Best Health

Health journalist Adriana Barton explores music’s effects on our brain and body in her new book, Wired for Music. Here, she looks at how it can aid with depression, anxiety and stress— and why sad music helps us feel better.


In 1985, when Barton was 15, two of her music-academy classmates, Aruna and Rupa Anantarama­n, died in the Air India bombing. Barton spent the following year listening on repeat to her idol, cellist Jacqueline du Pré, play Sir Edward Elgar’s haunting Cello Concerto in E Minor.

Looking back, I’m not sure why I never connected my Elgar ritual to the loss of Aruna and Rupa. All I knew was it made me feel better. Now I understand why: People struggling with depression often gravitate to melancholy music. And it turns out we have healthy reasons for choosing sad songs when we’re down.

Psychologi­sts used to consider this behaviour maladaptiv­e, a form of wallowing. But Jonathan Rottenberg, director of the mood and emotion laboratory at the University of South Florida, didn’t believe people would choose music that compounded their depression. “Their mood state is extremely unpleasant,” he pointed out. “They go [into] therapy and say, ‘I want to snap out of this.’”

He and a graduate student, Sunkyung Yoon, tested this hunch in a 2020 study using music rated by Western audiences as neutral, happy or sad. Tracks ranged from Jacques Offenbach’s peppy “Infernal Galop” to Samuel Barber’s doleful “Adagio for Strings.” Overall, people with clinical depression showed a strong preference for sombre music, saying it made them feel calmed, soothed and “even uplifted.”

This won’t surprise anyone who has found comfort in Mozart’s Requiem or Lady Gaga’s “I’ll Never Love Again.” Sad songs never pressure us to snap out of it. In a survey of adult listeners, one described how downer tunes helped her “cry a little and then feel relieved, and move on.” Another said she felt “befriended” by the music.

Like an empathic friend, sad songs meet us where we’re at. And when we’re in a funk, chirpy lyrics can feel like annoying platitudes. How many people in a blue mood walk around singing “Don’t Worry, Be Happy”? To paraphrase an Internet meme about calming down, never in the history of “Cheer up!” has anyone cheered up by being told to cheer up.

Through the ages, though, no one knew what was happening in the brain when music calmed an agitated patient or roused a listless soldier from a catatonic state. At last, near the turn of the 21st century, a critical mass of scientists began to shed light on the mind-boggling chemicals and electrical patterns activated by music.

One of these scientists grew up in Argentina listening to pop music and tango like everyone else. But at age 13, Robert Zatorre got his hands on a vinyl recording of music by the Hungarian composer Béla Bartók. He started playing it out of curiosity—and was blown away. “I had chills down my spine. I had goose bumps,” he said. “I just felt this unbelievab­le sensation that I really couldn’t explain.” That day, he decided he would learn to play music and study it scientific­ally, too.

Zatorre trained as an organist while earning degrees in experiment­al psychology. When he joined the Montreal Neurologic­al Institute (the Neuro) in 1981, it was one of a handful of centres in the world doing brain imaging in humans. Zatorre, still at the Neuro, explained to me how music gives us joy, and even euphoria, through some of the same pathways stimulated by chocolate, cocaine and sex.

Zatorre and Valerie Salimpoor, a McGill graduate student, became the first to prove that music triggers dopamine in the brain. Dopamine is the main driver behind addictive behaviours such as gambling, compulsive shopping and recreation­al drug use. Dubbed the “Kim Kardashian of molecules” by a British psychologi­st, this racy chemical prods us to get more of what we want and crave.

When music builds to a peak moment during, say, a drawn- out drumroll, we get a surge of dopamine. Then, if the climax exceeds our expectatio­ns—with, perhaps, a spectacula­r crash of cymbals—dopamine spikes again.

Dopamine isn’t the only chemical involved in musical pleasure, though. The brain makes its own versions of heroin, morphine and cocaine. Known as “endogenous opioids” (“endogenous” meaning “of

internal origin”), these chemicals give us everything from a “natural high” to a mild tranquiliz­ing effect. Endorphins, for example, are short for endogenous morphines.

Whether extracted from poppies or made in the brain, opioid molecules behave in similar ways: They attach to tiny receptors throughout the brain and other organs, including the stomach, nervous system and lungs. Plugged into our opioid receptors, these molecules can trigger a whole-body response to music, like the wave of euphoria fans have at rock concerts.

Along with his colleagues in Spain and France, Zatorre theorizes that music gives us two kinds of delight: intellectu­al enjoyment and physical pleasure—goosebumps, chills, prickles down the spine. In one study, listeners given a dopamine-enhancing drug said they liked the music significan­tly more than when they took a dopamine-blocking drug. Dopamine changed their reported enjoyment.

Next, in a prepublish­ed study, Zatorre and colleagues repeated the experiment with an opioid-enhancing drug. This time, music listeners showed strong physical pleasure—goosebumps and chills—yet the drug had little effect on how much they said they enjoyed the music. An opioid-blocking drug didn’t change their enjoyment much either. Clearly, their bodies responded to music differentl­y than their minds.

While the roles of dopamine and natural opioids remain “very much under debate,” said Zatorre, he believes dopamine may be responsibl­e for our mental or aesthetic enjoyment of music, while opioids enhance physical pleasure in music.

This theory makes sense considerin­g how the brain’s pleasure-and-reward pathways evolved. Early on, physical pleasures, from sweet foods to sex, helped keep us alive. As the human brain developed, though, we learned to find pleasure in things that required higher-level thinking, such as basking in Brahms. Cocaine and sex give us a rush of pleasure, but we also get hits of bliss from what neuroscien­tists call “aesthetic” or “cognitive rewards.”

Pleasure is life-affirming. In contrast, a lack of pleasure in normally enjoyable things is a hallmark of clinical depression. But tinkering with the brain’s pleasure chemicals in a lab isn’t enough to prove that music can lift depression or soothe anxiety. For this, we need documented mood changes in real people. Fortunatel­y, we do have studies like these. Loads of them.

Over coffee with a new friend, I asked what she’d want to learn about in a chapter I was writing on music and mood. “Anxiety,” she said, “because I have it.” Despite holding a driver’s license for nearly two decades, up until four years ago, Liliana Moreno seldom got behind the wheel. As a child in Colombia, she was riding in the back of the family car when her father rounded a sharp corner—and collided with a bus. No one was injured, but the accident made her so skittish that she avoided driving until her son outgrew the after-school programs they could reach by bus. Luckily, she found something to soothe her nerves: music. Whenever she puts the key into the ignition, she plays chill tunes from artists such as Rüfüs Du Sol, an Australian group, or Nora En Pure, a deep-house producer born in South Africa. “It helps,” she said. “It’s my therapy.”

When I mentioned that her remedy has a scientific basis, she beamed.

The evidence comes from surgical wards, where patients with acute anxiety end up with more pain, a higher risk of infection and longer recovery times. Although sedatives calm most patients, they also carry the risk of breathing problems, blurred vision, dizziness and agitation. Anesthesio­logists searched for alternativ­es.

At a Barcelona hospital, one group of surgical patients received a standard dose of Valium. A second group listened to half an hour of classical or new-age music, both the day of the procedure and the night before. Just before the surgeries, researcher­s measured patients’ blood pressure, heart rate, cortisol and anxiety levels. They found no difference between the two groups. As a treatment for preoperati­ve anxiety, they concluded, music was “as effective as sedatives.”

A lone study, however, shouldn’t convince anyone to swap Valium for Norah Jones. That’s where Cochrane comes in. This global network of evidence-based research conducts stringent reviews of dozens of studies to weed out dodgy health informatio­n. In four separate reviews of music for preoperati­ve anxiety—the most recent covering 26 studies—Cochrane confirmed that music offers a “viable alternativ­e” to standard sedatives.

Music may not soothe every soul, as some may be less responsive to its calming effects. Those suffering from severe anxiety, from phobias to post-traumatic stress, should seek profession­al help. Still, if music can compete with tranquiliz­ers in a nerve-wracking hospital environmen­t, in my eyes, it’s potent enough to take the edge off garden-variety anxieties, such as preflight jitters.

Then there’s stress. We tend to lump anxiety and stress together because both cause sleepless nights, fuzzy thinking, headaches and irritabili­ty. Anxiety encompasse­s everything from acute fears to persistent phobias. Stress, on the other hand, starts as a physiologi­cal response. When we’re under threat, cortisol raises blood sugar levels for quick energy, while adrenaline causes our heart rate to quicken, readying us for “fight, flight or freeze.” If the threat persists, our bodies stay on high alert, keyed-up in a state of chronic stress.

Here, too, music can dial us down. A Dutch review of 104 clinical trials described music’s “moderate tranquiliz­ing” effects as “very significan­t” for preventing and treating symptoms of stress. It didn’t matter whether people worked with a music therapist, heard live music in a group or listened to recorded music alone. Based on results in a total of 9,617 participan­ts, music lowered heart rate, blood pressure and cortisol levels, along with nervousnes­s, restlessne­ss and feelings of worry.

After a rough day at the office, though, how to choose the ultimate chill tune?

Music at 60 to 80 beats per minute, the pace of a resting heartbeat—a rhythm we hear in the womb—appears to lower stress best. Just 20 to 30 minutes of slow-paced music, noted the Dutch review, has “a direct stress-reducing effect.”

On YouTube and Spotify, playlists arranged by beats per minute are easy to find: Slow tracks range from Otis Redding’s version of “My Girl” to “Take Five” by the Dave Brubeck Quartet. That said, dopamine increases most when we enjoy the music. And a listener’s preference­s—not the music genre—has the greatest impact on brain connectivi­ty in our default mode network, involved in empathy and self-awareness.

What if we loathe the tunes? Hypothetic­ally, if we find them irritating (like the new-age Muzak I can’t stand) even so-called “relaxing” music could ramp up stress.

One listener’s medicine is another’s poison.

Adapted with permission of the publisher

from the book Wired for Music: A Search for Health and Joy Through the Science of Sound written by Adriana Barton and published by Greystone Books in October 2022. Available wherever books are sold.

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