Vagus Nerve Stimulation (VNS) for Depression
In one of the previous posts, we presented Vagus nerve stimulation (VNS) as a surgical procedure that can be used to treat those with treatment-resistant depression, using a pacemaker-like device that is implanted in the body. The device is attached to a stimulating wire that is threaded along a nerve called the vagus nerve. The vagus nerve travels up the neck to the brain where it connects to areas believed to be involved in regulating mood. Once implanted, this device delivers regular electrical impulses to the vagus nerve.
While there are promising results for depression treatment, especially, when all other methods are not successful, the surgical treatment is a critical procedure that requires intrusive medical impact. The simple question is if it is possible to stimulate vagus nerve manually through some holistic activities and healthy lifestyle.
“It’s almost like yin and yang,” says Mladen Golubic, M.D., of the Cleveland Clinic’s Center for Integrative Medicine. “The vagal response reduces stress. It reduces our heart rate and blood pressure. It changes the function of certain parts of the brain, stimulates digestion, all those things that happen when we are relaxed.”
What is the vagus nerve?
Тhe vagus nerve is the longest nerve in the body which originates in the brain as cranial nerve ten, travels down the from go the neck and then passes around the digestive system, liver, spleen, pancreas, heart and lungs. This nerve is a major player in the parasympathetic nervous system, which is the ‘rest and digest’ part (opposite to the sympathetic nervous system which is ‘fight of flight’).
Functions of the Vagus Nerve
The vagus nerve has the most extensive distribution of all the cranial nerves. It is actually two nerves, which both run from the brain stem and branch out through the neck and down each side of the body, across the abdomen and to the main organs.
As a result, the remarkably complex circuitry that makes up the entire vagus nerve has a role in myriad bodily functions, including breathing, maintaining digestive function, and monitoring the heartbeat to keep it in a regular rhythm. When we are hungry or feel our chest tighten, it is the vagus nerve relaying that message. The vagus nerve also relays sensory information from the ear, tongue, throat, windpipe and voice box.
Like the nerve itself, vagus nerve disorders are often also called 10th cranial nerve disorders. These disorders can have a variety of different impacts that are as complex as the nerve itself, though some effects are more common than others.
The tone of the vagus nerve is key to activating the parasympathetic nervous system. Vagal tone is measured by tracking your heart-rate alongside your breathing rate. Your heart rate speeds up a little when your breathe in, and slows down a little when you breathe out. The bigger the difference between your inhalation heart rate and your exhalation heart rate, the higher your vagal tone. Higher vagal tone means that your body can relax faster after stress.
What is high vagal tone associated with?
High vagal tone improves the function of many body systems, causing better blood sugar regulation, reduced risk of stroke and cardiovascular disease, lower blood pressure, improved digestion via better production of stomach basic and digestive enzymes, and reduced migraines. Higher vagal tone is also associated with better mood, less anxiety and more stress resilience. One of the most interesting roles of the vagus nerve is that it essentially reads the gut microbiome and initiates a response to modulate inflammation based on whether or not it detects pathogenic versus non-pathogenic organisms. In this way, the gut microbiome can have an affect on your mood, stress levels and overall inflammation.
What is low vagal tone associated with?
Low vagal tone is associated with cardiovascular conditions and strokes, depression, diabetes, chronic fatigue syndrome, cognitive impairment, and much higher rates of inflammatory conditions. Inflammatory conditions include all autoimmune diseases (rheumatoid arthritis, inflammatory bowel disease, endometriosis, autoimmune thyroid conditions, lupus and more).
How do we increase vagal tone?
After some practice, you will see that you can manage that intentionally. To some degree, you are genetically predisposed to varying levels of vagal tone, but this still does not mean that you can’t change it. Here are some ways to tone the vagus nerve:
1. Slow, rhythmic, diaphragmatic breathing.
Breathing from your diaphragm, rather than shallowly from the top of the lungs stimulates and tones the vagus nerve. That means expanding your diaphragm, a muscle located horizontally between the chest cavity and stomach cavity. Also known as “belly breathing,” diaphragmatic breathing is characterized by an expansion of the abdomen instead of the chest. Start by taking a deep inhalation into your belly while counting to five. Then very slowly exhale while pursing your lips. To get into a vagus-nerve stimulation mode, it is best to reduce the number of breaths from a typical 10-14 per minute to 5-7 per minute.
Since the vagus nerve is connected to the vocal cords, humming mechanically stimulates it. You can hum a song, or even better repeat the sound ‘OM’. An interesting study was performed by the International Journal of Yoga in 2011, where ‘OM’ chanting was compared with pronunciation of ‘SSS’ as well as a rest state to determine if chanting is more stimulatory to the vagus nerve. The study found that the chanting actually was more effective than either the ‘sss’ pronunciation or the rest state. Effective ‘OM’ chanting is associated with the experience of a vibration sensation around the ears and throughout the body. It is expected that such a sensation is also transmitted through the auricular branch of the vagus nerve and will produce limbic (HPA axis) deactivation. Hold the vowel (o) part of the ‘OM’ for 5 seconds then continue into the consonant (m) part for the next 10 seconds. Continue chanting for 10 minutes. Conclude with some deep breathing and end with gratitude.
3. Speaking. Similarly speaking is helpful for vagal tone, due to the connection to the vocal cords. In today’s world, we are more likely to send emails and text messages instead of actually speaking to people. The more human and vocal interactions you have the better your vagal tone will be. Even talking to yourself aloud counts!
4. Washing your face with cold water.
The mechanism of such impact is yet to be discovered but cold water on your face stimulates the vagus nerve. Some studies show that cold water facial immersion, especially after exercise, can quickly stimulate the vagus nerve and help reduce the heart rate while activating the digestive and immune systems. The area behind the eyeballs is a particularly accessible zone for stimulation. The best way to practice this technique is, while seated, bend your head forward into a basin of cold water, and submerge your forehead, eyes, and at least two-thirds of your cheeks. During studies of this technique, the water temperature was kept at about 50-53 degrees Fahrenheit.
Meditation, especially loving kindness meditation, which promotes feelings of goodwill towards yourself and others. A 2010 study by Barbara Fredrickson and Bethany Kik found that increasing positive emotions led to increased social closeness, and an improvement in vagal tone.
6. Balancing the gut microbiome.
The presence of healthy bacteria in the gut creates a positive feedback loop through the vagus nerve, increasing its tone.
7. Immersing tongue in saliva.
The tongue and the hard and soft palate are other accessible zones for stimulation. In order to promote salivation, try relaxing and reclining in chair and imagine that you are sucking on a juicy lemon. If that does not work, simply fill your mouth with warm water. Bathe your tongue in the saliva or water while breathing deeply through your nose. Enjoy the feelings of relaxation in your head, neck, hands, hips, and feet. Do this for three minutes.
The implications of such simple and basic practices on your overall health, and in particular on inflammation are far-reaching. If you suffer from an inflammatory condition, digestive upset, high blood pressure or depression, a closer look at vagal tone is highly recommended. We have known for years that breathing exercises and meditation are helpful for our health, but it is so fascinating to learn the mechanism by which they work.
4 Steps for the Longevity Maneuver
Longevity Maneuver is specifically designed exercise to achieve Vagus nerve stimulation naturally.
1. Lie down or recline on a comfortable chair or sofa. Imagine a juicy lemon and let your mouth fill entirely with saliva. Allow your tongue to be submerged. Permit your saliva to remain there for the duration of this process. Go to step 2.
2. Allow your tongue to relax and lay your arms at your sides and slightly away from your body. Spread your fingers so none touches. Close your eyes for the remainder of this exercise. Go to step 3.
3. Breathe deeply and slowly from your nostrils only. Allow your belly to rise and fall. Continue this style of breathing for the next 10 to 20 minutes. Go to step 4.
4. Briefly tense and relax your feet and hands before allowing them to just relax. Notice the relaxation growing in your body during the duration of this maneuver.
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