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All about Vagus Nerve, Vagal Tone and Mental Health

“By developing an understanding of the workings of your vagus nerve, you may find it possible to work with your nervous system rather than feel trapped when it works against you.”

Dr. Arielle Schwartz, Clinical Psychologist

Howland 2014 has reported that “…the vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality.”  Read more here:


Vagus Nerve Stimulation as a Treatment for Catatonia: A Hypothesis by Zilles 2019

Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany

Background: Catatonia is a syndrome comprising psychomotor, behavioral, and autonomous symptoms which may occur in the context of severe schizophrenic, affective, and other mental disorders or medical conditions. Treatment options include high dose benzodiazepines (lorazepam) and electroconvulsive therapy (ECT) with some evidence for the effectiveness of glutamate antagonists. However, due to a lack of randomized controlled studies in this severely ill population, evidence base is weak.

Methods: On occasion of the case of a patient with treatment resistant catatonia in schizoaffective disorder, we developed the hypothesis of vagus nerve stimulation (VNS) being a potential therapy for treatment resistant catatonia.

Results: Based on a selective literature search, we found a remarkable overlap of the pathophysiology of catatonia on the one hand and the putative mechanisms of action of VNS on the other hand in several domains: functional brain imaging, involved neurotransmitter systems, clinical, and theoretical. We thus decided to use VNS as a single subject clinical trial. During the 1-year-follow-up, we observed a fluctuating, but ultimately marked improvement of both catatonic symptoms and general psychopathology.

Conclusions: We assume there is a sufficient hypothetical corroboration for the potential effectiveness of VNS as a long-term treatment in predominantly catatonic syndromes. This hypothesis could be tested in proof-of-concept clinical trials.


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Creating space and waiting for the ‘adaptive reponse’

Children need to learn skills for life – learning not to jump in too soon to support and scaffold in therapy and supporting parents to step back and wait…–please-dont-help-my-kids?utm_medium=social&utm_campaign=postplanner&

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Talking to Parents about Sensory Sensitivities



How Do You Talk to Parents about Sensory Sensitivities?

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Ayres’ Sensory Integration Assessment: Structured Clinical Observations

So what are structured clincial observations? What do they mean?

In the practice of Ayres’ Sensory Integration, structured clinical neurological observations form part of the comprehensive assessment needed to understand the sensory systems and how challenges to sensory registration, sensory processing and sensory integration contribute to difficulties participating in activities of daily life.

In 1972, Ayres, who had worked with adults with traumatic brain injury, described her adaptation of adult neurological observations for the testing of children in her book Sensory Integration and Learning Disorders.

During assessment for sensory integration difficulties, a therapist will use clinical reasoning to start to hypothesise which sensory systems may be contributing to a person’s presentation and current difficulties in participation in everyday life. You can watch a therapist do a version of these tests here. Depending on what a therapist is seeing as they assess, they will choose which are the right ones to do next and in what order.

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ASI WISE were out and about in Northamptonshire : Now read about their learning put into practice 2 years later.

The ASI WISE team are out and about in Northamptonshire in 2018, sharing knowledge and skills about Ayres Sensory Integration with the mental health teams at Berrywood Hospital, part of Northamptonshire Healthcare NHS Foundation Trust.

And now nearly 2 year later, they have published an update about the impact of this learning; “The Difference we’re Making”.

You can read more here.

To find out more about our workshops including in house workshops please visit Mental Health and Wellbeing Workshops.