How Social Connections and Stress Management Transform Your Health
Recently, Surgeon General of the United States Vivek Murthy, M.D. released a new advisory on loneliness and isolation. The advisory calls on the nation to take action to address the growing problem of loneliness, which has been linked to a number of negative health outcomes, including increased risk of heart disease, stroke, dementia, and even early death. The epidemic of loneliness is compounded by the stress and anxiety in our modern world, even further amplified by the recent global pandemic. Isolation, lockdowns, and the shutting down of entire cities only elevated the numbers of stressed-out and lonely human beings.
According to the results of the 2020 Stress in America survey by the American Psychological Association, 55 percent of Americans are stressed daily; this is 20 percent higher than the global average.1 It is safe to say we are one of the most stressed-out societies in the world. Stress is sneaky, though, because it stealthily piles up layer upon layer, sometimes before we even realize the weight and consequences of this accumulative burden. Many of us have become stuck in an upregulated loop of go-go-go, which has come at a great expense to our health and quality of life. At the end of the day, we are left in a state of exhaustion and poor physical and emotional health.
But as the profound author Robin Wall Kimmerer so eloquently expresses, the anecdote to despair is restoration. And the good news is that we are already equipped with an intricate system that specializes in restoration. Understanding how our natural stress response works, the role of the parasympathetic nervous system and downregulation, and ways we can engage in restorative relaxation practices will help us to recalibrate the autonomic nervous system for a more balanced and less stressful life.
A Synopsis of the Stress Response
Our natural fight-flight-freeze response, also known as the stress response, is a survival mechanism that has kept our species alive for hundreds of thousands of years. Back when we were hunter-gatherers, we experienced imminent dangers daily in our search for food. In the face of a threat, say, a mother grizzly bear and her cubs collecting berries deep in the woods, a signal from the amygdala is sent to the hypothalamus, which activates the sympathetic nervous system and the release of hormones (adrenaline and cortisol) from the adrenal glands. The process triggers a physiological reaction to the stressor—elevated heart rate, dilated pupils, quickened breathing, heightened blood pressure, and a surge of energy—enabling us to respond to and hopefully survive the potentially life-threatening situation.
Proinflammatory gene expressions are also triggered by the stress response to provide a short-term boost in immune responses. Some evolutionary experts and immunologists hypothesize that this inflammatory-related immune response helped protect our hunter-gatherer ancestors from bacterial infections from everyday cuts and injuries that were very common in the hunting and scavenging lifestyle.2
Short-term stress processes are beneficial because they allow us to overcome or survive the stressor. Long-term stress processes, however, are detrimental. Our physiological and psychological stress-response system was designed to function acutely or short-term, not for prolonged periods or as in chronic activation.
Acute Stress Recovery
The parasympathetic nervous system (PSN) is the sympathetic nervous system’s (SNS) counterpart. While the sympathetic nervous system controls the body’s fight or flight response, the parasympathetic nervous system controls the body’s ability to rest, often called the “rest and digest” state. The PSN helps the SNS do something called downregulating, which is the biological process that takes place after the acute stress response to bring the body back down to a calm state. The PSN upregulates (or kicks in and takes over) so that the SNS can deregulate (dial down its activity, including the release of stress hormones).
These two systems have evolved to work in a state of harmonious flux and balance. However, when we get stuck in a stress cycle, the tag-team efforts of the PNS and SNS cease to function as optimally as they should. Sustained stress can throw everything out of whack.
How We Get Stuck in a Sympathetic Stress Cycle
On a daily basis, most of us aren’t worried about getting mauled by a protective mother grizzly bear as we gather berries for lunch. However, modern society certainly presents plenty of stressors, some that even warrant an acute stress response. We are dealing with a whole host of new types of stressors, though, that our ancestors didn’t face. Many of these stressors are ones that we tend to just push down and let pile up until they make us sick—increased cost of living, inescapable debt, demanding jobs, jam-packed kids’ schedules, global uncertainty, climate disasters, and an ongoing pandemic, to name a few.
Chronic stress occurs when the body constantly responds to stress and cannot fully recover from it. In a state of chronic stress, the sympathetic nervous system is locked in overdrive. When this happens, the relationship between the sympathetic and parasympathetic nervous systems becomes compromised and unbalanced. The adrenal glands become taxed, and other functions of the body fail to operate optimally in a sustained state of fight or flight. General adaptation syndrome results from a particular stressor—such as a troubled relationship, a traumatic experience, rigorous work deadlines—that remains for an extended period of time, causing the body to remain in a persistent stress response state.
When we don’t acknowledge and address the seemingly unrelenting stress in our lives, we subject ourselves to a sympathetic stress cycle.
How can we break this cycle?
Downregulation and the Relaxation Response
The capacity to downregulate the sympathetic nervous system is paramount to maintaining health and happiness. And while this is a biologically natural process that we develop during childhood (babies cannot downregulate), as adults, some of us need to relearn how to elicit the relaxation response.3 The relaxation response is the opposite of the stress response, and results in decreased heart rate, blood pressure, and breathing rate. Nitric oxide (NO) is an important molecule involved in the relaxation response and is linked to downregulating proinflammatory events, activating reward centers, and calming nervous tissues. NO has antimicrobial and antiviral properties and is an excellent free radical scavenger, further supporting repair and restoration processes.4 The parasympathetic state is also linked to feelings of well-being and present-mindedness.
The ultimate goal is to become parasympathetically dominant with the sympathetic nervous system on standby. When the PNS prevails, the body can focus on repair, which includes things like reducing inflammation and optimal digestion. On the other hand, a sustained sympathetically dominant state (also known as chronic stress) can come with grave health consequences like heart disease, digestive issues, anxiety, depression, muscle pain, headaches, and sleep problems.
One of the most influential players in our parasympathetic nervous system is the vagus nerve. The vagus nerve is the longest nerve in the autonomic nervous system, and it plays a critical role in regulating heart rate, breathing, digestion, and other bodily functions. It is also the longest cranial nerve in the human body and stretches from our brain to our gut, branching out at various parts of the body, including neck, thorax, and abdomen. The vagus nerve contains 75 percent of your parasympathetic nervous system’s nerve fibers. These fibers send information back and forth between your brain, heart, and gut. That “gut feeling” many of us have experienced before is the result of vagal messages.
A Theory for Regulated Wellbeing
Stephen Porges, Ph.D. is one of the preeminent researchers of the impact of the vagus nerve on health and longevity. His Polyvagal Theory is a model of the nervous system that emphasizes the role of the vagus nerve in regulating emotions and behavior.
Porges's theory suggests that the vagus nerve has three branches, each of which is associated with a different state of arousal:
The dorsal vagal branch is associated with a state of immobilization or shutdown. This branch is activated when we feel threatened or unsafe.
The ventral vagal branch is associated with a state of social engagement or safety. This branch is activated when we feel connected to others and safe in our environment.
The myelinated vagal branch is associated with a state of “rest and digest.” This branch is activated when we are feeling relaxed and at peace.
Porges's theory suggests that our ability to regulate our emotions and behavior is dependent on the balance of activity between these three branches of the vagus nerve. When we are feeling stressed or threatened, the dorsal vagal branch is activated and we may experience symptoms such as increased heart rate, shallow breathing, and stomachaches.
When we feel connected to others and safe, the ventral vagal branch is activated and we may experience symptoms such as decreased heart rate, slow breathing, and a feeling of calmness. And when we are feeling relaxed and at peace, the myelinated vagal branch is activated and we may experience symptoms such as increased digestion and a feeling of well-being.
Porges's Polyvagal Theory has important implications for our understanding of stress, anxiety, and trauma. By understanding how the vagus nerve regulates our emotions and behavior, we can develop strategies to promote relaxation, reduce stress, and heal from trauma.
Activating Your Vagus Nerve for SNS Downregulation
While the responsibilities of the vagus nerve are involuntary, certain practices can activate the vagus nerve further to promote relaxation and a shift back to parasympathetic flow. With practice, returning to and maintaining the parasympathetic state can become second nature again. Like a muscle, training will strengthen this response and, in turn, create a buffer against situations that would generally lead to an unnecessary stress response. Stimulating the vagus nerve stimulates the PSN and, in turn, reduces the neurophysiological symptoms of stress.
Deep, rhythmic, diaphragmatic breathing: Inhale through the nose, breathing deep down into the belly. Exhale slowly through the mouth. Try to exhale longer than you inhale, as it is exhalation that triggers the relaxation response. The average respiration rate is about 12 to 16 breaths per minute. Aim to cut this number in half during this breathing practice. Focusing on your breath also helps take the focus off the stress stimulus.
Belly laughter: Not only does laughter boost your immune system and improve mood, but it also stimulates the vagus nerve. According to Psychology Today, the average four-year-old laughs around 300 times a day, while the average 40-year-old only laughs four times a day.5 It’s time we reconnect with our inner giggly child; our health depends on it!
Singing, humming, chanting, and gargling: Your voice box (larynx) is connected to your vagus nerve. The vibrations created from practices like humming stimulate the vagus nerve.
Reflexology: Research shows that reflexology decreases sympathetic activity and lowers blood pressure.6 And while booking yourself a professional foot massage is truly a treat, you can perform a gentle foot massage on yourself to help activate the vagus nerve and downregulate the SNS. Sit in a comfortable seated position and start by gently rotating your ankles, rubbing the soles of your feet, and stretching your toes back and forth. Apply pressure as it feels good to you. You can incorporate some essential oil blends to create an even more relaxing self-care practice.
Probiotics: As the vagus nerve connects the gut to the brain and vice versa, it only makes sense that the health of the gut microbiome has a direct effect on the mind and behaviors of the central nervous system. Studies have demonstrated that probiotics have a positive impact on supporting central nervous system function.*7
Snuggling: Snuggling with humans or pets can be a great way to downregulate and tone the vagus nerve. When we snuggle with someone or something we love, our bodies release oxytocin, a hormone that has calming and bonding effects. Oxytocin helps to reduce stress and anxiety, and it can also help to improve heart health and gut function. In addition, snuggling can help to regulate our breathing and heart rate, which can further promote relaxation. One study found that people who spent 15 minutes cuddling with their pets had lower heart rates and blood pressure than those who did not cuddle.8
Other Practices that Promote Downregulation and Regeneration
Stress is a part of life; we are biologically adapted to handle acute stress. However, we must make a conscious effort to support our parasympathetic nervous system to counteract and alleviate the chronic stress many of us endure. Fortunately, doing so is something everyone can learn to do. The following three practices will help you get started.
Meditation isn’t “just” sitting cross-legged with our eyes closed while our thoughts dissolve into perfect nothingness. There are all sorts of different meditation techniques that are not only effective at downregulating the SNS, but also accessible for those who can’t seem to sit still and let go. Meditation can be moving or still; it can be short and sweet or long and deep. It can include a mantra, visualizations, sound bowls, or complete silence. Your meditation practice can be unique to you.
The common thread among all mediation practices, though, is learning to let your thoughts and feelings flow in and out of you instead of stopping and focusing on them. With practice, you might find that your flow becomes so fluid that you don’t even take note of worries and stresses that used to weigh you down, thus creating a freeing sense of nothingness and peace in mind and body. Creating this space within naturally promotes a relaxation response.
Engaging in activities that require focus and that bring you joy can activate the PSN. Maybe this is writing poetry, photographing wildlife, looking for sea glass and shells on the beach, or working on intricate puzzles—taking the time to focus on something you enjoy doing is a wonderful way to support the switch from the sympathetic state to a relaxed parasympathetic state.
Spending time in nature has been shown to have a number of benefits for our physical and mental health. Studies have shown that being near water, such as the ocean, a lake, or a river, can help to lower blood pressure and heart rate, and can also help to reduce stress levels.9 Additionally, the sound of birdsong has been shown to alleviate anxiety and paranoia.
If you are unable to get out into nature, you can still reap the benefits by bringing nature to you. Plants, both indoor and outdoor, have been shown to have psychological and physiological benefits, such as increased relaxation and reduced stress.
Here are some ideas for how you can incorporate more time in nature into your daily routine:
Take a walk in the park.
Go for a hike.
Sit by a river or lake.
Plant a garden.
Keep a houseplant.
Even just a few minutes spent in nature each day can make a big difference in your overall health and well-being. So get outside and enjoy the benefits of nature!
Numerous studies have revealed that social support is vital for maintaining physical and psychological health. High-quality, positive social support can enhance resilience to stress and the ability to adapt well in the face of adversity, by optimizing the neurochemical stress response and return to a parasympathetic state.10
Unfortunately, many struggle to connect socially, a problem that the Surgeon General’s advisory on loneliness and isolation hopes to correct. The advisory outlines a six-pillar framework for a National Strategy to Advance Social Connection. The pillars include:
Strengthening social infrastructure
Promoting social connection in schools and workplaces
Supporting older adults
Addressing the stigma of loneliness
Investing in research
Surrounding yourself with people (or pets!) who exude a specific type of energy or resonance can do even more than make you feel like you have a support system. It can directly affect your psychophysiological state and activate your PNS. Similarly, if you are experiencing chronic stress and you’re surrounded by other people who are chronically stressed, it is more challenging to exit the sympathetic state.
American Psychological Association. (n.d.). Stress in America™ 2020: A National Mental Health Crisis. American Psychological Association. Apa.org.
Bergland , C. (n.d.). Mind-body practices downregulate inflammation-related genes. Psychology Today. psychologytoday.com.
Bell, A. L. (2017, August 24). The biology of calm: How downregulation promotes well-being. GoodTherapy.org Therapy Blog.
Esch, T., Fricchione, G. L., & Stefano , G. B. (n.d.). Relaxation: Molecular and physiological significance. ResearchGate. researchgate.net.
Gerloff , P. (n.d.). You're not laughing enough, and that's no joke. Psychology Today. psychologytoday.com.
Lu, W.A., Chen, G.Y., & Kuo, C.-D. (n.d.). Foot reflexology can increase vagal modulation, decrease sympathetic modulation, and lower blood pressure in healthy subjects and patients with coronary artery disease. Alternative Therapies in Health and Medicine. pubmed.ncbi.nlm.nih.gov.
Wang, H., Lee, I.-S., Braun, C., & Enck, P. (2016, October 30). Effect of probiotics on central nervous system functions in animals and humans: A systematic review. Journal of Neurogastroenterology and Motility. ncbi.nlm.nih.gov.
Gordon, A., et al. "The effects of pet ownership on cardiovascular risk factors in older adults." Journal of the American Geriatrics Society 57.1 (2009): 126-133.
P.E. Wheeler. (1993). The influence of stature and body form on hominid energy and water budgets; a comparison of Australopithecus and early Homo physiques. Journal of Human Evolution, Volume 24, Issue 1. sciencedirect.com.
Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007, May). Social Support and resilience to stress: From neurobiology to clinical practice. Psychiatry (Edgmont (Pa. : Township). ncbi.nlm.nih.gov.