We all just want to calm down already.
Survey data from 2023 from the American Psychological Association (APA) found that a quarter of adults rated their average level of stress between 8 and 10 (10 being the highest). And nearly one-quarter of adults have been told by a provider that they have an anxiety disorder or depression.
There’s an arsenal of treatment options for mood disorders and their symptoms, such as psychotherapy and medication.
You also may have come across a social media influencer (or several) telling you that you can "fix" your mood problems or prevent them in the first place if you tap into a specific nerve in your body at the helm of the body’s stress response: your vagus nerve. (Notice that more than 10.8K posts use #vagusnerve on TikTok.)
Can you really fix your mood problems simply by plunging your face into a basin of ice water? (Not exactly — but that’s one way to stimulate this nerve!) Here’s more about the vagus nerve and how you may be able to use it to improve your emotional well-being.
“Vagus” is Latin for “wandering,” according to
Merriam-Webster — and that’s an apt description of this nerve's winding path through your body.
“The vagus nerve is a far-reaching nerve, or network of nervous system circuits, that extends from the brain stem into the inner ear, around the jaw, the larynx and pharynx in the throat and into the heart, lungs, and gut,” says
Arielle Schwartz, PhD, a licensed clinical psychologist in Boulder, Colorado. Often, people use the metaphor of the vagus nerve being a "mind-body superhighway."
The vagus nerve functions as the brakes on your sympathetic nervous system, which is your “fight or flight” response, explains Dr. Schwartz. In doing so, your parasympathetic nervous system — responsible for conserving energy to be used later and regulating maintenance bodily functions, like digestion and urination — turns on.
You don’t always want your nervous system in chill mode, of course; your stress response helps you deal with challenges and danger. It’ll give you the get up and go (thanks to stress hormones) you need to complete a demanding work task or think clearly and take action to get yourself out of a potentially harmful situation.
But once the stressor goes away, you want your nervous system to slow down. Have you ever been told to “take a deep breath” in order to calm down? Doing so activates the vagus nerve and activates your parasympathetic nervous system.
“Your sympathetic nervous system should not get stuck in the ‘on’ position,” Schwartz says. When it is stuck there, it's like you’re swimming in chronic stress. And chronic stress contributes to a host of problems, including anxiety and depression, says the APA.
Clearly there’s a link between the vagus nerve and mood, but what about when it comes to diagnosed mood disorders?
For Treatment-Resistant Depression
Vagus nerve stimulation, or VNS, is also used in clinical and university settings as a U.S. Food and Drug Administration–approved evidence-based therapy for treatment-resistant depression. This is different from the at-home methods used to ping the vagus nerve, which are available as devices and lifestyle practices (more on this below).
“Vagus nerve stimulation therapy is a medical procedure in which a pacemaker-like device is implanted beneath the skin of the chest and electrical signals are sent to the vagus nerve,” explains Muaid Ithman, MD, a psychiatrist at University of Missouri Health Care in Columbia. “The device sends electrical signals to the vagus nerve, which in turn transmits these signals to the brain stem and to the brain.”
These signals are believed to impact brain areas that regulate mood, though exactly how it works to address treatment-resistant depression isn’t yet known by researchers.
VNS therapy originally began as a treatment for epilepsy, and researchers discovered that patients also reported improvements in mental well-being, and so there may be overlap in the area of the brain that controls seizures and mood. In addition, VNS therapy may also improve transmission of neurotransmitters that respond to stress, the authors explained.
With an implantable device, you’re getting signals zipped to your vagus nerve 24/7, which can help improve depressive symptoms in six to nine months, explains Ziad Nahas, MD, a professor at the University of Minnesota Medical School in Minneapolis, whose research focuses on vagus nerve stimulation. Dr. Nahas says the effect is thought to be similar to that of taking a deep breath (and other types of DIY vagus nerve stimulation), but with the device, the stimulation is constant and consistent, which is why it’s been shown to be effective in certain clinical settings.
In addition to calming down the stress response and improving mood symptoms, there's evidence that this type of therapy also helps improve someone's resilience to stress over time, so they're less likely to experience as severe of symptoms to future stress, says Nahas.
One meta-analysis that looked at people with
treatment-resistant depression found that an implantable VNS device in addition to usual care improved depressive symptoms by nearly 30 to 44 percent over the span of two years — and it appeared to be better than usual care alone.
For Other Types of Depression
In a long-term follow-up case study of two patients with major depressive disorder (one who also had epilepsy) who received an implantable VNS device, researchers followed up on their wellbeing 15 and 16 years later and found that their mood and quality of life remained improved.
That said, there is limited evidence on the use of implantable VNS therapy in mild and moderate depression, and despite some studies on other non-invasive forms of VNS, the conclusion from one systematic review noted that it’s not certain if it can address depressive or anxiety symptoms in people with mild to moderate depression.
More research is needed to learn if VNS treatment is applicable to a wider set of people with mood disorders.
For PTSD
But VNS therapy may hold more promise when it comes to the treatment of posttraumatic stress disorder (PTSD). One trial found that these devices were able to help regulate the body’s stress response to traumatic memories compared to a placebo treatment; VNS also promoted recovery from stress.
Another double-blind, randomized controlled trial found that non-invasive VNS also blocked inflammatory responses to PTSD trauma, as well as lessened subjective measures of anger compared to a sham condition.
Here’s where it gets tricky. Although there is some limited research on transcutaneous or noninvasive VNS, most of the clinical research on VNS looks at implantable devices to very specifically address treatment-resistant depression, not necessarily whether at-home methods for stimulating your vagus nerve may have similar effects on mood (for people with mental health diagnoses or not).
Still, it’s fair to look at that research on VNS therapy, and say that vagus nerve stimulation at home may affect your mood in positive ways, too, says Dr. Nahas.
“I don’t think that it’s a major leap,” he says. “If you think about something like yoga, the benefit is that it slows you down and helps you be present in the moment — not in your fight-or-flight system. These things have been shown to help improve quality of life.”
Some more of the research on how non-invasive VNS (such as handheld devices that you can purchase without a prescription and hold against the skin of your neck or ear) has shown it may effectively activate the vagus nerve and improve vagal tone to decrease stress.
Those researchers say that VNS devices show promise for potentially being used in prevention of psychiatric disorders that are linked to stress, such as depression or post-traumatic stress disorder, in the future.
Yet the available research has not shown if these types of over the counter devices are effective on mood and who they may work for. “There are a lot of claims made about these devices. People are starting to market these, but we need to be very careful about the scientific claims behind them,” Nahas says.
For example, one consumer non-invasive VNS device notes on a disclaimer label that it is a general wellness product that has not been evaluated by the U.S. Food and Drug Administration (FDA) and includes the commonly seen wording as a result that it is "not intended to diagnose, treat, cure, or prevent any disease or condition.
And remember, diagnosed anxiety and depression are rarely cured with one simple fix. Will breathing slowly through your nose to switch your body into a parasympathetic state alleviate depression or anxiety on its own? Probably not. But it can be one strategy that you incorporate into your care.
And, for non-invasive TNS, although the research is lacking, they are generally considered safe and may be used as a complementary approach after discussing with your health provider team.
“I don’t see vagus nerve stimulation as a standalone treatment, and it’s not a replacement for [mainstream] medical therapy,” Schwartz says. “For example, you might have therapy to challenge unhelpful beliefs and narratives about yourself while also working on taking care of your nervous system.”
These DIY practices, when combined with a treatment like an oral antidepressant, for example, “can enhance [mainstream] treatment. For patients looking for improved therapeutic outcomes, this strategy might be a promising path,” adds Dr. Ithman.
And if you’re looking for another tool to help cope with day-to-day stress and anxiety, go ahead and try one of the many DIY vagus nerve stimulation activities — deep breathing, gargling and humming, cold exposure (such as splashing cold water on your face or a cold plunge), meditation, yoga, or ear massage, says Schwartz.
Schwartz points out that some have been profoundly impactful for people she teaches them to. See what resonates for you, she says: “Your body will give you feedback.”
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