There are several different ways to divide the nervous system up. It’s an incredibly complex system. In school I remember learning about the central nervous system and the peripheral nervous system but that was pretty much all I remembered. Okay I also remembered watching Lorenzo’s Oil and the word myelin sheath. When I was diagnosed with POTS though I started learning more about the nervous system. Despite having a wide range of symptoms and the fact that most people are diagnosed by a cardiologist POTS is actually a nervous system condition. I am a person who likes to do my own research anyway, then add to that the fact that many doctors still don’t even know what POTS is, I figured I’d better know my stuff.
Another way to divide the nervous system is into the sympathetic and parasympathetic. The sympathetic nervous system is basically your fight or flight response. Most people have heard of fight or flight. When your body goes into fight or flight mode it goes into survival mode. Cortisol and adrenaline are released, your digestive tract stops digesting food, your muscles tense, your body burns through all its quick energy, heart rate increases. From an evolutionary standpoint this response was used to run away from predators or to fight off enemies.
The parasympathetic nervous system is the opposite, it controls the rest and digest function. Most people should spend most of their time in a state of parasympathetic nervous system dominance. When your parasympathetic nervous system is running the show you can think straight, digest food, sleep well, etc…
POTS causes an increase in sympathetic nervous system activity, mainly due to blood pooling in the lower extremities. When your brain doesn’t get enough blood your body knows that something is wrong and it reacts accordingly. In POTS this is helpful in that the increase in heart rate often stops a person from passing out by pumping the available blood more quickly in order to get a sufficient amount of oxygen up to the brain. But it also means that people with POTS spend far too large a portion of their lives in a state of sympathetic nervous system dominance.
This is why we are so often told it’s just anxiety prior to being diagnosed. I’d be shocked if I met a POTS patient who hadn’t been given a talk about controlling their anxiety. We’ve all heard it, some of us for years and years. But as it turns out, our ‘anxiety’ is a physiological response to the very real problems happening in our bodies.
For POTS patients it’s important that, as a first step, we get our symptoms under control as much as possible to minimize the risks of passing out. Once that’s done it can be hard to retrain your body to do the rest and digest thing though. Just like when you use muscles they get stronger, when you use part of your nervous system more than another it builds tone. There’s some really interesting research being done in Australia and the Czech Republic right now having to do with stimulating the parasympathetic nervous system via the vagus nerve as a treatment for POTS.
So how do you stimulate the parasympathetic nervous system? In the studies I mentioned above they are implanting a small medical device that vibrates against the vagus nerve, usually for about 2 minutes every morning. The studies so far have been small, so take this with a grain of salt, but they have had promising results. This led me to start researching other ways to stimulate the parasympathetic nervous system. Basically how to tell my body to calm down from a physiological standpoint. This is in no way an exhaustive list.
1. The first thing I’ve used is very similar to the study in that it involves vibrating the vagus nerve. The vagus nerve is the largest nerve in your parasympathetic nervous system. It runs from you brain down through your neck and into your digestive tract. It goes very near your vocal cords. I had heard for years that it’s hard to cry while singing, this may be in part because singing stimulates the vagus nerve. Humming actually vibrates your vocal cords even more than singing does, which makes it a great option if you are in public.
2. Another thing to try is deep breathing. When the sympathetic nervous system is up your heart rate increases and your breathing rate goes up. If you can slow down your breathing, your heart rate will also start to slow down. This signals your body that the danger is over and it can go back to relaxing.
3. You can also try using imagery to trick your body into thinking you are in a relaxed place. When you picture yourself in a calming atmosphere and you really buy into it, your body will start to believe you.
4. Lastly, cold water on your face or held in your mouth can also stimulate the parasympathetic nervous system. It’s not fully understood why this is but I suspect it has to do with the fact that your lips are full of parasympathetic nerve fibers. As for having cold water (or ice) in your mouth, that would stimulate digestion, which is part of the parasympathetic response. How many of us have had a good cry and then splashed cold water on our faces to calm down? It works and this might be why it works.
These tricks are very important to POTS patients but they can be helpful to anyone who struggles with stress responses in their bodies for any reason. It could be from anxiety, trauma, PTSD, or a medical condition. What tricks do you use to help your body calm down?
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