Knowledge is Power
Irregularities in the vagus nerve can cause tremendous distress in physical and emotional health. Physical consequences can include irritable bowel syndrome (IBS), heart burn or GERD, nausea or vomiting, fainting, tinnitus, tachycardia, auto-immune disorders, seizures, and migraines. Mental health consequences include fatigue, depression, panic attacks, or a classic alternation between feeling overwhelmed and shut-down. It is always important to discuss these symptoms with your physician. It is also valuable to have access to information that helps us stay informed when it comes to our healthcare.
In a previous post I discuss Natural Vagus Nerve Stimulation as related to the treatment of PTSD. In response to that post I received a series question. Here are just a few:
- “If I am already experiencing anxiety isn’t my vagus nerve already over-stimulated?”
- “How can stimulating the same nerve help both depression and anxiety?”
- “I’m excited to learn about natural vagus nerve stimulation techniques but for how long do I do the exercises?”
Since these questions are quite common this post includes my response to these readers with you.
“Having an understanding about the neural and physiological substrates of the body and mind provides keys that can open many doors. Such an understanding can allow you advocate for your needs with healthcare providers and help you feel empowered in your healing journey. You can learn the practices that help you regulate your mind and emotions and as a result positively impact your physical health. Knowledge is power.”
-Dr. Arielle Schwartz
Vagus Nerve Stimulation Explained
Vagus Nerve Stimulation (VNS) has been a hot medical topic due to a promising new treatment option which involves surgically implanting a regulating device that provides stimulation for the Vagus Nerve. The vagus nerve, or tenth cranial nerve, connects the brain to major systems in the body including the stomach and gut, heart, lungs, throat, and facial muscles. Since this nerve is the primary communicator between the brain, heart, and digestive organs irregularities can lead to painful physical and mental health consequences. However, research on Vagus Nerve Stimulation suggests promising results for:
- Heart disease
- Auto-immune disorders and systemic inflammation
- Memory problems and Alzheimer’s disease
- Thyroid disorders
- Digestive difficulties such as IBS, colitis, GERD, leaky gut, gastroparesis or coli
- Traumatic Brain Injury (TBI)
As a Somatic Therapist and EMDR Therapist specializing in the treatment of PTSD I have been exploring non-surgical interventions that naturally stimulate the vagus nerve. Proper stimulation of the vagus nerve can improve depression and anxiety, relieve inflammation, improve sleep, reduce allergies, and reduces stress. Natural vagus nerve stimulation can be achieved through a wide range of behaviors that include:
- Mindfulness practices, loving kindness meditation, and yoga
- Slow rhythmic breathing
- Applying cold washcloth to the face (diving reflex)
- Vasalva maneuver (exhaling against a closed airway)
- Massage, craniosacral therapy, and acupuncture
- Positive social connections
- Humming, singing, or chanting
- Healthy diet with probiotics
Dr. Stephen Porges’ polyvagal theory reveals that our nervous system reflects a developmental progression with three evolutionary stages. The earliest evolutionary set of actions is maintained by what is called the “Dorsal Vagal Complex.” This branch of the vagus nerve engages the parasympathetic nervous system in an unrefined manner and is sometimes referred to as an abrupt vagal brake because of the immobilizing defensive actions such as fainting or feigned death. The second evolutionary stage of nervous system is maintained by the actions of the sympathetic nervous system responsible for actions mobilize us into self-protection (fight/flight) when under stress. The most recently evolved portion of the nervous system is the “Ventral Vagal Complex” which Dr. Porges has termed the “social nervous system.” This more recently evolved branch of the vagus nerve also functions as a brake on sympathetic activation; however, this occurs in a highly refined and regulating manner resulting in a calming and soothing effect.
Importantly, both the Dorsal Vagal Complex (DVC) and the Ventral Vagal Complex (VVC) will exert inhibition on the sympathetic nervous system. The DVC has serious repercussions on mental and physical health whereas the VVC is associated with increases in health and emotional wellbeing. You can read more in my post about polyvagal theory and the treatment of PTSD.
Frequently Asked Questions
So, let’s take a closer look some of the common questions asked by readers:
Question: “I hear about vagus nerve stimulation helping with anxiety. But, if I am already experiencing anxiety isn’t my vagus nerve already over-stimulated?”
Answer: What we aim to stimulate is the Ventral Vagal Complex (VVC) which exerts a refined inhibiting effect on the sympathetic nervous system. When the sympathetic nervous system is activated we tend to feel “keyed up”, panicky, or anxious. Our nervous system is wired to seek safety and the sympathetic nervous system protects us through mobilization into fight or flight. The VVC, social nervous system, helps us to regulate our nervous system. We can use the energy of the sympathetic nervous system to explore physical movements that feel safe and grounding such as going for a walk or shaking out the arms and legs to release stress.
Question: “How can stimulating the same nerve help both depression and anxiety?”
Answer: Dr. Porges identifies that the Ventral Vagal Complex or your social nervous system helps to regulate both sympathetic hyper-arousal and parasympathetic hypo-arousal. The social nervous system relies upon “neuroception,” our capacity to sense and therefore regulate these high or low energy states. It is not uncommon to alternate between panic and depression when the vagus nerve is dysregulated by highly stressful or traumatic life events. Practices that stimulate the vagus nerve are aimed towards either relaxing or re-energizing ourselves depending upon what is needed to feel in calm and in control.
Question: “I’m excited to learn about natural vagus nerve stimulation! I’d like to try these techniques but I don’t know the duration of the exercises. Should the humming or deep breathing be done for 1, 3, or 15 minutes?”
Answer: I think the answer to this question is very specific to each individual. Experiment for yourself. Become mindful and curious about your experience. For example, how long do you need to practice deep breathing until you feel a shift internally? Explore humming your favorite song or singing yourself a lullaby. It is valuable to have multiple strategies for regulating our nervous system because what works for one person may not work for you. Personally, I find that one longer (45-60 minute) mindfulness or yoga practice each day accompanied by mini breath awareness and movement breaks works for me. Once you discover what works for you keep practicing. You wouldn’t think brushing and flossing your teeth on Monday sufficient for an entire week. Likewise, I encourage you to think of vagus nerve stimulation as a kind of mental hygiene that requires regular practice to be most effective.
Having an understanding about the neural and physiological substrates of the body and mind provides keys that can open many doors. Such an understanding can allow you advocate for your needs with healthcare providers and help you feel empowered in your healing journey. You can learn the practices that help you regulate your mind and emotions and as a result positively impact your physical health. Knowledge is power.
Want to learn more about healing PTSD?
This post offers an excerpt from my book, The Complex PTSD Workbook, now available on Amazon! Click here to check it out.
About Dr. Arielle Schwartz
Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing. Dr. Schwartz is the author of The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole (Fall, 2016). She is the developer of Resilience-Informed Therapy which applies research on trauma recovery to form a strength-based, trauma treatment model that includes Eye Movement Desensitization and Reprocessing (EMDR), somatic (body-centered) psychology and time-tested relational psychotherapy. Like Dr. Arielle Schwartz on Facebook, follow her on Linkedin and sign up for email updates to stay up to date with all her posts.