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Can This Nerve Improve Mental Health?

Hadley’s Intro:  To prepare for hosting Love Quest TV

in the opening scene of my new sitcom, the protagonist

stimulates her Vagus Nerve with an exercise that looks

and sounds like an exorcism.  Find out how you may

gain focus and calm energy by taking good care of your

vagus nerve in a guest post courtesy of New York Times

written by Christina Caron

This Nerve Influences Nearly Every Internal Organ.
Can It Improve Our Mental State, Too?
On social media, exercises that aim to “tone”
one of our body’s longest nerves have been
touted as a cure-all for anxiety and other
psychological ailments. Here’s what the research
says.

Credit…Chloe Cushman

In recent years, the vagus nerve has become an
object of fascination, especially on social media.
The vagal nerve fibers, which run from the brain
to the abdomen, have been anointed by some
influencers as the key to reducing anxiety,
regulating the nervous system and helping the body
to relax.

TikTok videos with the hashtag “#vagusnerve”
have been viewed more than 64 million times and
there are nearly 70,000 posts with the hashtag on
Instagram. Some of the most popular ones feature
simple hacks to “tone” or “reset” the
vagus nerve, in which people plunge their faces
into ice water baths or lie on their backs with
ice packs on their chests. There are also neck and
ear massages, eye exercises and deep-breathing
techniques.

Now, wellness companies have capitalized on the
trend, offering products like “vagus massage
oil,” vibrating bracelets and pillow mists, that
claim to stimulate the nerve, but that have not
been endorsed by the scientific community.

Researchers who study the vagus nerve say that
stimulating it with electrodes can potentially
help improve mood and alleviate symptoms in those
who suffer from treatment-resistant depression,
among other ailments. But are there other ways to
activate the vagus nerve? Who would benefit most
from doing so? And what exactly is the vagus
nerve, anyway? Here’s a look at what we know so
far.

What is the vagus nerve?
The term “vagus nerve” is actually shorthand
for thousands of fibers. They are organized into
two bundles that run from the brain stem down
through each side of the neck and into the torso,
branching outward to touch our internal organs,
said Dr. Kevin J. Tracey, a neurosurgeon and
president of the Feinstein Institutes for Medical
Research, Northwell Health’s research center in
New York.

Imagine something akin to a tree, whose limbs
interact with nearly every organ system in the
body. (The word “vagus” means “wandering”
in Latin.)

The vagus nerve picks up information about how the
organs are functioning and also sends information
from the brain stem back to the body, helping to
control digestion, heart rate, voice, mood and the
immune system.

For those reasons, the vagus nerve — the longest
of the 12 cranial nerves — is sometimes referred
to as an “information superhighway.”

Dr. Tracey compared it to a trans-Atlantic cable.

“It’s not a mishmash of signals,” he said.
“Every signal has a specific job.”

The vagus is the main nerve of the parasympathetic
nervous system. Unlike the sympathetic nervous
system, which is associated with the body’s
“fight or flight” response, the
parasympathetic branch helps us rest, digest and
calm down.

Scientists first began examining the vagus nerve
in the late 1800s to investigate whether
stimulating it could be a potential treatment for
epilepsy. They later discovered that a side effect
of activating the nerve was an improvement in
mood. Today, researchers are examining how the
nerve can affect psychiatric disorders, among
other conditions.

What does the research say?
Evidence indicates that stimulating the vagus
nerve can help people with epilepsy, diabetes,
treatment-resistant depression and post-traumatic
stress disorder — as well as inflammatory
autoimmune conditions like Crohn’s disease or
rheumatoid arthritis. There is even some
preliminary research suggesting that long Covid
symptoms could originate, in part, from the
virus’s effect on the vagus nerve.

“It can sound sort of magical with all the
things it does,” said Eric Porges, an assistant
professor in the department of clinical and health
psychology at the University of Florida who
studies the vagus nerve. Our understanding of the
vagus nerve “continues to grow in richness and
depth,” he said, but there is still much to
learn about how it works.

In the early 2000s, researchers started to show
that vagus nerve stimulation could help some
patients who were severely depressed and had not
responded to other treatments.

A wave of studies followed.

By 2005, the Food and Drug Administration had
approved implantable pulse-generating devices that
sent electrical signals to the vagus nerve, for
use in patients with treatment-resistant
depression. Similar devices have also been
approved for obesity — to help control feelings
of hunger and fullness — and for the treatment
of epilepsy. The downside of these devices,
however, is that the surgery is expensive and it
can take months — and sometimes as long as a
year — to have an effect.

Researchers are now recruiting patients for the
largest clinical trial to date examining to what
degree vagus nerve stimulation may help patients
with depression who have been unable to find
relief with other treatments.

The device may be especially helpful for those
with bipolar depression because so few treatments
exist for them, said Dr. Scott Aaronson, one of
the senior psychiatrists involved in the clinical
trial and the chief science officer of the
Institute for Advanced Diagnostics and
Therapeutics, a center within the Sheppard Pratt
psychiatric hospital that aims to help people who
have not improved with conventional treatments and
medications.

In general, one of the problems with treating
depression “is that we’ve got a lot of
medications that pretty much do the same thing,”
Dr. Aaronson said. And when patients do not
respond to those medications, “we don’t have a
lot of novel stuff.”

Implanted vagus nerve stimulation isn’t
currently accessible for most people, however,
because insurers have so far declined to pay for
the procedure, with the exception of Medicare
recipients participating in the latest clinical
trial.

Dr. Tracey’s research, which uses internal vagus
nerve stimulation to treat inflammation, may also
have applications for psychiatric disorders like
PTSD, said Dr. Andrew H. Miller, the director of
the Behavioral Immunology Program at Emory
University, who studies how the brain and the
immune system interact, and how those interactions
can contribute to stress and depression.

PTSD is characterized by increased measures of
inflammation in the blood, he said, which “can
influence circuits in the brain that are related
to anxiety.”

In one pilot study at Emory, for example,
researchers electronically stimulated the neck
skin near the vagus in 16 people, eight of whom
received vagus nerve stimulation treatment and
eight of whom received a sham treatment. The
researchers found that the stimulation treatment
reduced inflammatory responses to stress and was
associated with a decrease in PTSD symptoms,
indicating that such stimulation may be useful for
some patients, including those with elevated
inflammatory biomarkers.

Meanwhile, Dr. Porges and his colleagues at the
University of Florida have patented a method to
adjust vagus nerve electrical stimulation based on
a patient’s physiology. He is now working with
the company Evren Technologies, where he is a
shareholder, to develop an external medical device
that uses this approach for patients with PTSD.

How do you measure vagus nerve activity?
The activity of the vagus nerve is difficult to
measure directly, especially given how complex it
is. But because some vagus nerve fibers connect
with the heart, experts can indirectly measure
cardiac vagal tone — or the way in which your
nervous system regulates your heart — by looking
at your heart rate variability, which are the
fluctuations in the amount of time between your
heartbeats, on an EKG.

An abnormal vagal tone — one in which there is
very little heart rate variability — has been
associated with conditions like diabetes, heart
failure and hypertension.

A high variability between heart beats may signify
an ideal vagal tone.

How can you improve your vagal ‘tone’ at home?
Holding your breath and submerging your face in
cold water can trigger the “diving reflex,” a
response that slows the heart beat and constricts
blood vessels. Some people who have tried it
report that it has a calming effect and can even
reduce insomnia. Others wrap an ice pack in cloth
and place it on their chest to relieve anxiety.

These specific exercises haven’t been
sufficiently studied as methods for controlling
anxiety or depression, so it is difficult to know
if they work, or if they do, how well. Even so,
some experts say they’re worth a shot.

“It’s certainly one of the more benign things
you can do,” Dr. Aaronson said.

But Dr. Tracey urged caution, adding that it’s
difficult to properly assess the risks and
benefits without clinical data. “I would not
advise anyone to do any intervention without
checking with their physician,” he said.

“For wellness, try to maintain high vagus nerve
activity through mindfulness, exercise and paced
breathing,” Dr. Tracey said. “These are all
very good for you.”

Christina Caron is a reporter for the Well
section, covering mental health and the
intersection of culture and health care.
Previously, she was a parenting reporter, general
assignment reporter and copy editor at The Times.
@cdcaron

A version of this article appears in print on June
7, 2022, Section D, Page 7 of the New York edition
with the headline: The Vast Potential Of the Vagus
Nerve. Order Reprints | Today’s Paper |
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