The big idea: could we use music like medicine? | Science and nature books

In my adolescence and early adulthood, I could barely contemplate a life without music. Each Saturday I would traipse an hour to my nearest CD store, and spend nearly as much time browsing the aisles before returning home with my new purchases. I could spend hours lying on my bed, headphones over my ears and notebook in hand, as I deciphered every line of lyrics.

As time wore on, music slowly became a soundtrack to other activities, played in the background through the tinny speakers of my iPhone as I washed the dishes, cleaned the bathroom, or folded the laundry.

My emotional life is much poorer as a result. Recent research shows that more active engagement with music can be a boon for our mental and even physical health, with benefits that go far beyond the temporary mood boost of hearing our favourite song. The scientists behind these results describe the new field as “music medicine”, with the prescription of playlists a treatment for common ills.

The idea that melodies can comfort a troubled soul has ancient origins. Jewish scripture reports that Saul would be visited by an evil spirit that made him depressed, upon which he would call for David to soothe him with his lyre. “David would take the lyre and play it; Saul would find relief and feel better, and the evil spirit would leave him.”

The academic literature tends to distinguish “music medicine” from “music therapy”. The latter requires the participation of a trained expert and may involve playing an instrument, composing or improvising. Music medicine is far easier to roll out: it involves listening to recorded music and can be done by yourself.

As you might expect, the creative expression of music therapy produces the most consistent benefits, but multiple studies confirm that the mere act of listening can be an effective treatment for symptoms of depression, anxiety, insomnia and physical pain. Two trials have even found that a regular prescription of music can reduce the blood pressure of people with hypertension by 6mmHg. That’s enough to lower the risk of a stroke by 13%.

For some of these studies the participants were prescribed specific pieces, such as a Bach’s Flute Sonata or Pachelbel’s Canon, that are thought to be particularly soothing. But the benefits are also evident when participants are given free rein to pick the tracks themselves. (Musical taste is highly subjective, after all – a song that’s searingly beautiful to one person may sound like nails down a blackboard to another – and our emotional responses will depend on personal experience and associations.) The participants had to pay deliberate attention to what they were hearing, rather than using it as an accompaniment to other tasks, and in most cases they had to commit to regular doses over a sustained period. The most effective treatments for depression involved at least 60 minutes a week of mindful listening, for instance, while blood pressure was reduced with a regimen of 25-minute sessions daily for one month.

Music medicine may work its magic through a range of mechanisms. While it might seem obvious that happier tunes can get you out of a rut of negative thinking, many people who feel sad also benefit from listening to something melancholic. It’s possible that these pieces help us to accept our feelings without fighting them, which is often important for recovery. Depending on the track, we might feel a sense of connection with the artist’s expression of the emotions we are encountering, which could lead us to recognise the shared humanity in our suffering – a prerequisite for self-compassion – and allow us to find meaning in what we are experiencing.

At a physiological level, low-tempo tracks could help to entrain the electrical activity in the brain stem to slower rhythms, which can bring about a more tranquil mood and regulate other biological processes – such as heart rate and respiration. Repeating musical motifs, producing a buildup and release of tension, are also known to play with the brain’s prediction and reward circuitry. This can trigger the release of neurotransmitters such as dopamine and endogenous opioids, which ease both emotional and physical pain. At its most extreme, we may feel these neurochemical changes as musical frisson or “chills” – an intense aesthetic experience.

When compiling a medicinal playlist, it can help to pick a couple of pieces that mirror your current mood, before moving on to compositions that express a greater range of feelings, finishing with a piece that better reflects the emotional state you would like to achieve (this is known as the “iso principle”). If you are struggling to get over a breakup, for instance, you may be tempted to play Alanis Morissette’s You Oughta Know or Sam Smith’s I’m Not the Only One on repeat, but it might be more useful to mix them up with tracks that express optimism alongside pain, or that remind you of sunnier periods in your life. This strategy may help you to find perspective and insight, rather than descending into negative rumination.

However good your playlist is, music medicine is not a cure for serious mental illness, nor a replacement for professional help. Instead, it can be thought of as a useful alternative to meditation and other reflective practices that help improve our overall resilience to life’s stresses.

Reading about this research has encouraged me to rekindle my former passion for music. Rather than being a distraction from more important concerns, I now recognise it as an essential act of self-care – and I’ve already experienced the benefits. During a recent family crisis that filled me with guilt, frustration and grief, I found myself turning to the music of Anohni. Her gentle, meditative songs, infused with both sadness and hope, were the perfect tonic, allowing me to find peace and beauty amid the storm.

David Robson is the author of The Expectation Effect: How Your Mindset Can Transform Your Life (Canongate).

Further reading

This Is Your Brain on Music: Understanding a Human Obsession by Daniel Levitin (Penguin, £10.99)

Musicophilia: Tales of Music and the Brain by Oliver Sacks (Picador, £10.99)

Wired for Music: A Search for Health and Joy Through the Science of Sound by Adriana Barton (Greystone, £18.99)