TOUCHED A NERVE
Not Sin City, but the little-known nerve that could hold the key to treating stress, anxiety and depression
The strong-mind secret you haven’t heard about
Unearthing a waterproof fiver in your jeans pocket postrinse cycle. An early finish on a Friday instigated by the boss. Unexpected surprises that take some topping. So allow us to try. Finding out the secret to optimum health and wellbeing is tucked away inside your body, just waiting for you to tap into it? Yeah, thought that might do it.
Introducing the vagus nerve, your body’s very own built-in stress-buster. The vagus (pronounced ‘vay-gus’, like the city) is one of the largest nerves in the body and among the most exciting, given that it could be key to treating many modern stress-based conditions, such as anxiety, insomnia, IBS, depression and even infertility. It runs from the brain stem, past the ear and down the back of the throat before branching out into the gut and passing messages between your organs and your brain – like a broadband cable connecting body and mind. Got a gut feeling? That’s your vagus talking. While vagus nerve stimulator (VNS) implants are already being used to treat conditions such as epilepsy, migraine and tinnitus, the focus on the stressreducing power of this nerve is relatively new. Ongoing research at the University of Texas is currently looking into how vagal stimulation can help alleviate post-traumatic stress disorder. What’s more, traditional ancient self-care practices such as yoga, meditation and chanting are increasingly being proven to have a measurable calming effect – and it’s all thanks to the vagus. It’s laying claim to the title of the ‘self-care nerve’ – if you look after it, it’ll look after you.
NOT-SO-NERVOUS SYSTEM
If Powerpoint crashes or an aggy message from your partner sends your mood into a nosedive, the vagus nerve jumps in to put the brakes on your stress response – the racing heart, sweaty palms and knotted gut that are all down to your sympathetic nervous system. It calms your breathing and heart rate and gets you back to the rest-and-digest mode the parasympathetic nervous system is
responsible for. This stress-regulating effect was discovered in 1921, when Otto Loewi – the Nobel Prize-winning physiologist – showed that electrical stimulation of the vagus slowed the heart rate. He also found that it triggered the release of a substance that was later identified as acetylcholine, a neurotransmitter that plays a key role in muscle activation and sleep.
Crucially, acetylcholine is part of your inflammation-fighting arsenal, which opens the door for using vagal stimulation to treat conditions characterised by acute or chronic inflammation – including autoimmune diseases (such as rheumatoid arthritis and inflammatory bowel disease) and even depression. A recent study in The Journal Of Clinical Psychiatry showed that people with depression had 46% higher levels of inflammatory markers in their blood than healthy participants. Professor Edward Bullmore, a neuroscientist at Cambridge University and author of The Inflamed Mind (£14.99, Short Books), puts the current depression epidemic down to inflammation, which he claims is caused by chronic stress.
STRESS HEAD
The problem? The vagus can’t keep up with the demands you’re placing on it. ‘There’s a mismatch between humans’ genetic evolutionary heritage and our modern living environment,’ explains Dr Rangan Chatterjee, a GP and author of The 4 Pillar Plan (£16.99, Penguin). ‘That mismatch is at the core of many modern afflictions and the vagus nerve plays a key role. The fight-orflight response is there for emergencies, but modern life is likely why you currently feel under constant attack. Hunter-gatherers would have experienced periods of boredom when they could let their brains switch off.’ We don’t allow ourselves that luxury – we spend our downtime glued to our phones. And it’s having consequences. Like you, your vagus is overworked and tired as hell.
If the vagus isn’t functioning well, it has what’s known as ‘low tone’. ‘This means it has a poor ability, or no ability, to calm the stress response,’ says Dr Magdalena Bak-maier, a neuroscientist and life coach (maketimecount.com). ‘So, if you’re in a state of fear or anxiety, you can’t get yourself out of that loop, which further impedes the ability of the vagus nerve to restore your system to balance. It’s why chronic stress is so damaging. Even the memory of a fearful event can potentially weaken vagal tone if it’s regularly replayed.’
Tone your abs by all means, but it’s vagal toning that will bolster your stress defences. For starters, try omming. ‘A long low “om” sound resonates in the roof of the mouth and back of the throat where the vagus nerve begins,’ explains Mercedes Sieff, a positive psychology coach and yoga teacher at Yeotown health retreat. The vagus responds to low-frequency sound as well as vibrations and can be most easily stimulated when such a vibration passes through the back of the throat and behind the breastbone. Yogic ‘ujjayi’ breath – a technique that creates pressure in the back of the throat and makes you sound like Darth Vader – works in the same way. Research by Dr Chris Streeter, an associate professor of psychiatry and neurology at Boston University School of Medicine, has shown that yoga practices in general improve stress-related disorders by increasing vagal tone.
And, of course, there’s an app for that. Launching this summer is a smartphonelinked wearable electronic pebble called the Sensate, which sends low-frequency sound vibrations to the vagus through the chest. Its creator – Harley Street acupuncturist Stefan Chmelik – has been using vagal toning via an electronic pad embedded in the back of a chair for several years. ‘It has enabled us to speed up the recovery process in our patients with complex chronic issues, such as stress and anxiety, some of whom previously hadn’t responded to treatment,’ he says. More than 100 volunteers tried the wearable device for 10 minutes a day over six weeks and 86% showed an increase in stress resilience (measured by heart-rate variability) – not bad for a pebble.
SAFE SPACES
That’s not all toning your vagus is good for. For patients who suffer from anxiety and IBS, which are often linked, Dr Chatterjee prescribes a ‘3, 4, 5’ breathing technique
(in for three, hold for four, out for five).
‘If you’re anxious, your breathing will be shallow, but deep breathing and deep relaxation stimulate the vagus nerve,’ he says. ‘Of course, there’s nothing wrong with counselling for anxiety, but that’s tackling it from the brain downwards. You also have to tackle it from the body upwards.’ Hacks like this could offer an alternative when talking therapies aren’t working or you don’t have access to them.
And you don’t need to be suffering from a condition in order to benefit from vagal toning. It can make you think more clearly, which can in turn help you perform better at work. And, as fertility expert Emma Cannon explains, it may even increase your chances of getting pregnant. She uses ear acupuncture to stimulate the vagus nerve as part of her body, mind and gut programme. ‘Many of my clients are highly stressed,’ she explains. ‘Electroacupuncture relaxes the gut and helps switch the body into what I call the feed-and-breed mode (rest and digest). In order to breed, we have to feel safe.’
That feeling of safety is key to a healthy vagus. It all comes down to something called polyvagal theory. Devised by Stephen Porges, a professor of psychiatry at the University of North Carolina, it posits that when you feel safe and experience positive social connections, your vagus nerve communicates to the body’s organs the message that all is well, slowing the heart rate and overriding your stress response. This could be stimulated by a smile, a friendly face or ‘motherese’ – the tone we use to talk to babies and pets. ‘We’re born
WHEN YOU FEEL SAFE, THE VAGUS TELLS YOUR ORGANS THAT ALL IS WELL
with a sensitivity to melodic vocalisations similar to a mother’s lullaby,’ says Dr Porges. ‘Melodic vocalisations signal safety to the nervous system. The voice is a way of selfcalming, by increasing vagal tone to the heart through chants and singing.’ In both, the emphasis is on the exhale, which is when the vagus does its thing.
Self-care practices that tap into the nurturing you received as a child are also vagus-friendly. ‘Activities that are physically or emotionally soothing, such as stroking a pet, cuddling a hot water bottle or wrapping yourself in a warm blanket – anything that promotes a visceral feeling of safety – will help trigger a return to homeostasis or balance,’ says Dr Bak-maier. Nesting comes under this category, too, she says. Permission to buy another house plant granted.
But with the octopus-like tentacles of the nerve spreading deep into the body, we still have much to learn about what happens in vagus. It’s part of the gut-brain connection: anti-inflammatory compounds called short-chain fatty acids are made by gut bacteria and send signals to the brain via the vagus; it’s linked to appetite: the hunger and satiety hormones act on the vagus; it has even been mooted that the vagus is responsible for that euphoric post-poo feeling. Oh, come on, you know the one.
‘I think we’re going to be hearing more and more about the vagus nerve,’ says Dr Chatterjee, ‘particularly as we’re finding out that a lot of our drug-based treatments are limited for some of these chronic lifestylerelated problems. We need a bigger toolbox and practices that support the vagus nerve are going to play a key role in the future.’
And perhaps what is really promising about this area of research, adds Chmelik, is that it provides a clinical explanation for some conditions – like migraines, IBS and anxiety – which are dismissed by some people as being all in the mind. One thing is clear: what happens in vagus doesn’t stay in vagus.