Series: Understanding Neuromodulation – An Evidence-Based Pathway to Self-Regulation 08
DESCRIPTION:
Vagus nerve stimulation (VNS) helps with conditions such as depression, ADHD, autism, chronic pain, cognitive decline and post-viral fatigue. Non-invasive, with few side effects and scientifically proven: everything you need to know about the effectiveness, clinical application and benefits of non-invasive taVNS – for greater inner peace, focus and quality of life for patients in everyday life.
Introduction to the series
The regulation of our autonomic nervous system is at the centre of many modern health debates – but there is often a huge gap between viral biohacks and sound science. This new blog series is dedicated to closing that gap. Step by step, chapter by chapter, we will show you how the nervous system, self-regulation and neuromodulation really work together – based on evidence-based research, not marketing promises.
These articles pave the way for a larger project to be published at the end of the year: a practical guide for people with post-viral syndromes, chronic fatigue, attention problems or psychosomatic complaints – and for anyone who wants to learn to trust their nervous system.
What you can expect:
Each article in this series focuses on a chapter from the upcoming book. We shed light on the basics of the autonomic nervous system, debunk common myths, present scientifically proven methods for neuromodulation, and show how to implement practical strategies in everyday life. Whether you are new to the topic or already have experience with topics such as vagus nerve stimulation, HRV measurement or polyvagal theory, this series offers guidance, clarification and concrete steps for action.
1. Changing the nervous system? A critical introduction to the topic of self-regulation.
2. How your nervous system really works.
3. Why many theories are more hypothesis than help.
4. What scientifically validated neuromodulation can achieve today.
5. Misconceptions about HRV, vagus and biohacking revealed.
6. Practical strategies for better regulation in everyday life.
7. How to develop your own individual self-regulation concept.
Future special chapters:
• The science of neuromodulation – A deeper insight into taVNS and related methods.
• Exercise as therapy – How targeted training strengthens the brain.
• Syndrome-specific strategies – Long COVID, ADHD, CPTSD, chronic pain & cognitive decline.
Stay tuned – because knowledge is the best foundation for trust in your own body. And trust is the first step towards healing.
Vagus nerve stimulation (VNS): Neuromodulation, invasive and non- e invasive stimulation of the vagus nerve for certain diseases and disorders
Vagus nerve stimulation (VNS) is a form of neuromodulation that is becoming increasingly important. Stimulation of the vagus nerve can be used to treat various neurological and mental illnesses and disorders, which can lead to a significant improvement in symptoms.
Vagus stimulation with implantable devices has been used for some time for specific diagnoses such as:
· Epilepsy: Vagus nerve stimulation can reduce seizures and improve patients' quality of life.
· Depression: This method can help alleviate symptoms in cases of treatment-resistant depression.
· Chronic pain: Stimulation of the vagus nerve can help modulate pain sensations.
· Inflammatory diseases: Some studies show that vagus nerve stimulation can have anti-inflammatory effects.
What it's all about:
· Areas of application for vagus nerve stimulation in certain disorders and diseases
· Positive effects on improving the quality of life of those affected
Vagus nerve stimulation (VNS) – A specific form of neuromodulation
Vagus nerve stimulation (VNS) is a targeted neuroelectric intervention that aims to influence the functioning of the autonomic nervous system. It focuses on the vagus nerve, the tenth and longest cranial nerve in the body. It runs through the neck, chest and abdomen, innervates vital organs such as the heart, lungs, gastrointestinal tract and liver, and transmits bidirectional signals between the body and the brain. Approximately 80% of the vagal fibres are afferent, i.e. ascending: they transport information from the body to the brain, not vice versa.
Therapeutic vagus nerve stimulation was first established in the treatment of therapy-resistant epilepsy. In this context, an implanted device has been used since the 1990s, which sends targeted impulses to the left vagus nerve in the throat via an insulated wire. Over the past two decades, however, a much broader profile of the method has emerged that goes far beyond epilepsy – particularly in chronic pain, depression, anxiety disorders, cognitive impairments and post-infectious syndromes.
Parallel to the invasive technique, transcutaneous auricular vagus nerve stimulation (taVNS) was developed: a non-invasive procedure in which mild electrical impulses are applied to the outer ear – more precisely, to the cymba conchae or adjacent areas. This auricular region has dense vagal innervation, so that stimulation through the skin has a similar effect on central vagus-mediated brain areas as its implanted counterpart – without surgical intervention, without anaesthesia and with ease of use in everyday life.
Objective of VNS
The central goal of VNS is to modulate the autonomic nervous system, with a particular focus on parasympathetic activation. The vagus nerve is a key player in the parasympathetic system, the branch of the autonomic nervous system responsible for recovery, regeneration and homeostasis. Electrical stimulation generates signals that trigger profound regulatory processes:
· Reduction of sympathetic overactivity (e.g. in chronic stress, panic or hyperarousal)
· Stabilisation of heart rate variability (HRV) as a marker of vagal flexibility,
· Promotion of anti-inflammatory processes through activation of the cholinergic anti-inflammatory reflex,
· Attenuation of central pain processing via modulation of thalamic and limbic pathways,
· Improvement of memory, attention and executive functions through reorganisation of prefrontal networks.
Unlike pharmacological methods, this modulation is not pharmacodynamic, but electrical – via targeted impulses whose frequency, intensity and duration can be individually adjusted. Electrical stimulation of the vagus nerve does not have a localised effect, but rather a systemic one: it not only addresses isolated symptoms, but also changes the functioning of entire neural circuits – across the brain stem, limbic system and cortical integration centres.
Level of effect: self-regulation instead of symptom suppression
VNS does not aim for short-term control, but rather for the long-term restoration of inner rhythms. It creates a physiological environment in which the body can return from a state of chronic alertness, functional fragmentation or exhaustion to a regulatable dynamic. The decisive factor here is that the stimulation does not act as an external control, but as a somatic signal that offers the nervous system an alternative to the dysregulated pattern.
Especially in states where language, insight or cognitive strategies are blocked – such as in trauma, brain fog, vegetative dysregulation or post-viral exhaustion – VNS offers non-verbal access to security, repeatability and gentle activation. It does not work through cognitive control, but through bottom-up modulation – via the body to the brain, via rhythm to integration.
VNS as a gateway to neurophysiological dialogue
Whether invasive or transcutaneous, vagus nerve stimulation is not a substitute for therapeutic relationships, reflection or medication. Nor is it a neurological panacea. Its value lies elsewhere: in inviting us to reconnect with the biological rhythms that have been disrupted by trauma, chronic stress or chronic dysregulation. As a repeatable, controllable, physically anchored signal, it does not promote functioning, but rather the availability of the body for regulation – and this is precisely where its therapeutic potential lies.
Vagus nerve stimulation and neuromodulation – similarities and differences
Vagus nerve stimulation (VNS) is a specific form of neuromodulation in which the vagus nerve, the longest cranial nerve, is electrically stimulated. Neuromodulation encompasses a broader spectrum of medical procedures that aim to influence the activity of the nervous system. While other neuromodulation procedures such as deep brain stimulation intervene more directly in the brain, VNS works indirectly by using the activation of the vagus nerve to influence neural modulation in the brain. Both aim to stimulate and positively influence neural function.
Conditions and disorders that VNS/neuromodulation helps with
Vagus nerve stimulation has emerged as a promising therapeutic option for a range of conditions and disorders. VNS was originally developed as an e treatment for epilepsy, particularly in patients who do not respond adequately to medication. The effectiveness of VNS is now also being investigated for depression, anxiety disorders, chronic pain and even for the treatment of long COVID. The ability of vagus nerve stimulation to influence the autonomic nervous system makes it a valuable tool in the treatment of complex, often chronic health problems characterised by an imbalance in the nervous system.
Infectious diseases, post-vaccination syndrome, ME/CFS
Vagus nerve stimulation shows particular potential in post-infectious, post-immunological and neuroinflammatory conditions such as post-vaccination syndrome, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the long COVID spectrum. These conditions are often characterised by persistent dysregulation of the autonomic nervous system, a chronic low-grade inflammatory response and impaired cellular energy supply.
Typical symptoms include:
· Fatigue/exhaustion – regardless of rest or sleep
· Post-exertional malaise (PEM) – severe deterioration after minimal exertion
· Brain fog – slowed thinking, word-finding difficulties, cognitive fluctuations
· Dysautonomia – circulatory instability, orthostatic intolerance, tachycardia
· Sensitivity to stimuli – to light, noise, movement, social contact
· Reactive sleep disorders – problems falling asleep, fragmented deep sleep, non-restorative sleep
In this constellation of symptoms, VNS does not aim to improve performance, but rather to restore basic regulatory functions. It acts as a gentle stimulus on an overstimulated and exhausted nervous system that is no longer able to flexibly switch between activity and rest. It is not the dose that is decisive, but rather the regularity, timing and rhythm.
Objective of VNS in post-infectious systemic dysregulation
In this context, VNS serves as a low-threshold approach to reorganising vegetative signals and works in the following three core areas:
1. Gentle parasympathetic inputs
taVNS should be used daily – preferably 1–2 times a day for 15 minutes – in a quiet environment, ideally combined with calming routines such as making tea, journaling or mindful breathing (e.g. 4:6 breathing pattern). VNS does not require prior relaxation, but rather enables it by providing a repeatable signal of safety.
2. Rhythmic physical activity
Since post-infectious conditions are often accompanied by a loss of stress balance, exercise is divided into small, plannable units (e.g. 3–5 minutes of sitting and stretching or 2 minutes of walking with music). VNS stabilises the system before and after these micro-units. The goal is not physical performance, but rather the development of a resilient framework without crash.
3. Cognitive relief through stimulus management
People with ME/CFS or long COVID often show pronounced stimulus intolerance and cognitive exhaustion. Instead of keeping symptom logs or using tracking apps, "benevolent observation" is recommended. VNS supports the ability to decode stimuli as non-threatening rather than threatening, especially when combined with a reduction in visual, auditory and cognitive overload.
Structured application in the first 2 weeks
The following is recommended throughout the day:
Period | Measure |
Morning | taVNS + tea ritual or 5 minutes of journaling |
Light stretching while seated (e.g. shoulder circles) | |
Lunch | Brief stimulus protection: light filters, earplugs, no multitasking |
Mini walk or music with eyes closed | |
Even | No screens 30 minutes before bedtime |
taVNS + listen to poetry or do voice exercises (humming) |
Daily use is not intended as a training plan, but rather as a framework for regeneration. Stimuli are deliberately reduced, transitions are made predictable and optimised in a non-measurable way, but rather adjusted sensitively.
Progress indicators
No quantifiable progress is to be expected in this phase – rather, the effect is evident in the form of:
· Reduced vegetative rebound after brief activity (fewer crashes)
· Prolonged stable waking phases without sensory overload
· less anxiety about routine tasks, even if objective performance remains unchanged
· Easier access to rest without exhaustion remaining dominant
It is crucial that progress is not confused with a return to baseline performance. VNS is not intended to restore an old state, but to build a new, sustainable physiological foundation – one that enables healing rather than demanding excessive performance.
Autism in adults
Autistic adults often do not primarily report "social deficits," but rather permanent vegetative overload: due to unpredictable stimuli, unstable rhythms, social interactions, sensory inconsistencies and the lack of safe transitions. Symptoms range from shutdowns, social withdrawal and physical exhaustion to executive function impairments, poor stimulus filtering and emotional overstimulation.
Transcutaneous auricular vagus nerve stimulation (taVNS) offers a novel, non-cognitively overloaded tool for self-regulation. VNS does not affect behaviour, but rather the basic vegetative tone, thereby creating space for presence, clarity and reconnection to the body. Its use is particularly relevant in combination with micro-routines, stimulus protection and a rhythmic daily structure.
Objectives of VNS in autism in adults
The application targets three core areas:
1. Stimulus stabilisation – downregulating the system to such an extent that stimuli can be reintegrated without overload.
2. Transition ability – facilitating the transition between states (e.g. work – break, contact – withdrawal) without dissociation.
3. Rhythm coordination – using rituals, repeatability and body-based rhythms to build predictability.
VNS does not replace therapy or social training – it makes the system available on which other skills can build.
Specific application (weeks 1–2): Start phase for greater vegetative stability
The initial phase serves to establish a physiological basis for stimulus processing, self-calming and interaction buffering.
What | How | Goal |
taVNS | 15 minutes per day, coupled with breathing rhythm (e.g. 4–6 breaths/min.). Timing: before/after social contact, therapy or mental stress. | Avoid crash-and-burn cycles, regulate transitions. |
Exercise | 5–10 minutes rhythmically (e.g. walking to music, gentle rocking, metronome), at the same time every day. | Sensory integration, reduction of stimulus vigilance |
Self-care | "Daily window" with self-directed activity without productivity requirements (e.g. sketching, folding, tidying up, resting). | Strengthen autonomy without pressure to make decisions. |
Emotional anchoring | Use your voice: humming, reading, talking quietly to yourself, contact with animals. | Activation without social overload, affective re-regulation. |
Daily structure (weeks 1–2): Stimulus reduction, Rhythm, enable reaction
Time of day | What | Observation |
Morning | taVNS + 5 minutes of breathing, diary or light housework | Is it possible to start without sensory overload? |
Mid | 5 minutes of rhythmic movement or rocking, short text message or audio message | Is contact possible without exhaustion? |
Afternoon | Daily window: quiet activity without exertion. Practise describing your state in three words | Recognise reactivity vs. regulatory ability |
Even | Humming, reading aloud, music (sound anchoring), stretching or resting with a weighted blanket | Easier to fall asleep? Less physical tension? |
Weeks 3–4: Gentle expansion – without overdoing it
After two weeks of basic stabilisation, you can gradually test what the system can tolerate without overloading it.
What | How |
taVNS | Use after social interactions or cognitive stress (e.g. email, shopping). |
Movement | Extend rhythmic walking by 2–3 minutes, combined with rhythm (e.g. naming colours). |
Self-care | Prepare three "options" for the daily window, e.g. listen to a text, draw, rest. |
Anchoring | Listen to a voice recording (e.g. a calming text in your own voice), send yourself an audio message. |
Do not measure progress by performance
· Fewer sensory overload episodes after social contact or sensory overload
· Better ability to name one's own states (even without a solution)
· Increased availability for transitions without stimulus avoidance
· Benevolent handling of boundaries, even if no improvement is noticeable
VNS does not "eliminate" irritability. It creates the possibility of not breaking down in the face of what is there – and perhaps even regaining some leeway.
ADHD in adults
Attention deficit hyperactivity disorder (ADHD) manifests itself differently in adults than in children – more subtly, but no less debilitating. Characteristic symptoms include chronic distractibility, inner restlessness, impulsivity, disorganisation, but also motivational blocks, fatigue after short periods of mental activity and a pronounced instability in daily rhythms. It is becoming increasingly clear that ADHD is not just an attention disorder, but a regulatory disorder of the autonomic nervous system.
This is where vagus nerve stimulation (VNS) comes in as a promising neuromodulatory approach – non-medicinal, non-invasive and focused on vegetative rhythmisation. Transcutaneous auricular vagus nerve stimulation (taVNS) in particular is increasingly becoming the focus of research in adults with ADHD.
Neurophysiological background
Adults with ADHD often exhibit:
· reduced vagal flexibility (e.g. low heart rate variability, impaired stimulus processing),
· increased sympathetic arousal with chronic feelings of internal stress,
· delayed initiation of action (executive inertia) despite good ideas or intentions,
· emotional reactivity with a tendency to frustration, shame or withdrawal.
Vagus nerve stimulation has a stabilising effect on precisely these patterns by strengthening the parasympathetic nervous system. Via the projections of the vagus nerve in the The locus coeruleus is an important nerve that can be modulated by vagus nerve stimulation. (noradrenaline), which The limbic system plays a crucial role in processing emotions and is influenced by vagus nerve stimulation. (affect regulation) and the prefrontal cortex (action planning), the functional basis of ADHD problems can be addressed directly – without overriding or requiring cognition.
Hypotheses and studies
Early studies on the use of taVNS in adults with ADHD show:
· improved task initiation, especially in activities without external pressure,
· better affect regulation after interruptions or frustration,
· prolonged cognitive attention spans without exhaustion,
· fewer crash cycles after intense concentration or social activity.
Imaging studies and EEG data indicate a normalisation of frontal oscillations and increased connectivity between prefrontal, insular and sensorimotor areas. Cortical processing of external stimuli also becomes more efficient, which counteracts the sensory overload experienced by many people with ADHD.
Application in everyday life – integration into the daily routine
For adults with ADHD, taVNS is particularly suitable as an accompanying tool for structuring the daily routine. Recommended points of use are:
Time window | Effect & rationale |
Morning | 15–20 minutes of taVNS while having coffee, showering or planning. Promotes a calm start to the day instead of hectic activity. |
Before tasks | Use before activities that require concentration (e.g. emails, accounting, conversations). Strengthens motivation and frustration tolerance. |
Afternoon | tVNS + mini-break in case of sensory overload, tiredness or social exhaustion. |
Evenings | Optional for calming down: combined with breathing, stretching, journaling. |
Combining it with meaningful anchors (e.g. body – task – break) increases its effectiveness. The effect is not spectacular, but cumulative: more days begin with rhythm and end without sensory overload. The decisive factor is not performance, but the reduction of transition friction.
AuDHS: Autism and ADHD in adulthood
Adults with pronounced characteristics of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) do not exhibit an additive but rather a dynamically intertwined functional profile, which is increasingly described by the term AuDHS. This constellation is neither rare nor marginal – but it has often been overlooked in the past because the symptoms partly compensate for each other and partly reinforce each other.
The underlying neurophysiological problem lies in simultaneous over-excitation and instability of the autonomic nervous system, combined with fragmented sensory integration. Two seemingly contradictory response patterns coexist in the same system:
On the one hand: sensory sensitivity, social withdrawal, stimulus avoidance (autistic).
On the other hand: stimulus-seeking behaviour, impulsive outbursts, chronic rhythm deficit (typical of ADHD).
This combination leads to a paradoxical everyday profile with rapid shifts between:
· hyperfocus and cognitive exhaustion,
· emotional self-monitoring and sudden impulsive outbursts,
· social withdrawal and contact overload,
· detailed stimulus perception and executive disintegration.
Those affected often experience themselves as both "too much" and "too little" at the same time, react to social demands with ambivalent overshooting or shutdown, and struggle with chronic frustration because their nervous system does not appear to be fully regulated in any environment.
Function of taVNS in AuDHS: a vegetative bridge between two areas of tension
Transcutaneous auricular vagus nerve stimulation (taVNS) acts on both parts of this tension field:
1. It addresses the overactive, stimulus-seeking nervous system (ADHD component) by promoting parasympathetic activity, lengthening the stimulus processing span and stabilising impulse control.
2. At the same time, it supports the overloaded, stimulus-avoiding system (ASD component) by reducing sensory hyperreactivity, promoting rhythmic body awareness and improving transition skills (e.g. from thinking to acting, from contact to withdrawal).
This dual effect makes taVNS a rare non-cognitive tool that can have both a relieving and activating effect – without internal overload or therapeutic pressure.
Recommended use: structured co-regulation without effort
In practical application for AuDHS, daily use has proven effective, targeting critical zones throughout the day:
Time | Application | Goal |
Morning | taVNS + calm start (e.g. with music, tea, light) | Avoidance of hyperactive cold start or cognitive "freezing" |
Before periods of stimulation | 10–15 min taVNS + physical routine | Stabilisation before social, auditory or administrative stimuli |
After overload | taVNS + passive ritual (e.g. with weights, blanket, sound recording) | Return from shutdown or dissociation without language |
In the evening | taVNS + physical contact, breathing or humming | Facilitate transition to rest mode, reduce barriers to switching off |
In weeks 1–2, consistent combination with stimulus protection (light, sound, multitasking) and conscious relief of executive control (no to-do lists, no tracking, no monitoring) is recommended.
From week 3–4, the application can be used specifically before transitions between activities or when sensory overload begins. Progress indicators are no longer productivity, but reduced system crashes, improved reaction flexibility and an increasingly benevolent inner perception, even in states of tension.
Limitations and special aspects of AuDHS
The combination of openness to stimuli and impulsive pressure requires precise dosing of stimulation. Too much or too intense application can increase restlessness.
The effect is not linear, but rather depends on regularity rather than intensity.
In environments with high social expectations (e.g. work context), taVNS can help to take a functional break rather than compensating in a non-functional way – without breaking down.
High sensitivity
High sensitivity (HSP) is characterised by a particularly intense reaction to sensory, emotional and social stimuli. Perception is not impaired, but refined – often without sufficient neural filtering and buffering mechanisms. As a result, even everyday situations (loud environments, social dynamics, time pressure, emotional tension) quickly become unbearable, which can manifest itself in chronic tension, withdrawal, overwhelm or stimulus avoidance. Many affected individuals do not experience themselves as "sensitive," but rather as constantly overwhelmed, internally hyperactive and externally exhausted.
From a neuroscientific perspective, highly sensitive people often show increased cortical sensitivity to stimuli combined with reduced central inhibition – particularly in the thalamic-cortical loop, which is responsible for filtering stimuli. The autonomic nervous system often responds to this abundance of stimuli with sympathetic activation – a physiological stress response that is triggered even when demands are low.
Potential benefits of VNS for high sensitivity
Transcutaneous auricular vagus nerve stimulation (taVNS) does not offer attenuation in this context, but rather a physiological regulatory structure: a repeatable, predictable vegetative signal that reminds the system not to be constantly on alert for threats. It does not act cognitively, but at the level of stimulus evaluation and stimulus transmission.
· Key effects of taVNS in high sensitivity could include:
· Improved stimulus filtering through modulation of thalamocortical networks
· Reduction of stimulus-response coupling – i.e. more reaction time between perception and action
· Stabilisation of the parasympathetic counterbalance – especially in social or sensory-rich environments
· Relief of interoceptive overidentification (e.g. in cases of strong reactions to other moods, tensions or atmospheres)
Practical application (weeks 1–2)
Highly sensitive adults benefit particularly from ritualised, low-stimulus application of taVNS – not for "calming", but to limit diffuse tension:
Time | Application | Goal |
Morning | taVNS + tea, daylight, quiet humming | Start without sensory overload |
Before stimulating phases | taVNS + gentle preparation (e.g. tidy clothes, take a break beforehand) | Buffer before work, conversations, social interactions |
After overload | taVNS + noise reduction, weighted blanket, place of retreat | Stimulus binding after event, avoidance of crash |
In the evening | taVNS + quiet music or text with a focus on rhythm | Transition to sleep without restimulation |
Important: High sensitivity often means that therapeutic interventions can also have too strong an effect. Therefore, the initial frequency should be low (once a day, max. 10–15 minutes) and not linked to performance goals.
Weeks 3–4: Permission to expand
After about two weeks, you can carefully check whether and when the system is stable enough to integrate new application points:
Before social contacts with emotional content (e.g. family visits, meetings)
After media consumption or news overload
In combination with physical self-awareness (stretching, breathing, music)
To decouple stimulus and behaviour – e.g. before responding to something that has triggered you
Progress indicators
For highly sensitive people, "success" is not measured in resilience, but in:
· Increased ability to recover after exposure to stimuli
· Reduced internal flooding response to new, complex or ambiguous situations
· Faster return to one's own rhythm after interruptions
· Less stimulus avoidance without having to overcome oneself
VNS does not replace coaching or psychoeducation – but it creates a vegetative basis on which sensitive, forward-looking self-control becomes possible without constant energy loss.
CPTSD and childhood trauma
Complex post-traumatic stress disorder (CPTSD) does not arise from a single event, but from repeated, often subtle or chronic experiences of violence – frequently beginning in childhood. These include emotional neglect, inconsistent attachment, psychological or physical violence, sexualised boundary violations or continued devaluation. The resulting symptoms go far beyond classic trauma reactions and affect fundamental dimensions of the self: affect regulation, self-perception, relationship formation, behavioural coherence and the ability to anchor oneself internally in one's own body.
At the heart of CPTSD is a learned separation between physiological alertness and psychological capacity to act. Many sufferers experience themselves as either functionally "disconnected" or overwhelmed – with no intermediate state. This is where transcutaneous vagus nerve stimulation (taVNS) comes in as a non-verbal, body-based regulation method: it works where language fails – on vegetative coordination, on the affective threshold and on the fragmented perception of internal states.
How taVNS works in CPTSD
taVNS addresses central symptom clusters that are often only achievable to a limited extent with conventional interventions:
· Hypervigilance (constant alertness, sleep disorders, sensory overload):
VNS can buffer the sympathetic overdrive system via parasympathetic activation.
· Emotional shutdown and dissociation (emotional numbness, depersonalisation, freezing):
Regular vagal inputs provide a physiological counterbalance to the freeze response.
· Spirals of shame and self-deprecation:
VNS has a stabilising effect on limbic-vagal networks that are linked to anxiety, shame and self-image.
· Relationship trauma and affect decoupling:
The vagus nerve plays a central role in the social engagement system (Porges). Rhythmic stimulation can help to better coordinate contact and withdrawal impulses.
Weeks 1–2: Reconnection without overwhelming
The focus of the initial phase is on safety, repetition and predictability – not on dealing with traumatic content.
What | How | Goal |
taVNS | 15 minutes/day, coupled with breathing rhythm (e.g. 4–6 breaths/minute). Use before/after contact, therapy or emotional work. | Prevention of collapse or panic reactions |
Rhythmic movement | 5–10 minutes: gentle walking, rocking, swaying, optionally with music/metronome. | Sensory integration, lowering the threshold for sensory overload |
Self-care | "Daily time slot" for purposeless activities (e.g. folding, resting, drawing) | Self-control without conflicting goals |
Emotional anchoring | Use of voice (e.g. humming, reading aloud quietly, speaking to oneself in a monotone voice or contact with animals) | Reactivation of presence without the burden of dialogue |
Important: taVNS does not replace "coping". It helps to regain access to your inner state and regulation – not through control, but through repetition.
Daily structure (weeks 1–2)
Time | What | Observation |
Morning | taVNS + 5 minutes of breathing or journaling; light, body-oriented activity without a goal | tolerable start? Connection to the start of the day noticeable? |
Mid | Rhythmic movement (walking, rocking), optional contact (e.g. text, voice message) | Is contact possible without sensory overload? |
After | "Quiet time" for free activity; name perceptions (e.g. three words to describe state) | Opportunity for reflection without escalation? |
Even | Humming, reading aloud or quiet music; stretching or weight stimulation (blanket) | Better sleep? Less reverberation of stimuli? |
Weeks 3–4: Capacity building without pressure to perform
After initial stabilisation, the application can be expanded to specifically target systemically challenging areas:
What | How |
taVNS | After social contact or stimulating interactions for re-regulation. Alternatively, during quiet forms of therapy. |
Movement | Combination with linguistic rhythm: naming colours, counting while walking, consciously "listening to your steps". |
Self-care | Prepare three "options" – don't decide, but feel what is right for today. |
Anchoring | Record audio files with your own voice, listen to them passively. Self-connection without direct speech. |
Progress indicators
· CPTSD progress is not reflected in "stability", but in:
· Reduced crash reaction after social or internal contact
· Improved ability to "leave" the protective state
· Less compulsion to self-monitor
· A more benevolent relationship with one's own condition, even if it remains unstable
Chronic pain
Chronic pain is not merely a prolonged form of acute pain – it is a neurobiological phenomenon in its own right. Over weeks, months or years, the pain system itself changes: nerve cells fire continuously, the central nervous system overinterprets stimuli, and inflammation signals persist even though the original cause has long since subsided. This so-called central sensitisation causes even minor stimuli to be perceived as painful – often without visible tissue damage.
Vagus nerve stimulation (VNS) does not act on the cause of pain, but rather on the level of pain processing and modulation. Using electrical impulses – either invasively via an implanted device or non-invasively via transcutaneous auricular VNS (taVNS) – it influences autonomic regulation, pain inhibition at the spinal cord level and processing in areas of the brain such as the thalamus, insula and anterior cingulate cortex.
Effect of VNS on chronic pain conditions
Mode of action | Therapeutic effect |
Modulation of nociceptive pathways | Reduction in pain intensity and frequency |
Inhibition of pro-inflammatory cytokines | Reduction of chronic inflammatory activity ( ) in peripheral tissue |
Activation of the cholinergic inflammatory reflex | Calming of systemic immune overreactions |
Parasympathetic reactivation | Improvement of sleep, digestion, ability to recover |
Reorganisation of central pain processing | Interruption of dysfunctional neural pain loops |
Indications (clinical and experimental)
· Fibromyalgia: widespread muscle and soft tissue pain with vegetative instability
· Migraine: especially with aura or sensitivity to triggers
· Neuropathic pain: e.g. after surgery, in polyneuropathy, trigeminal neuralgia
· Musculoskeletal pain: chronic back pain, shoulder pain, tension headaches
· Rheumatic inflammatory diseases: as an additional intervention for inflammation modulation
Weeks 1–2: Use to stabilise pain and trigger patterns
Goal: not maximum pain relief, but restoration of reliable pain predictability and vegetative recovery ability.
What | How | Goal |
taVNS | 15 minutes before and after exercise sessions; optionally in the evening to promote deep sleep | Reduction in pain sensitivity, improvement in sleep quality |
Exercise | Water-based exercise (pool walking), isometric exercises (e.g. wall push-ups, holding exercises for large muscle groups) | Activation without straining the joints, restoration of functional mobility |
Breathing + stretching | Twice daily: 4:6 breathing (inhalation/exhalation), gentle mobilisation of hips, shoulders and spine | Reconnection to body signals, relaxation of specific pain areas |
Mood enhancement | Once a day: dancing, singing, laughing, walking with music | Activation of dopaminergic and endorphin systems, pain distraction |
Daily structure (weeks 1–2)
Time | Application | Goal |
Morning | 5 min breathing + stretching, taVNS before breakfast | Raise stimulus threshold, ease start to the day |
Mid | 5–10 min isometric exercise, possibly pool exercise | Maintain function, activate circulation |
After | Walk or move to music, no multitasking activities | Avoid sensory overload, maintain energy levels |
Even | taVNS + stretching, gratitude/comfort list (3 simple points) if necessary | Reduce pain levels, shift focus |
Weeks 3–4: Expansion and confidence in movement
Goal: greater freedom of movement with less fear of pain, without relapsing into overexertion.
taVNS | Continue 1–2 times daily, especially after exercise and before bedtime. Focus: Observe changes in sleep quality and pain feedback. |
Exercise | Extend isometric holds, incorporate light squats against the wall or Theraband exercises. If possible, start with movement exercises in water with coordination elements. |
Breathing/stretching | Combine breathing with tapping techniques or self-massage (body scan with touch) to integrate body image. |
Mood enhancement | Combine movement with gentle social contact (e.g. a walk together, shared playlist, contact with animals). Goal: to re-establish a positive association with physical activity. |
Progress indicators
· Predictability of pain reactions (fewer sudden flare-ups)
· Reduction in "flares" (shorter duration, lower intensity)
· Increase in enjoyable exercise (even if pain persists)
· Less avoidance behaviour, without excessive activism
Chronic pain is not only located in the tissue, but also in the overstimulated nervous system. Vagus nerve stimulation does not provide anaesthesia – but rather a daily invitation to reconnect with oneself without threat. It does not replace pain therapy, but it changes the inner workings of pain processing – quietly, rhythmically, reliably. And that is exactly what many chronic pain sufferers lack: reliability in their own bodies.
Mental decline
Cognitive decline encompasses a range of functional changes in memory, attention, language, orientation and problem-solving abilities that go beyond normal ageing – but do not always immediately progress to manifest dementia. Many sufferers initially experience episodic word-finding difficulties, reduced mental stamina, slowed thinking, confusion when faced with sensory overload or difficulty switching between tasks. The transition from subjective cognitive decline to mild cognitive impairment (MCI) and on to neurodegenerative diseases such as Alzheimer's is gradual.
Vagus nerve stimulation (VNS) is being investigated in this context as a potentially protective and activating measure. The transcutaneous variant (taVNS) in particular does not have a pharmacological effect, but rather works by rhythmically activating central- ly located brain regions that are crucial for attention, learning and memory consolidation, such as the prefrontal cortex, hippocampus, basal nucleus and thalamus.
Mechanisms of action of VNS in cognitive decline
Mode of action | Functional effect |
Activation of cholinergic pathways | Promotion of memory formation and selective attention |
Promotion of neuroplasticity | Stabilisation of cognitive networks, especially in the medial temporal lobe |
Improvement of cerebral blood flow | Increasing the supply of oxygen and nutrients to sensitive areas of the brain |
Regulating the autonomic nervous system | Promotion of stable sleep-wake cycles and daily structure |
Inflammation modulation | Reduction of neuroinflammatory processes that impair cognitive functions |
Target
VNS is particularly suitable for the following groups of people:
· Adults with subjective cognitive impairment
· People in the early stages of mild cognitive impairment (MCI)
· Relatives with genetic risk (e.g. ApoE4) for prevention and activation
· People with long COVID or post-viral conditions with "brain fog"
· People with early to moderate stages of neurodegenerative diseases – in combination with cognitive training, exercise or social activation
Weeks 1–2: Cognitive rhythmisation and vegetative relief
The aim is to reliably re-establish mental activity without overtaxing the brain through repetition and stimulus reduction.
What | How | Goal |
taVNS | 20 minutes daily during morning reading (e.g. light factual texts, poems), preferably in daylight | Synchronisation with daily rhythm, activation of frontal networks |
Exercise | Walk + naming game (e.g. colours, letters), 5 minutes of dancing or rhythmic movement | Promotion of motor-cognitive coupling, increase in BDNF |
Neuro-tasks | Alternating cognitive tasks: Sudoku, storytelling, creative writing + rest phase | Modulate stimulus dose, avoid cognitive fatigue |
Mental hygiene | "Device-free" hours (e.g. 9–11 a.m.); mini rituals before bedtime and meals (e.g. breathing + words) | Promote intentional state changes |
Daily structure (weeks 1–2)
Time of day | Anchoring | Observation tip |
Morning | 20 min taVNS + reading; gentle stretching, walk with music | Are your thoughts clearer? Are you searching less? |
Noon | Puzzle or easy administrative task; rest break (no screen) | Less exhausted afterwards? Words more readily available? |
Afternoon | Storytelling (e.g. what you have read/experienced), no multitasking window (1–2 hours) | Is your concentration more stable? Less mental fragmentation? |
Evening | Transition ritual (3 breaths + word); optional taVNS application before sleep | Easier to fall asleep? Less noise? |
Weeks 3–4: Building neural endurance without sensory overload
taVNS | Continue using once a day, new test: in the evening after mental exertion (e.g. a lot of screen work) to facilitate system reset |
Exercise | Add coordinative patterns (e.g. step+sound, balance exercises); integrate into everyday life (e.g. stairs, rhythm) |
Neurotasks | Memory training after listening (e.g. recapitulating content); cooperative tasks (e.g. crossword puzzles with a partner) |
Cognitive order | Visual markers for transitions (e.g. symbols for breaks); simplify screen layout, keep memory aids physically available |
Progress indicators
The effect of taVNS is not evident in sudden leaps in cognitive performance, but rather in renewed availability:
· better access to familiar content, less frustration when searching for words
· Longer periods of clear attention, even during routine tasks
· Better switching between tasks, less mental disorientation
· more confidence in one's own orientation, even if overall performance remains the same
Cognitive decline does not require intellectual overload or performance training. What is missing is not effort, but regularity, rhythm and repetition – without pressure to perform. Vagus nerve stimulation can be a vegetative anchor for people who lose their way before they even get started. It does not train memory – it reminds the system of its ability to regulate itself.
Effectiveness and clinical studies
Current research findings on the effectiveness of VNS/neuromodulation
Current research on vagus nerve stimulation (VNS) and neuromodulation is providing increasingly convincing evidence of its effectiveness in treating various diseases and disorders. Clinical studies are investigating the effects of vagus nerve stimulation on neurological conditions such as epilepsy and chronic pain, as well as mental health problems such as depression and anxiety disorders. The results often show significant improvement in symptoms and an increased quality of life for those affected. Researchers are continuously working to optimise stimulation parameters and better understand the specific mechanisms of VNS in order to further refine its therapeutic application. These studies suggest that VNS may be a promising option for patients who do not experience sufficient relief from other treatments, et al. I will support you with empathy and clarity as you understand and evaluate these options.
Biomarkers for treatment success
Identifying biomarkers for the therapeutic success of vagus nerve stimulation is an important step toward personalising treatment and maximising its effectiveness. Biomarkers could help identify patients who are most likely to respond to vagus nerve stimulation and adjust the stimulation parameters accordingly.
Aspect | Details |
Possible biomarkers | Changes in heart rate variability, brain activity (measured by EEG) and the concentration of certain neurotransmitters in the brain. |
Goal of biomarker monitoring during VNS treatment | To better understand vagus nerve activation and tailor therapy to the individual needs of the patient. |
The development of biomarkers is an active area of research that opens up the potential for more precise and effective application of VNS. I offer you a space where you can open up without pressure – the focus is on you: your story, your goals, your change.
Comparison of invasive and non-invasive methods
Vagus nerve stimulation can be performed both invasively and non-invasively.
Method | Description |
Invasive VNS | Surgical implantation of an electrode on the vagus nerve in the neck area to deliver electrical impulses. |
Non-invasive VNS | Use of electrodes, e.g. in transcutaneous auricular vagus nerve stimulation (tVNS), which are placed on the ear to indirectly stimulate the vagus nerve. |
The choice between invasive and non-invasive methods depends on various factors, including the type and severity of the disease or disorder, the individual needs of the patient and the potential risks and benefits of each method. Current clinical studies are comparing the efficacy and safety of both approaches to determine the optimal treatment strategy for different patient groups. I will support you with empathy and clarity in finding the right treatment for you.
Risks and side effects of vagus nerve stimulation
As with any medical treatment, side effects may occur with vagus nerve stimulation (VNS), although these are usually mild and temporary. Common side effects of vagus nerve stimulation include hoarseness, coughing, sore throat, difficulty breathing or tingling in the throat during stimulation. These symptoms usually only occur while the device is activated and disappear shortly afterwards. In rare cases, difficulty swallowing or a change in voice may also occur. It is important that patients discuss all potential side effects with their doctor before deciding on VNS treatment. I support you with empathy and clarity in overcoming personal or professional challenges.
Long-term risks and safety considerations for vagus nerve stimulation
The long-term risks and safety aspects of vagus nerve stimulation are still being investigated in clinical trials to achieve promising results. Previous research findings indicate that VNS is generally a safe and well- e treatment method. However, there are some aspects that need to be considered for long-term use. These include possible changes in heart rate, especially in patients with pre-existing heart conditions, and the potential risk of infection or complications associated with the implanted device in invasive VNS. Regular check-ups and careful monitoring are important to identify and treat any problems early on. The efficacy and safety of VNS continues to be studied in large-scale trials to ensure a comprehensive understanding of its long-term effects. I offer you a space where you can open up without pressure – the focus is on you: your story, your goals, your change.
Patient reports and experiences with vagus nerve stimulation
Testimonials from patients and individuals who use vagus nerve stimulation provide valuable insights into the effectiveness and impact of the treatment on improving quality of life. Many patients report significant improvement in the symptoms of their condition or disorder, such as a reduction in the frequency of seizures in epilepsy, relief from depression or pain relief in chronic pain. Some patients also report positive effects on their cognitive functions and emotional stability. It is important to note that experiences with VNS can vary from person to person and that not every patient will experience the same benefits. However, patient reports can help provide a realistic picture of the potential benefits and challenges of vagus nerve stimulation. Vagus nerve stimulation shows promise for a variety of neurological and mental health conditions.
Future prospects for vagus nerve stimulation
Innovations in VNS technology
The future of vagus nerve stimulation (VNS) is characterised by continuous innovation in technology and stimulation parameters. New electrode designs and stimulation protocols are being developed to optimise vagus nerve activation and increase the effectiveness of treatment. Advances in wearable technology are enabling the development of smaller and more comfortable VNS devices that allow for continuous or on-demand stimulation in everyday life. The integration of artificial intelligence and machine learning into VNS technology could make it possible to adjust stimulation in real time to the individual needs of the patient and further improve therapeutic outcomes. These innovations promise even more precise and effective application of vagus nerve stimulation for various diseases and disorders. I will support you with empathy and clarity in finding the right treatment for you.
Advanced medical Applications of vagus nerve stimulation
The potential applications of vagus nerve stimulation (VNS) are constantly expanding as research discovers new areas of application and potential benefits. In addition to established indications such as epilepsy, depression and chronic pain, VNS is increasingly being investigated for other neurological and mental illnesses and disorders. These include, for example, the treatment of inflammatory bowel disease, the improvement of heart function in heart failure and the promotion of rehabilitation after strokes. The ability of vagus nerve stimulation to influence the autonomic nervous system and the immune system makes it a promising approach for the treatment of a variety of complex health problems. Future clinical trials will help confirm the specific applications and efficacy and safety of VNS in these expanded areas. I offer you a space where you can open up without pressure – the focus is on you: your story, your goals, your change.
Conclusion
Vagus nerve stimulation (VNS) and related non-invasive neuromodulation techniques are increasingly becoming the focus of integrative treatment approaches. With a growing understanding of the underlying neurophysiological mechanisms, VNS is developing into a connecting element between psychiatry, neurology, pain medicine, immunology and psychosomatics – not as a replacement, but as a bridge between specialist disciplines.
Especially for chronically stressed, multimorbid or therapy-resistant patients whose symptoms cannot be treated using conventional treatment methods, taVNS offers a structured, body-based and low-side-effect option for recalibrating autonomic rhythms – for example, in combination with:
· psychotherapeutic methods (e.g. schema, trauma, ACT or emotion-focused therapy),
· medication approaches that aim to reduce dosage or optimise combinations,
· exercise therapy, music therapy or occupational therapy, which gain depth through vagal co-activation,
· neurofeedback, biofeedback or HRV monitoring, which promote feedback and self-efficacy,
· and somatic mindfulness-based methods, if these are tailored to specific vegetative processes.
The central challenge today lies less in technical feasibility than in responsible integration into everyday clinical practice. This includes:
· interdisciplinary collaboration between neurologists, psychiatrists, pain and trauma therapists,
· differentiating indications (what can be achieved with modulation and what cannot?),
· individual dosing and integration into everyday life,
· patient education without promises of a cure, but with realistic perspectives.
VNS will be an important additive for functional stabilisation in the future, especially in the care of people with polyvagal stress profiles – i.e. those characterised by sensory overload, exhaustion, vegetative instability or post-viral conditions: non-verbal, low-threshold, accompanying the patient throughout the day.
Vagus nerve stimulation (VNS) is not a technical panacea – but it is a precise tool for vegetative support. Its potential lies not in "fixing" symptoms, but in restoring inner availability: in the ability to not react automatically to stimuli, but to remain grounded. Whether for epilepsy, depression, pain, trauma, cognitive decline or post-infectious sensory dysregulation, VNS opens up a new quality of medical dialogue: not through amplification, but through repetition; not through intervention, but through rhythmisation.
The next few years will show in which constellations VNS can permanently improve the quality of life of those affected, either as a stand-alone or combined measure. It will be crucial to understand it not only as a neurotechnical procedure, but as an embodied form of treatment in dialogue with individual realities of life.
The future of neuromodulation lies not in maximisation, but in regulability. And this is precisely where the strength of VNS lies.
FAQ – Frequently asked questions about therapeutic vagus nerve stimulation (VNS) for chronic diseases, sensory dysregulation and neuropsychiatric patterns
How does vagus nerve stimulation (VNS) work in autism and ADHD in adults (AuDHS)?
In AuDHS – a dual condition consisting of autism spectrum disorder and ADHD – taVNS addresses both sensory hypersensitivity and impulsive sensory overload. It stabilises vegetative transitions, facilitates the initiation of actions, dampens overload reactions and increases availability in social and cognitive situations – without any pressure to adapt.
What specific daily applications of taVNS are useful for post-viral fatigue (e.g. ME/CFS, Long COVID)?
We recommend using it 1–2 times a day for 15 minutes, combined with quiet reading ( ), breathing exercises or a tea ritual. It has a stabilising effect before exercise (e.g. stretching, 3 minutes of walking), after exposure to stimuli or to regulate rhythm in cases of dysautonomia. Progress here does not mean increased performance, but rather reduced vegetative reactivity.
How does VNS help with chronic pain such as fibromyalgia or neuropathic complaints?
taVNS modulates central pain processing, reduces inflammation signals and calms the autonomic alarm system. In combination with isometric exercise, breathing and stretching sessions and targeted mood activation (e.g. music, humour), pain predictability improves and movement is once again experienced as safe.
What are the benefits of vagus nerve stimulation for complex PTSD and childhood trauma?
It works not through processing, but through repetition: 15 minutes of taVNS daily, combined with gentle movement (e.g. walking to a rhythm), self-chosen activities (e.g. sorting, resting) and vocal anchoring (humming, speaking softly) help to return the system from protective reactions to rhythmic self-availability.
How can VNS support cognitive abilities in the early stages of decline?
taVNS promotes blood circulation, neuroplastic activity and working memory. Daily use while reading, combined with short intervals of movement and thinking (e.g. walking + naming, puzzles + breaks), supports attention control and reduces mental fragmentation – especially in cases of brain fog and MCI.
Does VNS also help with high sensitivity?
Yes. Highly sensitive people benefit from the stimulus buffering provided by taVNS – ideally in combination with stimulus protection (light filters, noise reduction), fixed anchor times (e.g. in the morning + after overload) and calm rituals. The aim is not to toughen up, but to restore availability after intense sensory experiences.
How is the use of taVNS structured – e.g. in the first four weeks?
In weeks 1–2: daily use (1× 15 min.), combined with stimulus reduction, micro-movements, breathing exercises, optional voice. From weeks 3–4: gentle expansion – e.g. use before transitions, after social contact or in combination with dual tasks (e.g. walking + naming colours). The goal is not progress, but vegetative reavailability.
Is taVNS suitable for independent use?
Yes – provided it is used in a trauma-sensitive manner, started in small doses and linked to everyday routines. The strength of the method lies not in intensity, but in repetition, rhythm and individual connection.
Related
Understanding neuromodulation – An evidence-based path to self-regulation 01: Changing the nervous system?Understanding Neuromodulation – An Evidence-Based Pathway to Self-Regulation 02: Understanding How Your Nervous System Works
Understanding Neuromodulation – An Evidence-Based Pathway to Self-Regulation 03: The Polyvagal Theory and Its Critics
Understanding Neuromodulation – An Evidence-Based Pathway to Self-Regulation 04 - Evidence-Based Neuromodulation
Understanding neuromodulation - An evidence-based path to self-regulation 05 - Vagus nerve stimulation and neuromodulation
Understanding Neuromodulation – An Evidence-Based Pathway to Self-Regulation 06 – Practical Strategies for the Autonomic Nervous System in Everyday Life
Series: Understanding Neuromodulation – An Evidence-Based Path to Self-Regulation 07: How to develop your own individual self-regulation concept
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