Activating The Vagus Nerve For Improved Mental Health and Behavior

Episode Transcript

Dr. Nicole Beurkens: 

Hi everyone, welcome to the show — I am Dr. Nicole, and today we’ll be talking about a fascinating topic, the Vagus nerve and how it’s connected to mental health and behavior. You may recall this nerve from maybe a past biology or anatomy class that you took, but it’s not something that most people think about on a very regular basis. But what I find so interesting is that this nerve is connected to so many aspects of our brain and body function, and when something isn’t working well with the Vagus nerve, it can have a negative impact in many different areas. Understanding this has helped many of the children and the adults that I see in my practice and I’m excited to have Dr. Navaz Habib on the show today to share this important information with all of you. Let me tell you a little bit about him. 

He’s the founder of Health Upgraded, a Functional Medicine and Health Optimization clinic in Toronto, Canada. By identifying the root causes of health imbalances, and addressing them naturally, his patients experience optimal health the way their bodies were meant to feel, and allow them to give back to the world in whatever way they want to serve. Dr. Habib’s book “Activate Your Vagus Nerve” is a simple to follow guide to help you identify and address a major missing piece in patients dealing with chronic health concerns such as anxiety and depression. By activating the Vagus nerve, we can optimize our productivity, focus and energy levels, allowing us to experience the effects of upgraded health. It’s a wonderful book, it’s a pleasure to have you with us today, welcome, Dr. Navaz!

Dr. Navaz Habib:

Thank you so much for having me, I’m very excited to be here. 

Dr. Nicole Beurkens: 

So I like to start the show by having guests share just a little bit about your journey. How did you come to be doing the kind of work that you’re doing today and focus so specifically on something as interesting as the vagus nerve?

Dr. Navaz Habib: 

Absolutely, it’s a great question. I love to tell that story because it really does explain why I’m so interested in it. So I live in Toronto, I live in Canada, so I do experience the winter and the cold here and I have always kind of been the type of person who’s interested in health and understanding why people experience health challenges the way that they do in Canada or elsewhere. So I went to college at the University of Western Ontario here in London, not too far from where Toronto is and I completed my degree in Medical Sciences. Always had this understanding that I was very scientific in nature, always wanted to really understand, I guess, the environment, the human environment, the external environment really in-depth. And as I went through medical sciences and completed my bachelor’s degree, I decided the next step for me was to figure out how I could help people to improve their overall health, to take science to a very clinical level. So I went into chiropractic care. So I went to chiropractic college and I did that for four years in Toronto here as well and loved it, every minute of it because it allowed me to understand anatomy, physiology, truly how the body functions, how to get our muscles and our bones working correctly, but also how our brain connects to all of the other organs and how our nerves have such an important role to play. 

There were always a couple of nerves that stuck out during all of my anatomy classes, and really understanding these things — there were two nerves that, to me, always kind of had an important place. The first was the sciatic nerve because so many people deal with sciatica — when I was doing chiropractic care completely, that was the number one most common thing that I would see, it was this low-back pain radiating down the leg. The second nerve that always stuck out to me was the vagus nerve. I really didn’t understand the full depth of it at that point, but it always was an interesting topic because the vagus nerve was the only cranial nerve. The only nerve that starts in the cranium or in the head area and actually goes out of the head area and goes to so many different organs in the body. And it was interesting to me, but I never really had a connection to it until I got into functional medicine. So during this time when I was in chiropractic college and completed chiropractic college and was working as a chiropractor myself, I wasn’t doing the best with my own health. I weighed 250 pounds on a 5’6” frame, that was pretty severe. I had high IBS, I had high blood pressure, I had high blood sugar, I was borderline diabetic at the time. My doctor wanted to put me on all of these different medications and I didn’t want to deal with these things, I knew that my body wasn’t lacking medication, my body was not using the tools that I was giving it correctly, and I probably just wasn’t giving it the correct tools. 

I always wanted to figure out why. Why my body was working the way that it was. Why my brain was causing me to go and snack as much as I was, or what was leading me to that. And that’s where I discovered functional medicine. And functional medicine allowed me to see what was going on at a deeper level. It allowed me to understand cellular function, it allowed me to understand brain function, brain chemistry. The understanding of physiology and why things happen the way that they do. And as I was able to kind of dig deeper and really understand what was going on with me, I was able to address all of my health challenges. 

The weight came off, the blood pressure came back to normal and optimal range, I was able to eliminate the IBS, I stopped snoring, my wife loves me for that now, these are great things that happened to me. And at the same time, my energy levels started to soar and I didn’t realize how poor my energy levels were until I got out of that. And so, I started working with clients, because I said this is something that I have to share with the entire world, functional medicine is such a wonderful tool, allowing us to really understand why things were happening and really dig deeper on an individual basis, not on a research-based, 80% of people get better with this versus that. We need to figure out why each person has the specific things that they do. So that’s where I started working with clients and I started to notice that there were a couple of different connecting points between a lot of the conditions that we were dealing with. A lot of the issues with anxiety, with depression, with gut-sensitivities, with auto-immunity were all linked to inflammation, they were all linked to a brain-gut access that was not working correctly, and that was where it clicked, because it said, what is this connecting point between the gut and the brain? And the answer was the vagus nerve. 

So this is where I got into — like, oh my goodness, the vagus nerve! This is where it’s so important. And I started doing some research and I started writing blog posts on it and I started going out and I finally had a publisher actually approach me and say, “Are you interested in writing a book on this topic?” And I said, “Yes” and that’s how the book came along. 

Dr. Nicole Beurkens: 

Awesome, I love it. Such a great story, how that personal journey then comes alongside the professional journey. I think that’s the case for so many of us. You touched on what the vagus nerve is, that it’s this nerve that starts in the head and goes all the way through the body. Delve into that a little more for people who are saying, “Whoa, that’s interesting! What exactly is that?” Maybe just a little refresher even on what nerves do and a little more about what the vagus nerve is.

Dr. Navaz Habib: 

Of course. Nerves are the essentially information transfer tunnels between the brain and other places. Our brain is our central processing unit. It’s the CPU, it’s the place where we get all of our processing to occur, but the information has to come from places to the brain, and then the brain has to send that information elsewhere, and it uses nerves to do so. And so these nerves are these long cells that have a very specific route, a very specific path and a very specific function. And each nerve is going to have a different effect, depending on where it’s ending and what the information is that it’s bringing upwards. The vagus nerve plays four roles. It actually has four different functions, and this is why it’s so important. About 80% of the information that’s presented or that remains on the vagus nerve is actually coming from all of our organs, from our stomach, gallbladder, liver, pancreas, spleen, kidneys, small intestine, large intestine, lungs, heart to the brain. So it’s all coming from down here, moving up to the brain. It’s telling the brain what the status is of what’s happening internally in the gut. You’ve had a meal. Now you need to know what’s going on. You’ve had some traumatic event, like you fell down and now there is a bruise, we have to send in information up to the brain to say, okay, this is what’s going on, here’s what needs to happen. Then the brain processes and sends information down. Sometimes through the vagus nerve, sometimes through other nerves to go and do or have an effect on those new cells.

That’s where 80% of the information is, it’s coming up to the brain, and this is really important to remember. About 15% of the information on the vagus nerve is actually going from the brain to each one of these organs, but it’s parasympathetic. So what this means, and I’m going to kind of level it down a little bit, we’re going to dig in here: We have automatic functions that occur in our body, I’m not consciously thinking of beating my heart, I’m not consciously thinking of digesting my food right now or detoxifying my blood. I’m not consciously thinking of doing these things. My body is doing them automatically or autonomically. And that’s the autonomic nervous system controlling those things. These are functions that we don’t consciously have to think about. They just happen. And this automatic system is split into two sides: Sympathetic and parasympathetic. The sympathetic nervous system manages the fight and flight responses, it’s the stress management. So when something occurs, for example, a dog starts barking outside the door. You get startled, you get a little bit stressed out. Or your boss comes down the hallway, and says, “Hey, I want to talk to you in my office right now.” That stress that occurs where you start to perspire, the pupils dilate, the heart starts to race, your breath becomes a little bit more shallow. When that system turns on, we’re going to shut off digestion. We’re going to shut off detoxification or shut them down at least to a level where the blood flow is going towards places where we need to survive, for fight or flight. It’s going to go to the muscles of the arms and the legs so we can either run away or fight back, and it’s going to take that blood flow away from the other organs. That is in contrast to the rest and digest system, which is the parasympathetic part of the autonomic nervous system. The rest and digest side is mediated through the vagus nerve, that 15% of information that’s going from the brain to all of those digestive organs and stuff like that is that parasympathetic information.

So it’s what’s helping the heart rate slow down. It’s allowing the breath to become deeper and more calm. It’s allowing digestion to occur, it’s allowing the stomach to start to break down foods by producing hydrochloric acid, or the gallbladder to pump out bile so we can absorb fat correctly — all of those things need to have a very specific input through the parasympathetic side of the vagus nerve, and that’s worth 15% of that information. Then we’ve got two little other spots and these are important for how we can affect the vagus nerve ourselves. So about 3% of the information on the vagus nerve is actually going to the muscles of the back of the throat and the vocal cords. And these are absolutely imperative to understand. We need to keep our airway strong, and open. If we don’t have an open airway, if that airway is collapsing, then we’re going to have these issues. When I was dealing with sleep apnea, when I was at my unhealthiest — sleep apnea is one of those reasons why the vagus nerve stops working correctly. We are not toning those muscles, we’re not using the vagus nerve to stimulate those muscles to work correctly. And so people that have breath issues, dealing with airway issues like sleep apnea, like emphysema or COPD… those are major issues that are decreasing vagus nerve function. So we have to really consider the breath as a major component to vagus nerve and autonomic function overall. 

Dr. Nicole Beurkens: 

That’s so interesting because I talk a lot about how vitally important good sleep is for kids and to assess for the presence of sleep apnea or those kinds of sleep-related breathing issues, and what you’re saying just clicks for me too. It’s not just the impact that the sleep apnea has on the sleep itself, but also the impact that it has on the vagal nerve tone, which then has an impact on everything, so that’s very interesting. 

Dr. Navaz Habib: 

Yeah. There’s a very, very strong connection to optimal sleep and vagus nerve function. We know now that sleep is where we recover, but recovery occurs through the vagus nerve. And we have that recovery taking place through mediating the airway to make sure that our breathing is optimal. So sleep apnea is one of the most common reasons why we have issues with the vagus nerve and why anxiety comes up with kids and adults as well. With these issues that our inability to recover from the stress of the day. And when that accumulates over time, that’s when we really get into big disease processes, so yeah, sleep is gigantic. 

Dr. Nicole Beurkens: 

I didn’t mean to interrupt, I know we’ve got one more to cover, but I just made that connection, I thought, oh that’s really important to note there. So what’s the fourth role?

Dr. Navaz Habib: 

Of course, the last one is actually just a little bit of sensory. And sensory information from the skin, and that skin specifically is in the ear. In the center part of the ear. There’s a very specific area that’s innervated by what’s called the great auricular nerve, which is a specific branch of the vagus nerve. So that nerve gets information from the skin of the ear. So there are things we can do. There are little tools and tricks that we can use to stimulate that branch and get the vagus nerve stimulated, as well as the motor nerves that we talked about as well.  

Dr. Nicole Beurkens: 

And I want to get into the techniques and the tips. Let’s talk a little bit more about — now that we have a good understanding of what this vagus nerve is, and really, how interconnected it is to all aspects of the brain and the body. What are some things that can cause the vagus nerve to not work optimally? So obviously when it’s working well, that has a positive impact on our physical health, our mental health, but what are some things that can cause that functioning to break down? We just commented on the sleep piece of things, breathing difficulties during sleep, sleep problems that that’s one of them, what are some other things that can cause problems with the vagus nerve?

Dr. Navaz Habib: 

A really important thing to remember is what the vagus nerve is actually controlling. And one of the major things that it is controlling is inflammation in the body. So inflammation is a huge component. If we have excess inflammation or inflammatory processes taking place in our body, then we’re going to have issues with the vagus nerve not being able to handle it, if it happens over a long period of time. So what the vagus nerve does is it uses, the neurotransmitter that it uses is called acetylcholine (ACH). And acetylcholine is part of what’s called the cholinergic anti-inflammatory system. By which it actually helps to reduce inflammation through macrophage activity, through spleen activity in the gut specifically. So now we know through a lot of research that’s come out that when we have inflammation coming up, it’s generally starting in our gut. 70% of our immune cells by volume are located in the lining of the gut. And so we need to make sure that gut function is optimized and we need to make sure that inflammation does occur when necessary, but that it is controlled. And so, excess inflammation, excessive poor diet, for example is one of those major things. If we’re not having good, clean green, lean foods with good fats and we’re not allowing our gut to really do the job that it needs to do because we’re adding abrasive foods and processed chemicals and what not — those inflammatory foods stimulate excess inflammation and over time, the vagus nerve is like the brakes to the inflammatory system. But over time, those brakes wear out the same way that our brake pads on our cars wear out.

So what we need to do is be gentle, be careful. Make sure that we’re using the brakes only when we need to, but we’re not constantly putting the accelerator on, pushing the car as far as it can go. We’re not constantly adding inflammatory diet into our gut and causing these things to occur. So a diet that’s highly inflammatory is a major reason for this.

Dr. Nicole Beurkens: 

And is it true then that really, anything that drives inflammation is problematic then for the vagus nerve? That includes the poor sleep, sedentary lifestyle, high stress, all of those things that we talked about that are drivers of that chronic inflammatory process, those are going to be problematic for the vagus nerve as well.

Dr. Navaz Habib:

That is exactly right and this can come down to something as simple as hormonal deficiencies in insulin resistance, for example, the inability to manage your blood sugar as a stressor on the body, and the pancreas itself is constantly trying to keep up with these blood sugars that are high, but we’re not able to handle it. Or for example, high cortisol levels because we’re under extreme emotional and psychological stress from the environment that we’re in, but also physical and biochemical stress from the environment that we live in. The paints on the wall or the plastic off gassing from our car, for example — these are all stressors that we need to take into account. So any stressor, anything that can cause the inflammatory process to become stronger is going to be, over time, the chronic inflammatory issue going to lead vagus nerve dysfunction for sure. 

Dr. Nicole Beurkens: 

And that’s a bad cycle to be in then, right? Because those things make the vagus nerve function worse, but then that makes our vagus nerve less able to help us manage the inflammation, so we just get kind of caught in the cycle. 

Dr. Navaz Habib: 

Exactly, it starts rolling and when it starts rolling, it’s very difficult to slow down. And that’s why people, for a long time, may not notice any symptoms and all of a sudden, one small symptom and it snowballs into this huge, massive chronic, autoimmune type of diagnosis or something major that comes up. And that’s very strongly linked to the inability to manage, and so that’s where the vagus nerve is not working very well at all. 

Dr. Nicole Beurkens: 

So let’s delve into the connection between vagus nerve and mental health, and particularly behavioral issues, because parents maybe listening and they’re going, “Okay, that’s really interesting, I get the connection of inflammation”, probably they now through listening to even just your personal story, identified several areas for themselves that are important to think about. Let’s get down to the issue of these challenges in kids. So kids with really anxious, irritable behavior, acting out behaviors, kids with neurodevelopmental kinds of things, what’s the connection between vagus nerve function and these kinds of issues?

Dr. Navaz Habib:

Absolutely, great question. We now know that the brain-gut connection is so strong. We know that our neurotransmitters are so strongly linked to what’s going on in our brain. In fact, there was a recent study that came out a couple of years ago, I believe, that said that 94% of our serotonin in our body is actually produced in our gut and is located within the enteric nervous system. I believe the numbers are similar, not quite 94%,  but still quite high for dopamine, for norepinephrine as well. We know that neurotransmitters are strongly linked to — like an imbalance in these neurotransmitters is strongly linked to anxiety, depression, anxiousness — the feelings that we get when there is an imbalance. What’s happening through the vagus nerve and why this is so important is that information that is going on in the brain, the imbalance of those neurotransmitters is being signaled to the brain through the vagus nerve. And that’s the link between how the brain actually has these negative effects occurring or notices the negative effects. But why it manifests as a behavior-based issue rather than simply a gut-based issue — a lot of kids don’t realize that there’s something going on in their gut, but our bodies are really, really smart, and this is something that we need to shift in our overall paradigm in how we see things, I think, in healthcare. We generally have had a lot of trouble realizing where these problems are rooted, where they’re coming from. And in 90% of cases, me working with clients as a functional medicine doctor, 95% of cases, the gut is the root of these issues. And we can’t see our gut, we can’t actually — unless we take a camera and go in and take a look at what’s going on, we can’t see those things, we can’t see what’s truly going on. 

That said, even when we do take a camera in, half the time we can’t see because we can’t see bacteria. They’re not visible through our eyes. We can’t see if there is an imbalanced normal bacterial flora. We can’t tell if there are parasites unless we are actually testing for these things. When we have these imbalances going on, our body is actually trying to tell us. Our bodies are really smart. It shows up as dermatitis and eczema on our skin, it shows up as behavior issues because there is an imbalance of something going on. There is a really great kind of way to think of this: When doctors finish medical college, they all recite the Hippocratic oath from Hippocrates. Hippocrates also stated that all disease, all chronic disease begins in the gut. And that’s a second thing that Hippocrates said, that generally, our medical practitioners have forgotten. And that’s where we really need to look. When there is something going wrong in the body chronically, the first place to go look is the gut. If the gut is not the source of the problem, then we should start to look elsewhere, but we really need to get rooted in the gut, and that’s where the vagus nerve comes into play, because when the gut is imbalanced, the vagus nerve is signaling that information. And if the inflammation levels are too high and can’t be managed through the vagus nerve, these things snowball into becoming significant challenges. 

Dr. Nicole Beurkens: 

And I think what you were saying before, too, with the chronic inflammation and the gut issues that the vagus nerve gets kind of burned out, right? It’s like constantly being activated, you talked about that brake pedal, it’s like constant gas and then slamming on the brake and the vagus nerve gets kind of burned out and kind of sluggish. And I think one of the things that I read in your book and that I find really fascinating is that issue of vagal tone, that just like our muscles — we think about muscle tone, right? And the ability to relax and contract a muscle and have good strength. And the vagus nerve is similar, we need it to stay well-toned. And I find it interesting in a lot of the children and adults that I see who have maybe just chronic anxiety or things like that, very reactive behavior. It’s like they have no ability anymore to gauge what they should be really upset about or not upset about or what should really maybe bring a little bit of anxiety or panic. It’s like their body just is in this all-or-nothing kind of mode, and you draw some really interesting connections to the role that the vagus nerve plays in that. 

Dr. Navaz Habib: 

Yeah, it really is that buffering kind of space. Because without that, that brake control, we’re either going to be at 0 or 100. That’s for sure going to happen, right? And when we see our kids acting out and dealing with anxiety and stuff, we feel for them, but obviously, when they’re at that 100 level, when they’re just going and there’s nothing that you can do about it, or you feel like there’s nothing you can do about it, the answer is: Think about why they’re unable to control that, the brake pedals are not working. So activating the vagus nerve, getting those brakes to start working, get that tone back up a little bit in the vagus nerve, you can really start to buffer that 100 level and bring it down. 

Dr. Nicole Beurkens: 

And I think that’s such a helpful thing for parents and practitioners to understand and there are some great tools that we can use to do that. So let’s jump into how can we assess vagus nerve function or how can a parent or somebody who’s listening determine if this maybe is an issue for their child?

Dr. Navaz Habib: 

For sure. There are a few different tools that we can use to determine if the vagus nerve is working really well, and things that we can do about it. There are simple tools, simple exercises, then there are things that cost a little bit more and take a little bit more time to do. With kids, it can be a little bit more difficult, but that said, if your child is dealing with significant behavior-based issues, inability to really control that stress level and just allowing them to go to 100, there is a very high chance the vagus nerve is not working correctly. And so, with cases like that, we want more instant results, we really want to make some changes, so I would recommend a few exercises that we can jump into. 

Before we do though, I want to make sure that everybody understands that testing for vagus nerve function is really important to really know where you’re at. If you have the ability, if you have the opportunity to test for these things, go ahead and do it. So there are two tests that I recommend, I talk a lot about them in the book. The first is the bowel transit time test. This is a really great way to see if bowel function or gut function is working really well. And being able to see the amount of time that it takes for us to swallow a food, and for it to actually finally come out the other end. There is an optimal amount of time. That timeline should be between 16 and 24 hours in an optimal scenario. 

So here’s what I get my clients to do. I’ll have them take a glass of water and take a spoonful of white sesame seeds. There’s a very specific reason for this, but the white sesame seeds, you’re going to put them into the glass of water, just a spoonful. You’re not going to chew them, you’re just going to swallow the water with the seeds in them. And you’re going to mark down the time at which you are doing this. And your kids can do this very easy, just say, “Okay, I want you to drink this water, don’t chew the seeds, just go ahead and swallow it.” So they drink this, and you’re going to mark down that time. Then you’re going to start to look in the bowl every time they go to the bathroom for the next couple of days. And you’re going to mark down when you start to see white sesame seeds in their stools. Ideally, like I said, that timeline should be 16 to 24 hours that you start to see them and finish seeing them, okay? Some people will start to see them a little bit earlier. Some of them might not see it for a little while. That tells us that your bowel transit time is not optimal, it’s probably a little bit off. And that’s very commonly linked to a lot of these gut-based issues. If there is a bowel transit time concern, it’s not diagnostic of anything, it’s just simply saying that it’s not working optimally. The reason we don’t chew the seeds is because our bodies don’t have the enzymes to break down the shell of the seeds. That’s why we have teeth. So in this case, in order to be able to see what’s going on, that 16 to 24 hours without chewing the seeds is key, and then the white sesame seeds, pretty obvious, they’re going to want to see them in the bowl, black sesame seeds, you probably won’t be able to see.  

Dr. Nicole Beurkens: 

Great, such a simple thing that we can do even with younger kids to be able to assess that. Wonderful. 

Dr. Navaz Habib: 

Exactly. It’s a very simple tool. Just a small — even a teaspoon of these seeds can give us a lot of information and this is less than a dollar’s worth to figure out what’s going on. If we really want to dig deeper and really see what’s going on with vagus nerve function, I talk more about this in the book, that’s where we look at heart rate variability. So there are specific tools out there. You can use tools like the Oura ring, which is a wonderful ring. Mine just stopped working, sadly, but the Oura ring is a great tool. You can use another tool like HeartMath, for example, is a great tool to help not only see where you’re at, but that’s a wonderful one to help you train and get your heart rate variability and your breath rate all synced up and get you into a calm state. 

Dr. Nicole Beurkens: 

We use that one at the clinic, very easy to use with kids.

Dr. Navaz Habib: 

Yeah. It’s a wonderful, wonderful tool. I give it out to my clients as well. It’s a great tool. And then there are little ones that you can use with your phone as well, I’ve got mine sitting over here, my Corsense, Elite HRV tool as well, which you literally just put your finger in. My daughter loves playing with this, so I get her to put it in and then you can see what’s going on with her heart rate variability as well. Heart rate variability is a sign of vagus nerve function. The higher the number, the better. And what we want to see is variation. We want to see a lot of variation. We don’t want a heartbeat to be rhythmic. If it’s rhythmic, that’s a sign that we’re too much on the sympathetic side, the fight or flight side. If it’s not rhythmic, if it’s up and down, that’s a sign of resilience and high vagus nerve function and parasympathetic activity. 

If you’re willing to make the investment and really get to know what’s going on, I recommend for something like this, the HeartMath is probably the easiest tool for you to use, it’s like $120, somewhere there. 

Dr. Nicole Beurkens: 

Very low barrier to entry there financially and usability and all of that. So those are some great ways that we can look at — aside from just the obvious symptoms like we talked about that 0-100 high reactivity, chronic anxiety, those things, some ways that we can assess that. Let’s get into strategies that we can use. Let’s start with maybe some basic overall strategies, things that are helpful for kids and adults, and then maybe we’ll talk about some specific things if people have younger kids, because I know that in the book, you talk about a lot of things that people can do to really support and optimize vagus nerve function. 

Dr. Navaz Habib: 

Yeah, definitely. There are so many different strategies. Once we truly understand the connections that the vagus nerve has, once we truly understand the 80% of information that’s coming up from the gut, that 15% that’s going back down to all of the organs, but then we keep in mind those little 2 and 3 percenters that are going to the muscles of the throat and the vocal cords and we know the sensation that’s coming from the ear, those pieces are very beneficial in being able to stimulate, because that’s where we can actually have a conscious effect. So the muscles of the throat is really where we want to start. And obviously, deep breathing is kind of a really big piece to this. Our breath is our major control point for our autonomic nervous system, for our parasympathetic and sympathetic control. And so when we’re under stress, we tend to breathe very shallowly, we use our chest, we don’t breathe through our belly. These are really important factors in determining whether we’re under stress or we’re relaxed. And so when we’re relaxed, we want to make sure that we’re breathing with our belly. 

And so, I’ll have people test to see which way they are breathing. Putting their hand on their chest and their hand on their belly and kind of noticing which hand is moving. If our top handing is moving with our chest expanding and coming up and down, that’s a sign that we’re under stress and we’re actually telling our brains and bodies that we’re under stress and that the fight or flight system should be turned on, thus the vagus nerve will actually be shut down or decreased in its function at that time, whereas, we can tell ourselves to get into that calm, relaxed state by breathing through our bellies. So having that calm, diaphragmatic belly breathing where our bottom hand is moving, that’s a direct sign that we’re under a relaxed state, that the stress is diminished and not causing us problems. So this is a great tool that anybody can do at any moment, whenever they’re feeling a little bit of pressure, a little bit of stress, really just to get your cognition working again. Get your brain really functioning under not a stressful environment but under a really happy and recovery-based mindset. 

Dr. Nicole Beurkens: 

What’s interesting, because a lot of times in the clinic when I’ll be working on or introducing the idea of breathing with people, I’ll say “Okay, show me what it looks like. I want you to take a deep breath”, and they’ll go — and their shoulders go up and their body tightens up, especially for kids, but a lot of adults do that too. And I think what you’re talking about here is an important missing piece in the education that we give people about why deep breathing is important, because I’ll get a lot of kids, teens, adults who will come in and say, “Oh yeah, my previous therapist told me about deep breathing.” But what’s missing is this education about, from a physiological standpoint and a neurological standpoint, why it’s helpful. It’s not just about deep breathing for the sake of deep breathing. I mean yes, it can slow us down, it can make us more mindful, but what you’re talking about is deep breathing is a tool for really toning that vagus nerve and helping our vagus nerve function more effectively, right? 

Dr. Navaz Habib: 

Yeah, that deep breathing really is, in the way that I’m talking about it, it’s a physiological change. It actually changes our physiology, it changes what we’re experiencing, it changes our blood flow in our body, it changes the way that we are thinking, our cognition, our brain function, and it actually allows the blood flow to go to the prefrontal lobe, where we have our executive function. So we actually begin to think more clearly and actually have these things change. So that breath isn’t a simple “somebody told me about doing deep breathing”. Here is why, because you’re actually going to think better, you’re going to digest better, you’re going to recover better. Everything in your body is going to do better when you’re under rest, not under stress. 

Dr. Nicole Beurkens: 

Do you have a breathing technique or any specific pointers or ways that you like to have people practice this or maybe even particularly for kids?

Dr. Navaz Habib: 

There are a lot of different ways out there. Some that work really well for some people, others that don’t and you kind of have to pick and choose for yourself. So there’s a couple that I really like. If you’ve ever read the book ‘Stress Less, Accomplish More’ by Emily Fletcher, it’s a really, really wonderful book. And if you’ve ever heard her speak — I’ve had the pleasure of hearing her speak a couple of times.

Dr. Nicole Beurkens: 

She’s wonderful.

Dr. Navaz Habib: 

She does a meditation, she actually does the breathing alternating with your nostrils, and closing a nostril with the fingers accordingly, and I actually found personally that one for me worked really, really well. And it was like a four-second breath in, holding for two and then breathing out for four as well. Ideally, everything, breathing through the nose. We have to remember that when we’re under stress, we tend to breathe through the mouth, right? When we’re stressed out, when we’re running away from something, you’re not breathing through your nose. You’re not consciously getting the airflow through your nose. 

Our mouth is actually our backup breathing hole. Our mouth is not our primary breathing hole. We should breathe through our nose and feed through our mouth, but our mouth is a backup breathing hole if our nose is stuffed or plugged or anything like that, but it’s a sign that if you’re breathing through your mouth that you’re under stress. And so it’s very important to try to get that breath in and out to go through the nose, and I think that’s a really important piece of the puzzle here. We’ll only ever breathe through our nose when we are relaxed. 

Dr. Nicole Beurkens: 

That’s a great point, and yeah, that alternate nostril breathing works really well for so many people. I find that with children, or even people who just are really disconnected from their body and struggling with what it feels like to take a deep breath, like you said, put your hand on your belly and practice working on expanding that. What I’ll do with younger kids is have them lie on the floor and put a small stuffed animal or something on their tummy and have them practice with just seeing can they move it up and down? Because I find that once kids can get that feel, that connection, of what that means and what that is, then you can start working with it, but a lot of them haven’t had the opportunity to even learn how to do that or what that feels like.

Dr. Navaz Habib: 

Yeah, most of us, actually, and this is a really interesting kind of point, but most of us have trained ourselves to breathe with our upper backs, shoulders and with our accessory muscles because the idea of a big belly is one of those things that it’s a negative connotation that our bellies should not be protruding, they should be flat. And that in itself, actually stops people from breathing correctly, because hey, we want to keep our bellies in, it’s not a good look to have that. And a lot of us have, as children, very young, are training ourselves to breathe incorrectly. And that’s why, so many of us, as we grow up, as teenagers and young adults and as we get into adulthood, have such tight muscles across our upper backs and shoulders. And like anybody who has tight traps really is probably using them for breathing more than they’re using them the way that they should be used, and that’s why oftentimes they’re so tight, and that’s why so many people hold their stress in those specific muscles. 

Dr. Nicole Beurkens: 

Interesting. How — so if you were to say, okay, somebody is saying, “I want to work on this for myself, for my child, some of this breathing.” Do you have a specific amount of time or a certain number of times a day that you recommend for people to just do some sort of conscious practice with their breathing?

Dr. Navaz Habib: 

I like the idea of three times a day because it’s not intruding on your day, on your life so much. But I also like to pick out, if there are moments where you feel extra stress, then doing three to five-second deep breathing practice for one minute could be really, really beneficial. So I like to start the day with breathing practice, laying in bed, just wake up and say “Okay, today is going to be a great day, I’m going to breathe in positivity and breathe out negativity.” Doing something along those lines and then ending the day with that. So bookending the day is a great place, and then as well, I like to do it kind of around lunch or right around that meal in the middle of the day because what it’s going to do is it’s going to get you again, calm, relaxed, allows the digestive system to start up. So I think three times a day is probably good if you’re able to do it four or five times, every time you’re having a meal, anytime there’s a stressful event that comes up and you’re mindfully just remembering, “I need to shift this, I need to get myself a little bit more relaxed,” then that’s another great time to do it. 

Dr. Nicole Beurkens: 

Awesome. So deep breathing is one really powerful tool for supporting vagus nerve function. What other things can we do?

Dr. Navaz Habib: 

So I’ll tell you a couple of the fun things that I do with my daughter, I have a two and a half-year-old daughter, I might have mentioned earlier. But with her, what I like to do is a couple of different exercises, so before a meal for example, oftentimes, especially when she’s feeling really stressed out or really amped up after having a fun playdate with one of her friends, what we’ll often do is have her sit at the table and we’ll hum. We’ll actually use our muscles around our throat, around our vocal cords and do some humming and get us into a calm state. So just a gentle “Mmmmm” right before a meal, do it for about 10 to 30 seconds. Initially, my daughter would look at me with really odd eyes to say, “What are you doing” and more than likely, if you’re doing this with your kids or anybody else is doing it with their kids, you’re going to get that reaction. But isn’t that a kind of a fun thing to do? Kids like to do things that are out of the ordinary, they like to create a bit of a memorable experience in that way. So humming before meals is something that you can do, or just doing some deep breathing or humming right before a meal is a great way to get kids into that calm state. Really get them to resonate those muscles, get them working, stimulate the vagus nerve accordingly and get you just down again, ready for that digestion to occur.

Dr. Nicole Beurkens: 

Because as you mentioned that the back of the throat is one of the few ways that we can directly impact the vagus nerve, right? So that humming, that vibration helps with that. 

Dr. Navaz Habib: 

Yeah. Vibration in and around the vocal cords is completely and 100% directed by a branch of the vagus nerve. Two branches in fact of the vagus nerve, and so if you’ve ever thought back to meditation and the practices in India, way back, the Hindu practice of saying “Om” while you’re meditating, that “Om”, that vibration that’s occurring is actually stimulating those specific muscles again. And it’s actually been shown to be very effective in getting you a little bit deeper into that parasympathetic state. And so, that humming is really beneficial. So in combination with deep breathing and meditation, for example, we’re just adding an extra layer and an extra complexity, but it’s very effective when used on their own and especially with kids. It’s difficult to get them to sit down and cross legs and say “Om”, but get them starting to hum and do some humming or chanting right before a meal can be very, very effective. 

Dr. Nicole Beurkens:

Well the thing that’s cool about humming is you can do that anywhere, right? You can do that in the car with kids, you can do that at bedtime, so it’s really versatile. That and breathing are things that you always have the capacity to do those anywhere, so those are really versatile strategies. I know that you talk about, in the book, also speaking of the back of the throat and activating that, you talk about gargling, which I know can be a little tricky for young kids, but talk about how gargling can be helpful.

Dr. Navaz Habib: 

It’s funny you bring that up. So yes, I do that with my daughter every morning as well. There’s a little bit of a gargle, she can’t do the gargling to the point where I would want her to, but we’re starting her at this point. So as kids become probably four or five years old, it’s probably a little bit easier to do this. I recommend that everybody do this. I do it myself. I’ve got a glass sitting beside my sink for morning and evening. So every time I’m brushing my teeth, I make sure that I’m going to gargle as well, and that helps to get everything kind of calmed down. So when I gargle, what I’m doing is I’m taking a little bit of warm water in my glass, adding a little bit of salt because of the beneficial antibacterial effects of that, breaking up some of the plaque in the back of the mouth, and then I’m going to gargle. I’m going to take a sip and then I’m going to hold it in the back of my throat, but I’m going to gargle as hard as I can. 

And the key to this is you know you’re doing it effectively and efficiently when you actually start to tear from your eyes. So gargling on its own, just doing a kind of basic small gargle is not effective in getting these muscles working. Gargling is really effective because A, you have to keep your airway open and B, you have to hold the water away from it. So gargling is one of those things that stimulates both the airway muscles and the laryngeal muscles together while still holding water in your mouth so that you don’t swallow and aspirate that. So it’s very important to use this as kind of a step up, a level up. So kids that are two years old, three years old, it might be a little bit more difficult. And yet, what I’ll do with my daughter is I’ll just give her some water and I’ll say, “Swish it around in your mouth and say Ahhhhhhh and spit it out”. At least we get that practice going, even when they’re that young. 

Dr. Nicole Beurkens: 

Yeah, And I’ve had some patients who have had remarkable benefit from this when I just start them on a simple gargling practice, they kind of look at you like, “Oh, right, like this is going to do anything.” But they’re amazed at how much more calm, especially some of these teens and young adults with just chronically high levels of anxiety and panic. They wake up in the morning and they’re already worked up, and that gargling practice in the morning and then again before bedtime, they come back and it’s just like, “Oh my goodness, I can’t even believe that that makes a difference, but it does, I feel so much better.” 

Dr. Navaz Habib: 

Yeah, the gargling practice is one of the most effective that I’ve seen and definitely a top recommendation for everybody that comes into the office with anything remotely inflammatory going on in their body. 

Dr. Nicole Beurkens: 

And then, I know that you also talk a little bit about music and how music can be helpful. So I want to make sure we touch on that before we wrap up.

Dr. Navaz Habib: 

Of course. Music is one of those things we tend to listen to to get us amped up when necessary, when we want to work out. But it’s also something that’s very calming and it has a different effect, it has an effect through our auditory system and through our temporal lobe in the brain. But there are certain types of music, there are certain rhythms, there are certain tones that actually get us relaxed and so in the book, there were some very — In the research that I was doing, I came across a couple of really interesting points. So classical music, actually, was shown to be very effective in relaxing us and calming us and stimulating heart rate variability and vagus nerve function and Mozart was found to be the most effective, listening to Mozart’s music, for whatever reason, helps to bring that down. 

But really what was funny was that there was a single piece by Mozart that stuck out and had higher HRV levels than any other piece, any other composition, that was K448, two pianos, and that was just — when I was going through this, I was so intrigued by this, I would turn it on while writing the book, and I actually noticed it kept me very relaxed, it kept me very low and able to kind of stay in my executive function and in my prefrontal cortex, which was really cool. So that’s a really easy way to kind of just turn on music in the background, I know I tend to — when I studied in school, I needed music in the background to just keep me kind of focused, and instrumental music does really great things for a lot of people. So something like that, just in the background. I know it’s on YouTube, it’s like a 22-minute piece, I believe, but it’s really great for just kind of background, calming, relaxing, and listening to music is great for kids as well, teaching them not only to get calm but also music has such beneficial effects on so many different things in our lives. 

Dr. Nicole Beurkens: 

And I feel like you’ve mentioned to me before about something that you listen to with your daughter who is younger. Is it birds chirping? I want to make sure that I mention that because I find that so interesting and some parents may find that really helpful. 

Dr. Navaz Habib: 

Yeah, this was a really cool thing that my daughter actually picked up from her school when she was in her toddler program when she was very young. What they would do once a day to get all the kids calm, relaxed after being all riled up for many hours was they would have all the kids lie down on the ground and say, “Okay, we’re going to listen to birds chirping, we’re going to do a bird chirping meditation”, and they would just turn on nature sounds with birds chirping and essentially all the kids had to lay down and they would hear and they would listen for when the birds were chirping, and when they’d hear it, they were just very excited to say, “Oh I heard the bird chirping.” So you had to be quiet because you can’t talk when the birds are chirping, or else nobody else is going to be able to hear it, so they were just laying there with smiles on their faces. My daughter loves doing that. Anytime she gets riled up, that’s something that we’ll always lean on, is just turning on the birds on YouTube or whatever and listening to that bird meditation to get her really, really relaxed. Often very good before bed as well to get her calmed down. 

Dr. Nicole Beurkens: 

Such great, practical strategies for supporting vagus nerve function, things that we can do for ourselves, for our kids, anytime anywhere, so really practical strategies, thank you for those. And I think that for parents, if you’re listening and you’ve been doing a lot of these sort of functional medicine strategies, working on healing your child’s gut, all of those things, these strategies related to the vagus nerve are just going to enhance that. And some people have been doing a lot of that for a while and feel like they’re not getting where they need to get, and I think this, as you said, is the missing piece of that. For those of you that haven’t delved into any of this at all, these are just some great entry points, I think, into helping support your child whether they have a diagnosis or not, helping to support yourself — we can all use strategies that just help our brain and body be more adaptable and more responsive to stress in healthy ways and just help us manage all of that. So I think the book really runs the gamut of really, really usable information for anybody. And I know that people can get it on Amazon and your website. What is your website so that people can go there for more information about you?

Dr. Navaz Habib: 

Yeah, you can go to healthupgraded.com or you can go to drhabib.ca and everything has links to the book information. There are some bonus interviews that I did as well, so if you go to vagusnervebook.com, you’ll also — if you just put in your email, you’ll get access to these 4 bonus interviews that I did with some very special people with a ton of information on how functional medicine affects vagus nerve and how we can use it as well, affecting your space — I speak to a couple of people, one specifically about feng shui and how it can have a positive effect on stress and vagus nerve and then even visceral manipulation and other tools we can use to help improve the function of the nerve as well. 

Dr. Nicole Beurkens: 

Awesome and so many blog posts and just great resources on your website as well. We’ll make sure to include all of those links in the show notes that people can access those. Dr. Navaz, I just want to thank you so much for being with us today. This has been a wealth of information, some really practical strategies, thank you so much for sharing that with us. 

Dr. Navaz Habib: 

My absolute pleasure, thank you so much for the opportunity. 

Dr. Nicole Beurkens: 

And thanks to all of you for listening, we’ll see you back here for our next episode of The Better Behavior Show.