Who doesn’t love a feel-good song? It’s an ageless question, really. Centuries before Freud and the development of psychotherapy, music was helping people feel better: The beating of drums or the sounds of a harp, flute, or church organ were inspiring, calming, consoling, and re-energizing human beings.
One reason for its long therapeutic track record may be that music has the power to bring together very different people in a positive, uplifting way. If in doubt, just watch the last scene of this year’s sequel to the 1989 movie “Bill and Ted’s Excellent Adventure.”
When music isn’t saving the world with Bill and Ted, it is also helping people find relief for their depression. The research says so— (more about these findings in a bit)—but so does my more anecdotal, professional experience. As a music therapist, I’ve had the privilege of working with patients in a mental health and substance abuse treatment setting. Many of these people have depressive symptoms. (Sometimes it’s a primary diagnosis of a mood disorder like major depression or bipolar disorder; other times— a function of being in early recovery from drugs or alcohol.)
But exactly how can music and music therapy help people who suffer from depression? What follow are some insights and lessons from my own work in this field as well as recent research in this area. (Learn more about how inpatient treatment that includes music therapy is helping people manage depression and other mental health disorders at FHE Health.)
Music Strengthens Close Relationships and Reduces Anxiety
Anxiety is a prevalent, co-occurring feature of depression and mood disorders and is so common among people with depressive symptoms that, from my experience, it’s almost rare to meet someone with depression who doesn’t have anxiety probems. Sometimes, too, this anxiety can be further aggravated, (at least temporarily), when a person begins inpatient treatment for depression. The experience of being away from family for an extended period— and in a new and foreign environment with strangers who have various mental health disorders—can increase the anxiety that’s already there.
Meanwhile, the stigma that still surrounds mental health disorders and substance addictions can amplify patients’ anxious thoughts and feelings. If someone perceives that they or those around them are unstable, crazy, and stuck in “the loony bin,” imagine the impact of that outlook on a person’s anxiety levels and their retention and engagement in treatment. (Not only can anxiety worsen depressive symptoms like insomnia, appetite, and avoidance of social interactions, among others, but it can prevent a person from participating in treatment.)
Very often music therapy relieves anxious thoughts and feelings, helping patients move into a calmer state of mind about where they are and why. For example, mental health patients often find relief from recording messages to their family with music. The exercise builds a sense of emotional connection with their loved ones that bridges the physical distance they sometimes feel— and decreases anxiety. From this place of acceptance, they’re better equipped to engage with treatment. (Engagement with therapy is one important predictor of successful long-term patient outcomes.)
Another thing that helps patients relax and shed those anxious thoughts and feelings: Once a week, taking about 3-4 hours to just listen to music and let themselves go. No agenda. No therapeutic prescriptions. Just listen to the music and let it be.
One of my favorite exercises when leading group therapy is to invite patients to share the songs that they find motivating or relaxing and then play these same songs for the group. I am not there to engage in complex musical or psychoanalytic analysis about why a song is motivating or relaxing, but I like to give patients the opportunity to share why they picked a song and why it motivates or relaxes them.
These moments when patients open up about the positive feelings that they associate with one or more songs are like momentary but powerful timeouts for anxiety; and, with more habit and repetition, these timeouts for anxiety can increase in both frequency and length.
Music Is a Great Distraction in Itself
How is it that even something as simple as listening to music can be therapeutic? Patients often share that music is a distraction in itself— which can be just what’s needed for a mind that is stuck in a cycle of anxiety, depression, and/or addiction cravings.
As illustration, for patients whose depressive symptoms can trigger a drug or alcohol relapse, music isn’t just an outlet for expression; it’s a way to disengage from cravings (the sticky and compulsive thoughts and feelings related to using drugs or alcohol). Doing something creative like playing guitar or learning an instrument is an especially good distraction from drinking or using.
Music Therapy in Combination with Depression Treatment Improves Patient Outcomes
Given this experience, it’s not surprising that research in recent years has concluded that treatment outcomes for people with mood and depressive disorders improve when music therapy accompanies “treatment as usual” (TAU). In 2017, a review of more than 28 studies looked at various music genres (drums, percussion, other instruments, etc.) and their use in music therapy or “music medicine,” with a view to evaluating whether they relieved depression (over and above TAU), as measured on clinical scales of depression.
Not surprisingly, music correlated with marked improvements on these clinical measures of depression— and another study in 2017 came to the same conclusion. This good news is one more reason to believe that, with treatment and interventions like music therapy, people with even severe depression can feel better more of the time.
I remember a guy in one of my groups— let’s call him “Mike”—who was severely depressed and couldn’t snap out of it. He was so depressed that he believed he wasn’t even worth working with and a waste of my time.
Somehow, Mike came around to the suggestion that we do some brainstorming. From there, he did some song writing and brainstormed some skits. Then we recorded the song he had written and those skits. Listening back to what he had recorded gave Mike—and me—a sense of pride, accomplishment, excitement, and ownership.
Mike’s depression didn’t suddenly evaporate there and then, but for the first time in a long while, he saw and experienced a patch of blue sky. It was enough for him to want more.
This article was provided by musician Gary Wayne, who directs the music and fine arts therapy program at FHE Health, a national behavioral health provider.