Feel Program quantifies COVID-19’s impact on our mental health for the first time

Feel Τherapeutics
feel the blog
Published in
7 min readMay 7, 2020

With the world population either just emerging or still experiencing some form of lockdown, there has been much speculation that people’s mental health has been severely impacted by the COVID-19 pandemic. This can now be proven based on objective data collected from physiological signals by the Feel Emotion Sensor, a wearable digital therapeutics mental health device

How are our bodies connected with our emotions?

How do our bodies process emotions? Neuroscience research in past decades has shown that emotions are actually created by our brain and involve the entire nervous system*. More specifically, it is the Autonomic Nervous System (ANS) that is the control system that unconsciously regulates bodily functions such as heart rate, respiratory rate, the ‘fight-or-flight’ response, etc. The ANS is part of the peripheral nervous system and comprises two antagonistic sets of nerves, the sympathetic and parasympathetic systems.

Imagine now that you’re taking a stroll in the park when suddenly, an angry bear appears. Your heart starts to beat faster, the palms and feet start to sweat and your muscles tense. The body is preparing you to fight back or run away from danger, aka enter “fight or flight” mode**. This is the sympathetic branch of the Autonomic Nervous System at work to give your body increased energy and strength in order to escape danger. This corresponds to changes in heartbeat patterns and various indicators in your skin’s electrical properties. For example, have you noticed that when people get angry their heart starts racing more or when they are stressed they tend to sweat more? That’s another example of an indication from the ANS that an emotional stimulus just happened.

Thus, it has been widely known*** that these bio-signals are strongly correlated with the functioning of the ANS and a person’s emotional status:

  • Electro-dermal activity (EDA)
  • Heart rate variability (HRV) and
  • Skin temperature (ST)

How was the data gathered?

In 2015, Sentio Solutions developed its proprietary Feel Emotion Sensor, a mental health digital therapeutics wearable device that continually monitors and detects a variety of physiological signals to understand and quantify the changes to a person’s emotional state, allowing objective data to be used for the very first time in the mental health field.

Data was collected from physiological signals detected by the Feel Emotion Sensor of a sample group of participants in Europe and USA, between 20 February and 13 April 2020. The signals collected from the Feel Emotion Sensors were tracked in the linked Feel mobile app where the participants identified and confirmed the specific emotion but also rated the intensity of the emotion and what triggered it.

Over the course of eight weeks Sentio analysed 128 million EDA samples, 400 million HRV samples, 64 million ST samples, and approximately 900 significant emotional moments.

What did the data reveal about our emotions?

When there are changes different from the typical pattern to EDA, HRV and ST across multiple users in a short space of time, this indicates that emotional changes or new emotions are being experienced.

Radical Change of the Emotional Space

A representative example is shown in the graph below which shows that there was a dramatic drop in the EDA bio-signal after lockdown, which is a clear indicator that the activity of the ANS has been significantly modified and the emotional space radically changed. Indeed, a shift towards lower EDA values is observed for negative emotions, possibly indicating the emergence of novel emotional areas.

Figure 1: Temporal evolution of the mean width of the EDA responses for days 51 to 104 of the year.

Negative Emotions Almost Doubled and Became More Intense

Analysis of emotions tracked based on the notifications provided from the Feel Emotion Sensor and that validation of those emotions by the user on the app, showed that the number of negative emotions experienced almost doubled after lockdown. More than 60% of those negative emotions increased in intensity and reached a level of 7 or more on the standard scale of 1–10, the respective number prior to lockdown was less than 30%.

New Emotions Emerged

It is possible to attribute these increased intensity levels to the introduction of new emotions after lockdown. This can be clearly seen in the graphic below, as emotion space and intensity levels shift from the norm of the most common experienced emotions into a new territory.

Figure 2: Contour plots of the distribution of the most important EDA and HRV features related to the emotional space before and after the lockdown.

Further analysis of user feedback confirmed that the COVID-19 pandemic and subsequent lockdown have triggered the occurrence of novel emotions such as:

  • Feeling vulnerable
  • Feeling empty
  • Feeling terrified and fearful
  • Feeling miserable

The graph below shows how common emotions such as anxiety, boredom and tiredness have become less common after lockdown and have been replaced by the new emotions.

Figure 3: Normalized histogram of the emotion tags of the “Sad” emotion moments before and after the lockdown.
Figure 4: Normalized histogram of the emotion tags of the “Distress” emotion moments before and after the lockdown.

The Fight or Flight Initial Reaction

Feedback from Feel’s therapists, who were treating participants, gave a clear indication that during the first week of lockdown many people were experiencing a ‘fight or flight’ response and a resistance to continuing with their mental health support routine which was attributed to an increase in anxiety, an inability to maintain any new activity and/or a basic survival instinct to prioritize what was essential for survival.

However, the engagement of the therapists served to ground participants’ thinking, helped them avoid the instinct of quitting and maintain their focus and engagement with the program to help them cope with their feelings. This is depicted by the significantly enhanced user engagement levels in the Feel Program, where after the lockdown there was a 97% participation rate in weekly therapy sessions and a 60% engagement with the Feel App.

If you would like to read the full study, click here.

How to cope?

It’s not surprising that periods of enforced lockdown have affected people’s mental health, nor is it surprising that new negative emotions have emerged as a result. What is clear though, is that the effects on our mental health will be around for many years to come, and the need for increased and democratised access to mental health support is bigger than ever

The following coping techniques have demonstrated a high degree of efficacy when practiced.

  • Identifying Circle of Control: Begin by identifying the facts of the coronavirus and what social distancing means. Then ask yourself what you have direct control over in protecting yourself from infection. Identify what resources are available to protect you, like medical interventions, personal protective equipment, financial aid or technology tools to enable working from home. Ask yourself what you can do to utilize these resources and what would be the first step to access or implement them
  • Acceptance: Start by recognizing that highly infectious diseases exist and cause people to get ill. Distinguish between what is a fact and what is speculation and concern. Accept the facts and what you have control of and what you do not have control over. Accept that change will happen in your daily routine. Accept that although we do not have an end date for the pandemic, it will not be permanent.
  • Grounding Techniques: Practice at least one technique to bring your thoughts back to the present and gain control over your physical response to fear and distress.
  • Cultivating the positive****: Take a moment to observe what is working; are you able to feed yourself and your family, are you safe in your home, can you call or videochat with friends? Then reflect on what you are grateful for; friends and family to talk to, watching a movie, playing a game with your children or friends, reading a book. Practice beginning the day by saying or writing down what you are grateful for and/or what is working.
  • Identifying daily routine and habits: Begin by reviewing what your current daily activities are. Ask yourself what you want to consistently accomplish everyday. Then identify what time of day is ideal to accomplish those tasks. There may be a shift in time from when you usually accomplish those tasks but that does not mean you cannot accomplish them. Explore what new activities you may need to add and what previous activities you may need to relinquish until social isolating policies change. Remind yourself that this is your current routine and that you will have opportunities in the future to modify it to your needs but your health and safety takes priority.

Get more info on how to support your mental health with the Feel Relief program.


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* https://www.noldus.com/blog/how-emotions-are-made


***Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological Psychology, 84(3), 394–421.

Shu, L., Xie, J., Yang, M., Li, Z., Li, Z., Liao, D., Xu, X., & Yang, X. (2018). A Review of Emotion Recognition Using Physiological Signals. Sensors, 18(7), 2074.

Kim, K.H., Bang, S.W. & Kim, S.R. (2004). Emotion recognition system using short-term monitoring of physiological signals. Med. Biol. Eng. Comput. Vol 42, pp. 419–427.

****Kong, F., Zhao, J., You, X., & Xiang, Y. (2019). Gratitude and the brain: Trait gratitude mediates the association between structural variations in the medial prefrontal cortex and life satisfaction. Emotion.



Feel Τherapeutics
feel the blog

Feel develops Digital Biomarkers & Therapeutics to bring objective data & measurement in the way we diagnose & care for Mental Health➡️https://goo.gl/fz9BV5