A Scientific Review on the Relationship between Mental Health and Music
As defined by the WHO, mental health is “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.” (Source 1) An experience or environment that threatens this state of wellbeing, or hinders the ability to cope and interact with one’s community, will in turn increase the risk of developing mental health problems. Of course, mental health illnesses range in both categorizations and severity, impact people at varying levels, and are therefore addressed using differing solutions. Those clinically diagnosed with a minor (e.g. anxiety or insomnia) to severe (e.g. PTSD or schizophrenia) mental health disorders are commonly treated with pharmaceutical intervention, psychotherapy, and social-rehabilitation programs. (Source 2) However, these traditional methods of treatments may not be universally accessible to all, nor might they be the most appropriate path of treatment. As a result, ongoing research has turned to non-pharmaceutical and alternative approaches for supporting mental health diagnoses.
A novel research field has shifted its focus to music and its incorporation within the healthcare field. Numerous studies report significant benefits as a result of music being used as an aid to health treatment. For example, a clinical study investigating the effect of music on postoperative recovery in older patients outlines that older patients are at higher risk for complications post surgery, and that the traditional treatment approaches might in fact be more detrimental to one’s overall health. Although evidence is still preliminary, they discovered that using music as an alternative, non-pharmaceutical approach had “a positive effect on recovery of older patients, with pain and anxiety reduced, and relaxation,” and that more importantly, “no negative side effects of music as an intervention were found.” (Source 3) This in itself serves as evidence that music can help as a “non-harming and non-invasive” intervention within the healthcare system.
What is so special about music? What qualities does it possess that are beneficial to healthcare, and more specifically, to combating mental health disorders? Researchers have determined that music helps address a common challenge faced by many patients with mental health disorders: the ability to express/verbalise their thoughts and emotions, as well as their capacity to connect with those around them in a community. In the review Music, Mental Health, and Immunity, researcher Lavinia Rebechini outlines that music therapy, among other creative art therapies, is “effective for people who face barriers in expressing themselves with spoken languages, […] who find it difficult to talk about their experiences and feelings in words”, as it provides individuals with a safe and comfortable environment that promotes expression. (Source 4) In addition, studies indicate that musical participation paired with “verbal discussions, reflections, or interpretations” serve as a form of self expression, which more greatly allows patients to “explore the potential meaning of an experience, and to relate a new experience within therapy to situations in the client's life.” (Source 5) Furthermore, research on the benefits of music therapy on health outcomes support the idea that musical intervention provides greater “emphasis on improvement in mood, relationships and fostering of motivation” within recovery. (Source 3)
Music’s contributions to health treatment go beyond just its influences as a universal language and as a mechanism for expression and connection. Investigations of musical impacts on physiological/ behavioral responses document numerous cases in which music positively influences reductions of symptoms and physical/outward management of mental health disorders. Reviews of clinical studies investigating the relationship between music therapy and mental health management in general unearthed evidence that music significantly reduces anxiety and improves depressive symptoms, with substantial improvements to a patient’s “global state, negative symptoms, depression, anxiety, [and] functioning” positively correlated to increasing dose dependency. (Source 6 and 5 respectively) In other words, in studies that offered enough sessions to a sufficiently large enough group of individuals, researchers discovered that improvement of physiological symptoms was proportional and observable to the number of “doses” of treatment, aka the frequency of exposure to music therapy sessions.
Researchers have increased efforts to isolate the relationship between music application and specific mental disorders - to essentially answer the question as to whether mental health disorder diagnoses can predict the most suitable plan/type of music treatment necessary. For example, research has demonstrated that chronically depressed patients tend to indicate higher, stable EEG activity - electroencephalogram measures electrical activity of the brain - in the right front part of the brain. When treatment was supplemented with music therapy, one study found that not only did application of music throughout treatment decrease right frontal EEG activity in adolescents, it also decreased the release of cortisol, the hormone oftentimes associated with anxiety and stress - the fight or flight mechanism. (Source 7) In addition, a study investigating the effect of music for people with schizophrenia and schizophrenia-like disorders found that the supplementation of music therapy helped patients “improve their global state, mental state (general negative, depressive and anxiety symptoms), functioning (general and social), and quality of life” during treatment and lasting up to short/medium term post treatment. (Source 8)
The application of music within the healthcare system is still an ongoing research field, and there have been notable efforts to implement music therapy on a systemic and national scale within health - as seen with the UK's initiative to Scale up their Health Arts Programmes and Effectiveness Research within communities (SHAPER). (Source 9) However, it is important that we take the insights from these ongoing research studies and seek to apply the benefits to our everyday lives. The prioritization of mental health should not be solely reserved to those clinically diagnosed with a mental disorder, but also to the average individual within the community. Of course, music is not a cure-all type solution, but rather should be tailored or personalized to best suit the individual’s needs. Using music as a mechanism and as a supplemental vessel to nourish one’s mental health is one possible outlet, as music is so thoroughly integrated within everyone’s lives. Music offers the possibility and capacity for mindfulness and to gain a greater awareness of one’s physical, emotional, and mental health. Music is absolutely a universal language, and has qualities and components that every individual is capable of connecting to. In effect, music brings forth a community to which we can all relate to shared experiences of happiness, meditation, nostalgia, and other emotions of stability that benefits one’s health.
References:
World Health Organization. (2022, June 17). Mental health. World Health Organization. <https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response>
Mayo Staff Clinic. (2022, December 13). Mental illness. Mayo Clinic. <https://www.mayoclinic.org/diseases-conditions/mental-illness/diagnosis-treatment/drc-20374974>
Carr C, Odell-Miller H, Priebe S (2013) A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients. PLoS ONE 8(8): e70252. https://doi.org/10.1371/journal.pone.0070252
Rebecchini L. (2021). Music, mental health, and immunity. Brain, behavior, & immunity - health, 18, 100374. https://doi.org/10.1016/j.bbih.2021.100374
Gold C, Solli HP, Krüger V, Lie SA (2009) Dose-Response relationship in music therapy for people with serious mental disorders: Systematic review and meta-analysis. Clin Psychol Rev 29: 193–207 <https://www.sciencedirect.com/science/article/abs/pii/S0272735809000026>
Lee J., Thyer B.A. Does music therapy improve mental health in adults? (2013) A review. J. Hum. Behav. Soc. Environ. 2013;23(5):591–603. <https://www.researchgate.net/publication/274385051_Does_Music_Therapy_Improve_Mental_Health_in_Adults_A_Review>
Field T, Martinez A, Nawrocki T, Pickens J, Fox NA, Schanberg S. Music shifts frontal EEG in depressed adolescents. Adolescence. 1998 Spring;33(129):109-16. PMID: 9583665. <https://pubmed.ncbi.nlm.nih.gov/9583665/>
Geretsegger M, Mössler K, Bieleninik L, Chen X, Heldal TO, Gold C (2017) Music therapy for schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev 12: CD004025 <https://doi.org/10.1002/14651858.CD004025.pub4>
Estevao C., Fancourt D., Dazzan P., Chaudhuri K.R., Sevdalis N., Woods A. Scaling-up Health-Arts Programmes: the largest study in the world bringing arts-based mental health interventions into a national health service. BJPsych Bull. 2021 Feb;45(1):32–39. <https://www.cambridge.org/core/journals/bjpsych-bulletin/article/scalingup-healtharts-programmes-the-largest-study-in-the-world-bringing-artsbased-mental-health-interventions-into-a-national-health-service/542A58B075DD36AB52F05A4B2E9D741E#>
