The Pain Exchange

Managing chronic stress during Covid-19 - a Polyvagal approach

When the brain senses threat, it triggers the 'flight-or-fight' response. In recent weeks you may have experienced a racing heartbeat or tightness in your chest/stomach when you read/hear news about the coronavirus pandemic. This occurs as a function of our sympathetic nervous system. Conversely, our parasympathetic nervous system plays a role in calming our bodies. For example, running away from a snake and returning to safety will signal to our brain that the threat is gone, causing the stress response to come to an end. Once the threat is resolved, we can return to a state of calm.

At the moment however, we are being exposed to a chronic stressor with no definitive ending — the coronavirus pandemic may go on for months? Without managing our nervous systems, we could suffer some health consequences in the longer run. Chronic stress results in raised levels of Adrenaline and Cortisol. Prolonged excess levels of these hormones can have a negative impact in the following ways:

·    Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues.

 

·       Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with the brain regions that control mood, motivation and fear.

The long-term activation of this stress-response system and the overexposure to these stress hormones can disrupt your body's processes putting you at increased risk of many health problems, including:

·        Anxiety

·        Depression

·        Digestive problems

·        Headaches

·        Heart disease

·        Sleep problems

·        Weight gain

·        Memory and concentration impairment

  

The vagus nerve

The vagus nerve is a major nerve in the parasympathetic nervous system. Recent research suggests that we can tune into our nervous systems and find ways back to a “rest and digest” state amidst chronic stress. Psychiatrist Stephen Porges, author of The Polyvagal Theory, describes the parasympathetic nervous system as having two parts which result in two different responses: the dorsal vagal nerve network and the ventral vagal nerve network.

Since we can’t resolve the current threat through fight-or-flight or establish to more or lesser degree, the connection to help calm us (also known as regulation), we may instead have ‘checked out’ physically and mentally. Our bodies have opted for a freeze response, also known as dissociation, and it’s the work of the dorsal vagal nerve network. When we’re dissociated, we may often feel powerless and hopeless, or even depressed. It’s as if our body has begun to decide it’s trapped!

The ventral vagal nerve network becomes activated when we connect with another person, or when we respond to our body’s signs of stress, which triggers calmness - regulation. This is the part of our nervous system we need to stimulate when we’re stressed.


For this reason, the ventral vagal network is also known as the social engagement system. It runs upward from the diaphragm area to the brain stem, crossing over nerves in the lungs, neck, throat, and eyes. Therefore, actions involving these parts of the body, such as deep breaths, gargling, humming, and even social cues like smiling or making eye contact with someone, will send messages to the brain that it’s okay to relax. Activating the ventral vagus nerve also activates the prefrontal cortex, the part of the brain that deals with logic. So calming yourself down allows you to think more clearly and process your difficult circumstances — which will further resolve your stress.


Using this four-step plan can help you activate your ventral vagal network to limit the effects of stress and prevent dissociation. It should help you regain a sense of calm while the threat of our current circumstances are overwhelming you….. and hopefully beyond!

 

Step 1: Tune into how your body feels

The first step back to “rest and digest,” is paying attention to our body’s sensations. If we’re not aware of how our body feels when we’re stressed, we are likely to find it hard to know when we need to give our nervous system some rest and relaxation.


Start by noticing your body’s baseline physical state when you’re calm so you can notice how stress changes your body. Maybe go for a walk, stretch your legs, or bend over and touch your toes, paying attention to what feels good and what doesn’t. Once you’ve worked out your body’s baseline, start noticing the small ways stress impacts you physically. For example, you may notice your shoulders tense slightly when you hear of the daily rates in deaths on the news. Take a moment to consciously relax them — this act of compassionate self-care will signal to your ventral vagus nerve that you are in a safe place.

 

Step 2: Use your breath

Mindful breathing — or paying focused attention to your breath, can be a powerful way to self-regulate, as deep breathing directly stimulates the ventral vagal system, since the vagus nerve passes through the vocal cords.


Research shows that mindful, deep breathing from the diaphragm reduces cortisol, the stress hormone mentioned above. A recent 2017 study recorded people who participated in a guided breathing program as having lower cortisol levels in their saliva immediately after the exercise. The exhale is one of the most important aspects of mindful breathing. Exhaling longer than you inhale puts the ventral vagal network into action and promotes the ‘rest and digest’ response.

 

Step 3: Connect with people

Social connection with other people or ‘compassionate attention’ to ourselves, is one of the most important ways to activate the ventral vagal network. With current social distancing restrictions in place, we are unable to connect physically with friends and wider family, therefore it is especially important to FaceTime a loved one or have a meaningful conversation with someone you’re isolating with. Establishing a sense of safety and connection with someone, making eye contact even online, can cue your body to relax.

 

If you become frustrated with blurry and broken online interactions, you could try visualizing someone you trust and imagine feelings of safety and connection. Or make yourself comfortable in a relaxing room in your house and hunker down for a bit.

  

Step 4: Harness anxious thoughts

The story we tell ourselves about our situation and its danger can dictate how our body responds, and the level of our chronic stress. Knowledge that our situation is not likely to change anytime soon, makes it that much more important that we change our perception of the threat by changing how we perceive it reframing our situation.

For instance, rather than thinking about social distancing as being stuck in your house indefinitely, think about being home as a way to contribute to public health, and an opportunity to slow down. Steering your thoughts in a more hopeful direction could cause the brain to send messages through the vagus nerve, triggering calm in all the organs and systems along the way.

A way to do this is by using our five senses. For example: go outside, listen to the birds, smell a flower etc: - these are all simple “grounding” techniques which help activate the ventral vagus nerve.  If you are actually in a dangerous situation, like being abused, then you should try to get away. But if you’re safe in the present moment but your body feels like it’s threatened, grounding can calm perceived threats.

 

Essentially all these strategies bring your body back to the present moment, which may feel safer to your nervous system than the potential scenarios of the future.

 

When you’re paying attention to both your mind and body under stress, you should feel more relaxed and ultimately, more yourself. Perceiving everything as a threat will drain you of your resources. But paying attention to your emotional response will give you more energy and clarity to problem-solve effectively.

 

Take care. Stay safe x