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Thoughts / The craft

Does music therapy help with anxiety and depression? What the research (really) says

November 9, 2026 · Thoughts / The craft

First the short answer, for those in a hurry. For depression, music therapy can help, but only as an addition to treatment, not in its place: reviews of the studies find that symptoms improve more when, alongside usual care, there is also a course of music therapy. The effect, however, is seen in the short term, at the end of the sessions, and the evidence is still weak: whether it lasts in the following months has not, so far, been shown. For anxiety there is more evidence, and it shows a moderate effect on the anxiety people report, but it comes mostly from hospital settings, for example from people undergoing radiotherapy. On anxiety disorders proper, research is still scarce. And the major guidelines on depression and anxiety disorders, the NICE guidelines in England and the German one, do not recommend it today; an American oncology guideline, on the other hand, recommends it for symptoms of anxiety and depression in people being treated for cancer.

It is not the neat answer you may have been looking for. But it is the one that holds up. The rest of this page is there to explain it, one question at a time.

“What music should I listen to for anxiety?”

In 2020, in an episode of my podcast, I said that one of the questions journalists asked me most often was of this kind: what music would you recommend for a trip to the dentist? And there were those who asked me for music for headaches, for colitis, for anxiety. My answer was that there is no such thing as music that is good for everyone, at every moment and in every situation. Behind the question, asked in perfectly good faith, lies an idea borrowed from the pharmacy: if music is good for you, there must be a piece for anxiety just as there is a pill for blood pressure. I even imagined “auditory tablets”: fifty seconds of Mozart, packets on the pharmacy counter, side effects if instead of fifty seconds you listen to it for fifty minutes.

It is worth, however, sorting out three things that, in everyday language, we call by the same name. Two Italian researchers, Raglio and Oasi, do exactly that in a short article from 2015 that distinguishes three families. The first is music therapy, with a trained music therapist, a setting and, at its centre, a relationship. The second is music listening: one’s own favourite music (individualized music listening) or pieces chosen for their characteristics (music medicine), where what counts is the music itself and not a therapeutic relationship. The third is musical activities, a choir, a group, a workshop, for well-being and social connection.

In their table, among the aims of music medicine, we find precisely depression, anxiety, stress and sleep disorders. But those pieces are not auditory tablets: they are chosen according to the aim of the treatment, within a programme designed for that person. And listening, as we will see, has evidence of its own.

Careful, though: the boundary does not run between playing and listening. In music therapy there is plenty of listening. It runs between a playlist, even a well-chosen one, and listening done with someone, within a process, with goals. It is that togetherness, as I said back then, that differentiates us from a pill.

Does music therapy work for depression?

The starting point is the 2017 Cochrane review, one of those reviews that bring together, under strict rules, all the studies on a question (Aalbers et al., 2017): nine studies, just over four hundred people with depression, from adolescents to older adults. The main comparison was between usual care alone and usual care plus a course of music therapy, for up to three months. With music therapy, depressive symptoms decreased more, with a large effect, both when they were rated by the clinician and when they were reported by the people themselves; each of these two estimates, however, rests on four studies. The certainty of the evidence, according to the authors, was moderate.

Then comes the rest of the small print: every study had been carried out at a single centre, and only in four out of nine is it known for certain that the therapy was delivered by a trained music therapist.

In 2025 a review of forty meta-analyses on music in psychiatry, that is, of forty papers that each pool the results of many studies, re-examined those data with stricter criteria (Lassner et al., 2025): the effect remained of the same size, but the certainty of the evidence went down, to the point of being very low. And taking all disorders together, studies on listening included, the effect on depressive symptoms, clear at the end of treatment, is no longer visible at follow-up.

Two studies help us see this up close. In Finland, a study of seventy-nine adults with depression assigned thirty-three of them, in addition to standard care, to twenty individual sessions of improvisational music therapy; the others received routine care only. At three months, those who had had music therapy were doing better; at six months the difference was no longer significant (Erkkilä et al., 2011). In Heidelberg, the MUSED study divided one hundred and two women with major depression into two groups: fifty-two took part in ten sessions of group music therapy, fifty remained on a waiting list. On clinician-rated depression there was no significant difference between the two groups; only the depression the women rated several times a day, in everyday life, changed (Gaebel et al., 2025). The authors wonder whether ten sessions were too few. This too is research doing its job.

And does it work for anxiety?

Here there is more evidence, but you have to look at where it comes from. A recent meta-analysis, from 2025, included only studies in which the therapy was delivered by trained music therapists: fifty-one studies, more than three thousand two hundred adults (de Witte et al., 2025). On self-reported anxiety there is an effect, a moderate one. On physiological indicators, by contrast, it is not significant.

Two details change how we read this. The first: thirty-eight studies out of fifty-one come from medical settings, only nine from mental health. In those nine the effect is there, of the same size: but nine studies are too few to say much. The second is a small surprise. On anxiety, purely active music therapy, the kind in which people play, sing, improvise, shows no effect. Receptive music therapy, in which the music therapist guides a listening experience, does, and so does the kind that combines the two.

What “guided listening” means is described in a study on radiotherapy, where there was a single session (Rossetti et al., 2017). Seventy-eight people with cancer, at the simulation session before their radiotherapy, were randomly divided into two groups. Half spent about twenty minutes with a music therapist, who got to know them, played for them on the guitar with a few guiding words and prepared a selection of pieces based on their tastes, to listen to during the procedure. In that group anxiety went down, in the other it did not; but the comparison group received no extra attention, and the authors themselves suggest adding one that does.

And diagnosed anxiety disorders, such as generalised anxiety disorder or panic disorder? Here research is scarce: we found no review dedicated to music therapy for these disorders.

The guidelines reflect this picture. The NICE guidelines for depression in adults and for generalised anxiety disorder and panic disorder do not mention music therapy (National Institute for Health and Care Excellence, 2011, 2022). The German guideline on depression discusses it together with the other arts therapies, explicitly refrains from making a recommendation and judges the value of the evidence to be still very limited (Bundesärztekammer et al., 2022). Oncology is the exception: an American guideline from 2023 recommends music therapy for symptoms of anxiety and depression during cancer treatment (Carlson et al., 2023).

So is listening to music on your own enough?

The honest answer is that listening helps: the evidence is there. A 2020 meta-analysis found effects of listening on depression that were even larger than those of music therapy (Tang et al., 2020); the authors suggest this may depend on the people studied, because music therapy has more often been tested in severe psychiatric conditions, and in any case it is an indirect comparison, between different studies and different people. And the review on psychiatry (Lassner et al., 2025) observes that, taking all disorders together, active music therapy, receptive music therapy and listening usually achieve similar effects.

No one, then, can tell you that music therapy works better than listening. The meta-analysis on anxiety admits it too: it is not yet known how much the music therapist’s work adds to listening alone. And the answer from 2020 comes back: the right music, the one that keeps you company at the dentist or on a bad day, is chosen by the person who listens to it.

What, then, does a relationship add? Today the difference is explained by what is done and who it is done with, not by figures that prove superiority. What is done: an initial assessment, goals shared with the professionals already treating the person, music that adapts session after session. Who it is done with: the German guideline, while stating that there is no clear indication, observes that from a clinical point of view the arts therapies, music therapy included, are suited above all to people who struggle to access their emotions or to manage them. And then there are those who, on their own, can no longer use music: the playlist is there, and it stays silent.

And can music therapy replace medication or psychotherapy? No. In the studies on depression it is an addition to usual care; and the comparison with psychotherapies, made on very few people, does not allow us to say whether there are differences. Its place is within a team, alongside those who prescribe medication and those who provide psychotherapy.

In Italy, where do you start?

In 2024, Italian mental health services cared for more than 845,000 people (with data from the Abruzzo region missing), and in community services depression is the most frequent diagnosis (Ministero della Salute, 2025). Music therapy, in psychiatric rehabilitation, is a small presence, at least in the most recent snapshot we found: in a survey by the Italian Society of Psychosocial Rehabilitation of activities in the years 2012–2015, expressive techniques, from art therapy to music therapy, made up 8.3% of psychiatric rehabilitation activities in the participating facilities (Viganò et al., 2023).

The practical advice is simple. If you are thinking about music therapy for yourself or for someone you care about, talk about it first with your doctor or with the mental health service. It is not a matter of permission. Music therapy makes sense when it becomes part of a plan, with shared goals and someone who checks whether they are being reached.

So, does music therapy help with anxiety and depression?

With depression, yes, it can help: alongside treatment, in the short term, with evidence that is still fragile. With anxiety, the evidence comes mostly from hospitals, and among the ways of doing music therapy, the ones that show results are those in which the music therapist guides a listening experience, on its own or together with playing; playing alone, so far, does not. On anxiety disorders proper, there are still too few studies to say.

In 2020 I confessed that I dreamed of the day when someone, instead of asking me whether music therapy works, would ask me whether it is beautiful. On anxiety and depression, meanwhile, the question is becoming more precise: who it helps, how much, and alongside what. Research is starting to answer. One step at a time, and without tablets.

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