Can music help with my mental health?
By Colin Murray
“[I] guess there are times when we all need to share a little pain, and ironin’ out the rough spots is the hardest part when memories remain. And its times like these when we all need to hear the radio, ‘cause from the lips of some old singer we can share the troubles we already know… When all hope is gone, sad songs say so much.” -Elton John
Arguably one of the most successful artists in recent decades, Elton John evidently believes—among countless others—that music can reach us when no one else can. Perhaps not a surprising logic for most of us, but why is this the case?
Why does music speak to us?
Almost all of the species on our planet can communicate through vibrations. Whether it be arthropods, snakes, dolphins, elephants, humans, and perhaps even plants, communication through vibrations is among the oldest evolutionary mechanisms for sharing information.
Grouped in with this is sound. Among animals, the ability to create sounds with the voice caused by the larynx—a structure in our neck that allows us to breath and make sounds—is highly conserved, evolving from a relatively primitive larynx like that of the lungfish, to the incredibly complex and specialized larynx of humans. So, what drove the continued evolution of the larynx into a structure capable of manipulating sound with such precision?
“These phenomena are really rooted in social communication”, says Dr. Daniel Bowling (PhD), a translational neuroscientist and instructor of psychiatry and behavioural neuroscience at Stanford University, whose research focusses on music-based treatments for mental health disorders. Dr. Bowling goes on to explain that the physiology of the larynx and its ability to constrain sound is also tied to emotional state, which is often expressed in the quality of tone (i.e., pitch, loudness, timbre, etc.).
This is a highly advantageous adaptation. The ability to convey an internal emotional state simply with tone, without spoken words, allowed animals to reach a new level of mutual understanding and connectedness. Knowing this, it is perhaps not surprising that many researchers believe that composing coordinated sounds and tones with the voice—otherwise known as music—is how spoken language began. Right from the beginning music was inescapably intertwined with emotion, social connection and communication, and has continued to be so across all ages and cultures for millennia.
This begs the question, with such tight evolutionary roots to emotion and social connection, what is the evidence for music’s contribution to mental health?
“People do use music to modulate their mental health all the time, … 70 to 80% of people [in global surveys] will say music is very important to their mental health. That’s a big deal”, says Dr. Bowling. He continues in saying that “our best therapies [for mental health] don’t help people that much, … they help on average a third of people… Music is a powerful alternative”.
This is also supported in clinical studies showing that music and/or music therapy can help reduce symptoms associated with mental illness, including depression, anxiety, stress and pain, with many patients believing that music should be a part of the healthcare experience.
What about on a biological level? How can music be modulating our emotions and possibly helping overall mental health and well-being?
Good vibrations in the brain
Pinpointing the brain regions responsible for the beneficial effects of music is challenging because music engages the entire brain rather than being localized to just one or two areas. That being said, we will look at few key areas in the brain that contribute to our emotional and physiological responses to music.
The amygdala and hippocampus, which play roles in emotion and social interaction, are involved in generating feelings such as joy, peacefulness, and sadness when we listen to music. The nucleus accumbens, often called the brain’s reward center, is linked to the pleasure or chills we may experience while listening to music. Additionally, the nucleus accumbens can change the way the hypothalamus (a critical regulator of the stress response) works, possibly altering stress levels. Finally, it is known that music can modulate neurotransmitters (signalling molecules in our brain) that control systems in the brain responsible for reward, movement, social bonding and pain, and all of these systems also contribute to emotional state.
Dr. Bowling highlights the fact that many of the fundamental dimensions of mental health, including emotional regulation, anxiety and social isolation/loneliness, and the brain networks associated with these, are also some of the exact aspects of the brain that music impacts. This means that music may influence many different systems in the brain that alters our emotional state, but the overall influence it has on our mental health depends on how we choose to engage with music.
“Music is a powerful emotional modulator, and that has two sides to it”, says Dr. Bowling. On the one side, music can help distract, comfort or alter your emotional state in a positive direction, but on the other side, music can also exacerbate negative emotions that can further worsen mental health, and this very much depends on the individual. This is common in people suffering from depression, for example, where they will tend to listen to sad music, which may intensify that emotion. But this same principle can also be used to help.
Music therapy
There are helpful and basic principles in music therapy that most people don’t know about, explains Dr. Bowling. One such is called Iso principle, which uses music to help guide an individual from an undesirable emotional state to a more constructive one. How does this work?
Music that initially matches your emotional state can lend a certain aspect of understanding that builds an unconscious trust between you and the music. Now that you're connected to the music, changes in rhythm and tone that are more associated with positive emotional states may be able to pull you out of your current state towards that positive emotional state. Dr. Bowling explains it as “mapping a trajectory through emotion space”.
Music therapy, whether in a group session, one-on-one or as an individual, is currently not a mainstream treatment option for different forms of mental health disorders. One reason outlined by Dr. Bowling is the extreme lack of music therapists available to perform this sort of work. Other reasons are perhaps a skepticism that’s present in the medical field in terms of the efficacy of music in mental health. “We think of music as entertainment, … but we should all take [music] seriously as a therapeutic option”, says Dr. Bowling.
Music—a complex symphony of vibrations—has deep roots in the evolution of language, emotion, expression of emotion and social communication, and is ubiquitous in every culture and community on Earth. Because of this, it’s perhaps not surprising that the word ‘vibes’ (i.e., vibrations) is used to describe social situations. Vibrations have been an absolutely essential aspect of social connection and emotion since well-before we could put these emotions into words. As it turns out, sad songs really do say so much.
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If you’re interested, check out some of the sources I used in researching this answer! All sources used for this answer are strictly evidence-based.
A randomised controlled trial for individual music therapy for depression.
A systematic review and meta-analysis for the effectiveness of music therapy and stress reduction.
The Paul Lepsoe music initiative: The integration of live music into healthcare.
A global scoping review of the use of music and treatment/managment of mental illness.