ANS Retraining Toolkit For MECFS
Safe, Simple, and Free Ways To activate your parasympathetic nervous System
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Warning: Not A Cure
This post will talk about some tools for balancing your autonomic nervous system that can be incredibly helpful to pacing and giving your body room to recover, it is essential to stress that MECFS has many biological components and ANS dysfunction is only one of those components.
ANS dysfunction is one part of MECFS. Our consistent overbalance towards fight or flight as demonstrated in HRV studies is a real dysfunction. But it is only one of many dysfunction.
There are no studies showing that parasympathetic activation cures MECFS.
Fixing ANS dysfunction will not fix your mitochondria, neuroinflammation, immune system, or brain perfusion. In lucky patients, fixing ANS may allow their bodies to self-resolve these other issues. But that is not up to the patient and all you can do is try your best.
Like all pacing tools, ANS training is about giving your body space to heal. Not controlling whether it does. Attempting progressive increases in movement outside of your body signaling it is ready is dangerous regardless of ANS balance.
This post intends to provide information on parasympathetic nervous system activation not as a cure for MECFS but as a tool that can be used to help manage symptoms and pace better.
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Harm Reduction: Deactivating
It is important to note that active techniques like biofeedback and meditation may sometimes be inaccessible to patients during severe adrenaline spikes, pain crises, etc.
In these situations, we need to find ways to deactivate the ANS by self-soothing, distraction and/or medication.
Self-soothing is any exercise that helps you to feel safe and secure for example:
-Cuddling with a pet or loved one
-Using heat packs and weighted blankets
-Tapping exercises
-Tightly hugging yourself
Distractions can include:
-Calming tactile activities like stim toys, knitting, crochet, or coloring
-Low cognitive effort videos like sit coms, reality TV, cute animals, nature documentaries or comfort shows
Medications include:
-GABA supplements
-Calming / bedtime herbal teas
-Benzodiazepines*
-CBD
When using all of these you should also adopt a neutral mindset to your symptoms. Remember that sympathetic activation is your body's way of trying to protect you, not punishment or an enemy. Just not useful to you anymore.
*Caution should be used with Benzo medications to avoid addiction and withdrawal issues.
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Meditation
Meditation is a powerful tool for increasing parasympathetic activation.
Breathe is one of my favorite meditation apps. Medito is another great free app with guided meditations. Headspace is very well-known and popular as well. Finch is a self-care app that also features breathing exercises and can be used to set other custom goals around pacing. All have extensive free versions.
Meditations focused on releasing or disconnecting from negative emotions can also help to reduce anxiety. These meditations often have you imagine pain or negative thoughts as clouds or bubbles floating away.
Not everyone with ME can meditate. Meditation is a skill and it is best to learn and practice under lower stress situations so that you are prepared when you need it. If you can't meditate and are in distress simply turn to a different tool.
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Breathing Exercises
Certain breathing patterns are particularly helpful for parasympathetic activation.
Ones you can try include:
Box breathing: 4 4 4 4*
7 11 for anxiety: 7 0 11 0
4 7 8 for sleep: 4 7 8 0
Long hold: 4 14 8 0
Relaxation breathing: 5 0 10 0
*These numbers represent seconds spent on each step where the steps are: in hold out hold.
Other helpful breathing tips can be to vocalize a deep ohm on the exhale or to exhale slowly through pursed lips. This is thought to increase vagus nerve stimulation.
Binaural Beats
There are numberous free recordings of binaural beats on youtube. These recordings must be used with earbuds or headphones. There is preliminary evidence that binaural beats can assist with mood and anxiety and many people find them a helpful form of meditative music.
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Vasovagal Maneuver
Inhale and then with your nose and mouth blocked try to exhale as long as you can. Then lie with your legs elevated. Your hr will increase and thn drop sharply when you lie back.
Rosenthals Basic Excercise
Interlock you hands and place behind your head. Lying flat with your head facing straight ahead:
Look to the right 30 sec
Look straight forward
Look to the left for 30 sec.
Cold therapy
The mammalian dive reflex is a primal reflex that decreases hr and increases parasympathetic activation. There are many way to trigger it including:
Placing a cold pack for 15 sec on each side of your neck alternating.
Submersion of the face is cold water.
Splashing cold water on your face.
Taking a cold shower.
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TENS Unit For Vagus Nerve Stimulation
TENS units can be very effective for vagus nerve stimulation but require an upfront and/or ongoing purchase. I recommend trying free techniques first and if you benefit you can consider investing.
Parasym:
$700 Up front
No stickers needed
$1.92 inclusive per day over a year
Settings: custom based on intake questionnaire.
Advantage: more comfortable and faster to set up initially and each session
Generic TENS for Vagus Nerve:
$150 Up front
$0.10-$0.50 per day for stickers/clips
$0.50 inclusive per day over a year
Settings:
Current: .25 - 1.5 mA
!!!High currents can damage your nerve!!!
Pulse width: 150-300 μs
Frequency; 20 Hz
Recommended: 1mA 250μs 20Hz
Electrode placement: Left or right tragus and adjacent back shoulder or outer ear. Ear requires a special ear clip electrode.
Advantage: more affordable and can also be used for pain management all across the body
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Testing & Biofeedback
To objectively determine if you are successfully activating your parasympathetic nervous system check that your
Heart Rate Decreases
&
Heart Rate Variability (HRV) Increases
These metrics can be measured for just a few dollars with the HRV4Training app and a smartphone. Tracking your morning heart rate and HRV with the free app Visible designed specifically for MECFS can also be helpful.
Biofeedback breathing takes this a step further. By breathing in when your hr increases and out when it decreases you create resonance with your natural relationship between breath and heart rate to increase HRV. This can be done with a chest strap like the Polar H10 and a live HRV app like Elite HRV.
Tracking HRV can also tell you when your parasympathetic activation is already or exceptionally high in which case these excercises are counter productive.
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Sympathetuc Activation
When your HRV is very high and you have very high parasympathetic activation you may want to bring your system towards balance through activating the sympathetic nervous system.
THIS HAS MUCH HIGHER RISKS.
The majority of people with ME have high sympathetic activation by default. Activating the "fight or flight" side of the nervous system can lead to adrenaline surges and make pacing difficult, disturb sleep, and increase pain. However some people are exceptions to the rule and may require sympathetic activation to increase functionality.
Because of the high risks sympathetic activation holds for many people with ME I will not be listing excercises here. However, you should be aware of the possibility of high parasympathetic activation and if the excercises listed here do not help you this may be the reason why.
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How To Find Further Resources
Search For: "Parasympathetic Activation" "Vagus Nerve Stimulation" and "Autonomic Nervous System Balancing"
I find Youtube the best platform to search.
Look for resources that:
-Quickly introduce concrete actions
-Are free
-Are taught by doctors, yoga & meditation instructors, therapists, or physical therapists
Avoid results that:
-Try to upsell you to a paid course rather than just showing you the exercises
-Promise miraculous results
Further notes:
Yoga Nidra: The form of yoga most associated with parasympathetic activation is yoga nidra. Searching this term may be helpful in finding results.
Trauma healing: There is no evidence that trauma healing can cure MECFS or any physical illness. But if you have significant trauma addressing that may help your mental state and ANS balance.
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Don't pay for brain retrainingnscams! Use this free toolkit created for people with ME to use in persuit of symptom management.
In my previous post I discussed how increasing parasympathetic activation will NOT cure MECFS.
There is much more wrong in ME bodies than just ANS imbalance.
However, ANS retraining can still be a powerful tool for managing symptoms. Yoga Nidra, Parasympathetic Activation, Vagus Nerve Stimulation, all of these are methods of rebalancing your autonomic nervous system.
The autonomic servous system (ANS) is responsible for our fight, flight and freeze reflex related to sympathetic activation and the rest and digest mode triggered by #ParasympatheticActivation.
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While Myalgic Encephalomyelitis is a complex neuroimmunological disease with no FDA approved treatments or cures. Studies show that pwME have unusually high levels of sympathetic activation and low levels of parasympathetic activation. In other words we are in fight or flight all the time. We have ANS imbalance.
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Increasing parasympathetic activation can reduce symptoms and be a helpful tool! Which is why it is so incredibly frustrating to see so many practicioners marketing it for exhorbitant prices and alongside toxic positivity and dangerous false promises.
There are so many simple ways to control your fight or flight response and promote a restful state of mind. Most of them are completely free, and those like tVNS are very affordable. There is no reason to spend hundreds of dollars on a course that will simply tell you things you can learn for free and promise to cure your incurable illness.
So take advantage of what we know about the autonomic nervous system to help your symptoms! Just don't get caught up in scams along the way ♡
