Illustration: Kieran Blakey

The Nuance

Music Can Get Us Through This

Why a good tune is so good at relieving stress, anxiety, sadness, and other negative emotional states

Surgical operations tend to be stressful experiences, and that stress can cause problems.

“The outcome of a surgery is very much predicted by the state a patient is in right before the operation — their emotional and physical state,” says Daniel Levitin, PhD, a neuroscientist at McGill University in Canada and author of, among other books, This Is Your Brain on Music.

Anxiousness can elevate a person’s heart rate and blood pressure in ways that slow wound healing, delay recovery, and increase the risk of infection. Heavy pre-op jitters can also interfere with the onset of surgical anesthesia. “So those preoperative minutes are crucial to the long-term success of the operation,” Levitin says.

To counteract these risks, doctors often give their patients a mild sedative such as Valium — something to settle the heart and nerves. But for a 2009 study, a team at Södertälje Hospital in Sweden took a different tack: Instead of administering a drug, they had patients listen to relaxing music for roughly 20 to 40 minutes before going under the knife. (The patients could choose from several genres of music, such as classical, soft pop, and jazz, but the specific tracks were preselected by a professional music therapist.) Compared to a second group of surgery patients who received the usual drug sedative, the group who listened to calming music experienced a more pronounced pre-op reduction in anxiety, the study found.

The Swedish team’s finding is a common one. According to a 2013 Cochrane review of 26 studies involving more than 2,000 people, music reliably reduces anxiousness among people preparing to undergo surgical operations. And the emotional benefits of music are not confined to the OR. The field of music therapy has exploded in recent decades, and trained music therapists are now helping people manage anxiety disorders and other physical or psychological conditions — everything from pain disorders to PTSD.

“People use music therapeutically all the time in their life,” says Peter Jampel, an adjunct associate professor in the Department of Music Therapy at New York University. “But when talking about music therapy, we’re talking about the intentional use of music to address specific areas of problematic functioning.”

According to an August report from the Centers for Disease Control and Prevention, nearly one-third of Americans experienced anxiety and depression symptoms during the month of June. At a time when sociopolitical strife and the threat of a deadly virus continue to cause widespread worry and despair, it’s possible that music — listening to it, but also playing it, singing it, and composing it — may offer many a light in the darkness.

“During this time of Covid-19 and the isolating effects of the pandemic, music can provide a meaningful, easily accessible way of connecting to the ineffable — to tapping inner experiences and memories and emotions that might otherwise not be accessible,” Jampel says.

Humankind’s primal relationship with music

In his text The Descent of Man, Charles Darwin theorized that spoken communication among early humans or prehuman species may have begun as something much more musical than the relatively tuneless modes of talking that we exchange today.

“Primeval man, or rather some early progenitor of man, probably first used his voice in producing… musical cadences,” Darwin wrote. In other words, we may have sung to one another before we learned how to speak.

Darwin is just one in a long line of scientists who have observed the profound and instinctual relationship that human beings have with music. Every culture known to anthropologists — current or past — has made music, and music is often referred to as a universal language because, like a smile or a hug, its themes and sentiments tend to require no prior teaching or translation.

Music activates a broad network of brain regions and centers, including areas related to reward processing, attention, and memory, says Abbey Dvorak, PhD, an assistant professor of music therapy at the University of Iowa. “Put something to a tune, and you remember it better,” she points out. (The alphabet song is one example.)

Research has also found that both alpha and beta wave activity in the brain shifts in response to music, which can either increase or decrease attention and arousal depending on its style and tempo. While mellow and simple tunes tend to be calming, research has repeatedly shown that jaunty, upbeat music quickens the heartbeat and provides a sustained infusion of energy to those who are running, lifting weights, or engaged in other forms of physical activity.

“A very large number of people use music almost as a drug,” says McGill’s Levitin. “There’s a certain kind of music they’ll put on to get their day started, a certain kind while driving or walking to work, something else for exercise, something else to wind down.”

It should come as no surprise that people can also use music to address their negative emotional states.

Using music to manage anxiety and depression

A 2017 review in the journal Psychology of Music found evidence that among people with clinical anxiety or depression, listening to music can lower heart rate, blood pressure, and other physical symptoms associated with one or both of these conditions. It can also selectively activate emotion-related brain regions in ways that improve mood and strengthen emotion regulation.

“Music can activate or downregulate the amygdala, which is the intense-emotion center of the brain,” Dvorak says.

“Someone who is feeling very sad and who needs a cathartic moment — listening to a piece of sad music may allow them to cry, and so get back to homeostasis.”

She explains that the profession of music therapy — the kind that involves a board-certified music therapist — is a personalized approach to mental wellness that may combine music listening with singing, playing an instrument, or even composing music. For people who are interested in exploring music therapy, Dvorak says the American Music Therapy Association is a great nonprofit resource.

You don’t need a therapist’s help to experience some of the soothing or mollifying benefits of music. But Dvorak says that accessing music’s benefits isn’t as simple as switching on Spotify. “In our lives, we have a lot of music around us,” she observes. Music is playing in the grocery store and at your coffee shop, and you may have music going all the time when you’re in your car or even in your workspace. She describes this steady background soundtrack as a source of “passive listening,” and in some cases it can be distracting or even disturbing.

For those hoping to manage stress or negative emotion, Dvorak says active listening can be a more fruitful practice. “This means listening with a purpose,” she says. “It means focusing completely on the music, which is a type of mindfulness practice.” Doing this involves setting aside your phone or other distractions and taking time to fully immerse your mind and senses in a piece of music.

Of course, the type of music you listen to matters. But there’s no one-size-fits-all soundtrack for mental health. “The ‘right’ music is very subjective,” Levitin says. “It depends on the time of day and your mood.” Generally speaking, he says music that is slow in tempo and that doesn’t feature any abrupt changes tends to be more calming. “But most people know what sort of music makes them relaxed,” he says.

Relaxation may not always be a listener’s goal. “Someone who is feeling very sad and who needs a cathartic moment — listening to a piece of sad music may allow them to cry, and so get back to homeostasis,” Dvorak says. Following that moment of music-aided catharsis, tracks that a person finds hopeful or encouraging or redolent of happy memories can help them move past those feelings of sadness, she says.

Music isn’t the solution to all our problems. But in those times when the drudgery or disappointments of life seem overwhelming, music — like all art — can help many of us reconnect with a sense of wonder and beauty.

“Sometimes there are things we can’t express in words,” Dvorak says. “But through music, we can express them.”

I write about health and science. I live in Detroit with my wife and kids. I’m trying to learn German, but my progress so far is nicht gut.

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