Study uncovers some underlying reasons why music therapy helps treat depression

• Music therapy is a treatment option that may help manage many conditions, particularly different forms of mental illness.
• Experts are interested in understanding more about why music therapy is helpful in treating certain conditions.
• One study found that music therapy’s effectiveness in treating depression is related to people’s subjective enjoyment of the music.
• Researchers further identified distinct brain activity in participants who experienced improved depressive symptoms and found that changing music familiarity could improve participants’ enjoyment.

Using music to help treat mental illness is one focus of mental illness research. Experts are interested in understanding music therapy and how to achieve the best results from its use.

A study published in Cell Reports looked at some of the underlying mechanisms involved in the effectiveness of music therapy as a treatment for depression.

The researchers found that subjective enjoyment was a key factor in seeing an effective response in participants with treatment-resistant depression.

The results further highlight the underlying reasons why music therapy is helpful and what steps could enhance its effectiveness.

The benefits of music therapy for depression

This research involved 23 participants who had treatment-resistant depression. Treatment-resistant depression is depression that doesn’t respond to typical first-line treatments. All participants were between eighteen and sixty-five. Researchers wanted to understand more about how the brain responded to music in these participants.

Researchers looked at the effect of music on two key areas of the brain: the bed nucleus of the stria terminalis (BNST) and the nucleus accumbens (NAc). The study notes that both areas are related to the brain’s reward circuitry and emotions. They also explained that the brain’s auditory cortex takes music and then activates the brain’s reward circuitry to create an emotional response.

All participants had implanted electrodes in the BNST-NAc circuit. Researchers used these in their data collection, as well as temporal scalp electroencephalogram (EEG), to collect information on brain activity. Thus, they were able to collect data on different areas of brain activity: cortical and subcortical areas.

The researchers divided participants into two groups based on their familiarity with the classical music in question. In the familiar group, participants listened to a playlist regularly for two weeks and rated their preferences for specific pieces.

The participants who were able to listen to their preferred music saw more improvement in depressive symptoms, indicating that the anti-depressive effects of music are related to individual enjoyment. In addition, the participants who were unfamiliar with the music but enjoyed it also saw more remarkable symptom improvement than those who did not enjoy the unfamiliar music.

Enjoying the music helps reduce depression symptoms

Further analysis of all groups also suggested that higher levels of music enjoyment lead to higher synchronization between EEG readings and music and higher music enjoyment induced greater activity within the observed reward circuit.

The results also indicated that among the high-enjoyment group, the reward circuits’ response was influenced by the activity of the auditory cortex.

The researchers found that in participants who had a lower musical enjoyment experience, adding low-frequency sounds increased enjoyment and helped reduce depressive symptoms.

Based on all the results, the researchers further noted that familiarity may enhance the response elicited by the enjoyment of music.

Noah Kass, DSW, LCSW , psychotherapist, who was not involved in the study, commented on the study’s findings to Medical News Today :

“The findings underscore the need to tailor music selections to the individual preferences of patients if we want to see the greatest reduction in depressive symptoms. Music therapy, like many other forms of therapy, is most effective when based on a thorough assessment of what motivates the patient to achieve relief and ongoing change.”

“The study makes clear the importance of the patient having a strong, emotional connection with the music used in therapy. It suggests that the enjoyment of the music is the key factor in the effectiveness of music therapies for treating depressive symptoms.”
— Noah Kass, DSW, LCSW

Study limitations

This research does have some limitations. First, it only included a small number of participants. Thus, future research could work on replicating the findings in larger groups.

In addition, this research focused on a specific type of depression , so caution should be used in generalizing the findings to other depression types or other mental illnesses. The study only included Asian participants, so future research could have more diversity among participants. Researchers also did not perform analyses of components like sex and socioeconomic status in participants.

The researchers further noted that environmental factors, data resolution, and small sample size could have impacted results, so the observed oscillatory changes might be individualized. They also acknowledge that they were limited by the precision of the tools they used and that using higher-precision recording technologies could be beneficial.

Scott Horowitz , licensed professional counselor, and board certified music therapist, who was not involved in the study, also noted the following limitations of the data:

“As with any research there are certainly some limitations of this study, many of which are identified by the author. However, one that was only briefly mentioned and could be explored further or more explicitly discussed are the cultural factors in relation to music listening and music preferences.”

“As this study occurred in China and only seems to include Asian-identified participants, there may be some cultural elements that could be influencing or simply limiting the universality of the findings. So, a broader international study of similar design would be beneficial,” he added.

Understanding how music engages the brain

This research opens the door to finding the most effective applications of music therapy so that more people can experience the benefits. It also highlights how music therapy could be used more to help people with treatment-resistant depression.

“The study provides a deeper understanding of how music engages brain structures relevant to emotional processing. If we can continue to deepen our understanding of how and to what extent music can influence brain function, we could develop more effective therapies for treating mental health conditions such as depression, among others.”
— Noah Kass, DSW, LCSW

Horowitz also noted the following areas for continued research:

“One major piece that this study is lacking in relation to clinical applications and could be further explored are expanded contexts of the listening experience such as whether listening alone or with others. As the therapy process is based on relational dynamics, the impact of having the music experience with a therapist present and supporting and/or in a group format could better inform clinical implications. Another factor is the use of live vs. recorded music. This study focused on the use of recorded music which therefore cannot be modulated in response to a patient.”

“Perhaps integrating music therapy practice approaches could enhance the clinical applications of this study’s findings. The design and subsequent findings of this study also lay a foundation for additional future research to explore impacts on other mental states, such as anxiety ,” he added.