The brain operates all of our thoughts, feelings and movements — and it also helps us adjust to a rapidly changing environment. This hour, host Krys Boyd is joined by three guests who will explain how we can regain our ability to focus and tame our overactive minds – plus we’ll learn all about the growing research into the many ways listening to music benefits our brains.
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Transcript
Krys Boyd [00:00:00] Your brain is a powerhouse. It connects with other organs in your body to make you function. But what happens when your brain isn’t working to the best of its ability? And it starts to feel like you are running on empty. Some of us handle stress better than others based on our genetics, our upbringing, or our current place in life. Some have it easier than others, but everybody faces challenges. Namely, how do we check all of the boxes on our to do list and still find time to recharge at the end of the day? From KERA in Dallas. This is Think. I’m Krys Boyd. Today we are talking all about the brain. Our desire to stay centered and focused, and strategies we can practice in our daily lives to get there. Later in the hour, we’ll talk about how our brains respond to stress, how we can maintain work life balance, and we will hear how music might be the cure for easing our busy minds. But first, we’ll hear how we can find our equilibrium and why it may be difficult to get there. Camila Nord leads the mental health neuroscience Lab at the University of Cambridge, and she is the author of “The Balanced Brain: The Science of Mental Health.” She joined us in March 2024. Camila, welcome to Think.
Camila Nord [00:01:09] Hi, Krys, it’s great to be here.
Krys Boyd [00:01:11] There are definitely relationships between what our bodies experience and how our brains feel, or what our moods are. First of all, what do we need to understand about the difference between a mood and an emotion?
Camila Nord [00:01:23] So scientists conceptualize emotions as the sort of things that you feel every day, relatively fleetingly. Oh, I felt angry in that moment. I felt sad, and the next I felt happy when that happened. It’s often things that are consequences of other things. You can sort of pinpoint what happened and then how that led to an emotion. Whereas moods are a kind of underlying state, and you could be in a very low mood for a prolonged period of time and nevertheless experience that mood is peppered with a few different emotions, maybe even happiness sometimes, but it would still revert to that kind of attractor state of the low mood that you were in. So the mood is sort of the background color on which various emotional states can come and go.
Krys Boyd [00:02:12] So good mental health, this is important, is not necessarily about the absence of negative emotions.
Camila Nord [00:02:19] I don’t think so. I think good mental health specifically is our ability to respond to the mental and also physical challenges in our everyday environments. I don’t think that there is some lofty ideal of a brain that doesn’t experience negative emotions. The point is, being able to respond to those negative challenges is really difficult things that we all experience in our lives.
Krys Boyd [00:02:43] Camila, can we experience a low mood in response to internal inflammation somewhere in our bodies, even if we can’t physically feel the effects of that inflammation, like, even if it’s not causing us physiological pain.
Camila Nord [00:02:57] So yes, in short, you might have felt this. If you’re the kind of person who feels blue when you have a cold in the UK that sometimes called man flu. I don’t know if that same term existed.
Krys Boyd [00:03:09] We have that here.
Camila Nord [00:03:09] But yeah, people who have man flu which women can get to it’s, you know, you feel very sorry for yourself when you have a cold. I am 100% in this category. It really affects your mood. Similarly, another way you can kind of test this association is you can increase someone’s inflammation by giving them some kinds of vaccine. So for example the flu vaccine temporarily increases inflammation. That’s you know, one of the ways in which you’re immediately having a immune response to the vaccine. And for some people, that also makes their mood worse temporarily. And in fact, there’s a correlation between the two of these. So the more it increases your inflammation in that acute state, the worse you might feel mood wise. And that is tightly coupled to changes in a particular region in the brain, which is also affected in depression. So that’s not to say that temporarily increasing inflammation gives you depression. It just gives you the kind of cognitive and brain changes temporarily that look like you’re in some kind of low mood state, like depression.
Krys Boyd [00:04:13] Why might inflammation potentially drive depression in some people, but not in everyone?
Camila Nord [00:04:20] Initially, it looked like overall patients with depression had higher levels of inflammation, which we can measure by taking their blood and looking at things like in circulating cytokines, little immune signals in the blood that come up as a result of an infection. Incidentally, you also see raises in these kinds of markers of inflammation just from going through something stressful. So they’re not just affected by things like infections, but actually when we look a little deeper, it looks like not only do only some people with depression have these disruptions. But actually, even amongst those with so-called inflamed depression, they might show different kinds of disruptions in their immune system, suggesting that you wouldn’t necessarily want some new immune targeting drug for everyone with depression. You might want a couple new ones. For some people with depression, for those people who have these inflamed states.
Krys Boyd [00:05:18] I want to talk about how our brains prediction systems might play into mental health. Lots of us have heard about dopamine and think it’s, you know, somehow associated with pleasure. It’s a lot more complicated than that, right?
Camila Nord [00:05:32] Yeah. I would say it’s actually not associated with pleasure at all. I know that that’s the hype that it’s got. That’s the label it’s got. I think when people are talking about getting in popular culture, like getting a dopamine rush from something, if anything, I think there may be talking about the endogenous opioid system. They’re not talking about dopamine. That doesn’t mean dopamine doesn’t do some really, really cool stuff, though. So one of the coolest things it does is something called a prediction error. When it signals when something is better than what you were expecting. So initially, if you get something rewarding that you weren’t expecting, yes, you are going to get a dopamine signal for that. But if you get something rewarding that you were expecting, you actually won’t get a dopamine signal for that thing. Dopamine might track the predictor of what’s going to give you a reward. So that anticipation signal is one thing dopamine is doing. So in telling you what is surprising, it’s actually telling you something really crucial, which is what to learn about in the world. So dopamine is this molecule that’s signaling in some regions of the brain. What things in the world we should pursue, what things we should learn about, what’s what we think we should anticipate coming in the future and helping us build those expectation models of the world that are so crucial in our sense of our own mental health.
Krys Boyd [00:06:55] If everything always went along as expected, and if we were satisfied with absolutely everything in our lives, would we lose motivation to do anything?
Camila Nord [00:07:05] Yeah, maybe we would. So dopamine has other roles, and one of its key roles is in drive in motivation. And so this isn’t entirely the same as its kind of ability to help us learn about the world. But in essence, you really need that motivation in order to be exposed to anything pleasurable, anything worth learning about. So that drive and motivation is sort of the undercurrent that then leads to lots of other things that can improve your mental health. And I would imagine that in some hypothetical brain that didn’t have any reward prediction errors. Well, there would be very little to learn about and very little to kind of motivate yourself to change.
Krys Boyd [00:07:47] Help me understand this. Wanting things we don’t have doesn’t always give us pleasure, but it is still a critical component of good mental function.
Camila Nord [00:07:57] Yes. So the drive to sort of do anything, and it doesn’t necessarily have to mean achieve something pleasurable, it could mean avoid something negative. But that intrinsic drive is just as important for our survival, but also, of course, for our ability to kind of not just survive, but thrive in the world. This is sometimes called drive motivation. It’s an aspect of mental health is very, very ancient, existing in lots and lots of other species, not just humans. It’s the thing that kind of helps people keep going. But we also see disruptions in it, in mental health disorders. So for example, in depression, but also in neurological disorders like Parkinson’s disease, we see profound deficits in this motivational drive. And in the case of Parkinson’s disease, that’s because of a deficit in dopamine.
Krys Boyd [00:08:51] So why is it that people with depression sometimes experience a lack of motivation to seek out rewards? I think those of us who are mentally healthy assume that, you know, people could feel better if they would go out and do the things they once loved.
Camila Nord [00:09:06] I’ve been thinking about this a lot lately, because sometimes if you’re someone who doesn’t experience depression, you almost have this bias to think like, well, everybody should engage with things in the world the way that I do. That’s the normal way to engage with it. But actually, there are some real adaptive benefits to not going out and getting things. One of those is conserving energetic resources. So every decision we make, whether you have depression or not, is actually a kind of balance between conserving your resources, maybe not subjecting yourself to threats out in the world as well. But even just at the very basic, basic level, keeping your calories, keeping your energetic resources versus engaging with something in the world that might be very good, but would undoubtedly expend some of those resources, maybe put you at risk of things in the outside world as well. So there is definitely an argument that it’s adaptive in some circumstances, not always have drive and motivation to somehow achieve more, but in fact to conserve what you have to stay safe.
Krys Boyd [00:10:12] We hear so much these days about the importance of gut health without necessarily thinking about why it matters. What have we learned about the communication that takes place between the brain and the gut?
Camila Nord [00:10:25] So there have been some really formative animal studies suggesting that the gut microbiome influences behavior, or perhaps cognition in the brain. And this means the diversity of the microbiome, which can be affected by so many different things. But it’s essentially the kind of bacterial environment that we live in that can then multiply. The microbes in this gut. So babies are born without a microbiome as soon as they’re born. So if you’re born through vaginal birth, then you develop a microbiome immediately. And then throughout your life, you’re experiencing changes to your microbiome, often from the foods you eat, but also from other things. Infections. Inflammation can change your microbiome. Antibiotics change your microbiome. So lots of things change it. So animal studies seem to show that there’s this kind of mysterious link between how diverse the populations of gut bacteria are and behavior. So is the animal showing sort of depression like behavior, anxiety like behavior. If their gut microbiome diversity’s worse, then so too are these mental health like symptoms. And this is quite exciting because it accords with big population studies that show that in the population, the same people who experience worse mental health also tend to have worse gut health. So I think this is a really cool field. It’s actually a field that I would suggest is missing kind of some key evidence before you go out and buy any kimchi, which is we don’t really know if changing the human microbiome for the better for most people will affect their mental health, it might affect their gut health. And maybe if you’re somebody whose mental health is worse because you’re experiencing gut disturbances, then maybe it could affect your mental health. But is there this direct link in humans? I think the jury’s still out. And the reason for that is that these sorts of studies are super, super well controlled in animals. The animals live in a germ free environment. Their genetics are controlled for it. In the human world are microbiome is just a mess. It’s constantly exposed to different things. Scientifically. Would giving someone something that increased the diversity have enough of an effect to really change their mental health? I would love to see a study that suggests that, but we haven’t had it yet.
Krys Boyd [00:12:44] We have talked so much about endogenous brain chemicals and the ones we ingest. What about talk therapy? How could we possibly change the way our brains work by thinking and talking?
Camila Nord [00:12:55] So one thing that really frustrates me is that sometimes discussions about mental health either stay entirely in the kind of psychological realm speaking about talk therapies, speaking about psychological causes, or in the biological realm, speaking about antidepressants, speaking about quote unquote, chemical deficits. But in fact, we really need to speak the same language across both causes and also treatments, because that’s what our brain does. Our brain responds to things, whether that thing is a drug or a talk therapy. And in some of my own work, I’ve shown that the brain changes from both antidepressant drug treatment and from psychological therapies, but it’s actually slightly different regions of the brain that are changing. So I think of them both as brain based treatments. It’s just that they’re doing slightly different things.
Krys Boyd [00:13:48] So the syndrome you call busy brain is not quite as straightforward as, say, leading a busy life and having a brain. You’re talking here about this pattern of neuroinflammation caused by chronic stress. What are some common signs that our brains are being physiologically affected by our mental burdens?
Romie Mushtaq [00:14:08] Krys, thank you so much. You’re absolutely right. When people hear the word busy, they think of the external factors that are competing for our attention. But this is actually a chronic stress management crisis. We’re in a place in a post-pandemic world. Nobody wants to be told, Krys, just eat berries and breathe and everything’s going to be fine, right? And so as I was researching with all the corporate clients I was working with, there were a few patterns that emerged. Number one, I call it being stuck on the stimulant sedative cycle, a stimulant like caffeine, or even maybe prescription ADHD medicine like Adderall, which is overprescribed here in the United States. You think there’s no way I can focus, let alone tune into my personality, without an extra boost of energy drinks or coffee or these stimulant medications, and then you’re wired all day and maybe even low key anxious and you don’t know what to focus on. And a simple email like me email you after the show and saying, hey Krys, thanks for reading my book will take me 37 minutes to complete and I’m still anxious. And then you’re wired and you can’t leave work behind when you go home. And when you put your head down on the pillow, they’re racing thoughts or what’s known as ruminating anxiety, creating insomnia. Or even worse, you wake up somewhere in the middle of the night between 2 to 4 a.m. you’re wide awake and you can’t go back to bed. So you fool yourself to thinking, I’ll feel better if I tackle something on my to do list. And you get up and you do a load of laundry before the kids get up.
Krys Boyd [00:15:37] Okay, so what you’re talking about here is all tied to inflammation, which is this immune response that is supposed to help us heal. Why is it that chronic inflammation is bad for us?
Romie Mushtaq [00:15:49] What happens in the brain? We know this mechanism of interleukin one in the brain gets elevated. And other disease states like dementia or neurodegeneration of Parkinson’s, or if you have a virus in the brain. But what was shocking, as I was doing the research for this book, Chris was sitting under chronic stress month after month, year after year. We’ll create the same response. And it’s not just in the limbic system of the acute stress response that a lot of us has heard about. It actually affects a particular part of your brain, what I call the busy brain center, or in clinical neuroscience terms, your hypothalamus and the SC and nucleus, which governs something known as your circadian rhythm or your body’s biological clock. And just like an airport traffic control tower that’s linking one airport, like in Dallas, to airports all around the world. Our hypothalamus is the same way, Krys. It’s linked to the memory and attention and mood centers of our brain. But guess what? Also, it’s linked to our hormones and our digestion and our respiration. So now this synchrony or symphony that should be happening in your body for all your organs to be working in a 24 hour cycle are completely disrupted. Just like a storm coming through DFW airport and canceling all incoming and outgoing flights.
Krys Boyd [00:17:08] You are writing about this as a physician with years of experience treating neurology patients, but also as a person who has experienced these effects. Would you share just a little bit about your catastrophic run in with your own busy brain?
Romie Mushtaq [00:17:22] Yeah, Chris. It was probably one of the most important reasons I wrote this book. I know what it feels like to be walking the halls of the workplace alone, and it’s visible that something is wrong. This happened to me back when I was in neurology at a time where less than 5% of the brain doctors in America were women, and we didn’t have terms back then, like a mental health crisis or burnout at work. And my patients knew I was struggling and asked if I was okay, but none of my colleagues did. It was the loneliest place to be in the world, and I remember it started out as simple chest pain, which was initially diagnosed as just acid reflux. You’re too stressed. But it turns out I have a rare medical disorder known as echolalia. And because I was prescribing to that burn and turned special that so many listeners are, I’m just going to churn through the day and burn the midnight oil to get my work done. It caught up with me, and the symptoms became so severe that I was waking up in the middle of the night, choking on my own saliva and vomit and getting pneumonia. We knew something was wrong, and by the time I was correctly diagnosed, I had pre-cancerous lesions and ended up in life saving surgery. And Krys, I was sitting there in the hospital knowing that nothing I learned in medical school up till this point is going to help me now.
Krys Boyd [00:18:33] So you came to realize you were caught up in what you call this stress success cycle, which is about what believing a certain kind of success is essential, regardless of the cost. And then assuming that running around, being stressed all the time is assigned to you and everybody else of how committed you are.
Romie Mushtaq [00:18:50] Yeah. You know, so many high performing leaders I work with feel like success at all costs. And I hear this term often. I’m living at the edge of burnout, or we were stressed as a badge of honor, or you’re just resigned to the fact of Krys, who in journalism or tech or health care or the legal field is not stressed these days. You’re stressed. I’m stressed. Everybody is keep pushing. And that’s the stress success cycle. I’m here to say, hey, success is sexy. I want you to achieve your life and personal goals and professional goals, but not at the cost of stressing and burning yourself out. And there’s a different way to handle this.
Krys Boyd [00:19:29] Over time, you develop the brain shift protocol to give patients tools for healing. We’ll go through some of those, but we should note none of this assumes that we have the option to just drop our current responsibilities and move to some tropical island somewhere. This is about finding ways to stay healthy despite whatever it is we have to deal with.
Romie Mushtaq [00:19:49] Yeah, you know what? I unapologetically write that I wrote this book for you. Success driven, unapologetic, Type-A professionals who don’t have the luxury to slow down or work a four hour workweek. I work with journalists like you, Krys. Doctors, CEOs, athletes, people, teachers, airline pilots, people who work irregular hours and love their jobs. I want you to succeed. I want success to be sexy, but not at the cost of burning out. That’s why we gave this busy brain test a free neuropsychology battery than people can do for free on our website and social media to get a brain score. 17,000 people took this test. That gave me unique insight of what’s happening in chronic stress and burnout in our brains and body, and that’s how we developed the protocol.
Krys Boyd [00:20:37] I hope that people will go and take the test, but can you just give us some examples of how we might know that we have a busy brain problem?
Romie Mushtaq [00:20:44] Yes. That you’re like, Krys, Romie, please don’t talk to me about all this brain science or make me focus without having caffeine in the morning. And I told you it was just a ventilator, but it was really three energy drinks. You have multiple browser windows open on your brain and in your on your computer in front of you, and your to do list is really controlling you. It’s multiplying faster than you can even check off one item when you go home. You need alcohol or a sedative to take the edge off. Or you just like I can’t show up as mom or dad without having this bourbon or overpriced supplement. And when you put your head down on the pillow at night, there are 72 battling conversations going on and the voices are really negative. Or you’re waking up in the middle of the night and you can’t fall back asleep. Those are all signs that you’ve got a busy brain.
Krys Boyd [00:21:32] We should note here, Romie, that not all stress is exactly the same, and its effects on our bodies and our brains can vary as well. So let’s go through some of these. What is acute stress?
Romie Mushtaq [00:21:43] Acute stress is, you know, the busy brain center is that typically a calm station. And then there’s ice on the road. And acute stress is going to help you in that moment so that you’re not focused on the car coming in, oncoming traffic and how great the rims are. But you’re actually all focused on how to steer your car and and not slip into oncoming traffic and ice. That’s acute stress that lasts seconds or minutes at the most hours, and you come back down to the calm station. That’s when a breathing technique or taking a nap or self-care can work. Chronic stress is unrelenting stress in your personal, professional life that’s been going on for months or years, and often people in the situation have at least one, if not more critical life change happening. You may have a loss of a loved one dealing with the chronic disease, financial burden, changing a job, even good news like getting married or having a new baby can be a cause of chronic stress because it’s change. And then the last thing is burnout. And that’s when you’ve just churned and burned, and that the chronic stress has made you reach a point where not only are you overwhelmed, you’re cynical and you’ve lost that joy in life.
Krys Boyd [00:23:02] How does neuroinflammation lead to the all too common experience of feeling both anxious and exhausted at the same time, what you call wired and tired?
Romie Mushtaq [00:23:12] Yes. You know, you’re listening to this interview with Krys and I, and you’re like, ladies, I got you. I’m going to go stand on self-care tonight. I’m going to skip the alcohol. I’m going to shut my laptop down, do the digital detox that we talk about in the book and try to sleep. The issue is, is when we’re under chronic neuroinflammation. Remember I went back to that airport traffic control tower, your circadian rhythm in the brain. Your stress hormone levels now are jacked up at full energy at night when you need to go to bed. So that means and translates in neuroscience term your cortisol your dopamine is elevated. The more screens you have open at night, the more dopamine is there. And sadly, your protective restorative hormones in your brain like serotonin and melatonin that are going to help you rest and find calm. Your feel good and sleep good. Hormones plummet. And so now physically, you could be really tired that you’re really wired. And when dopamine, adrenaline and cortisol are surging at bedtime, all we do is stress, obsess and worry and fool ourselves into thinking, if I knock one more thing off my to do list, I’ll sleep peacefully. That just fuels the energy hormones even more.
Krys Boyd [00:24:28] So, Romie, there’s the problem of overcaffeinated and racing thoughts. What do we know about how neuroinflammation from chronic stress actually messes up our sleep wake cycles over time?
Romie Mushtaq [00:24:40] We know that over time. And it could be months to years for everyone. Your circadian rhythm, your biological clock in your brain is now distorted when energy hormones are surging at night and your sleep good and fuel good hormones in the brain, serotonin and melatonin are depressed. We know this pattern exists. You can measure this in the blood, in the saliva, in people that are chronically sleep deprived or have racing thoughts at night.
Krys Boyd [00:25:08] What are some things we can do to restore a healthy and natural circadian rhythm without prescription medications or over-the-counter medications?
Romie Mushtaq [00:25:17] Even this was the part of the brain shift protocol. Shift is an acronym for sleep or circadian rhythm is the US, and in chapter 11 or week two of the protocol, we go through the seven daysSleep challenge, which is based in cognitive behavioral therapy for insomnia techniques, as well as two supplements. So an example of those is really committing that for the next 7 to 10 days, no matter what’s going on in your life, you’re going to restore your sleep wake cycle by number one, setting a regular time to go to bed, number two, backtracking 30 to 60 minutes and turning off all digital devices. That includes your laptop and smart TV and e-readers. Even if you’re reading the book or listening to this show late at night with your loved one. And the last one is as we talk about key supplements that can help. As always, this is medical education or health education. Talk to your health care provider. But in our research, we found two things are really off when your circadian rhythm is disrupted. One, you need magnesium bliss and a key mineral for all these systems in the brain. Number two is a powerful natural supplement known as five HTP five hydroxy tryptophan. In clinical studies, in low doses, it’s found to be very powerful, not only in helping you fall asleep and stay asleep, but resetting their circadian rhythm. It breaks down naturally into the body, into serotonin and melatonin. And here’s a pro tip if you’re taking melatonin chronically, please stop. And please don’t keep giving it to your children. When you take melatonin more than 3 to 7 days, it actually disrupts your circadian rhythm. It’s saying, hey, Krys, you don’t need to make any more melatonin in your brain. But also it can disrupt other key hormones like human growth hormones and estrogen levels in men and women.
Krys Boyd [00:27:05] What is a brain pause, and how can that be helpful for calming a busy brain?
Romie Mushtaq [00:27:10] I started to get hired by companies and professional athletes to teach mindfulness and meditation, and then people would come back and say, that was helpful, but there’s something else going on, And that’s where this busy brain cure started. If you’ve ever tried to sit down and have present centered awareness and meditate and you’re like, I can’t shut down the thoughts in my brain, I must be meditating. Wrong. This is for you. What a brain pause teaches us to do is what I call step away from the scene of the crime. Now, this isn’t about CSI Miami or the crime podcast you’re listening to, but the scene of the crime for most of us is our work desk. So step away. Like there’s yellow crime tape from your work desk at home or in your office. And I want you to help visualize that you’re seeing, touching, tasting something different than work. Our five senses are key in a brain pause. That’s the way the brain receives information through those five senses. So in a brain pause, we talk about scheduling breaks during the day. If you have a job like I do and you work from home, it’s ideal. You are forced to go out in nature, leave your digital devices behind or go to the kitchen and chop up some vegetables and have a snack. But we also talk about some other serious ways that clinical medicine and science has told us can work. Two things that I advocate for in this book is the power of music and sound healing. We give a list in the book of particular type of sound healing music that’s actually been studied to help the brain, initially done in stroke patients, to help them regain movement back after they had lost movement in a stroke. We know we can help you by putting on headphones and listening to binaural beats, a certain type of music. Refocus. And if that isn’t enough and every muscle in your body is tense from work, we get up and we say, shake it off. Like that famous Taylor Swift song and literally shake your body. There’s a method called shaking, and we describe it in week four or chapter 13 of the book, and we have resources on our website that give you the techniques to take a brain pause.
Krys Boyd [00:29:18] As we start to heal our busy brains, Romie. Will we know it’s happening? Like, what are some signs that these measures of care are working for us?
Romie Mushtaq [00:29:26] Yes. You’re going to wake up and feel energized without needing coffee. You’re going to find that your to do list is not controlling you, but you’re controlling it and you’re able to actually focus. You know what? Three things on your calendar are the most important thing to do, and everything doesn’t feel like a competing emergency. Even better, the carb cravings stop and the stress eating stops and you fall and you stay asleep again.
Krys Boyd [00:29:51] So when Hippocrates was thinking about the potential for music to cure what ails us, this was actually already an ancient idea, right?
Daniel Levitin [00:29:59] Oh, well, the idea goes back even to pre-history, 20,000 years ago. As far as we know, shaman and faith healers were using music to cure injuries and disease, psychological disorders, depression, and to encourage wellness among members of a tribe.
Krys Boyd [00:30:18] Now, in ancient Greece, physicians thought may be particular scales worked for particular illnesses. Right? So like they thought there was a healing power and exposure to certain pure tones rather than just listening to music in general.
Daniel Levitin [00:30:32] Yeah. And there are still people that think that that there is a magical frequency that will somehow cure you of cancer, or a different frequency that will make you productive and focused. And so far as we know, that’s not actually true.
Krys Boyd [00:30:47] It’s too bad because everybody wants a magic pill, right? Or a magic note.
Daniel Levitin [00:30:51] Yeah, exactly.
Krys Boyd [00:30:53] We know, of course, there’s no evidence that there’s no distinct frequency in isolation that has any effect on the body. So if it does have healing properties, then what might be the source of those?
Daniel Levitin [00:31:05] Well, you know, like anything biological, it’s a complex system and it’s probably not one thing. So when we’re talking about Parkinson’s disease, for example. It’s the rhythm that can help a Parkinson’s patient be able to walk when they otherwise can’t. It’s because there are clusters of neurons in the brain that can fire in synchrony to the beat of the music, and allow for the brain to use alternative pathways to maintain a steady gait and movement. Even though the primary pathways are damaged now, the mystery is that although it’s the rhythm of the song that does that, music works better than a metronome.
Krys Boyd [00:31:49] Why are our brains so good at keeping in sync with a sound?
Daniel Levitin [00:31:55] Well, for that very reason that the neurons fire in synchrony with with tempo, with the beat, and that probably has an ancient evolutionary origin having to do with being able to get out of the way of something that might be hurtling towards you. So think back 20,000 years. And the startle response. You hear a sudden loud noise and you jump out of the way without even thinking about it. That was a good thing to be able to do. You don’t want to have to stop for a moment and consider that may or may be an avalanche coming, or a tiger might be coming towards you. And so it turns out that the ear is directly connected to motor movement centers. And it’s also the case that the brain is a giant pattern detector. When it detects patterns, it loves it. And so the pattern of a steady beat is something the brain responds to.
Krys Boyd [00:32:46] Where does music happen within the brain?
Daniel Levitin [00:32:48] Well, music affects every area of the brain that we have mapped so far. So it happens everywhere. Not all music, not all at once. But for example, we were talking a minute ago about how different aspects of music are separated, like rhythm. Rhythm happens in one part of the brain, melody in another, loudness and yet another. And it all comes together later. And there are different pathways, which is why music therapy works so well. It’s working on different systems. So, for example, take Alzheimer’s disease or dementia in advanced stages of memory loss. Patients don’t recognize their loved ones. They don’t know where they are. They don’t know what year it is. They might not even recognize themselves in a mirror. Now imagine that was you. You look around. Nothing is familiar. Some patients have the response of just folding in on themselves and becoming catatonic, or most others become angry and aggressive agitated. But if you play either of those kinds of people, music from their youth, they suddenly come alive. They can remember the music of their youth because it’s more deeply encoded in the brain. It’s resistant to disease and degradation, and they suddenly find who they are. Again, they connect with that earlier self. They become relaxed, animated. It’s really something.
Krys Boyd [00:34:12] Most of us probably at least sing, even if only in the shower or in the car occasionally. But I wonder, does music activate more of the brain or activate the brain in fundamentally different ways? For people who read and play it as it does for those of us who mostly experience it just as listeners?
Daniel Levitin [00:34:31] Yeah, so performing and playing music not only activates more regions of the brain, but it is neuroprotective. It helps you to build up new neural pathways that strengthen your ability to do a variety of things. It also releases an important hormone called oxytocin. And I’ll add that it’s never too late to pick up an instrument. You can learn an instrument at any age, even if you’ve never been musical before. And by building up those new neural pathways, or if you’re already a musician learning a new piece or new instrument, you’re protecting your brain against eventual decline just due to the normal effects of aging or perhaps Alzheimer’s.
Krys Boyd [00:35:14] I want to move on and talk more about movement disorders. First of all, what is —
Daniel Levitin [00:35:18] I see what you did there. You want to move on.
Krys Boyd [00:35:21] The the accidental puns. Honestly, did I want to say on another note and then I stopped myself from saying that earlier.
Daniel Levitin [00:35:28] Well you’re in Texas where there’s a lot of cows who want to move.
Krys Boyd [00:35:33] Precisely. Well, what is rhythmic auditory stimulation? I think you alluded to this earlier, but I want to talk more about it.
Daniel Levitin [00:35:40] Yeah. So this is a way that we retrain the body’s internal clock when it’s damaged, and we can retrain other parts of the brain via guidance from an external source, like a drum beat or, or music. What what’s happening is we’re synchronizing auditory input to motor output through what’s called auditory motor and treatment. And that way we bypass damaged circuits using the cortical thalamic pathway. Just a fancy way of saying the cortex and the thalamus that govern thought and movement, and the actual technique of rhythmic auditory stimulation was implemented and discovered by Michael Tout, a famous person in our field who worked on it when he was at Colorado State, just up the road from you now in Toronto. And we find that if the therapy is given consistently over a period of weeks, the benefits can last for up to six months.
Krys Boyd [00:36:38] So this could be used to help people with with gait problems, trouble walking caused by something in their brains as opposed to their legs.
Daniel Levitin [00:36:46] Yeah. So, you know, not having a spinal cord injury or having a broken leg or a badly healed ankle or something like that. But yeah, brain or brain difficulties that might have arisen through a stroke or a concussion or damage to your head or Parkinson’s or multiple sclerosis.
Krys Boyd [00:37:05] My late father had Parkinson’s disease, and I appreciate the treatment that you give it in the book. He benefited from joining this therapeutic singing group called Parkinson Voice Project. Will you talk about what singing can do for somebody who might have trouble with speech and swelling over time?
Daniel Levitin [00:37:24] Well, so singing requires a different kind of breathing. And in fact, talking is one of the most difficult things for your vocal cords. One of the harshest things you can do with them is to talk. Singing is easier on the vocal cords. What my friends who are professional singers tell me is if I’m going to sing, I should try to not talk all day because that I can sing all I want, but try not to talk. Singing is more effortless even for non singers. As I say, it involves different breathing. And for your late father who was singing in a group, he probably benefited from oxytocin, that trust hormone and also Singing together increases serotonin, which is a a neurochemical that increases mood. Serotonin is the thing we take Prozac in order to boost, but we find that people who sing in choirs together have a lot of it. And it also reduces cortisol, the stress hormone, which can be toxic.
Krys Boyd [00:38:25] Maybe also a little surge of dopamine, which is often in short supply for people with Parkinson’s.
Daniel Levitin [00:38:29] I’m glad you mentioned that. Dopamine is really interesting because it does different things in different parts of the brain, in the frontal lobes just behind your forehead. It helps us to maintain attention in the basal ganglia, which are the structures damaged by Parkinson’s. It helps us to maintain synchrony in a steady gait. When dopamine is released in the limbic system, including an area I’ve studied called the ventral tegmental area, mine was the first laboratory to show that dopamine is released when you listen to music you like, and it gives you that warm feeling of pleasure. It’s the same thing that you feel the same dopamine hit when you eat a cupcake. If you like sweets, when you have sex, if you like having sex. And if you’re a gambler winning a bet, it’s part of the reward network.
Krys Boyd [00:39:21] How is music used to help people with symptoms of PTSD?
Daniel Levitin [00:39:25] So let’s define what PTSD is. It’s the lingering effects of some trauma. So, you know, people experience trauma differently and they experience the aftermath of it differently. But if it gets to the point where it interferes with the activities of daily life, we call it a post-traumatic stress disorder. Otherwise, it’s just stress, or it’s just a trauma that you’ve somehow dealt with or managed to shove away in a corner. But when it pops out and starts negatively impacting your life, it’s PTSD. We are seeing five out of 100 adults reporting new cases of this every year. A lot of this has to do with the stress of Covid and the lockdown, particularly among young people now. Music releases prolactin, which is a soothing tranquilizing hormone, the same one that is released when mothers and infants are nursing it released and both the mother and the infant during nursing. Music that you like produces serotonin and this helps to stimulate neurogenesis. That is, the growth of new neurons and simultaneously reduces your stress response by reducing cortisol and adrenaline. So in a course of therapy, you can recontextualize the the negative experience while you’re feeling more relaxed, while your mood is being improved through the music, through talk therapy, through talking about the experience and. Various forms of what are called exposure therapy, exposing you to the trauma of little bits at a time you either recollecting it or seeing pictures of it. That increase in their difficulty. And another thing that’s been very profoundly helpful in post-traumatic stress disorder, particularly among veterans, is collaborative songwriting, where you have the shared experience of some trauma. You bond through that and you write songs to express the trauma. You don’t have to be a songwriter to do this. And it can be very, very powerful.
Krys Boyd [00:41:31] How can the people prescribing and administering music therapy really understand what their patients need and respond to so that they’re not delivering one song fits all solutions that maybe work for some in up for others.
Daniel Levitin [00:41:46] We know that one song fits all, doesn’t work. So it’s not as simple as saying, oh, you’ve got depression. Take two Joni Mitchell songs and call Me in the morning. One of the things that people dislike most about public life. Public spaces is music piped in that they don’t want to hear because again, that music is so personal it gets inside your head. So music therapy will always involve you either choosing your own music or working in a dyadic relationship with a therapist, or in group therapy, where they help you to find the music that meets your therapeutic goals. It may be familiar, music may be new, unfamiliar music, but it has to be music you like or it won’t work.
Krys Boyd [00:42:29] So how can we choose music in hopes of relieving our own symptoms? Do we instinctively tend to know what we need, or are there suggestions you might offer to somebody who is looking to feel better using music?
Daniel Levitin [00:42:43] Well, all of us self-medicate to some degree with music. We use it kind of like we use caffeine and alcohol. We have a certain kind of music we know we help wake us up or get us through a difficult workout. Another kind of music to relax us before bed. We have songs that we bring out as social lubricant at parties. And we know that they’ll work. The problem is that if you’re talking about very refined medical uses of music for the kind of diseases we’re talking about Parkinson’s, depression. Stuttering, Alzheimer’s, you might need a more fine grained approach. And that’s where licensed music music therapists come in. I believe that I will begin to learn from music therapists and from your own playlists how to help you choose music. An additional problem is that we become immune to the effects of music that we know too well, and we seek new music to help us to feel good or to relax. Because the old stuff loses its luster. And that is the future of music. Medicine helping. There are 200 million songs now available on streaming services 100,000 new songs being uploaded every day. And I think this is a golden age of music making and music consuming. But we need to be directed to that new music or we’ll never find it. And I think that’s the future of music as medicine.
Krys Boyd [00:44:11] Dan, thanks so much for making time to talk.
Daniel Levitin [00:44:14] Nice to be with you again, Krys.
Krys Boyd [00:44:15] Daniel Levitin is a neuroscientist, musician and visiting professor at UCLA. He’s also author of I Heard There Was a Secret Chord: Music as Medicine. We also heard This hour from Camilla Nord, author of The Balanced Brain: The Science of Mental Health, and Dr. Romie Mushtaq, author of The Busy Brain Cure: The Eight-Week Plan to Find Focus, Tame Anxiety and Sleep Again. You can hear extended versions of each of these conversations at our website think.kera.org. You can also check out upcoming shows while you’re there. Think is distributed by PRX, the Public Radio Exchange. Again, I’m Krys Boyd. Thanks for listening. Have a great day.
