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Anxiety, depression and the Vagus Nerve

Anxiety is in medical terms a feeling (emotion) of fear or tension and the body is reacting with a slight increase of blood pressure, pulse and possibly adrenalin.  In general, it is considered to be some degree of ‘fight or flight’ activation.  This though is not always the case.  For instance, according to the polyvagal theory by Stephen Porges, a person can also become ‘Dorsal Vagal’ overactivated and then fear is considered to become an overwhelming ‘freeze’ reflex.  It is important to distinguish between anxiety as a feeling or experience, and an anxiety disorder as a psychiatric diagnosis. A person may feel anxious without having an anxiety disorder. In addition, a person facing a clear and present danger or a realistic fear is not usually considered to be in a state of anxiety.  In PTSD and trauma, anxiety can be caused by a dorsal vagus nerve reflex.  It is important to distinguish between these different types of anxiety:

  1. Anxiety originating from ‘fear’ as temporary ‘fight or flight’ rection
  2. Chronic anxiety as anxiety disorder
  3. Dorsal Vagal anxiety reflex possibly arising from trauma

These all have different autonomic nervous system ‘signatures’ and the person suffering from it can benefit from understating its cause & effects by monitoring and self-learning.   The ‘good’ thing with anxiety is that it is a autonomic nervous system ‘dysfunction’ and therefore measurable for instance with methods such as VAGUS ECG or by blood tests.

Depression is defined broadly as an illness that negatively affects how you feel, the way you think and how you act.  A depressed person knows that she/he is in a depressed state of mind.  The level of energy goes down (fatigue), the person has lack of interest in most matters, the mind is doing negative rumination, no interest in meeting other people and generally nothings give the sensation of pleasure or meaning.  It is traditionally and still currently mainly viewed as a disease of the ‘mind’.   The very big problem with depression is that the mind is not a medical- or scientifically definable term.   According to strict materialistic science, the mind does not exist.  It is an illusion and basically a person considering herself or himself of having a mind ‘is not of right mind’.   The only reason we as humans accept the concept of mind is because everybody seems to ‘experience it’ and hence believes in it.    

Since the ‘mind’ does not materially exist, there obviously is no way to ‘measure’ its malfunction.  (note for instance that EEG or MRI are side effect of neural activity – not measurements of the mind) depression in a scientific sense.  There are no biomarkers (blood tests), brain-scans or scientifically speaking serious ways to evaluate how a person’s state of depression is developing.   Psychiatrists and depression treatment is therefore working within the most ancient field of medical science – namely Cartesian Dualism.  All diagnostics and ‘work’ with depression are founded on the perception that the mind is separated from the body.   It presumes that a person can and does have ‘faults’ within this ‘ether’ that is flowing around inside our brains.   

As an ‘modern’ engineer and agnostic, I am honestly appalled and shocked of the way we conceptualize and treat depression.  Modern psychiatry- from my personal experience as patient – more resembles medieval religious rites and snake oil practices than anything belonging to the 21st century.   The field is the worst functioning part of western medicine.  It should be held accountable for its practices and forced to follow otherwise accepted normal modern scientific norms.   That though will not happen until we find fundamentally new ways to diagnose, measure and treat depression. (But do not make the mistake to hope that this change will come from medical pharma-companies.)

Now I know that many will say – we have a modern proper way –  Selective Serotonin Reuptake Inhibitors (SSRI, for instance Prozac).  SSRI antidepressants are a type of antidepressant that work by increasing levels of serotonin within the brain. Serotonin is a neurotransmitter that is often referred to as the “feel good hormone”.  But here I remind that SSRI:s are not more ‘scientific’ than red wine.  The clinical trials backing them up are questionable to say the least and the only reason they are approved and used so widely is because there is nothing else.  Psychiatry and depression treatment has not made any significant progress or discoveries since the approval of SSRI:s more than 35 years ago.   The same 30 years old books are still used for education of new psychiatrists.   Best care practice rules are practically unchanged for decades.

The solution to depression will not come from pharma companies or psychiatry.  The most promising solution is in the field of neuro-immunity.   A very large number of scientific studies has already proved that the majority of depressions are caused by inflammations and depression is a natural immune response to these often-low-grade inflammations.  The only reason that these findings have not been implemented is because the established field of psychiatry is fiercely defending its Cartesian Dualism   It is a ‘belief’ war and we all know how long they can last.   If immune system-based depression is accepted, dualism and the basics for all past treatments will have to be re-evaluated.  

Inflammation is the body’s immune system’s response to an ‘irritant’. This irritant might be bacteria, virus, muscle damage, a foreign object under the skin or mental issues such as depression and chronic stress.    Inflammation is the most important part of the body’s repair process but it needs a person to designate energy to this repair process.   For it, evolution has designed a brilliant way – it causes depression so that the person is being still, not meeting other people and resting the brain by doing ruminations so that not un-necessary energy is consumed.  

The Vagus nerve immune system

In recent decade it has become clear that the human body has 2 main immune systems: 

  1. The molecular immune system.    We are partly born with it (innate) and then it adapts as we live.   It consists mainly of molecules such as white blood cells, antibodies etc.   These organs involved are for instance spleen, bone marrow, lymphatic system and thymus. 
  2. The neurological immune system.  This is mainly considered to consist of the Vagus nerve-based neuro-immune system which is also called the cholinergic immune reflex.

The Vagus nerve carries an extensive range of signals from digestive system and organs to the brain and vice versa.  It is the tenth cranial nerve, extending from its origin in the brainstem through the neck and the thorax down to the abdomen. Because of its long path through the human body, it has also been described as the “wanderer nerve”.  

Mainly thanks to the work of Dr Kevin Tracey, this part of the immune system has been widely recognized during last twenty years.  Since 2020 there has already been more than 10000 science papers discussing it.    The Vagus nerve received even greater attention after the start of the Covid-19 pandemic.  It was early recognized that the main cause of death due to Covid-19 is a so-called Cytokine storm. 

Cytokines are very important immune system ‘signalling’ molecules.  Cytokines are found to be elevated in the majority of MDD patients.   If there are too many ‘immunity activating’ cytokines, there will be too many immune cells.      It is very important that the vagus nerve is working properly and also sending out enough ‘deactivating’ Cytokines when the immune systems have become fully activated.  

The cytokines are only a part of the cholinergic immune system activity of the Vagus nerve.  I consider it the ‘central intelligence headquarters of immune response.  If the vagus nerve is not working properly, then we know that the immune system cannot work properly.   If the immune system is not working properly or stays ‘on’ – then evolution has programmed us to be depressed.  The Vagus nerve is the one that signals the ‘sickness response’ to the brain.  If the vagus nerve says ‘sick’ – then the brain should go into depression.  If the vagus nerve signals ‘all fine’ then a person should cease to be depressed.  Hence you can understand my conviction that the Vagus nerve is the most potential source of solving and treating depression.   Implanted vagus stimulation has been approved by US and Europe as treatment for depression.  It is only the beginning.

As conclusion therefore I hope you understand how important it is to measure the Vagus nerve.  With VAGUS® ECG it is easy to monitor when the Vagus nerve is working properly and it can work on immune system-based improvements.  The VAGUS® ECG gives ‘in-depth’ analysis of the persons autonomic nervous system, health, inflammation levels and prediction of performance/recovery.  To evaluate inflammation levels, I recommend doing regular tests three times per day.§

Have a great day and enjoy life.

Gustaf

Ps:  To do the VAGUS® ECG test, users need to perform controlled breathing.  Proper diaphragmatic breathing often requires practice.  Relax muscles in the neck and shoulders.   Follow the timer on the watch and breath in through the nose for five seconds.  Then exhale fully during next five seconds.   Start again until the 30 seconds ECG recording is finished.  Feel how the lungs fill with air and inflate like a balloon while the upper part of the belly and lower ribs move outward.   As you get better, the breathing value and most other vagal tones also usually improves.

Pss: Contact me to [email protected] if you are interested in implementing the VAGUS® COACHING platform for e-health.

Science:

A lot of the information in this blog is from Dr. Edward Bullmores excellent book ‘The Inflamed Mind’.  Professor Bullmore is since 1999 Professor of Psychiatry at the University of Cambridge.    

The Inflamed Mind, book published 2018. 

Quotes: ‘Bearing in mind what we now know about how the vagus nerve controls inflammation, maybe we could use nerve-stimulation devices to treat inflamed depression?  And recalling the crucial importance of stress for both inflammation and depression, maybe we can monitor the effectiveness of psychological and social interventions by inflammatory vagus biofeedback?   We know from the recent discovery of the inflammatory reflex that the vagus nerve controls cytokine release by macrophages in the spleen.  We also know that vagal nerve stimulation by an electrical device implanted in the body can dramatically reduce inflammation. 

For more information on the Cholinergic immune system, I recommend for instance Dr Kevin Tracey research.  He is considered the founding father of bioelectronic medicine for his discovery of the body’s Vagus nerve based inflammatory reflex.

Other interesting Vagus nerve and immunity research papers:

The vagus nerve and the inflammatory reflex—linking immunity and metabolism. Nat Rev Endocrinol. 2012 December.   Pavlov & K. J. Tracey

The inflammatory reflex.   Dr. Kevin Tracey, Nature. 2020; 

Loss of Vagal anti-inflammatory effect in-vivo visualization and adoptive transfer, O Mahony, Aug 2009.  Quote:  The Vagus Nerve by releasing Acetylcholine stimulates T-regulatory cells that lower inflammation.

The Vagus Nerve in the Neuro-Immune Axis: Implications in the Pathology of the Gastrointestinal Tract, Bruno Bonaz, 2017.

Cholinergic modulation of the immune system – A novel therapeutic target for myocardial inflammation, Jing Lu et al, April 2021. 

Vagal tone diagnostics with hand-to-hand electrocardiogram (ECG).  Gustaf Kranck, study presented at BFE in April 2019.  (request a copy: [email protected])

© Gustaf Kranck

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