Designing for self-help during panic attacks
Panic attacks are periods of intense fear or apprehension of sudden onset accompanied by different bodily or cognitive symptoms (such as heart palpitations, dizziness, shortness of breath, or feelings of unreality) of variable duration from minutes to hours.
Many find it difficult to handle their attacks and help themselves get through them. This both because of the accompaning symptoms and the shame and taboo attached to mental illness. Dealing with panic attacks through avoidance or distraction is not recommended, since this can worsen the attacks in the long run. There was a need for a tool to help users experiencing panic attacks face their attack in a calm and accepting way.
The result was a palm-sized self-help tool. The device has an organic design with strong focus on tactile sensations. The functionality is simplified and focused, for it to reach the user in their acute state. It initially assists breathing by glowing, expanding and contracting. After sensing the attack has subsided by measuring pulse, thought-pattern breaking messages are displayed.
The process and design strived to follow ISO 9241-210:2010: Human-Centred Design For Interactive Systems.
Context of use & user requirements
- Bakground research (medical information, existing treatments and tools, personal stories available online)
- In-depth interviews and future workshop (inspired by Löwgren & Stolterman) with users
- Specifying & validating scenarios with users using storyboards
Analysis and synthesis
Clustering the results produced three themes: the situation, strategies to deal with the situation (with two different kind of strategies: logical and emotional) and the long term goals and needs. This was then synthesized into a hypothesis of initial design requirements.
- Panic attack
- Intense fear and anxiety, catastrophic thinking, derealization, fear of dying, physical discomfort
- Feeling lonely, fear of what others might think
- Difficulty focusing on the here and now, closed off
Strategies - Logical
- Facts and rationalization of symptoms and thoughts
- Convincing oneself that it’s not dangerous
- Identifying and challenging negative thought patterns
- Separating symptoms and thoughts from oneself - "I'm not my thoughts"
Strategies - Emotional
- Compassion, reassurement, feeling safe, confirmation of experience - often from friends or family
- Focusing on positive things - good memories, loved ones, childhood teddy bear
- Mindfulness, calm, getting back to the physical reality, focus on physical stimuli
- Accepting and embracing feelings - crying it out
Long-term goals and needs
- Acceptance - changing attitude towards attacks, preventing fear
- Empowerment and independence - reduce need to rely on others
- Preventing avoidance - actively facing and dealing with the attack
- Very simple functionality to be able to reach the user in their acute state
- Not part of or resembling already stress-related artefact such as smartphone
- Easy to bring with you
- Aesthetically pleasing, calming design - not look like medical equipment
Producing and evaluating design solutions
Idea generation was done through brainstorming sessions, sketching, inspiration collection with Pinterest and creative workshops with clay, paper, fabric and other materials.
Through low fidelity prototyping we explored properties such as size, material (soft fabrics, rubber, glass and so on) and resistance (softness/hardness/"squeezability"). At this stage we had honed in on four functionality alternatives:
- Breathing guidance
- Calming - calming animations, sound, pictures, scents and movies. For example waves, crackling fire and jelly fish.
- Positive thinking - memories, messages from loved ones.
- Identifying and challenging destructive thought patterns - for example mind reading and all or nothing-thinking.
Tests were done with users where they got to explore and role-play with different materials and look at sketches.
A prototype with higher fidelity was made for further feedback and testing with users. After this we specified the final functionality and made our final protoypes.
- Material and behaviour with distinct tactility
- Calming and aesthetically pleasing design
- Breathing guidance through light and the artefact expanding and contracting
- Screen with messages that help identify and challenge negative thought patterns, and separate your symptoms from yourself
At this stage we realized that it wouldn't be practically possible to make only one prototype to illustrate the entire concept. Therefore, we made one prototype focusing on the screen functionality and another focusing on the breathing guidance. The interactive parts of the prototypes were made with a smartwatch face, Arduino, Adafruit Gemma.