What is the dreadful thing that we never want, is never invited, but visits us daily? Although we accept and learn to live with it, it negatively affects our mood, our concentration, our families, our sleep… even our love lives. Worst of all, it can affect our health; studies have shown that it can even shorten your life. Have you guessed it yet? Stress. We accept it as part of our daily life. Unfortunately, short of drugs, there is no easy way to keep it out of our lives. In order to understand how to mitigate its uninvited appearances, we must first understand the science behind this indolent, elusive beast.
Anatomy
Our nervous system is often said to be infinitely complex. However, basic knowledge of human neuroscience is all that is necessary to understand how stress affects almost every aspect of our bodies. The brain’s connection to our entire body is made up of three essential biologic “circuits”:
- The spinal cord – responsible for sending signals to and from your brain that involve sensation, skeletal muscle contraction, and reflexes of said muscle. The ability to go for a run and the subsequent feeling of soreness in your calves and quads is mediated by electrical signals within the spinal cord.
- The sympathetic chain – The sympathetic chain is responsible for facilitating the proverbial “fight or flight” response. This neurologic “wiring” is the conduit by which your brain tells your eyes to dilate, your heart to beat faster, breathing to get rapid and shallow, your skin to sweat, and redirects blood flow from your stomach and intestines to supply better the muscles you may use to fight or to run away. If we stay in the “fight or flight” state for longer than a few minutes, it becomes difficult to focus on any one task.
- The parasympathetic nervous system (mediated by the vagus nerve). Everyone would agree that situations that trigger intense sympathetic chain activation can feel decidedly unpleasant. Now, let’s not get unnerved yet (no pun intended), because the third brain-body connection carried out by the vagus nerve serves as the corollary to sympathetic chain activation: It delivers signals that slow your heart rate, your breathing, rebalance your blood flow, etc., etc.
This system is activated when a human is in a relaxed, content state.
In normal, non-stressful situations, our parasympathetic system (via the vagus nerve) keeps the sympathetic system in a balanced state, also referred to as being in “check.” Many people, especially Americans, suffer from a constant baseline of stress because their parasympathetic system is dominated by an overactive sympathetic system. This imbalance has been hypothesized to be a result of society’s high expectations for achievement, communication, financial pressures, simply attributable to one’s genetic makeup, or a combination of these factors. Nonetheless, we, as the innovative creatures we are, over thousands of years, have tried just about everything to achieve the reduction of our own anxiety and improvement in calmness, mood, focus, and sleep. Interestingly, over the last few thousand years, techniques that were effective in this endeavor all induced, what we now know to be, effective vagus nerve stimulation! Next, we will discuss what those historically developed techniques were, as well as modern, cutting edge solutions.
History
In ancient times, Buddhist monks spent many lifetimes developing and perfecting the art of meditation. Reaching “enlightenment” through meditation put those who were able to achieve it, in a state of total contentment, extremely slow heart rate, slow, deep breathing, complete absence of stress, and “infinite” clarity of thought. With modern science and extensive research, we now know that the monk’s meditation techniques actually cause profound upregulation of the vagus nerve! Although some can successfully meditate like Buddist monks, most of us don’t have the time or commitment to spend years perfecting these techniques. For those that have, they still require a significant time commitment, as well as a conducive environment. Don’t get me wrong; meditation is an excellent way to stimulate your vagus nerve—it’s just impractical for most people in today’s society.
For hundreds of years, certain African tribes would calm their babies by rubbing their ear canal with a finger (not recommended). Due to the recent discovery that the vagus nerve can be activated by stimulating about the ear, the historical effectiveness of this technique is easily understood (and, not to mention, that we’ve all experienced the“eargasm” elicited by the ill-advised cotton swab swirl in the ear canal).
Not wanting to mire you in this piece with the myriad historical “calming” techniques that we now know confer their effectiveness by stimulating nerves, I will mention one final historical technique: auricular acupuncture. The practice of performing acupuncture on the ear has been an effective means of helping with smoking cessation as well as chronic pain mitigation. Until now, its demonstrated effectiveness was not understood by modern science. The recent realization that this technique is actually stimulating the vagus nerve elucidates the neurophysiology of this technique and explains why it works to treat the aforementioned conditions.
VNS today
Let’s now talk about modern vagus stimulation methods and the science behind them. In the last three decades, there has been voluminous experience with direct methods of stimulating this “wonder nerve.” There have now been thousands of people that have undergone surgical implantation of vagus nerve stimulators. In the wake of these implants, scientific data is well established that these devices confer substantial benefit for the treatment of a number of disorders. The data is so compelling that the FDA has approved such surgically implanted devices for the treatment of epilepsy, depression, and even weight loss. Many other indications for various implantables are pending approval. Please understand that these surgically implanted devices are not without risk (infection, bleeding, to name a few) and have huge cost—we’re talking tens of thousands of dollars! Clearly, these devices are not a good option for stress relief or focus. So, let’s move on to the most exciting direction of vagal stimulation devices that are low-cost and don’t require dangerous surgery.
Lastly, Neuvana, a company that manufactures a transcutaneous vagus nerve stimulator by the same name utilizes a generator and separate electrodes that are placed within the left ear canal (outer third), thus accessing the vagus where it is commonly present and easily accessible. The Neuvana device is a lifestyle device designed to stimulate the vagus for purposes of reducing stress, enhancing focus, and promoting healthy sleep. It is a safe, inexpensive means of getting your “vagus kick” whenever and wherever you like!
In summary, using direct or transcutaneous stimulation of the vagus nerve has not only demonstrated scientifically proven positive effects on a plethora of conditions, but it also confers a continuum of benefits by balancing one’s nervous system promoting innumerable wellness benefits. As we look toward the future, these “bioelectronic” breakthroughs, I foresee this becoming a common and safer alternative to drugs.
Richard G. Cartledge MD, FACS
