The Relationship Between Chronic Stress and Health
Stress is commonly perceived as a psychological term. That is simply not true. Life is not guaranteed for any living creature. Stress represents our reaction to ongoing daily threats to remaining safe. Any real or perceived mental or physical threat causes your body to go into “fight or flight” in order to increase your odds of survival.
However, it is critical for your body to rest. When the body feels safe, it maintains an anti-inflammatory state with lowered metabolism and calming neurotransmitters, promoting healing and regeneration. Otherwise, you’ll break down leading to chronic illnesses and disease.
The Autonomic Nervous System (ANS) is at the center of the stress response, and is located in the midbrain, just above the top of the spinal cord. The ANS regulates internal organs and maintains a delicate neurochemical balance. It consists of the activating sympathetic nervous system (SNS) and the calming parasympathetic nervous system (PNS). The SNS and PNS constantly counterbalance each other to maintain homeostasis (balance).
The role of the ANS in regulating complex body functions has been highlighted for over four decades by Dr. Stephen Porges. He is the originator of the Polyvagal Theory, which delineates the role of the vagus nerve when you sense danger versus feeling safe.1 His work is the center for characterizing chronic disease states and is a framework for other scientists and clinicians to further define the factors affecting chronic illness and disease. Understanding the problem allows solutions. The Dynamic Healing model evolved out this collective body of work .
It is a framework for categorizing interventions that decrease exposure to threat physiology and increases safety. There are conceptually three portals.
- Input (processing stresses to have less impact on the nervous system),
- The nervous system itself (lowering its reactivity)
- Output (directly stimulating the body to shift from stress to calming physiology)
Recruiting the PNS through stimulating the vagus nerve to counteract the SNS falls under the “output” category. The approaches have an immediate effect, are easily accessible, and allow you to calm down enough to engage in the rest of the healing journey.
The vagus nerve is the longest nerve in the body and is connected to every internal organ. PNS activation lowers metabolism, stimulates regenerative hormones, lowers inflammatory markers, and calms the nervous system
There are many ways to accomplish this:
- Breath work:
- Voluntary relaxed slow breathing exercises (diaphragmatic breathing, alternate nostril breathing, mindfulness practices)
- Slow breathing during stressful experiences at a rate of 6-10 breaths per minute
- Slow long exhalations linked with deep short inhalations
- Breathing slowly through the nose (stimulates nitric oxide release, which is anti-inflammatory)
- Meditation with deep breathing (using counting methods or alternate nostril breathing)
- Stimulating cranial nerves close to the vagus nerves (10th cranial nerve)
- Quiet humming – 7th cranial nerve
- Listening to relaxing pitches of quiet music like a lullaby – 8th cranial nerve
- Massaging your forehead or applying a cold washcloth to it – 5th cranial nerve
Cranial nerves come directly off of the midbrain. There are 12 of them.
- Non-invasive devices to directly stimulate the vagus nerve.
- Transcervical VNS (tcVNS) – devices held close to the vagus nerve in the neck next to the carotid artery
- Trans auricular VNS (taVNS) – again stimulate the 8th cranial nerve
- Stimulation to parts of the ear lobe
- Sounds – various types and pitches of music
Safe and Sound protocol (SSP)
The Safe and Sound (SSP) protocol utilizes sounds as a non-Invasive acoustic vagal Nerve stimulator that helps regulate the autonomic nervous system. It contains several vocal and non-vocal music playlists, is suitable for all ages, and is designed to complement a variety of therapeutic approaches and modalities
The music has been filtered through a patented, evidence-based algorithm that highlights specific sound frequencies to engage the social engagement system, helping the listener think, feel, and connect better with others.
Providers report that the SSP “opens up” their clients and relaxes their defenses, improving accessibility and leading to quicker progress and increased engagement in therapy. When individuals experience the world as safe, they can more effectively and efficiently use their internal resources to support health and well-being, building the foundation for awareness, embodiment, and resilience.
The Science Behind the SSP
Music has been shown to penetrate neural activity deep within the brain, with potential to restore optimal neurological activity.
Here are some of the benefits:
- In a 3-year, blinded randomized controlled trial, listening to classical music during the night significantly reduced seizure activity.
- Music and movement share an intimate relationship in neural circuitry, and pairing rhythmic movements with music has been found to improve mobility, recall, and quality of life in patients with Parkinson’s disease.
- Listening to music has been shown to support the learning and re-learning of motor patterns, applied in both neurological rehabilitation and sports performance
- Music has been found to enhance physical recovery, evidenced by lower levels of pain and anxiety, less use of analgesics, and higher patient satisfaction.
- Listening to music lowers stress hormones (cortisol) and improves bonding (oxytocin) and regulation essential for healing
Accessing VNS Treatments
Trans auricular (taVNS)
The Safe and Sound Protocol (SSP) is a taVNS therapy available through trained providers. Unyte is the company that manufactures and markets SSP technology. It can only be accessed through trained providers. They are teamed up with Dr. Stephen Porges who is the originator of The Polyvagal Theory and has been instrumental in presenting these concepts to the medical world.
Their website is https://integratedlistening.com. Here is their Provider Map, which allows you to find a nearby provider. You can contact the provider directly for SSP services. Many provide services online.
They can also pair you with an SSP provider, and here is the Client Connections webpage .Below are some additional resources on the SSP:
Dr. Les Aria is an experienced pain psychologist and colleague of Stephen Porges and me. He has extensive clinical experience utilizing SSP in his practice and has observed many people respond in a positive way. As mentioned earlier, it is not a definitive treatment, but seems to be an effective way to begin healing. It is also helpful to access along the way. His services are available only to California residents through his company, Menda.
To trial the Safe & Sound Protocol, please contact:
- [email protected]
- Most insurances are accepted or cash pay.
- Anticipate about 3-4 visits.
Steps to Receiving SSP:
- Phone consultation (10-15min) to understand why you are seeking SSP and to explain what SSP helps with and when it is not indicated/recommended.
- After the phone consultation,an intake is scheduled.
- At the next visit (aka, follow up visit), then SSP is trialed.
- Anticipate 3 to 4 follow up visits (once every 2 weeks).
Transcervical (tcVNS)
Several companies manufacture handheld vagal nerve stimulators. Truvaga is one of the earlier companies. Their website is www.truvaga.com. The stimulation is used for two minutes at a time once or twice a day. Truvaga is considered a wellness device and can be used prophylacitally. When it is used for stress, the idea is to promote “biological resiliency,” which then activates “psychological resiliency.”
Here is an extensive review of the device: https://cybernews.com/health-tech/truvaga-review/.
Another hand held vagal nerve stimulator is called gammaCore, and is manufactured by the same company. It is FDA approved for headaches and it is used in a similar manner. Their website is: https://www.gammacore.com/.
Summary
Chronic mental and physical illnesses are complex problems that require a multi-pronged approach treat. Vagal stimulation should be considered as an adjunct to your care and not as an isolated solution. The goal is to create a “shift” in your physiology from a fight or flight (threat) state to safety and allow you to engage with your healing journey. Theoretically, if you are feeling “stuck”, this may be a way to get you moving forward.
As all of these devices activate the vagus nerve, the final choice will be up to you. Its effects will vary from individual to individual, and you may not have a noticeable response. However, stick with it, as repetition is key to reprogramming your body, including the nervous system.
References
- Porges, S.W., & Lewis, G. F. (2010). The polyvagal hypothesis: common mechanisms mediating autonomic regulation, vocalizations and listening. Handbook of Behavioral Neuroscience, 19, 255-264. https://doi.org/10.1016/B978-0-12- 374593-4.00025-5.
Resources
Vagus Nerve Stimulation by Martin Frasch and Eric Porges. Springer Books, 2024
- Vagus nerve stimulation (VNS) was once limited in application to the treatment of refractory
epilepsy. With its remarkable safety record, over 100,000 patients carry implanted VNS …
Vagus Nerve Stimulation by Peter Staats, Cenk Ayata, Imanuel Lerman, and Alaa Abd-Elsayed. Elsevier, 2024.
- Vagus Nerve Stimulation serves as a compendium of current knowledge about stimulating the vagus nerve in many different disease states. Chapters include applications to neurologic conditions, psychiatric conditions, inflammatory conditions, metabolic disease, reperfusion injuries, long covid, cardiac disease and even optimizing performance in healthy individuals.
