A report published by the World Health Organization (WHO) in 2017 shows that depression is one of the most common chronic diseases on earth. The numbers are staggering: around 322 million people live with some form of clinical depression. That’s close to five percent of the entire population of the planet. This is a serious, population-level issue: people with clinical depression can experience significant emotional, physical, and social difficulties or impairments. Depression can interrupt work, family, and school activities. When untreated, the symptoms of depression can cause extreme loneliness and lead to isolation, which often exacerbates the symptoms further.
People living with depression – especially when it goes untreated – may lose their passion for life and lose hope their depressive symptoms will pass. Some lose the will to live. Depressive symptoms can be so unbearable that, in some cases, they lead to suicide attempts and death.
That’s why it’s important for us to understand depression.
We need to know depression is not uncommon. We need to understand depression can be treated. We need to learn people diagnosed with clinical depression can and do learn to manage their symptoms and live full, productive lives.
The most common course of treatment for depression is a combination of psychotherapy – i.e. talk therapy – and medication. This approach has a broad evidence base and is proven effective. In addition, research shows various complementary modalities can also help improve the symptoms of depression. These include lifestyle changes such as diet and exercise, mindfulness activities such as yoga, meditation, and tai chi, and expressive therapies such as writing, drama, and music.
This article will discuss the latest evidence regarding the use of music in treating depression, and answer a question many people interested in the subject ask:
Does music help people living with clinical depression?
First, we’ll define depression, then we’ll move on to the evidence.
And we’ll answer that question.
What is Depression?
In their 2017 report on depression, the WHO offers the following definition:
“Depressive disorders are characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. Depressive disorders include two main sub-categories:
- A major depressive disorder or episode involves symptoms such as depressed mood, loss of interest and enjoyment. Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe.
- Dysthymia is a chronic form of mild depression, the symptoms of which are similar to a depressive episode, but tend to be less intense and last longer.
Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide.”
While this definition is not an exact match for the diagnostic criteria used by mental health professionals in the DSM-V (the go-to diagnostic reference manual for mental health disorders), it is a solid working definition that helps us understand what we’re talking about: a real mental illness that can dramatically alter the lives of those who experience it.
One thing the DSM-V includes that’s missing from the WHO definition is the criteria that the depressive symptoms must be present every day for at least two weeks or more to cross the threshold from typical sadness or feeling down to clinical depression.
This is important to understand, especially for parents of adolescents.
For example, a teen who becomes sad over a breakup or social problems but bounces back after a couple of days is probably not clinically depressed. However, if the sadness persists – for whatever reason – every day for two weeks or more, then they may be clinically depressed.
But this article is not just about adolescents. It’s about how music can help anyone with depression – and we’re getting closer to the answer.
Now, on to the evidence.
Music and Depression: The Latest Science
One challenge we face when writing articles like this is what evidence we present. It’s possible to find one-off articles or studies on any subject you can imagine. However, just because someone publishes a peer-reviewed article that shows – in this case, for instance – that music helps with depression, that doesn’t mean the question is settled.
A study may have few participants, a flawed design, or an incomplete statistical analysis – sometimes all at the same time.
That’s why we look for publications called meta-analyses. A meta-analysis takes a research question, such as “Does music improve depressive symptoms?” and looks for all the studies published on the subject. Researchers then apply advanced statistical analyses to all the results from all the studies they find and report their results.
The most recent, large-scale meta-analysis on music and depression we located was published in 2017. It’s called “Reviewing the Effectiveness of Music Interventions in Treating Depression.” This paper is important because of its size and scope. After an exhaustive search of over 60,000 potential publications, study authors settled on 28 papers that included 1,810 participants. The smallest study included in the analysis had five participants, while the largest had 236. All 28 met the stringent criteria adopted by authors for inclusion in the meta-analysis.
So, what did they find?
Here are the results:
[Note – in this meta-analysis, authors included music-related treatments that involved all of the following: music therapy, playing music, listening to music (including jazz, classical, hard rock, pop, and other), and drumming]
The Effect of Music on Depressive Symptoms
- Across all studies, as compared to treatment as usual (TAU), a combination of music + TAU showed a 43% reduction in depressive symptoms for mild, moderate, and severe depression.
- Mild/minimal depression:
- Compared to treatment as usual (TAU), a combination of music + TAU showed significant improvements in depressive symptoms.
- Moderate depression:
- Compared to treatment as usual (TAU), a combination of music + TAU showed significant improvements in depressive symptoms.
- Severe depression:
- Compared to treatment as usual (TAU), a combination of music + TAU showed significant improvements in depressive symptoms.
- Across all studies, the length of treatment needed to achieve significant reduction in depressive symptoms was different for individual treatment v. group treatment
- For individuals, significant reduction of symptoms was achieved with at least seven weekly sessions of half an hour each.
- For groups, significant reduction of symptoms was achieved with at least six weekly sessions of one hour each.
- Mild/minimal depression:
Interpreting these results is not rocket science.
The answer to our thesis question “Can Music Help Treat Depression?” is simple:
“Yes.”
The Power of Music
One interesting thing about the meta-analysis we’re discussing is the broad, inclusive definition used by the study authors as to what constitutes music treatment. Most people have heard of Music Therapy, which is a specific type of therapy that uses music in a clinical setting to treat people with emotional or behavioral disorders. You can get an undergraduate or graduate degree in Music Therapy, then become a music therapist.
But in this meta-analysis, music treatment included more than Music Therapy delivered by a degreed and licensed music therapist.
Whereas Music Therapy is officially defined as follows:
“The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”
The authors of the meta-analysis defined music treatment as:
“Implementation of acoustic stimuli (“music”) as a medium for the purpose of improving symptoms in a defined group of participants (patients) suffering from depression.”
This is a big deal because it means music can help treat people with depression whether it’s delivered by a credentialed music therapist or not. The 43% reduction in depressive symptoms seen over all 28 studies and 1,810 included people who received official music therapy, people who listened to music passively, people who listened to music and then composed lyrics, people who played instruments, and people who played drums. It included people who listened to jazz, classical, hard rock, pop, and the music of their choice. It included people who listened to music in individual and group therapy sessions. Across all these various scenarios, one pattern emerged: music has a positive, measurable effect on depression.
That may be a surprise to some people.
Those who have always believed in the power of music to heal, however, are not surprsed. And now have science and statistics to back up their belief. Now they can say with certainty: yes, music does help with depression – the latest data says it can lead to a 43% reduction in symptoms.
For the 322 million people living with some form of clinical depression, that really is a big deal.