If Miley Cyrus has planted "Flowers" in your head, rest assured you're not alone.
An earworm — a bit of music you can't shake from your brain — happens to almost everyone.
The culprit is typically a song you've heard repeatedly with a strong rhythm and melody (like Miley's No. 1 hit this year).
It pops into your head and stays there, unbidden and often unwanted. As you fish for something new on Spotify, there's always a chance that a catchy hook holds an earworm.
"A catchy tune or melody is the part of a song most likely to get stuck in a person's head, often a bit from the chorus," said Elizabeth H. Margulis, PhD, a professor at Princeton University and director of its Music Cognition Lab.
The phenomenon, which has been studied since 1885 (way before earbuds), goes by such names as stuck song syndrome, sticky music, musical imagery repetition, intrusive musical imagery, or the semi-official term, involuntary musical imagery, or INMI.
Research confirms how common it is. A 2020 study of American college students found that 97% had experienced an earworm in the past month, similar to findings from a larger Finnish survey done more than 10 years ago.
One in five people had experienced an earworm more than once a day, the study found. The typical length was 10 to 30 minutes, though 8.5% said theirs lasted more than 3 hours. Levels of "distress and interference" that earworms caused was mostly "mild to moderate."
Some 86% said they tried to stop it — most frequently by distraction, like talking to a friend or listening to another song.
If music is important to you, your earworms are more likely to last longer and be harder to control, earlier research found. And women are thought to be more likely to have them.
"Very musical people may have more earworms because it's easy for them to conjure up a certain tune," says David Silbersweig, MD, chairman of the Department of Psychiatry and co-director of the Institute for the Neurosciences at Brigham and Women's Hospital in Boston.
Moreover, people who lack "psychological flexibility" may find earworms more bothersome. The more they try to avoid or control intrusive thoughts (or songs), the more persistent those thoughts become.
"This is consistent with OCD (obsessive-compulsive disorder) research on the paradoxical effect of thought suppression," the authors of the 2020 study wrote. In fact, people who report very annoying or stressful earworms are more likely to have obsessive-compulsive symptoms.
Earworms have been linked to other medical conditions as well, and even harmless earworms can be intrusive and time-consuming. That makes them worth a closer look.
Digging for the Source of Earworms
Scientists trace earworms to the auditory cortex in the temporal lobe of the brain, which controls how you perceive music, as well as deep temporal lobe areas that are responsible for retrieving memories. Your amygdala and ventral striatum, parts of your brain that involve emotion, also tie into the making of an earworm.
MRI experiments found that "INMI is a common internal experience recruiting brain networks involved in perception, emotions, memory and spontaneous thoughts," a 2015 paper in Consciousness and Cognition reported.
These brain networks work in tandem if you connect a song to an emotional memory – that's when you're more likely to experience it as an earworm. The "loop" of music you'll hear in your head is usually a 20-second snippet.
Think of it as a "cognitive itch," as researchers from the Netherlands put it. An earworm can be triggered by associating a song with a specific situation or emotion. Trying to suppress it just reminds you it's there, "scratching" the itch and making it worse. "The more one tries to suppress the songs, the more their impetus increases, a mental process known as ironic process theory," they wrote.
"It's also worth pointing out that earworms don't always occur right after a song ends," said Michael K. Scullin, PhD, an associate professor of psychology and neuroscience at Baylor University in Waco, TX. "Sometimes they only occur many hours later, and sometimes the earworm isn't the song you were most recently listening to."
These processes aren't fully understood, he said, "but they likely represent memory consolidation mechanisms; that is, the brain trying to reactivate and stabilize musical memories." Kind of like switching "radio stations" in your head.
When to Worry
Earworms are most often harmless. "They're part of a healthy brain," said Silbersweig. But in rare cases, they indicate certain medical conditions. People with OCD, for example, have been shown to have earworms during times of stress. If this is the case, cognitive behavioral therapy as well as some antidepressants may help.
Take an earworm seriously if it's linked to other symptoms, said Elaine Jones, MD, , a neurologist in Hilton Head, SC, and a fellow of the American Academy of Neurology. Those symptoms could include "loss of consciousness or confusion, visual loss or changes, speech arrest, tremors of arms or legs," she said.
"Most worrisome would be a seizure, but other causes could include a migraine aura. In a younger person, less than 20 years old, this kind of earworm could indicate a psychiatric condition like schizophrenia." Drug toxicity or brain damage can also present with earworms.
Her bottom line: "If an earworm is persistent for more than 24 hours, or if it is associated with the other symptoms mentioned above, it would be important to reach out to your primary care doctor to ensure that nothing more serious is going on," said Jones. With no other symptoms, "it is more likely to be just an earworm."
Japanese research also indicates that an earworm that lasts for several hours in a day can be linked to depression. If a person has symptoms such as low mood, insomnia, and loss of appetite, along with earworms that last several hours a day, treatment may help.
There's another category called "musical hallucinations"— where the person thinks they are actually hearing music, which could be a symptom of depression, although scientists don't know for sure. The drug vortioxetine, which may help boost serotonin the brain, has shown some promise in reducing earworms.
Some research has shown that diseases that damage the auditory pathway in the brain have a link to musical hallucinations.
How to Stop a Simple Earworm
Here are six easy ways to make it stop:
Mix up your playlist. "Listening to songs repeatedly does increase the likelihood that they'll get stuck," said Margulis.
Take breaks from your tunes throughout the day. "Longer listening durations are more likely to lead to earworms," Scullin said.
Use your feet. Walk at either a slower or faster pace than the beat of your earworm. This will interrupt your memory of the tempo and can help chase away the earworm.
Stick with that song. "Listen to a song all the way through," said Silbersweig. If you only listen to snippets of a song, the Zeigarnik effect can take hold. That's the brain's tendency to remember things that are interrupted more easily than completed things.
Distract yourself. Lose yourself in a book, a movie, your work, or a hobby that requires concentration. "Redirecting attention to an absorbing task can be an effective way to dislodge an earworm," said Margulis.
Chew gum. Research shows that the action of doing so interferes with repetitive memories and stops your mind from "scanning" a song. Then enjoy the sound of silence!
Elizabeth H. Margulis, professor, Princeton University, and director of the university's Music Cognition Lab.
David Silbersweig, MD, chairman, Department of Psychiatry, and co-director, Institute for the Neurosciences, Brigham and Women's Hospital, Boston.
Michael K. Scullin, PhD, associate professor of psychology and neuroscience, Baylor University, Waco, TX.
Elaine Jones, MD, , neurologist, Hilton Head, SC; fellow, American Academy of Neurology
Bulletin of the Menninger Clinic: "Stuck in my head: Musical obsessions and experiential avoidance."
Consciousness and Cognition: "Tunes stuck in your brain: The frequency and affective evaluation of involuntary musical imagery correlate with cortical structure," "Musical hallucinations, musical imagery, and earworms: a new phenomenological survey."
PLOS One: "Sticky Tunes: How Do People React to Involuntary Musical Imagery?"
Psychology of Music: "Musical activities predispose to involuntary musical imagery."
British Journal of General Practice: "Stuck song syndrome: musical obsessions – when to look for OCD."
New Music Express: "Scientists name the ultimate earworm and explain what makes songs addictive."
Harvard Gazette: "Why That Song is Stuck in Your Head."
Music Perception: "Singing in the Brain: Investigating the Cognitive Basis of Earworms."
Annals of General Psychiatry: "Major depression with musical obsession treated with vortioxetine: a case report."
Brain: "Minds on replay: musical hallucinations and their relationship to neurological disease."
Quarterly Journal of Experimental Psychology: "Want to block earworms from conscious awareness? B(u)y gum!"
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Cite this: Song Stuck in Your Head? What Earworms Reveal About Health - Medscape - Mar 31, 2023.