# Using Smartwatches in Stress Management, Mental Health, and Well-Being: A Systematic Review
## 3 Smartwatches as Stress Assessment Tools
### Smartwatches for Mental Health Monitoring
(2018) evaluated the increasing use of wearables in mental health monitoring for the prediction and early diagnosis of mental disorders. The research assessed the effectiveness of wearable sensors in detecting mental conditions such as anxiety and depression and in analyzing collected data to manage these states. The study concluded that wearables using sensors like ECG and skin temperature can provide accurate readings for detecting and monitoring mental health conditions, especially when supported by advanced AI algorithms. At the same year, [PERSON] et al. [PERSON] et al. (2018) introduced M3 Sense, a system for representation learning to detect emotional states using wearable sensors. The study aimed to improve mental state detection by using physiological data from wearables. A major challenge addressed was the potential inaccuracy of sensor data due to limited datasets and variation in sensor devices. M3 Sense applies Domain Alignment techniques to transfer learned representations across tasks without needing additional data or labels. The results showed that M3 Sense outperformed traditional machine learning methods with handcrafted features, improving performance by 9.6% to 26.2% in areas of anxiety and emotion detection. Also, [PERSON] et al. [PERSON] et al. (2018) presented MHDeep, a Deep Neural Network system for the early diagnosis and monitoring of psychiatric disorders such as schizoaffective disorder, major depressive disorder, and bipolar disorder using medical-grade wearable sensors. The models achieved diagnostic accuracy rates of 90.4%, 87.3%, and 82.4%, respectively. Synthetic data generation techniques helped enhance training quality, overcoming the limitations of data availability for these conditions. Moreover, [PERSON] et al. [PERSON] et al. (2018) focused on the acceptance of smartwatch-based self-monitoring in clinical settings for depression. Their study analyzed user experiences with the Mood Monitor app during an 8-week digital cognitive behavioral therapy (iCBT) intervention with 69 participants. The results showed broad acceptance, with patients reporting that smartwatch-based mood tracking offered more privacy and was less burdensome than handwritten logs, improving engagement in therapy. In addition, [PERSON] et al. [PERSON] et al. (2018) studied smartwatch use in promoting healthy behavior in older adults. In a 4-week study with 20 healthy seniors, participants used the Garmin Vivasmart 4. During the final week, they received feedback on their sleep and activity levels. The survey results revealed behavioral improvements and, more specifically, 50% improved their diet, 45% increased physical activity, and 30% reported better sleep. Whilethese results support the potential of wearables in encouraging healthy habits among the elderly, further research is needed to determine whether feedback leads to long-term behavioral change. Also, [PERSON] [15] reviewed the broader role of smartwatches in healthcare, especially for physical fitness and mental health in conditions like dementia, depression, and high stress. The study highlighted how smartwatches measure biometric data such as heart rate, blood pressure, and sleep quality and concluded that they are highly useful in supporting individuals with various mental health conditions and improving overall well-being. Similarly, [PERSON] et al. [15] analyzed smartwatch use across diverse populations--including seniors, individuals with dementia, people with depression, and athletes--and concluded that smartwatches offer valuable tools for daily health management by continuously tracking physical activity, fitness, and mental health. According to the study by [PERSON] et al. [23], the integration of smartwatches into mental health care holds significant potential for health monitoring and relapse prediction in individuals with severe mental illnesses. This research focused on four patient cases involved in a study exploring the implementation of mHealth technology for monitoring mental health.