In a previous blog that I wrote seven years ago, I looked at the concept of ‘music addiction’. As Philip Dorrell pointed out in his 2005 book What is Music? Solving a Scientific Mystery, music (like drugs) acts on our emotions and feelings. Regular readers of my blog will know that I describe myself as a ‘music obsessive’ and have written many articles about my own passion for listening to and collecting music (a few examples here, here, and here). One of the proudest moments of my life was getting a populist article on ‘music addiction’ published in Record Collector, my favourite magazine (see screenshot below and ‘Further reading’ for the full reference).
A 2011 study published by Dr. Valorie Salimpoor and her colleagues in Nature Neuroscience reported that on a neurochemical level, the pleasurable experience of listening to music releases the neurotransmitter dopamine that is important for the pleasures associated with rewards such as food, psychoactive drugs and money. This led to many headlines in newspapers along the lines of ‘people who say that they are addicted to music are not lying’. The team also reported that just the anticipation of pleasurable music led to increased dopamine release. Therefore, this helps explain why individuals (like myself) continually repeat songs or albums all the time as we want to re-experience those sensations repeatedly.
My previous article examined the concept of ‘musomania’ (i.e., an obsession with music). I noted that there had been very little in the way of academic or clinical literature on the topic although since writing my original article I have come across a couple of more recently published studies looking at the concept (one which published shortly after my original blog on the topic).
Dr. Nicolas Schmuziger and his colleagues published a paper in a 2012 issue of Audiology Research entitled ‘Is there addiction to loud music? Findings in a group of non-professional pop/rock musicians’. They hypothesized that listening to loud music may be an addictive behavior and that it could result in hearing damage (which is one of the reasons they published their findings in an audiology journal – also, they probably would have found it harder to publish their study in an addiction journal). They hypothesized that individuals who were members of non-professional pop/rock bands who had regular exposure to loud music would be more likely to show an addictive-like behavior for loud music compared to individuals who were not.
In their study, the researchers recruited 50 non-professional musicians and matched them with 50 control participants. Both groups completed a questionnaire called the Northeastern Music Listening Survey (NEMLS) comprising two basic scales. The first scale was an adaptation of the Michigan Alcohol Screening Test (MAST) to study the addictive-like behavior towards loud music. The NEMLS was developed by Dr. Mary Florentine and her colleagues to assess Maladaptive Music Listening (MML). It is a 24 item scale that (in relation to listening to music) examining five distinct areas: “(i) recognition and admission of the problem by self and others; (ii) legal, work and social problems; (iii) seeking involvement with treatment programs; (iv) marital-family difficulties; and (v) medical pathology”. In addition to socio-demographic questions (on age, gender, and level of education), a second component of the NEMLS included “four items assessing three out of seven clinical diagnostic criteria for substance dependence as outlined by the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association…The other four criteria were already embedded within the MAST”.
Findings showed that nine (out of 50) met the DSM-IV criteria for ‘music dependence’ compared to just one individual in the control group. Seven of the nine musicians endorsing DSM criteria also had a positive score on the NEMLS. The researchers concluded that traits of addictive-like behavior to loud music were detected more often in members of nonprofessional pop/rock bands than in matched controls. The authors themselves pointed out that they did not explore the reasons why their participants “with repeated exposure to high-sound levels of electro-amplified music may be more likely to show traits of maladaptive behavior to loud music than the control subjects, and whether they develop such behavior before or after joining a pop/rock band”. They also concluded that only a few participants in their sample may have maladaptive music listening.
A more recent paper by Dr. Christine Ahrends entitled ‘Does excessive music practicing have addiction potential?’ was published in the journal Psychomusicology: Music, Mind, and Brain. She noted that:
“A theory that has previously been put forward but has not yet been empirically examined is the idea of “musical addictivity” (Panksepp, 1995)… Panksepp assumes an involvement of the opioid system for the emergence of “chills” when listening to music and concludes from there that listening to emotionally arousing music can be addictive through the release of opioids. On those grounds, Panksepp compares the phenomenon of music-induced chills (defining the main bodily response as a feeling of coldness) with that of drug addiction and its related withdrawal symptoms (like the so-called “cold turkey”). Although this comparison has major limitations, the general hypothesis might provide a new perspective on certain types of music-related behavior”.
Put simply, it has been argued that music has the capacity to activate the reward centres in the human brain and this can lead to behavioural addiction. Dr. Ahrends noted that recent studies supported the idea of addictive music consumption (citing the studies by Schmuziger and colleagues, and the study by Florentine and colleagues, both mentioned above) but not for music practicing. She wrote that:
“Anecdotal evidence has shown that some musicians either continue to practice through practice-induced pain or have psychosomatic disorders at deprivation, thus transforming a former goal-directed behavior into a maladaptive one”.
Based on the small empirical literature and anecdotal evidence, Dr. Ahrends hypothesized that music practice has the potential to be addictive and carried out an exploratory empirical study. To assess music practice addiction, she adapted the Exercise Dependence Scale Revised (EDS-R) (very similar to my own Exercise Addiction Inventory) and investigated the extent to whether musicians fulfilled the criteria to be classified as being “at risk for dependence” in relation to their music practice. A total of 25 musicians were recruited from German conservatories. Based on the scale scores three of the participants were classified as “at risk for dependence,” 20 of the participants were classified as “nondependent-symptomatic,” and two were classified as “nondependent-asymptomatic.” Based on these results, Dr. Ahrends claimed the findings provided tentative support for music practice addiction. She went on to argue that the concept of music practice addiction is a promising concept for further research and “may have implications for the understanding of mental health problems in musicians”.
In relation to this latter study, I would argue that this isn’t a case of ‘music practice addiction’ (if it exists at all) but if it exists, it is actually akin to ‘study addiction’ (a pre-cursor to ‘workaholism’) that I and my colleagues have published a number of papers on over the past few years (see ‘Further reading). The notion of ‘study addiction’ is highly controversial so it’s unsurprising that ‘music practice addiction’ would similarly be seen as controversial by most scholars working in the behavioural addiction field.
Dr Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Ahrends, C. (2017). Does excessive music practicing have addiction potential? Psychomusicology: Music, Mind, and Brain, 27(3), 191-202.
Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2015). Study addiction – A new area of psychological study: Conceptualization, assessment, and preliminary empirical findings. Journal of Behavioral Addictions, 4, 75–84.
Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2016). Study addiction: A cross-cultural longitudinal study examining temporal stability and predictors of its changes. Journal of Behavioral Addictions, 5, 357–362.
Atroszko, P.A., Andreassen, C.S., Griffiths, M.D., Pallesen, S. (2016). The relationship between study addiction and work addiction: A cross-cultural longitudinal study. Journal of Behavioral Addiction, 5, 708–714.
Dorrell, P. (2005). Is music a drug? 1729.com, July 3. Located at: http://www.1729.com/blog/IsMusicADrug.html
Dorrell, P. (2005).What is Music? Solving a Scientific Mystery. Located at: http://whatismusic.info/.
Florentine, M., Hunter, W., Robinson, M., Ballou, M., & Buus, S. (1998). On the behavioral characteristics of loud-music listening. Ear and Hearing, 19(6), 420-428.
Griffiths, M.D. (2012). Music addiction. Record Collector, 406 (October), p.20.
The Local (2007). Man gets sick benefits for heavy metal addiction. June 19. Located at: http://www.thelocal.se/7650/20070619/
Morrison, E. (2011). Researchers show why music is so addictive. Medhill Reports, January 21. Located at: http://news.medill.northwestern.edu/chicago/news.aspx?id=176870
Panksepp, J. (1995). The emotional sources of “chills” induced by music. Music Perception, 13, 171–207.
Salimpoor, V.N., Benovoy, M., Larcher, K. Dagher, A. & Zatorre, R.J. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neuroscience 14, 257–262.
Schmuziger, N., Patscheke, J., Stieglitz, R., & Probst, R. (2012). Is there addiction to loud music? Findings in a group of non-professional pop/rock musicians. Audiology Research, 2(e1), 57-63.
Smith, J. (1989). Senses and Sensibilities. New York: Wiley.
Those that know me well often comment that I have a general inability to sit still and that I am a ‘fidget’. (This is not necessarily a bad thing and in fact there are some positives to fidgeting that I outlined in a previous blog on bad behaviours that are sometimes good for you). There is certainly some truth to the observation that I fidget but sometimes the fidgeting is out of my control. Every few weeks my right lower leg appears to take on a life of its own and I will get strange (uncomfortable) sensations (such as tingling, itching, and aching, and occasionally cramp-like feelings) that force me to move my right leg and foot around. It only happens when I am in a resting and relaxing state and usually lasts about 30 minutes (but can occasionally last much longer). On occasions it disrupts my work and sleep but I find that just getting up and moving around is sometimes enough to alleviate the uncomfortable feelings.
A few years ago I Googled my ‘symptoms’ and was surprised to find that I am not the only person who appears to experience such effects and that there is a whole medical literature on what has been termed ‘restless legs syndrome’ although in my case it would be in a singular rather than plural form). I’ve had the condition for about 15 years now and it may be related to some of the medication I take for an unrelated chronic degenerative health condition that I have. According to the Wikipedia entry on restless legs syndrome (RLS):
“The first known medical description of RLS was by Sir Thomas Willis in 1672. Willis emphasized the sleep disruption and limb movements experienced by people with RLS…The term ‘fidgets in the legs’ has also been used as early as the early nineteenth century. Subsequently, other descriptions of RLS were published, including those by Francois Boissier de Sauvages (1763), Magnus Huss (1849), Theodur Wittmaack (1861), George Miller Beard (1880), Georges Gilles de la Tourette (1898), Hermann Oppenheim (1923) and Frederick Gerard Allison (1943). However, it was not until almost three centuries after Willis, in 1945, that Karl-Axel Ekbom (1907–1977) provided a detailed and comprehensive report of this condition in his doctoral thesis, Restless legs: clinical study of hitherto overlooked disease. Ekbom coined the term “restless legs” and continued work on this disorder throughout his career. He described the essential diagnostic symptoms, differential diagnosis from other conditions, prevalence, relation to anemia, and common occurrence during pregnancy. Ekbom’s work was largely ignored until it was rediscovered by Arthur S. Walters and Wayne A. Hening in the 1980s. Subsequent landmark publications include 1995 and 2003 papers, which revised and updated the diagnostic criteria”.
As well as being referred to as RLS, it is sometimes referred to as Willis-Ekbom Disease or Willis-Ekbom Syndrome. Since being ‘rediscovered’ in the 1980s, there have been a lot of scientific papers published on the phenomenon although many of these are medical case studies (I don’t think my own experiences are extreme enough or strong enough to appear in any medical textbook. The Wikipedia entry on RLS provides a good summary of what is known medically and empirically:
“Restless legs syndrome (RLS) is a disorder that causes a strong urge to move one’s legs. There is often an unpleasant feeling in the legs that improves somewhat with moving them. Occasionally the arms may also be affected. The feelings generally happen when at rest and therefore can make it hard to sleep. Due to the disturbance in sleep, people with RLS may have daytime sleepiness, low energy, irritability, and a depressed mood. Additionally, many have limb twitching during sleep. Risk factors for RLS include low iron levels, kidney failure, Parkinson’s disease, diabetes, rheumatoid arthritis, and pregnancy. A number of medications may also trigger the disorder including antidepressants, antipsychotics, antihistamines, and calcium channel blockers. There are two main types. One is early onset RLS which starts before age 45 [years], runs in families and worsens over time. The other is late onset RLS which begins after age 45 [years], starts suddenly, and does not worsen. Diagnosis is generally based on a person’s symptoms after ruling out other potential causes… Females are more commonly affected than males and it becomes more common with age…Some doctors express the view that the incidence of restless leg syndrome is exaggerated by manufacturers of drugs used to treat it. Others believe it is an under-recognized and undertreated disorder…An association has been observed between attention deficit hyperactivity disorder (ADHD) and RLS or periodic limb movement disorder. Both conditions appear to have links to dysfunctions related to the neurotransmitter dopamine, and common medications for both conditions among other systems, affect dopamine levels in the brain”.
According to a review by Dr. Richard Allen and Dr. Christopher Earley in the Journal of Clinical Neurophysiology, RLS affects 2.5-15% of the US population. In another review on sleep disorder in the journal American Family Physician, Dr. Kannan Ramar and Dr. Eric Olson reported that RLS is typically characterized by four essential features: These are:
“(1) the intense urge to move the legs, usually accompanied or caused by uncomfortable sensations (e.g., “creepy crawly,” aching) in the legs; (2) symptoms that begin or worsen during periods of rest or inactivity; (3) symptoms that are partially or totally relieved by movements such as walking or stretching; and (4) symptoms that are worse or only occur in the evening or at night”.
Various online articles and papers report a variety of potential treatments based on the notion that RLS might be caused by a dopamine imbalance in the body. Some medics advise a regular sleep routine (such as that advised for those with insomnia), and cutting out the drinking of alcohol and the smoking of cigarettes. Pharmacological treatments include the use of drugs that are also used in the treatment of Parkinson’s disease such as L-DOPA and pramipexole, and the use of magnesium sulphate therapy (as reported in a 2006 paper in the Journal of Clinical Sleep Medicine – magnesium is known to be a natural muscle relaxant). In a 2011 issue of the journal Sleep Medicine, In an online article about RLS, Dr Michael Platt, author of the 2014 book Adrenalin Dominance, claims that RLS sufferers can be treated using a progesterone cream:
“Excess adrenalin during the night can cause restless leg syndrome. People often have associated symptoms also resulting from elevated adrenalin, such as teeth grinding, the need to urinate, and tossing and turning, and they often awaken in the morning with low back pain. Characteristically, RLS patients have an excess of adrenaline, may toss and turn all night, be quick to anger, might be workaholics, will usually have fibromyalgia (aches and pains – low back, side of the hips, and grind their teeth), they might drink too much, and will be hypoglycemic (sleepy between 3-4 p.m. or when in a car), and so on. There is an associated over-production of insulin and an under-production of progesterone…[By using a progesterone cream] I have had 100% success with eliminating RLS by getting hormones into balance, often within the first week. Patients feel more relaxed, they can sleep at night, rage disappears, and they can focus more easily”.
Dr. Luis Marin and his colleagues reported a different treatment for RLS altogether. They reported the case of a 41-year-old male RLS sufferer who after being on medication for RLS discovered his own solution – having sex. Following sex, the man reported that all RLS symptoms would disappear. Marin and colleagues speculated that the release of dopamine following orgasm might alleviate RLS symptoms. This appears to be a reasonable speculation given the findings of research published in the Journal of Neuroscience by Dr. Gert Holstege and his colleagues who examined brain activation at the point of ejaculation. In their paper they reported the similarity between ejaculation and using heroin in terms of brain activation:
“We used positron emission tomography to measure increases in regional cerebral blood flow during ejaculation compared with sexual stimulation in heterosexual male volunteers. Manual penile stimulation was performed by the volunteer’s female partner. Primary activation was found in the mesodiencephalic transition zone, including the ventral tegmental area, which is involved in a wide variety of rewarding behaviors. Parallels are drawn between ejaculation and heroin rush”.
It could well be that the increase in dopamine following ejaculation acts in a similar way to the medications that are given to RLS sufferers. Of all the treatments for RLS that I have read about, I think I know which one I would prefer!
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Allen, R.P., & Earley, C.J. (2001). Restless legs syndrome: A review of clinical and pathophysiologic features. Journal of Clinical Neurophysiology, 18(2), 128-147.
Bartell S1, Zallek S. Intravenous magnesium sulfate may relieve restless legs syndrome in pregnancy. Journal of Clinical Sleep Medicine, 15, 187-188.
Chaudhuri, K.R., Appiah-Kubi, L.S., & Trenkwalder, C. (2001). Restless legs syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 71(2), 143-146.
Ekbom, K., & Ulfberg, J. (2009). Restless legs syndrome. Journal of Internal Medicine, 266(5), 419-431.
Holstege, G., Georgiadis, J. R., Paans, A. M., Meiners, L. C., van der Graaf, F. H., & Reinders, A. S. (2003). Brain activation during human male ejaculation. Journal of Neuroscience, 23(27), 9185-9193
Leschziner, G., & Gringras, P. (2012). Restless legs syndrome. British Medical Journal, 344, e3056.
Marin, L.F., Felicio, A.C., & Prado, G.F. (2011). Sexual intercourse and masturbation: Potential relief factors for restless legs syndrome? Sleep Medicine, 12(4), 422.
Ondo, W. G. (2009). Restless legs syndrome. Neurologic Clinics, 27(3), 779-799.
Ramar, K; Olson, EJ (Aug 15, 2013). Management of common sleep disorders. American Family Physician, 88, 231–238.
Satija, P., & Ondo, W. G. (2008). Restless legs syndrome. CNS Drugs, 22(6), 497-518.