Smartwatches, Health Tracking and Mental Wellbeing
A look at using smart devices as a tool to improve and support mental health and wellbeing.
BOUNDARIESTHERAPISTS PERSPECTIVE
Zak Zango
8 min read
1. Introduction
It started with a few clients, I noticed them glancing down mid-session, not out of boredom or
distraction (or so I hope), but in response to buzz of a wearable device. Smartwatches were appearing more and more frequently in my practice, and not just on wrists, but in sessions too. Clients would refer to their heart rate during an argument, their stress scores after a long workday, or ask questions about certain metrics and their own mental health.
Curious, I decided to wear one myself. I was very impressed. The device offered useful insights, and in some ways, it made me more conscious of how my choices affected my sleep, fitness and energy, both crucial aspects of mental wellbeing. The more I observed, however, the more complicated the picture became. There were benefits, yes: a sense of accountability, structure, even motivation, but I also could see the potential for some not-insignificant downsides: a subtle erosion of trust in one's own internal signals and self-surveillance that, for some, becomes an obsession.
In this article, I want to explore both sides: what do smartwatches and health trackers offer us, and what might they take away?
2. Awareness is the First Step to Change
The appeal of smartwatches lies partly in their promise to show us what we might otherwise overlook, as without some kind of mirror, most of us might not observe how well we’re sleeping, how our heart responds to stress, or whether that anxious flutter we felt walking into work had any measurable ripple. In that sense, wearables offer feedback that appears to help make the invisible visible.
This can be incredibly useful, after all: To do what you want, you need to know what you’re doing. To make meaningful changes in our lives, whether that’s improving sleep, reducing anxiety, or feeling more energised, we first have to notice what’s happening.
Smartwatches help map the terrain. You don’t need to guess how that extra episode (or two) affected your rest, or wonder whether your lunchtime walk actually helped bring your stress down; the data is there. Sometimes that data confirms what we already know (“I felt rough, and yep, my HRV was through the floor”), and sometimes it reveals patterns we’ve been brushing past.
In therapy, a lot of people speak about feeling isolated in their experience, as though their tiredness, irritability, or brain fog is a sign that they’re broken or uniquely failing. But when you can trace these dips to concrete factors like a bad night’s sleep, a sustained period of high stress, it has a way of restoring some compassion. You realise, “I’m not just struggling out of nowhere. My body’s carrying something.”
Awareness becomes the ground upon which healthier habits can be built, and that is powerful. It may help a person move from vague unease to executing a more informed choice, or at the very least, being a little less ruminative and self-critical: “Maybe I’m not lazy. Maybe my system’s depleted.”
Still, it’s worth remembering: this awareness can also become a trap. Data that was meant to enlighten can easily become something we chase, measure ourselves against, or grow anxious about. Numbers alone don’t define us, they only open the door, and what matters is how we relate to what they show.
3. Data is Not the Same as Insight
Just because something is measured doesn’t mean it’s meaningful, which might sound obvious, but when it’s your own body being quantified, and the numbers look concerning it can be surprisingly hard to hold perspective. A raised heart rate might mean stress, yes. But it might also mean you’ve had a strong coffee, just walked up the stairs, or are simply excited about something. The watch doesn’t know that; it only knows how to count, and sometimes that too is unreliable.
This is where things can get slippery. Data invites interpretation but many of us are so eager to understand ourselves that we skip straight to judgment and that comforting sense that we ‘know’. “My sleep score was low, so I must be exhausted.” “My stress alert went off, so something must be wrong.” But what if you actually felt rested? What if your “stress” reading was your body responding to an intense but necessary conversation? Without context, numbers become shapes we try to fit our stories into, sometimes distorting the story in the process.
That’s the risk. Health trackers tend to present simplified versions of complex physiological processes, and while they’re incredibly clever, they are also blunt instruments. Most don’t account for your psychological state, your relationships, your trauma history, your menstrual cycle, your caffeine intake, or whether you’re simply nervous about a job interview. In a therapeutic sense, they’re offering content without containment.
There’s a difference between knowing that your heart rate is elevated and knowing why it matters. That gap between raw data and real insight is where emotional literacy lives. And it’s where a lot of my work begins with clients: not just noticing what’s happening, but asking what it might be trying to say.
So while the metrics can be useful, even eye-opening, they aren’t infallible. Nor are they neutral. If you’ve grown up distrusting your body, or feeling like you need to be constantly improving, then the data might not just reflect your state; it might reinforce your inner critic. And that’s where we have to tread carefully, as a smartwatch can inform, but it can also amplify.
4. The Good: Structure, Encouragement, and Accountability
There’s something comforting about having a structure, a sense that your actions matter and that there’s a rhythm to how you care for yourself. For many people, smartwatches offer just that. You move your body, you sleep a little better, you see the numbers improve, and suddenly, there’s a feedback loop: a link between cause and effect that makes your efforts feel visible.
This is where health tracking really can support change. For someone feeling lost in a fog of low energy or disconnection, even a small win (hitting a step count or seeing your heart rate return to baseline more quickly after a walk) can be reassuring. It’s not just about fitness, it’s about reassurance that you’re not stuck.
That kind of encouragement matters, especially during times when motivation is fragile. Behavioural psychologists have long known that what gets measured tends to get managed. But it’s more than that, being “seen,” even digitally, can change how we relate to ourselves. The watch becomes a silent witness to your intentions: the skipped late-night snack, the early bedtime, the extra 15 minutes of movement. When life feels chaotic, those small tracked moments can offer a feeling of traction.
It can also help break down the belief that things have to change dramatically or not at all. When the metrics nudge upward, ever so slowly, it can validate that small actions matter. And that can make it easier to keep going.
There’s also something to be said for the placebo-like effect of being monitored. When we know something’s being measured, we often behave differently. This isn’t necessarily a bad thing. For some, it prompts a kind of gentle accountability, not from shame, but from a desire to follow through on intentions that matter. In that way, the device can act a bit like a therapist: not fixing, but reflecting, with just enough presence to help you shift your choices.
5. The Bad: Over-Tracking Can Erode Trust in the Body
Of course, what’s helpful in one moment can become unhelpful in another; it's all about context. Smartwatches are not neutral observers; they interrupt, nudge, and at times, provoke. One evening, I was sitting still, perfectly at ease, when my watch buzzed to alert me that my SpO₂ had dropped to 76%. A level that, according to my limited knowledge, placed me somewhere between critical and unconscious. I felt fine, but for a moment, I wondered if I should feel otherwise. That seed of doubt, that sliver of “should I be worried?”, is exactly the kind of micro-anxiety these devices can quietly plant.
For someone already attuned (or over-attuned) to their body, this can become more than a passing thought. If a client already struggles with interpreting their heart’s faster rhythm as a threat, then being pinged about an elevated rate mid-commute, or during a meeting, doesn’t soothe, it confirms. Suddenly, the physiological becomes psychological. The watch reinforces the idea that something is wrong, even if the body is just doing what it’s designed to do.
This creates a kind of feedback loop. You check your data to feel in control. You see something “off,” and your anxiety spikes. The anxiety itself changes your physiology, which the watch then tracks, and round you go. For those who have a more obsessive or perfectionistic relationship with health, sleep, or performance, it becomes very hard to let go. You’re chasing numbers you don’t fully understand, in pursuit of a version of yourself the watch deems “recovered” or “optimal.”
And to make matters more complex, the data isn’t always accurate. Faulty sensors, incorrect positioning, dark skin, hairy wrists or tattoos can all impact the data you are being shown. Will we recall that fact when it is important to do so?. SpO₂ readings can drop for no reason. HRV can tank after a perfectly ordinary day. And because we’re often not equipped to interpret this information critically, the temptation is to take it as gospel. The body says “I’m okay,” but the device says otherwise, and the watch, being sleek and data-backed, tends to win.
The issue here isn’t just anxiety. It’s where we locate authority. In therapy, we sometimes talk about the “locus of evaluation”: the idea that we either look outward for confirmation or inward for truth. Smartwatches gently nudge that locus outward. Instead of asking how you feel, you ask your watch. Over time, this can chip away at your capacity to self-reference, and you forget that you might already know.
What starts as helpful data can become a form of self-surveillance, a subtle but persistent pressure to be monitoring, optimising, and improving. And when life feels unstable, it can be especially tempting to over-rely on numbers. The act of tracking offers a false sense of control. But underneath, it can mask a much deeper uncertainty the kind that no metric, no matter how granular, can actually resolve.
In today's society, we are already prone to a preoccupation with overoptimisation. Is it beneficial to enable ourselves to do so with increasingly sophisticated technology?
6. Smartwatches as Tools, Not Authorities
Used well, smartwatches can be powerful tools. They can help us notice patterns, nudge us toward healthier habits, and provide a bit of structure when we feel unmoored. But they are just tools, and like any tool, they work best in conjunction with other tools and when we stay in charge of how to use them. As the old saying goes, if all you have are hammers, every problem starts to look like a nail.
The danger arises when the watch starts to feel more like a supervisor than a support. When the data it provides begins to shape our mood, our self-worth, or even our sense of what’s real. I’ve had clients wake up feeling fine, only to have their entire morning coloured by a “poor” sleep score. Others have delayed exercise because their “readiness” score was too low, despite feeling energised. The body is ready but the numbers say no, and so we defer.
It’s worth pausing here to ask: who gets to decide how well you’re doing? Who holds that authority. The algorithm or your own felt sense? The truth is, no app can know you fully. It can’t account for how deeply a conversation moved you, or how much grief you carried into that restless night. It doesn’t know the difference between stillness and stagnation, between stress that’s damaging and stress that’s meaningful.
That’s not to say we should discard these tools, far from it. But we do need to use them with discernment. Sometimes that means checking the data and using it as a prompt. Other times it means deliberately not looking. It means asking yourself: what do I already know, before I check? That question alone can begin to restore something smartwatches often pull us away from: trust in our own inner signal.
In the end, mastery isn’t just knowing how to interpret the numbers. It’s knowing when to ignore them. Or when to hold them lightly. When to trust the data, and when to trust yourself more.