The effects of music on dementia and mental health

Without music, life would be a mistake. Friedrich Wilhelm Nietzsche

A fundamental aspect to start this topic is that we have not understood mental health in its proper dimension and complexity. A mental illness intuitively from the most remote times was related to a behavior different from the rest of the group and it was located in some part of the body. But not only that, a cause was sought and some appropriate treatment was also practiced, according to the circumstances of the time and the social context..

The classification of mental illnesses has been a more recent chapter in the history of humanity and in everyday knowledge, everything that departs from the conventional we put a label of "madness". A screw came out, you say nonsensical things, the goats went to the mountains, it seems that he escaped from the manicure (referring to the asylum metaphor), you don't know what you're saying, you don't even recognize me, you act crazy . All of them refer to different symptoms of mental illness.

On the other hand, a popular saying says: "Of musicians, poets and madmen, we all have a little." And, music in some way, has been present in the evolution of man. Even before the word; say some theorists.

Contents

• A brief tour of dementia
• Cortical dementias
  • Alzheimer's
  • Pick's disease
  • Creutzfeldt disease - Jacob (Jacob)
  • Lewy body dementia
• Subcortical Dementias
  • Parkinson's
  • Huntington's disease
• Global Dementias
  • Vascular dementia
• What is sound and music?
  • External ear
  • Middle ear
  • Inner ear
• Music and its influence on our mood
• Relationship between music and mental illness
• Final reflection
  • Bibliography

A brief tour of dementia

Dementia is a syndrome or set of symptoms of an organic nature and of multiple origin, which gives rise to deficits; cognitive, motor, social and personality very diverse.

The word dementia comes from the Latin de (which means "far from") and mens (which means "mind"). Dementia is a cognitive impairment that involves generalized progressive deficits in areas such as memory, learning new information in the person, the ability to communicate, judgment, and motor coordination. In addition to experiencing cognitive changes, people with dementia suffer changes in their personality and emotional state (Halguin & Krauss, 2004).

Previously, it was thought that older people could suffer from it, but it has been proven that it does not necessarily happen that way and we can all suffer from it. This clarification is important because dementia is incorrectly known as senile dementia. However, it is not a condition that occurs only in the elderly..

Dementia has an organic basis and groups together different types of mental illnesses which are listed below:

Cortical dementias

Alzheimer's

• Development of multiple cognitive impairment, manifested by:
• Memory impairment (learning new information and recalling what has already been learned), and
• One or more of the following cognitive impairments:
  • Aphasia (trouble speaking): Aphasia is a disorder caused by damage to the parts of the brain that control language (Broca's and Wernicke's area). It can make it difficult to read, write, and express what you want to say. It can manifest itself in: expressive, receptive, anomic and global (MedPlus, 2017).
  • Apraxia (inability to execute coordinated movements without a physical cause): It is a disorder of the brain and nervous system in which a person is unable to carry out tasks or movements when requested, although: the request or order is understood , she is willing to carry out the task, the muscles necessary to perform the task function properly, and the task has possibly already been learned (MedlinePLus, 2017).
  • Agnosia (inability to recognize and identify sensory information): interruption in the ability to recognize previously learned stimuli, or to learn new stimuli, without having a deficiency in perception, language or intellect (Wikipedia, 2017).

Alzheimer's presents alteration of executive functions, a deterioration of the previous capacities of the patient that produces significant difficulties in the occupational and social functions. And, in more severe stages, ongoing cognitive decline.

Pick's disease

• It is progressive degenerative and relatively rare and affects the frontal and temporal lobes of the cerebral cortex. It is caused by the accumulation of unusual protein deposits called Pick bodies in neurons. In addition to having memory problems, people with this disorder become socially uninhibited, act inappropriately and impulsively (socially and sexually), or apathetic and unmotivated (Halguin & Krauss, 2004). The disease is characterized by early and slowly progressive changes in character and by alterations in behavior, which evolve towards deterioration of intelligence, memory and language, accompanied by apathy, euphoria and, on occasions, extrapyramidal symptoms or signs ( tremors, gait disturbances, etc.) (Instituto Gerontológico, 2017). A part of the patients have a tendency to joke (Witzelsucht) and to laugh easily. "Witzelsucht", the curious disease of those who cannot stop making jokes, generally very bad and almost always laugh at their own jokes, but not at those of others (Robson, 2016). Associated with a constant need to produce dopamine (the happiness hormone).

Creutzfeldt disease - Jacob (Jacob)

• It is a neurological condition that is believed to be caused by an infectious agent that results in abnormal accumulations of protein in the brain. Initial symptoms include fatigue, impaired appetite, trouble sleeping, and difficulty concentrating. As the disease progresses, the individual shows increasing signs of dementia and eventually dies. Underlying these symptoms is widespread damage known as spongiform encephalopathy, which means that large holes develop in brain tissue (Halguin & Krauss, 2004).

Lewy body dementia

• There is progressive loss of memory, language, calculation and reasoning, as well as other higher mental functions. However, the progress of the disease may be faster than that seen in Alzheimer's disease. Lewy bodies are tiny spherical structures that are protein deposits found in dying nerve cells within the brains of people with Parkinson's disease. Lewy body dementia is diagnosed when Lewy bodies are scattered more diffusely throughout the brain (Halguin & Krauss, 2004).

These four variations of dementia have in common the aphaso-apraxo-agnosic syndrome, which means that the patient: has problems speaking, inability to perform physical movements without apparent cause, and inability to recognize and identify everyday objects (toothbrush, glasses, forks, spoons, etc.).

Subcortical Dementias

Parkinson's

• It involves neuronal degeneration of the basal ganglia, the subcortical structures that control motor movements. Parkinson's disease is generally progressive, the most notable feature being the suffering of various motor disturbances. At rest, the person's hands, ankles, or head may jerk involuntarily. The person's muscles become stiff and it is difficult for them to start movement, a symptom called akinesia. A general decrease in motor activity known as bradykinesia also occurs, as does a loss of fine motor coordination. For example, some people with Parkinson's disease walk quite slowly and drag their feet; have difficulty stopping. The individual's face also appears expressionless and speech becomes unnatural, losing its normal rhythmic quality. They have difficulty producing words on tests that demand verbal fluency. However, many cognitive functions, such as attention, concentration and immediate memory remain intact (Halguin & Krauss, 2004).

Huntington's disease

• It is a degenerative neurological disorder that can also affect personality and cognitive functioning. Huntington's disease is a genetic condition that involves abnormality in chromosome 4 that causes a protein known as Huntington's to accumulate and reach toxic levels. The disease involves the death of neurons in the subcortical structures of motor control, as well as the decrease in the neurotransmitters AGAB, acetylcholine and substance P. The disease is associated with mood disturbances, changes in personality, irritability and explosiveness, suicidal tendencies, changes in sexuality and a range of specific cognitive deficits (Halguin & Krauss, 2004).

They show a decrease in higher functions (attention, perception, memory, thought and language) and motivation.

Global Dementias

Vascular dementia

Vascular dementia is caused by a series of small strokes (strokes) over a long period of time (MedlinePlus, 2017). It is associated with ischemia or deficiency of blood flow or venous blockages in the brain causing the death of neurons in the affected area.

Preliminary symptoms of dementia may include:

• Difficulty performing tasks that used to be easy, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines
• Get lost in familiar routes

• Language problems, such as having trouble remembering the names of familiar objects
• Losing interest in previously enjoyed activities, indifferent mood
• Misplace items
• Personality changes and loss of social skills (MedlinePlus, 2017).

Fools open the paths later traveled by wise men. Carlo Dossi (1849-1910) Italian writer

What is sound and music?

The process by which we feel something has several facets: the reception of the external signal that excites the corresponding organ of sense; the transformation of information into a nervous signal; the transport and modification that this signal undergoes to finally reach the brain and give us the feeling of having felt something. The sense organs are what in engineering are called transducers, that is, transformers of certain signals, physical or chemical, into electrical signals that are transmitted by our nerves (Braun, 2011).

The main objective of the sense organs is to collect information about the environment that surrounds us and to be able to coexist and survive with the environment. The ear is supported by mechanical deformations, it registers the sound waves formed by variations in the density of the air as described below and by the deformation that it produces in some membranes.

The ear is also the sense of balance and is divided into three parts:

External ear

It is made up of an outer wing, the pavilion, which is a visible part. Next is the opening of the ear canal. At its outer end it is cartilaginous, while inside it is more bony and has a skin that secretes a waxy substance, the wax.

Middle ear

The middle ear or eardrum is a small cavity found in the temporal bone. It is separated from the ear canal by the tympanic membrane. In the cavity there are three small bones: the hammer, the anvil and the stirrup, articulated with each other and supported by means of different ligaments. The tympanic cavity is filled with air. At the bottom there is a very narrow channel, the so-called Eustachian tube.

Inner ear

The inner part of the ear, also called the labyrinth, is separated from the middle part by the oval window. At the top is the maze itself and at the bottom there is an appendix, the snail, which is twisted two and a half times. The upper part of the inner ear, the labyrinth, is made up of the semicircular canals and a vestibule. These organs are related to the balance of the body, while the other part, the snail, is the one that serves hearing (Braun, 2011).

When an object is struck, struck or torn like a taut rope, for example; it vibrates, but why don't we hear anything? Because we lack a medium that conducts the sound, for example; the air. How surely you know air is made up of molecules of nitrogen, oxygen, carbon dioxide, water vapor, argon, and other substances. When the object vibrates (string) it pushes the nearby molecules, these in turn press the ones next to them and so on. This movement is called a sound wave and in air it travels at about 340 meters per second (depending on air conditions). Note that it is the waves that travel, not the air particles. If there is an ear nearby, these waves vibrate the eardrum, which in turn moves the hammer that shakes the anvil, which passes its energy through the stirrup to the snail, which converts the vibrations into nerve signals, which are transmitted through the auditory nerve to the primary auditory cortex of the brain, where sound perception takes place (Curiously, 2016).

If the object vibrates faster with a shorter string, the wave has a higher frequency and we perceive it as a higher sound. When we make music we have to take into account the rhythm (force or movement formed by a certain succession of sounds), the volume (high or low), and the timbre (the same sound that comes from a different instrument) of the sounds, but the element we most recognize is: the melody.

Music can change the world because it can change people. Paul David Hewson, better known by his stage name Bono (Irish musician and lead singer of the rock group U2)

Music and its influence on our mood

The musical rhythm influences the mood. A fast pace prompts fast, euphoric movement. While a leisurely pace facilitates relaxation.

The melody can be defined as the set of sounds that, when grouped in a certain way, can be transformed into a pleasant sound to the ear of the listener (Concept definition.de, 2014).

Hearing a melody has different reactions, it is a subjective action and what for some is a pleasant sound for others is not. Ugly music for some would be a delight and for others not and vice versa. Fortunately it is something subjective and relative in each person. What moves some, paralyzes and irritates others.

Human beings live with music at all times.

It is an art that makes us enjoy pleasant times, encourages us to remember events from the past, makes us share emotions in group songs, concerts or sports tribunes (Manes, 2015).

Music accompanies us throughout life; From childhood to adulthood, music is with us and in some way it is also part of our identity. Our musical taste reflects: individuality, belonging or not to a social group, the culture, the country, the historical period of belonging or the taste for that time, the customs, the ideology, the origins and even the feeling we are projected in their lyrics, as it is part of our life. Music is recorded in our most remote movements and of course in our emotional memory.

Relationship between music and mental illness

Throughout the history of humanity, different therapeutic strategies have been used to seek the well-being or healing of patients. These have ranged from the most cruel and inhumane to the most radical and sublime:

• Healing by air (trepanation or perforation of the skull), fire (burning at the stake as in the inquisition), water (cold water baths and drowning), electricity, electrosocks, animal magnetism (Mesmerism), laying on of hands (Jesús de Nazaret ), whipping, kicking, chaining, exsanguination (bleeding), frontal or lateral lobotomy (Egas Moniz) and transorbital lobotomy (Walter Freeman), medications (Thorazine), hypnosis (Freud and Charcot), masturbation, psychotherapy, transcranial magnetic stimulation, fields pulsating electromagnetic low frequency and music therapy, to name just a few.

The perception of the mentally ill has more of prejudice and ignorance than of reality, they have been seen as beasts, wild animals, lunatics, demons, degenerates, socially alienated, human garbage. And, depending on the vision of the patient and the context in which he lives, the therapy of the time has been practiced..

Dementia and its different variants cause serious motor and cognitive alterations and affect the global identity of the person who suffers from it, to the point of not remembering Who is it? in the most extreme cases and this prevents them from even recognizing their closest loved ones and everyday objects, until they reach total disability.

Despite the devastation that this disease causes in the brain and, in particular, in memory, a large part of patients retain their musical memories even in the later stages. The temporal lobe, the part of the brain that runs from the temple to the back of the ear, is, among other things, the disco of humans. Our auditory memory is managed there, songs included. Jörn-Henrik Jacobsen neuroscientist at the Max Planck Institute for Neuroscience and Human Cognition in Leipzig (Germany), claims to hear music and remember it (musical memory) are processed in brain areas that are not those that are usually associated with episodic memory, semantics or the autobiographical (Criado, 2015).

As a therapeutic strategy, the use of music therapy has great hopes for the brain stimulation of patients with this condition, as it opens an access door in neuronal plasticity to recover long-term stored memories that are part of their identity..

Music can connect people with who they have been with who they are and their lives. Because what happens when you get older is that all the things you know and your identity are forgotten, says Dan Cohen social worker and founder of the Music and Memory Association. Neurologist Oliver Sacks points out that: music is inseparable from emotions, not just a physiological stimulus. Music is more capable of activating more parts of the brain than any other stimulus. (Rossato-Bennett, 2014).

There are various theories about this intimate coexistence with music in evolution. Some of these occurred because when studying the response of the brain to music, the key areas that are involved are those of control and execution of movements. One of the hypotheses posits that this is the reason the music was developed: to help us all move together. And the reason this would have an evolutionary benefit is that when people move in unison they tend to act more altruistically and be more united (Manes, 2015).

Listening to your favorite music produces dopamine (the pleasure hormone), as do sex, food, and even drugs. The surprising thing is that we listen to music from the cradle and that calms us down. We have been in contact with a rudimentary music in the heartbeat of our mother as well, which puts us in contact with music from the beginning of life and is being stored in our brain materially from early times..

On the other hand, let us remember that in dementia one of the behaviors with the greatest impact is the loss of short and long-term memory. However, the reason that the brain of a patient with Alzheimer's can remember the music and lyrics of his favorite songs is that everyday memories and music are stored in different areas. In the more advanced cases of the disease, if the patient cannot pronounce words, he hums them, and in those who are speechless and prostrate, he still produces slight movements. As shown by the project of the social worker and founder of the Music and Memory Association, Dan Cohen, shown in the program “vive por inside” broadcast by the Netflix network. The key is to stimulate them with the music of their choice.

The health area uses music in order to improve, maintain or try to recover cognitive, physical, emotional and social functioning, and to help slow the progression of different medical conditions. Music therapy, through the clinical use of music, seeks to activate physiological and emotional processes that allow the stimulation of diminished or impaired functions and enhance conventional treatments. Important results have been observed in patients with movement disorders, difficulty in speech due to a stroke, dementias, neurological disorders and in children with special abilities, among others. Music can be a powerful tool in the treatment of brain disorders and acquired injuries, helping patients to regain language and motor skills, since it activates almost all regions of the brain (Manes, 2015).

"The memories that last the most are those that are linked to an intense emotional experience and the music with which it is most linked is with emotions and emotion is a door to memory", says the music therapist of the Alzheimer Spain Foundation, Fátima Pérez-Rob (Servant, 2015).

Final reflection

None of us have bought emotional health and therefore we are not guaranteed to suffer from any of the variants of dementia or other disabling mental illnesses. Therefore, it would be well worth leaving some testimony of our music library, with the songs that move us the most, incite us to movement or produce meaningful memories to stimulate our brain if necessary..

Drug therapy would not be the only alternative in the treatment of patients with dementia or a mental illness.

Bibliography

Braun E. (2011) Knowledge and the senses (Science for all) Number 73, Editorial Fondo de Cultura Económica, Mexico.

Concept definition.de (2014) Definition of Melody, consulted on May 6, 2017, online: http://conbetodefinicion.de/melodia/

DSM-IV (2017) DSM-IV criteria for the diagnosis of Alzheimer's disease, consulted on May 3, 2017, online: http://demencias.sen.es/articulos/criterios-para-el-diagnostico- for-alzheimer's-disease-or-other-dementias / dsm-iv-criteria-for-the-diagnosis-of-alzheimer's-disease /

Halguin R. & Krauss S. (2004) Psychology of Abnormality (Clinical perspectives on psychological disorders), Editorial McGraw Hill, Mexico.

Gerontological Institute (2017) Pick's disease, consulted on May 3, 2017, online: http://www.igerontologico.com/salud/gerontologia/enfermedad-pick-6558.htm

Manes F. (2015) What does music do to our brain ?, Consulted on May 6, 2017, online: http://elpais.com/elpais/2015/08/31/ciencia/1441020979_017115.html

MedlinePlus (2017) Aphasia (Speech problems), accessed May 3, 2017, online: https://medlineplus.gov/spanish/aphasia.html

MedlinePlus (2017) Vascular Dementia, accessed May 6, 2017, online: https://medlineplus.gov/spanish/ency/article/000746.htm

Rossato-Bennett M. (2014) Film Alive Inside: A Story of Music & Memory, Bond / 360, Production The Shelley 6 Donald Rubin Foundation

Wikipedia (2017) Agnosia, consulted on May 3, 2017, online: https://es.wikipedia.org/wiki/Agnosia