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?
ΠΆhe
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.
Vagal tone
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.
2. Humming.
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.
5. Meditating.
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.
Sources and
Additional Information:
