I mean you’re doing amazing stuff. Before I let you go, I can’t finish before without asking you about some neuroscience based things. Have you got any personal interest in, kind of, cognitive enhancement or any tips or supplements you know useful kind of better cognition?

Dr. Adam Chekroud: I don’t. I do take like a multivitamin every day. But that’s really just kind of covering my bases. I’m not sure whether the literature is out there saying that it’s good or bad or anything but I think it probably probably won’t hurt so I do it anyways.

Dr. Sohaib Imtiaz: Okay so that’s how you seem to be kind of live your life but you’ve been great Adam. I hope to be getting you o up and keep doing great things with Spring Health.

Dr. Adam Chekroud: Yeah it’s great to speak to a fellow Manchester-

Dr. Sohaib Imtiaz: No of course, from Manchester. That’s where entrepreneurship is being-

Dr. Adam Chekroud: Exactly.

Dr. Sohaib Imtiaz: -supported, it seems. If I go to America.