How Music Affects Health

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Music listening is a ubiquitous and constant phenomenon in our lives. This desire is driven by music’s core effects on motivation, pleasure, and social connection. These effects promote health and well-being (Levitin, 2024). Listening to music (self-selected) reduces stress and pain, improves mood, and reduces anxiety. The power of music comes from four core elements of human musicality: tonality, rhythm, reward, and pro-social affiliation (Bowling, 2023). However, to be effective, music medicine must consider individual tastes. There is no song that everybody likes.

1. Tonality

Tonality is a core element of human musicality. It includes harmony, melody, and timbre (the quality of sounds). Musical tonality conveys emotion and can regulate the listener's feelings. For example, a positive, calming voice can relieve high anxiety and agitated negative mood. Similarly, lullabies typically comprise tones with relatively more low-frequency energy with repeating patterns. However, some people (around 4 percent) lack the ability to experience the emotional qualities of music, and they find music unrewarding. They suffer from a condition known as amusia (commonly known as tone deafness).

2. Rhythm

Rhythm is a central component of music. Rhythm refers to the absolute timing of individual notes or sounds. The most notable thing about musical rhythm is that it urges listeners to move. This movement tends to be synchronized to the regularities in the rhythms. Music that is rated as high in groove motivates more spontaneous movements than music that is low in groove.

The capacity to synchronize accounts for a significant proportion of the benefits of musical treatments for anxiety and depression. For example, a widely cited study found that listening to music for at least one hour per day over a two-month period significantly lowered self-reported depression at 3 months post-stroke, as compared to standard medical care and rehabilitation. Rhythmic music has often been used to positively transform the experience of work otherwise experienced as negative and draining (e.g., cleaning the house, harvesting food, military drills, and moving cargo). It is similar in the context of physical exercise, where music can increase enjoyment and reduce perceived exertion.

3. Reward

Listening to enjoyable music activates the reward circuitry of the brain. Perhaps this is the most important reason why music is so rewarding. The pleasure is a key element of how much money one is willing to pay for a given musical piece. Musical pleasure is commonly called “chills” or “frissons.” It is the pleasurable bodily reactions such as goosebumps that many people experience while listening to certain musical passages. Much of music’s pleasure comes from the patterns of melody, rhythm, and sudden changes.

4. Prosocial Behavior

Engaging in music with other people is an effective way to stimulate social connection. Sharing rhythmic behaviors such as singing, dancing, walking, smiling, or talking together can increase social bonding. Engaging in musical activities with others fosters social connection and a sense of belonging. Listening to music together leads to synchronization of brain activity. Feeling connected to our social communities causes the release of endorphins, which are associated with feelings of pleasure, gratification, and a sense of trust.

In sum, the four core elements of human musicality—tone perception, rhythm, reward, and sociality—explain the observed benefits of musical treatment. There are, however, individual differences in musical preferences and appreciation that suggest substantial differences in individual capacity to benefit from musical treatment. In general, patients with a history of strong engagement with music and strong sensitivity to its tonal, rhythmic, rewarding, and social elements would appear to be good candidates for musical treatment.

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