In space, no one can hear your nervous breakdown

Floating in a most peculiar way: Even spacemen (and women) get the blues -- but a new Stony Brook University-led study could help astronauts deal better with depression and anxiety in the void.

It’s lonely out in space.

And the mental health of astronauts embarking on long-term missions to the final frontier is a paramount concern for the National Aeronautics and Space Administration, which is funding a new clinical trial of an innovative e-mental health tool that could relieve astronomical anxiety, star stress and deep-space depression.

The study, led by a Stony Brook University psychiatry professor in conjunction with Australian researchers, officially kicked off Sept. 18, featuring 135 earthbound but “astronaut-like” individuals, according to SBU.

The participants – physicians, graduate students and other “well-educated individuals who are relatively healthy, with elevated distress levels,” the university said – will engage the e-mental health program myCompass, an interactive self-help tool developed by researchers from Black Dog Institute, a mood-disorders research facility associated with the Prince of Wales Private Hospital and the University of New South Wales in Australia.

myCompass delivers evidence-based psychological interventions for patients suffering from depression and anxiety, entirely via online platforms. Its treatment options – including cognitive behavior therapy, which revolves around the development of personal coping mechanisms – are fully automated and accessible around the clock via smartphones, computers or tablets.

Over seven weeks, the 135 participants will be randomized into different conditions to test myCompass in isolation and myCompass supported by time-delayed therapist texts and video messages – delayed up to 44 minutes, to simulate real-life deep-space communications lapses.

About a month after the seven-week course, the participants will be assessed and the treatment packages reevaluated, according to SBU.

Previous studies have demonstrated myCompass’ clinical effectiveness insofar as reducing symptoms in people with mild-to-moderate depression, anxiety and stress, but the NASA-funded trial will mark the first time the technology has been tested on “astronaut-like” adults – a giant leap for mankind, or at least for space jockeys who may come down with the Solar System blues when real-time psychological assistance is far, far away.

While it’s only lifting off this week, the clinical trial actually dates back to 2015, when Assistant Stony Brook Psychiatry Professor Adam Gonzalez, founding director of the university’s Mind Body Clinical Research Center, received a four-year, $1 million NASA grant to evaluate myCompass as an e-mental health tool for astronauts.

Adam Gonzalez: Exploring strange, new mental health challenges (and treatments).

The study, Gonzalez said this week, blasts into warp speed by focusing the evaluation on astronaut-like people in astronaut-like conditions, with specific attention paid to that communications delay. Captain Kirk might be able to make instant planet-to-planet calls, but in the real world, beaming voicemails over millions of space miles takes time – and investigators want to know how those lapses affect myCompass’ relative effectiveness, and by extension the mental health of deep-space crews.

“We are most interested in investigating the methods of delivering delayed support from a therapist when individuals are completely relying on web-based treatment,” Gonzalez noted. “This study will test different methods – video or text-based messaging – for delivering delayed therapist support.”

Focusing the interactive platform on astronauts makes a lot of sense, according to Janine Clarke, who heads up myCompass programs at the Black Dog Institute and paints star pilots and mission specialists as “high-risk” populations for “mental distress.”

“They are generally extremely high-achieving,” Clarke noted. “They experience long-term social isolation. They confront ongoing physical strain and mental challenges, including persistent threats to their safety.

“And they have limited access to the types of supports that many of us take for granted, including ready access to friends and family and physical activity.”

Better understanding the full potential of what SBU dubbed “unguided self-help treatments” could pay huge dividends during hypothetical Mars missions and other long-duration star treks, Gonzalez noted – and might even beef up terrestrial treatments.

“This research is critical to inform the best way for NASA to care for the mental health needs of astronauts,” the Stony Brook professor said. “The results may also help to serve as a guide to providing mental healthcare for individuals in rural settings worldwide, where mental healthcare providers are few in number or access to providers is difficult.”