Tag Archives: mental illness

Music therapy and schizophrenia

All art constantly aspires towards the condition of music” – Walter Pater

Can you imagine life without music? There’s scarcely anything in this world that can improve our mood as much as beautiful, uplifting music. Of course, depressing music can do the opposite. But can music be used as a form of medicine to help treat mental disorders like schizophrenia? Before we explore this complex, fascinating issue, let’s make sure we all know what schizophrenia is. According to the Mayo Clinic:

Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behavior.

Contrary to some popular belief, schizophrenia isn’t split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking.

Schizophrenia is a chronic condition, requiring lifelong treatment.

Can music therapy help treat this disorder? According to the University of Bergen, Bergen, Norway, in Music therapy for people with schizophrenia and schizophrenia-like disorders:


Music therapy as an addition to standard care helps people with schizophrenia to improve their global state, mental state (including negative symptoms) and social functioning if a sufficient number of music therapy sessions are provided by qualified music therapists. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcomes measures in relation to music therapy.

It looks like there may be some promise here. I know nothing about music therapy, but if it truly does work, I wonder if music therapist/composers will write music unique to each patient depending on what the patient responds to? Or is this what they already do?

Related articles:

Can exercise help overcome drug addiction?

Drug addiction is a public health crisis of epic proportions. Besides this, the illegal drug trade is closely associated with violent crime, and family breakdown. Many communities around the country are devastated by rampant drug addiction(which includes alcoholism) and violent crime. Virtually all of us know someone who is an addict or has someone in their family who is an addict.

The South Bronx in the 1970s. Drug abuse was a big contributor to the extreme urban decay of the South Bronx during this period. Drugs and crime are still a problem here. Photo by Mel Rosenthal, Duke University

The South Bronx in the 1970s. Drug abuse was a big contributor to the extreme urban decay of the South Bronx during this period. Drugs and crime are still a problem here. Photo by Mel Rosenthal, Duke University

Drug rehabilitation is rarely successful in the long-term, since most addicts relapse within a year or leave early. If the addict is poor, and/or has no family to support them, they all too often end up living on the streets, or in jail, or back in rehab. They are one of the most marginalized groups of people in the country, especially if they also suffer from mental illness, and are almost always unemployable. Needless to say, drug rehabilitation could use some serious improvement.

Now I am no expert on drug addiction, I have never used drugs, but not being an expert in something hasn’t stopped me from talking about it before. I often like to say that the best way to overcome a health-destroying addiction is to replace it with a good addiction. In my experience, this does appear to be work to some degree, although it is easier said than done.

Can exercise play this role, and should it be incorporated into drug treatment programs? We all know about the mood-enhancing effects of exercise, but let’s look at what our Danish friends at the Institute for Sports Science and Clinical Biomechanics, University of Southern Denmark, have to say in the study Exercise treatment for drug abuse–a Danish pilot study:


The results show that physical exercise can provide important support in the treatment of drug abuse and that the main problem is maintaining change in behaviour and peer group influence to ensure long-term change.

A small study, but this sounds good to me. Even if it doesn’t help overcome addiction, exercise helps improve health in so many ways it should be included whenever possible.

I also found this very inspiring: Running for her life – Dedication carries woman beyond addiction, crime, and homelessness:

Kenyon is a recovering drug addict, a formerly homeless woman who stole from stores on Newbury Street to fund her habit, a child of alcoholic parents, a victim of domestic abuse, a convicted criminal who spent nine years bouncing between jails in Massachusetts and New Hampshire. And she is a marathon runner.

This is simply amazing. To go from being a homeless drug addict to peak physical condition to allow her to run marathons. That is resilience. Incredible resilience. I think all of us have this kind of resilience in us. It is beautiful thing, and almost magical.

So if you are out of shape, what is stopping you?

Exercise and schizophrenia

Let’s have some fun today. Come with me deep into the human brain and have a look at what exercise can do for those suffering from schizophrenia. We’ve already explored how it may be beneficial for those with OCD(obsessive compulsive disorder), but I think it would be more interesting to see what exercise can do for those with a more “serious” mental condition.

Here is a list of the common symptoms of schizophrenia:

1) Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).
Disorganized speech, which is a manifestation of formal thought disorder
Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)
If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
2) Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.
3) Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).


Based on some of these symptoms, it looks like it may be difficult to motivate some people with schizophrenia to adopt a regular exercise regimen. There is a vast spectrum of severity of symptoms of this condition, with evidence that schizophrenia is correlated with some brain abnormalities(though this is not used to diagnose it).

According to the Department of Psychiatry, The Saarland University Hospital, Homburg, Germany:

Hippocampal volume is lower than expected in patients with schizophrenia; however, whether this represents a fixed deficit is uncertain. Exercise is a stimulus to hippocampal plasticity.

The results and conclusion of their research:


Following exercise training, relative hippocampal volume increased significantly in patients (12%) and healthy subjects (16%), with no change in the nonexercise group of patients (-1%). Changes in hippocampal volume in the exercise group were correlated with improvements in aerobic fitness measured by change in maximum oxygen consumption (r = 0.71; P = .003). In the schizophrenia exercise group (but not the controls), change in hippocampal volume was associated with a 35% increase in the N-acetylaspartate to creatine ratio in the hippocampus. Finally, improvement in test scores for short-term memory in the combined exercise and nonexercise schizophrenia group was correlated with change in hippocampal volume (r = 0.51; P < .05).

These results indicate that in both healthy subjects and patients with schizophrenia hippocampal volume is plastic in response to aerobic exercise.

While this study looked at the brain plasticity of schizophrenics, it didn’t monitor any improvements in living with their condition. Luckily, other researchers have explored if exercise can improve the lives of schizophrenics.

After examining many studies in the scientific literature, the Schizophrenia Bulletin reports that:

Although studies included in this review are small and used various measures of physical and mental health, results indicated that regular exercise programs are possible in this population and that they can have healthful effects on both the physical and mental health and well being of individuals with schizophrenia. Larger randomized studies are required before any definitive conclusions can be drawn.

Although it can’t “cure” schizophrenia, it looks like exercise should be included in the treatment of schizophrenia and other mental conditions whenever possible. I don’t think there is anything that provides nearly as many benefits to health as exercise. Healthy body, healthy mind.

Of drugs and juggling

As long as I can remember, I’ve had a deep fascination with addiction and drugs. The neighborhood I grew up in, though not necessarily a terrible one was surrounded by communities ravaged by drug addiction and the associated violence. The crack wars were raging and there were often spill-over effects into my usually peaceful neighborhood.

I remember the “troubled” kids at school, and the stories about their drug-addicted parents. There was the occasional death by overdose, leaving a child motherless or fatherless. I remember playing with friends in the park and discovering crack vials and hypodermic needles nestled in the grass. They often spooked us, since they indicated the presence of drug addicts in the park. We naively believed this drug paraphernalia and the drug addicts responsible for them weren’t supposed to be in our suburban park – this isn’t the south Bronx, this is the “safe” north Bronx.

The exact borders of that the hell-on-earth called the south Bronx was and still is disputed. Us kids who grew up painfully close to it always liked to think of it as being very far away, though it always crept a bit closer each year. We always knew not to walk too far toward it, lest our souls get destroyed, since we always heard horrible stories about it which indicated an absence of civilization there. I remember many childhood friends moving upstate to escape from the horrific violence and social decay that appeared to be crawling closer.

In response to this, the schools did all they could to terrify us kids so that we would never do drugs. They told us how bad drugs were, never to use them, and to say “no” to smoking since it is a “gateway” drug(yet so many adults, even the ones against drugs smoked, which confused us children). Anti-drug messages were plastered almost everywhere – it is a “war” after all. “Drugs” already struck terror in me due to a neighbor I knew who died from an overdose. And every now and then a celebrity would die from a drug overdose or get arrested for possessing drugs. It often seemed that all celebrities were drug addicts, for some perplexing reason, as if you needed to do drugs to be a celebrity. These “glamorous” celebrity drug addicts were in very sharp contrast to the filthy homeless drug addicts we regularly encountered around town.

I never did take any drugs and my friends for the most part were drug-free, but by high school I would witness kids bringing drugs to school and even smoking pot in the bathrooms. And so many students smoked cigarettes.

I always wondered how otherwise intelligent people could become addicted to substances that rob them of their health, and in a large enough dose, their life. It’s like these substances “trick” the mind in some ways, to get a person to do something that is not in their best interest. The “trick” is that drugs tend to make people feel wonderful; it’s an escape, its empowering. The anti-drug crusaders in grammar school tended to leave this out of their anti-drug diatribes(they seem funny in retrospect), which made drug addiction very mysterious to us.

There still is a certain element of mystery in all of this, even if we can understand how substances like cocaine or nicotine trigger the pleasure centers(especially on dopamine) of the brain. Science helps us understand addiction, but it currently offers little hope to people who want to overcome their addictions. Addictions are nowadays labeled “diseases” by the medical establishment, which always seemed bizarre to me.

Whatever it is, it is obvious that some people are more prone to addiction than others. Some people can snort cocaine occasionally and never become addicted. Most people who drink are not alcoholics. Some people are so hopelessly addicted that even the best detox and addiction treatments fail to help them. People like this are looked down on by society, and are often alienated from friends and family, especially if they turn to crime to support their addiction.

People who manage to overcome their addictions often do so by “fixing” the underlying psychological issues that drives them to do drugs as a form of “self-medication”. Indeed, psychiatric problems are often co-morbid with addictive behavior. If their psychiatric problem is treated properly, it is often much easier for them to overcome their addiction(except perhaps their doctor prescribed medication, assuming they need medication). It looks like replacing one addiction with another.

Another way some addicts become drug free is through religious rebirth. It’s almost a cliche: The addict has hit bottom, their entire life is one big hopeless mess. Even their families and friends have given up on them and they have no reason to live. But then they have this epiphany. They see the light. They hear or feel God, and they regain their strength and will to live. They manage to give up drugs by devoting themselves to God. In some ways, these religious feelings approximate the “high” they experienced through drugs, so this in turn may be another case of replacing one addiction with another addiction.

Some other addicts may overcome their addiction through sports or physical activity. It’s well known that vigorous exercise can cause a drug-like “high”, so this may be an ideal approach to overcoming addictions. This doesn’t mean it can help everyone. Yet again, this is replacing one addiction with another, though this is a much healthier, life-affirming addiction.

IMG_0823Which brings me to the subject of juggling. Can it help people overcome addiction? It is a physical activity and it can bring about a “high” if done long enough. It does require intense focus, to the point that a juggler can get lost in the activity and keep doing it for long periods of mine. Sort of like an addiction! I know of a few jugglers who can juggle for several hours straight with little to no breaks. Sometimes this includes me. But is this a kind of addiction, or do we only use “addiction” to refer to compulsively doing something that are detrimental to our health? Can juggling be a helpful replacement addiction to overcome deadlier additions?

As a person with a passion for juggling, I always run the risk of over-stating its benefits. It’s certainly not bad for you, but it is hardly a panacea, and there is little to no evidence it may be beneficial for your mental health in a manner different from other forms of exercise. What I mean is that the benefits of juggling may very well be generic effects, since it is a form of exercise, and any form of exercise that significantly raises your heart rate has benefits. We do know that exercise can be addictive for some people, and since juggling does count as exercise, it can also be addictive.

The brain is such a magnificent organ. No computer can come close to doing what it can do. Yet it still has serious flaws that can lead a person to do self-destructive things, regardless of how “smart” they are. Trying to outsmart an addiction is really just another way of saying we should try to outsmart ourself. Unfortunately, the smarter a person is, the easier it might be for them to rationalize their addiction.

Whatever you want to call it that is in the brain that leads to addiction, a “flaw” or “genetic predisposition”, it’s a part of being a complete human, and it’s a part of being uniquely you, and could just as easily be used to do good as do bad. For as François de La Rochefoucauld once said: “Our virtues are most frequently but vices disguised.”

Can you relieve stress with juggling?

For me, the answer is definitely yes, but this isn’t evidence that it can help others deal with stress. Few things are like juggling 3 or 4 balls, and doing tricks to forget about certain stressful problems or to gain a different perspective on them. It puts me into a different brain zone where it seems problems are both smaller and more manageable. Indeed, effectively dealing with various responsibilities and stressful problems is not unlike a juggling act.

What does science have to say about this? We are very fortunate that some scientists did put the title question of this post to the test and did some good, though preliminary research: Effect of juggling therapy on anxiety disorders in female patients published in Biopsychosoc Med. 2007; 1: 10:

After 6 months, an analysis of variance revealed that scores on the state anxiety, trait anxiety subscales of STAI and tension-anxiety (T-A) score of POMS were significantly lower in the juggling group than in the non-juggling group (p < 0.01). Depression, anger-hostility scores of POMS were improved more than non-jugglers. In the juggling group, activity scores on the vigor subscale of POMS and FAI score were significantly higher than those in the non juggling group (p < 0.01). Other mood scores of POMS did not differ between the two groups.

These findings suggest that juggling therapy may be effective for the treatment of anxiety disorders.

This sounds promising, but this study did have many limitations. For one thing, it involved only 17 people, all of them female. Also, the effect from the juggling may be due to the juggling helping the test subjects relax; any other relaxation therapy may have achieved the same results. Similarly, juggling is a form of light exercise, which can also help relieve anxiety. Unlike yoga or meditation, juggling does increase gray matter in the brain, possibly in a manner that may make it more resistant to stress or depression, although this is speculation on my part. After all, a person whose brain is more “adaptive” is probably better able to adapt to stressful conditions. I think the control/non juggling group in this study should have done light aerobic exercise, to see how juggling compares to exercise in general.

There is also the issue of EMDR therapy that was covered in the study:

Eye movement desensitization and reprocessing (EMDR) is an integrative psychotherapy approach that has been consistently evaluated as effective for treating several anxiety disorders, inclucing PTSD [6], panic disorders [7], and phobias [8]. Although conflicting data has been reported for the efficacy of EMDR [9], this therapy is considered to be of low to moderate level of efficacy [10]. Originally, research on this therapy found that moving the eyes rapidly in a side-to-side motion reduced disturbing thoughts and related anxiety [11].

So rapidly moving the eyes side-to-side, all by all by itself can help relieve anxiety? That is intriguing. I suggest reading the full study since there is a lot of interesting information in there. This research is promising, but a lot more needs to be done.