Music Therapy vs. Antidepressants for Teens with Depression

Abstract

This research evaluated the advantages and disadvantages of two types of treatment for depression in teens, music therapy and antidepressant drugs. The purpose of evaluating these two treatments is to decipher which is ultimately the best treatment, according to studies, articles, and documentaries. It is important to note that while this research has analyzed data in order to understand what the best treatment is, there is no single treatment that will work for every patient. This research is important for teens coping with depression, as it indicates that there are many ways to treat depression. It is also important that teens not feel alienated with their mental illness, therefore more research should be targeted towards adolescents dealing with mental health problems. The method used for this research was a content analysis, as it effectively organized the data and quantified studies, articles, and other forms of data. Eight thematic concepts have been recognized, and then turned into questions that were answered using a 4 Point Scale. This 4 Point Scale evaluated strong and weak advantages/disadvantages, based on data provided, for each thematic concept. According to the 4 Point Scale, music therapy received 28 out of a possible 32 points, meanwhile antidepressant drugs received 16 out of 32 points. These findings state that in ratio terms, music therapy received an overall better score than antidepressants. In terms of thematic concepts, music therapy gained points in categories regarding emotional support and a less invasive technique style, whereas antidepressant drugs received points in areas regarding long term relief and the positive effects of chemically balancing the brain.

Introduction

Alarmingly, “about 20 percent of all teens experience depression before adulthood” (Center for Discovery, 2016). Often times, parents choose to put their adolescent kids on antidepressant medication. Antidepressants aim to chemically balance neurotransmitters that control mood and emotion, such as serotonin and norepinephrine. Common antidepressants include select serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and monoamine reuptake inhibitors (MOAs). (Smith, Robinson, and Segal, n.d.) While antidepressants are effective in treating major depressive disorders, they often produce physical side effects, including nausea, migraines, and dizziness, mainly due to the chemical alteration of the brain. On the other hand, there are holistic approaches to treating depression, such as music therapy. Holistic therapy does not use medicine in order to achieve “optimal health” by gaining “proper balance” in life (WebMD, n.d.). “Music expresses that which cannot be put into words”- Victor Hugo, a French poet, novelist, and dramatist of the Romantic movement was able to understand the healing capabilities of music. As stated by Laura Theismann, MT-ВС Music Therapist and Curriculum Director of Key Changes Music Therapy, music is a natural drug that “activates areas of the brain that are associated with memory, emotions, and motor planning”. As a natural drug, music is able to release dopamine, which can decrease depression and reduce stress and anxiety (Theismann, 2015). However, not much research has been found that proves that music therapy can work by itself or over a long period of time. This research discusses the advantages and disadvantages of antidepressants and music therapy in terms of aiding adolescents with depression through a content analysis, in order to conclude which of the two is the best primary form of medicine.

Literature Review

Depression and Its History of Healing

Initially, depression was called “melancholia”. Early traces of melancholia were found in Mesopotamian texts dating back to second millennium B.C., where “mental illnesses were attributed to demonic possession” (Nemade & Reiss, 2007). Early Babylonian, Chinese, and Egyptian civilizations would use exorcism techniques in order to heal depression, as these civilizations believed that depression was a form of demonic possession. Meanwhile, early Roman and Greek doctors believed that “depression was both a biological and psychological disease” (Nemade & Reiss, 2007). These doctors would heal patients with gymnastics, massages, specialized diets, music, baths, and a donkey milk and poppy seed concoction. Hippocrates, a Greek physician, believed that mental illnesses were caused by body fluid imbalances, which were classified into four humours, “yellow bile, black bile, phlegm and blood”. He also categorized mental illnesses into three categories, “mania, melancholia, and brain fever” (Nemade, n.d.). According to Hippocrates, melancholia was a result of too much blood in the spleen, and it could be healed with bloodletting, bathing, exercise, and dieting. Cicero, a roman philosopher, believed that melancholia was caused by “violent rage, fear and grief ,(Nemade, n.d.). Treatment for mental illness took a step backwards during the Christianity-dominated middle ages, as treatment resorted back to exorcism techniques or being locked up in “lunatic asylums”. Throughout the Renaissance, some doctors were returning to the views of Hippocrates, meanwhile mentally ill executions were common. When the Anatomy of

Melancholy was written and published in 1621, the author, Robert Burton, described the psychological and social causes of depression and included healing techniques, such as “diet, exercise, distraction, travel, purgatives, bloodletting, herbal remedies, marriage, and music therapy” (Nemade, n.d.). However, once the Enlightenment era occurred, depression was seen as an “unchangeable weakness of temperament” (Nemade, n.d.), and people were locked up.

During the 1700s and 1800s, a variety of explanations for depression were contemplated. Some believed that it was caused by solely aggression, whereas others believed that depression was an internal conflict between “unacceptable impulses and a person’s conscience”.

Depression in Teens

It is often difficult for teens to understand the difference between typical sadness or stress and depression. According to a pamphlet highlighting the differences between typical sadness and depression written by the National Institute of Mental Health, “depression is a more intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer”. For teens specifically, this could mean feeling a lack of motivation towards everything in life. Some symptoms include, but are not limited to, weight loss or weight gain, not sleeping enough or sleeping too much, lack of motivation, and feeling worthless (National Institute of Mental Health, n.d.). Symptoms are often difficult to see, as adolescents often experience a multitude of hormonal changes throughout their teenage years. While it is difficult to identify, there has been a 37% increase in the depression amongst adolescents and young adults from 2005 to 2014. In addition to this, teens with depression often deal with suicidal thoughts, and among students in grades 9-12 across the United States, approximately 17% seriously considered attempting suicide (Hurley, 2018).

Music Therapy and Its History

There have always been healing techniques associated with music, even in ancient societies. According to Dr. Debbie Carroll, a professor of music therapy at the University of Quebec at Montreal, music therapy has connected “music, healer, and patient” since the beginning of “antiquity” societies, as music healers would use their instruments to “purge evil spirits” to the point where the patients would reach a form of “trance,” thus making it easier to perform catharsis (Carroll, n.d.). In recent years, Dr. Gottfried Schlaug, a neuroscientist studying music and the brain at Harvard, found that stroke victims that were once “aphasie”, meaning they were unable to understand language, however after “70 hours of intensive singing lessons” the patients’ brains had the ability to “rewire” and “create a homologous speech center” (Gupta, 2012). So, what is music therapy? Per the American Music Therapy Association Fact Sheet, music therapy is “an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals”. The effects of music therapy have been studied in cases of learning disabilities (ie: speech impairments), Alzheimer’s, Parkinson’s, Chemotherapy, and Autism Spectrum Disorder, only to name a few.

Antidepressant Medication

The 1950s sparked the era of the discovery of antidepressants. The drug, isoniazid, was used in order to treat tuberculosis. A side effect of this drug caused patients to become “energetic” and “rowdy”. Due to these symptoms, researchers began testing the drug on psychiatric patients with depression disorders. This discovery led to the overall interest of pharmaceutical companies in developing drugs specifically for depression. The first class of medication, called tricyclics, were used in order to increase serotonin and norepinephrine levels and “block the action of acetylcholine” (Ogbru, 2016). In the 1960s, neurologists believed that the anti-tuberculosis drug was able to slow down the enzyme that breaks down serotonin, thus improving mood. This discovery led to a second class of drug, MAOIs, a form of antidepressant that inhibited monoamine oxidase enzymes, is capable of removing norepinephrine, serotonin and dopamine from the brain (Mayo Clinic Staff, 2008). Psychiatrists heavily relied on the use of the classes of these drugs, until SSRIs were discovered. SSRIs block the reuptake of serotonin and are used to treat symptoms of both depression and anxiety (Brought to Life Science Museum, n.d.). Overall, antidepressants have the ability to chemically alter the brain and increase appetite, balance sleeping schedules, and improve overall mood, just to name a few (Hurley, n.d).

The Gap:

While music therapy and antidepressants have been researched for their ability to treat depression, they have not compared within the same research. This research will attempt to evaluate each form of treatment in a way that will effectively compare both treatments. The ultimate goal of the research is to decipher the benefits and detriments of each technique, and compiling these aspects into a general consensus. This general consensus of advantages and disadvantages for each technique will ultimately evaluate which treatment has the most advantageous qualities in terms of treating adolescents with depression. It is also important to note that, while one form of treatment may seem more advantageous than the other, every patient's road to recovery is different.

Methods

A content analysis was chosen in order to conduct this research. In this content analysis, questions were created based off of thematic concepts found throughout sources regarding music therapy or antidepressants. In order to answer these questions and quantify the information, the questions were given a 4 Point Scale. The questions were created as “yes” or “no” questions, as it would be the most effective way to answer using the scale. In order to compile an eclectic group of research, this content analysis looked at Ted Talks, scientific journals, formal definitions, medical blogs, and case studies. The following sections will provide a step by step process of the methods.

Step One: Understanding Depression

In order to effectively analyze the advantages and disadvantages of music therapy and depression, a list of depressive symptoms was compiled. This allowed for an in depth analysis of both treatments. This list of depressive symptoms was found HelpGuide.org in an article aiming to aid parents in noticing symptoms in their teens.

Symptoms

Sadness or hopelessness

Irritability, hostility, or anger

Frequent crying

Withdrawal from friends and family

Loss of interest in activities

Poor school performance

Changes in eating and sleeping habits

Restlessness and agitation

Feelings of worthlessness and guilt

Lack of enthusiasm and motivation

Fatigue or lack of energy

Difficulty concentrating

Unexplained aches or pains

Thoughts of death or suicide

Figure 1: Symptoms of Depression

Step Two: Thematic Concepts

The following themes were used to evaluate the two treatments: Emotional Harm, Physical Harm, Scientific Breakthroughs, Ability to Stand Alone, Long Term Relief, and Effect on the Brain. In order to reduce the confusion of any definitions, operational definitions specified for this research were used for each theme. The use of operational definitions was inspired by uc Davis' article, “Introduction to Content Analysis ", as it was visually pleasing and well organized. The table that was used is listed below.

illustration not visible in this excerpt

[...]