Music Aids Mental Health: Science Shows Why

Peace, joy, healing. You can see it, plain and powerful, in the faces of those who make music on the path to recovery. You can hear it as they speak of music’s role in their journeys out of psychiatric darkness and into the light of reclaimed lives.

Just watch and listen to those who harmonize through Sing Your Heart Out, an English program that’s open to anyone with any story — some with psychiatric diagnoses, some without, no questions asked either way. Or hear the words of James O’Flynn and his band, the Claddagh Rogues — among the many who gather for music and fellowship at 49 North Street, a well-being initiative in Skibbereen, Ireland.

Some say that music literally saved their lives, pulling them from the brink of suicide. Others say its mental-health benefits have played a significant role in their quest for wellness, providing relief from depression, anxiety, addiction, and freedom from hospitalization, incarceration, homelessness. “It kept me together,” said O’Flynn of the songs he created to carry him through his time in institutions. “It was the only sanity I could find.”

This all begs the question: Why? What is it about music that makes it such a potent and transformative force for healing? As a species, we like it — that’s obvious enough. But what does the science say about it? What can it tell us about music’s impact on our cognition and on our mood, on our capacity for empathy, and our sense of connection with others? How does it change the brain, an organ exquisitely designed to respond to its environment? In the process, how does it change us?  In study after study after study, the links between music and wellness have been repeatedly confirmed, as scientists keep digging into its social, emotional, mental, and neurological effects.

“Music is good for us,” said Steven Mithen, an archeologist with the University of Reading, UK, and author of the 2005 book The Singing Neanderthals: The Origins of Music, Language, Mind and Body. “It’s been known for many, many years that music has therapeutic properties. It’s been in all sorts of areas — people who’ve got mental stress or physical pain. Doctors use it during operations, during dental surgery. . . . But nobody’s ever explained why it does have these therapeutic properties. Why is music so good for our well-being?”

“The medicine of the soul”

None of this is new — not the questions sparking inquiry from researchers, not the widely held conviction that music benefits us. A belief in its significance, even a mystical faith in its restorative properties, has gripped the minds of poets and philosophers since the dawn of both. The ancient Egyptians used musical incantations to heal the sick; the Ancient Greeks played flutes to calm the agitated and dulcimers to aid the sad. Plato, one of Greece’s greatest sages and one of music’s biggest fans, declared it “the medicine of the soul.”

A Greek vase depicts a music lesson.

“Music produces a kind of pleasure which human nature cannot do without,” opined Confucius, and a couple of thousand years later, Talking Heads frontman David Byrne argued more or less the same. “You can’t touch music — it exists only at the moment it is being apprehended — and yet it can profoundly alter how we view the world and our place in it,” he writes in How Music Works. “Music can get us through difficult patches in our lives by changing not only how we feel about ourselves, but also how we feel about everything outside ourselves. It’s powerful stuff.”

Kahlil Gibran once called it “the language of the spirit. . . . bringing peace, abolishing strife.”  Or, in the words of Louis Armstrong: “Music is life itself.”

No single piece of research has verified such wisdom with raw data. But taken together, analyses exploring the neurology, psychosocial impact, and evolutionary underpinnings of music suggest that all those gurus were onto something. A vast range of studies examining functional outcomes illuminate its impact on how we think, how we learn, how we feel, how we age, and how we recover from illness and damage to the brain.

Cognitively, music assists in developing and maintaining “executive function” skills, helping kids and adults alike tune out distractions and nimbly navigate tasks. Children see improvements in math and language; kindergartners taking piano lessons are better at recognizing words. High schoolers who continue with music get better grades. Adults who play music have more plastic and adaptable brains. Stroke victims who listen to music recover faster. Parkinson’s patients who dance to music see improvements in their mobility, with tango helping them most of all. Music helps improve symptoms of depression. It helps memory, depression, and anxiety in people with Alzheimer’s.

Group music-making nurtures social skills in people of all ages. Teenagers in extended music classes enjoy enhanced social lives. Four-year-olds display “cooperative and helpful behavior.” Even babies respond to music: In one 2014 study, 14-month-old infants who bounced to music in synchrony with researchers later helped them pick up objects dropped to the floor. The authors conclude: “Interpersonal motor synchrony might be one key component of musical engagement that encourages social bonds among group members, and suggest that this motor synchrony to music may promote the very early development of altruistic behavior.”

All such research, so far, points to clear ties between music and wellness, and it confirms the impression it leaves on the brain. But the neurological dimensions of that impression — and, again, the whys behind them — include many unknowns. Illuminating and analyzing music’s benefits requires a gradual and meticulous analysis of exactly how it affects us, and precisely what goes on.

“The science is slow,” wrote neuroscientist Thibault Chabin, responding via email to questions on a recent French study that tracked the pleasure response of musical chills with EEGs, “and we need to understand mechanisms brick by brick.”

Also: the brain is really, really complicated. As Daniel J. Levitin points out in This Is Your Brain on Music: The Science of a Human Obsession, “It is difficult to appreciate the complexity of the brain because the numbers are so huge. The average brain consists of 100 billion neurons.”

Any one of us has more thoughts or brain states than all the known particles in the universe, he says. And as Byrne pointed out, music doesn’t even exist unless we’re there to process it. Any given snatch of it is assembled in silence, traveling on soundwaves that ripple through the air — set off by the snap of vocal cords, or the pluck of a guitar — until they smack up against an eardrum. Those sound waves cause vibrations that move from middle ear to inner ear and the cochlea. There, tens of thousands of hair cells shimmy, causing electrical signals that neurons ferry along to the cerebral cortex — which then begins the hugely complex, profoundly human business of turning them into music.

A full-body workout for the brain

But music isn’t just one thing — and it takes myriad provinces of the brain to take all of its elements, decrypt and then assemble them into Beethoven’s “Ode to Joy” or a song belted out in the shower. Rhythm gets uncoded on the right side, in the auditory belt and parabelt. Melody and harmony are channeled mostly in the auditory cortex of the temporal lobe, with assists from other areas; anticipation, a key piece in the enjoyment of music, builds in the prefrontal cortex. Other regions get involved, too: the hippocampus (memory), the visual cortex (reading music), the motor cortex and sensory cortex (making music or dancing), plus all the many zones of neurological real estate involved in emotion.

“I don’t think that there is anything besides music,” said Sarah Lock, executive director of the Global Council on Brain Health (GCBH) and senior vice president for policy at AARP, “that engages so many multiple parts of the brain and helps them work together.”

The result is the gray-matter equivalent of a full-body workout, building flexibility and muscle across the brain. As Oliver Sacks writes in Musicophilia: Tales of Music and the Brain: “Anatomists today would be hard put to identify the brain of a visual artist, a writer or a mathematician —   but they would recognize the brain of a professional musician without a moment’s hesitation.”

Again, this begs the question: Why? What happens inside our brains when people engage with music? Whether you play it, sing it, hear it at a concert or listen to it on your morning commute, it lifts the mood and lowers anxiety, firing off endorphins, releasing dopamine and deregulating cortisol.

Or consider the sensation of “chills,” that tingling pleasure many of us feel when we experience music we love — be it that snippet of Beethoven or a track from Drake. According to Avram Goldstein’s germinal 1980 study, roughly half of us get them while listening to music. For those who do, they’re unmistakable — sneaking up the spine and crawling around the scalp, a tiny blast of sensory fireworks that both anticipate the thrill of a favorite musical phrase and add to its pleasure. Their effects have been documented over the years by researchers looking at music’s effects on reward circuits in the brain (and the implications for people with depression) as well as the neurotransmitters and other “biochemical messengers” that respond.

In Cortical Patterns of Pleasurable Musical Chills, published in November in Frontiers in Neuroscience, Thibault Chabin and his colleagues at the Université de Bourgogne Franche-Comté in Besançon captured and tracked musical chills via electroencephalography (EEG), an approach that opens new directions in studying the neurology of musical pleasure. Electrodes attached to the scalps of 18 participants showed activity in the orbitofrontal cortex, an area of the brain — located just above the eyes — that’s closely associated with emotion and memory.

Thibaut Chabin and a study participant, from a poster session in the 32nd edition of the Eurockéenne Music Festival.

While the scalp results did not directly involve the brain’s reward structures, the activity did align with past research using fMRI and PET, Chabin said. Both of those are heavier, more unwieldy neuroimaging machines that can only be used in laboratories. EEGs, by contrast, can be taken into the field and used to track such electrical activity in people experiencing music in groups.

That’s the main significance of the recent study, Chabin said — to demonstrate that “musical pleasures and the chills” can indeed be captured with electroencephalography for future experiments. “The question of ‘why’ is essential,” he wrote, “because we know how it can be pleasurable, so future researchers should prove why. The fact that it recruits reward circuits involved in motivated behaviour, essential on the survival plan, such as sex, food, money etc., is intriguing.”

The mechanisms of musical pleasure

All of those pleasure sources have clear benefits for individual humans and the species — among them, staying alive and thriving. But as past studies have suggested, different clusters of reward circuits in the brain are engaged with different types of pleasure. Or not engaged, as exhibited in different types of anhedonia, i.e., an inability to feel pleasure. Failure to take pleasure from money is one type, leaving one part of the brain disengaged; failure to take pleasure from music leaves another part disengaged. This means that people can take high pleasure from music and not from money, or high pleasure from money and not from music.

With the EEG scans, Chabin said, three brain areas are “supposed to reflect” the mechanisms of musical pleasure. One is the prefrontal area, which is involved in emotional processing. Another is the temporal area, involved in auditory processing and linked with the orbitofrontal cortex; he cited recent research, published last year by Alberto Ara, that identified it as key to musical appreciation. Also involved, though less significantly, is the central area, which “we linked with the supplementary motor area involved in motor planning and maybe involved in rhythmic planning” as well as “musical imagery” — that is, the ability to conjure a tune in your own head.

As Chabin emphasized, the latest EEG research follows numerous other studies on the topic over the years — starting with Goldstein’s, which confirmed opioid peptides, i.e., endorphins, as part of the chemistry of chills by successfully blocking them with the opioid “antagonist” naloxone. The neurochemistry and emotional rewards sparked by music, and the self-reported experiences of those who feel them, have been re-confirmed in the four decades since.

In a 1991 study exploring physical responses to music, more than 80 percent of respondents reported “shivers down the spine, laughter, tears and lump in the throat.” In a 2009 study examining the link between subjective and objective effects of music, researchers showed that, yes, the intensely pleasurable chills felt by people listening to their favorite music equate with arousals in the sympathetic nervous system. Ten years after that, another study showed the neurotransmitter dopamine, the so-called “happy hormone,” plays a causal role in musical pleasure. A study from last year confirmed dopamine’s role in “mediating” same.

In another, as-yet-unpublished experiment, Chabin and his colleagues simultaneously scanned the brains of 15 people during a concert, tracking their physiological parameters — heart rate and skin activity — while they reported “their subjective emotional pleasure,” he said.

“The aim was to study how people share similar emotional experiences when they live a situation together, how they influence each other, if their neurophysiological activities are coupled in some part of the concert and try to understand how and why.”  At this point the results are confidential, but he called them “exciting.”

Why is all of this important? In Chabin’s view, because music itself is important in the lives of so many people — “like no other hedonic stimulation.” To understand the cerebral processing behind such pleasure could mean using music “to treat, or at least to soften, effects of several diseases.”

Music on our minds, and on our bodies

While hard science trains a lens on the brain, other research weighs the self-reported experiences of people themselves — and overwhelmingly, they say that music makes them feel better. Such are the findings of the GCBH, an international brain-health consortium that examined the impact of music on adults of all ages, training a particular eye on older populations. Formed by AARP in 2015, the council held a conference in February of 2020 that explored the role of music in improving mental health and well-being.

Its conclusions were unambiguous. “Any type of musical engagement – including singing, dancing, playing an instrument, composing music, and listening to music – appears to hold benefits for adults age 18 and older.” Further: “A higher percentage of adults who engage in music self-rate aspects of their cognitive function, brain health, quality of life, and happiness as excellent or very good. Adults who engage in music also report lower average levels of anxiety and depression.”

The full report, “Music on Our Minds: The Rich Potential of Music to Promote Brain Health and Mental Well-Being,” is based on the conference and accompanying survey of 3,185 respondents aged 18 and over. Conducted online, the survey showed small but significant ties between music and wellness.

“Adults who engage in music are more likely to self-report their overall health, brain health, and cognitive function as excellent or very good,” it states in its list of key findings. “Listening to music shows a small, positive effect on mental well-being, depression, and anxiety. This includes listening to music in the background, attending musical performances, and focused listening to recorded music.”

According to the survey, those who listen to music at least half the time they engage in “everyday activities” report slightly higher mental well-being and slightly lower depression and anxiety; they also remember names better, learn new things a little more easily, finish what they start more regularly, and claim better brain health overall. More focused listening to recorded music and live attendance of musical performances also yield positive effects on self-reported well-being, anxiety, depression, and brain health.

Sarah Lock.

The survey “showed us that even listening seems to be beneficial — and that’s another great thing about music,” Lock said. “It’s not just for those gifted people, right? It’s for everyone.” And for the older population, she added, “It really is a boon to healthy aging.”

When it comes to more active engagement, the survey shows that adults of any age who have ever — ever — participated in musical activities report better memory, capacity to learn, quality of life, overall health, and brain health. In the subset of adults over 50 who’ve actively engaged in music, they self-rate their cognitive function, happiness, and quality of life higher than those who haven’t. The larger report also cites research showing the benefits of active engagement over listening alone, and it notes the role of improved neuroplasticity — which aids memory, reason, adaptability, and focus, and creates a “cognitive reserve” that can help a brain rebound following injury or disease.

“Not all cognitive reserves are created equal,” it states. “People who have exercised and challenged their brains throughout their lives gain an edge. And it turns out that musical training is an effective way to help build the valuable cognitive reserve.” Taken together, the visual, auditory, and physical aspects of music-making all add up to a cognitive boost. “Studies suggest that people who engage in music-making as they age, either as a profession or a hobby, appear to have better brain health over the course of their lives compared to non-musicians.”

Childhood exposure is a big assist. But as the AARP report emphasizes,  it’s never too late to start: For those 65 and older, current engagement in music “amplifies the mental well-being effects of early music exposure or ‘makes up for’ a lack of initial musical exposure. Adults with no early exposure to music but who currently engage in some music appreciation show above-average mental well-being scores …  thus ‘making up for’ this lack of early exposure.”

In addition, the report stressed the social bonds encouraged by music, helpful in an age when omnipresent smartphones can lead to isolation. It builds social connections. Simply listening to music encourages empathy, as exhibited in brain scans of college students.

Music seems to have a social role.

Overall, Lock said, the findings of the survey and the round-up of research in the report all point to music as a powerful, widely accessible, and relatively inexpensive force in shaping wellness over lifetimes. With the Global Council’s input from international participants, she noted public-health movements in Asia, Canada, and elsewhere to open up avenues for music as therapy — making it easier for people to practice it and more accessible to people in need.

“Here in the States, we have a lot to learn,” she said. Such approaches could help many and might well be implemented “without having to spend tons of money on the concept.”

No, Lock said, music is not a cure-all.  “You don’t want to oversell what it can do. It can’t cure dementia. But it can make life a heck of a lot better.” And as a tool for well-being, she said, “It’s incredibly cheap, it speaks to many people, and it’s shockingly powerful.”

Prescribing music for what ails us

Given that trifecta of compelling characteristics, why not prescribe it as an alternative form of treatment? Debra Shipman makes precisely that point in “A Prescription for Music Lessons,” her 2016 paper in the Federal Practitioner.

“Playing an instrument may help decrease the need for antidepressants and provide a healthy recreational activity,” she writes. “Based on its physical and mental benefits, learning to play a musical instrument should be explored as complementary alternative medicine. Compared with filling prescription medications over an individual’s life-time, the cost of a portable keyboard is substantially less.”

Making her argument, she lays out the research showing all the reasons why anyone — old or young, healthy or facing a physical or emotional challenge — should take up an instrument.

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