From Fight or Flight to Rest and Restore: A Guide to Vagal Tone
by Dr. Grace Downs
With the stressful, fast-paced life that many of us live, the body and nervous system can become dysregulated, contributing to uncomfortable symptoms and even chronic health conditions. By understanding how the nervous system functions and influences overall health, we can begin to work with the body to restore a greater sense of calm and resilience. In this blog, we’ll explore how the nervous system works and share practical strategies to support more balance and regulation.
The body’s autonomic nervous system operates through two complementary branches that constantly work to maintain balance. The sympathetic nervous system is often described as the “fight or flight” response. This helps to mobilize the body in times of stress by increasing heart rate, raising blood pressure, and directing energy toward immediate survival. In contrast, the parasympathetic nervous system supports “rest and digest” functions, helping to slow the heart rate, promote digestion, and restore a sense of calm after stress has passed. The nerve that is essential in this communication is the vagus nerve. When the vagus nerve is active, it brings the body into the parasympathetic state.
Modern life often keeps the body in a more sympathetic (fight-or-flight) dominant state for extended periods of time. Over time, this can lead to an increase in anxiety, depression, developing chronic digestive conditions such as irritable bowel syndrome (IBS), insomnia, decreased immune function, hormone dysregulation, cardiovascular disease, fatigue, and changes in memory. In some cases, underlying conditions—such as Postural Orthostatic Tachycardia Syndrome (POTS)—can further impact the body’s ability to shift smoothly between sympathetic and parasympathetic states.
Luckily our bodies are very resilient and highly adaptable. With the right tools and support, we can begin to gently guide the nervous system back toward a more regulated, parasympathetic state.
Here are some specific tools you can explore to help support a parasympathetic (rest-and-digest) state:
1. Diaphragmatic breathing
Our breath can be one of the easiest and most accessible ways to support our vagus nerve and parasympathetic nervous system. The breathwork that has shown to be most supportive for the parasympathetic nervous system is inhalation for 3 seconds and exhalation for 6 seconds. Doing this regularly can help strengthen parasympathetic tone (Chung et al., 2019).
2. Exercise
Regular exercise is one of the most powerful ways to boost vagal tone. For decades, scientists believed that vagal activity decreased during exercise, but recent research has revealed the opposite. The vagus nerve actually becomes more active during physical activity, and this repeated activation strengthens it over time, similar to training a muscle. Studies show that consistent exercise training increases resting vagal tone, improves heart rate variability (a measure of how well the heart adapts to changing demands), and enhances the body's ability to recover after exertion (Casanova-Lizón et al., 2022). Whether through brisk walking, cycling, swimming, or other aerobic activities, moving the body regularly appears to create lasting positive changes in the nervous system that support cardiovascular health, increased resilience to stress, improves mood, supports healthy immune function, among other benefits.
3. Bitter herbs
Bitter herbs are known to help stimulate digestion, bringing us into the parasympathetic state. There are multiple proposed mechanisms on how bitters do this, but one thought is that by triggering the bitter tastebuds on our tongue stimulates our nervous system to start preparing for digestion including stimulating our vagus nerve (McMullen et al., 2015). It is important to note that not all bitters work the same way. For example, coffee is bitter but can cause decreased appetite and increased heart rate which may make someone feel worse. Examples of bitter herbs that would be supportive for the parasympathetic nervous system are gentian, wormwood, artichoke leaf, chamomile, bitter orange, fennel, and ginger.
4. Social engagement and doing activities that bring joy
Research reveals that individuals with higher vagal tone naturally gravitate toward social connection, seeking support from others and using emotionally intelligent strategies to navigate relationships. But the relationship runs both ways. When we cultivate positive social experiences and feelings of connectedness, our vagal tone actually increases over time, creating a self-reinforcing cycle of physiological and social well-being. This reciprocal dynamic suggests that the warmth we feel during genuine human connection isn't just emotional, it's measurable in the flexible responsiveness of our nervous system. Understanding this heart-brain-social connection opens new possibilities for enhancing well-being: practices that increase positive emotions and social bonds, such as loving-kindness meditation, have been shown to boost vagal tone, while higher vagal tone makes us more likely to seek out and benefit from social opportunities. The health of our vagus nerve and the health of our relationships are intimately intertwined (Geisler et al., 2013).
5. Acupuncture
Research has shown that acupuncture increases parasympathetic nervous system activity, as measured by heart rate variability (HRV). In particular, acupuncture has been found to increase high-frequency HRV power and improve the balance between the sympathetic and parasympathetic branches of the nervous system. These effects appear to be point-specific, with certain acupuncture points. Low-frequency electroacupuncture applied to auricular (ear) points has also demonstrated impressive results, with one study reporting a 56% increase in parasympathetic vagal tone after a single session. The mechanisms behind these effects are thought to involve stimulation of deep sensory nerves that send signals to key brain regions. As research continues to grow, acupuncture is emerging as a promising, safe, and non-pharmacological tool for supporting vagal tone and overall autonomic health (Hamvas et al., 2023).
6. Vagus nerve stimulators
Non-invasive vagus nerve stimulators are a growing area of study for supporting the vagus nerve. These are devices that are used on the neck over the carotid artery or attached to an area of the ear called the tragus. These use gentle electric impulses to stimulate vagus nerve activity. There has been research to show that these devices can improve POTS (Stavrakis et al., 2019), depression (Austelle et al., 2002), anxiety (George et al., 2008), migraines (Song et al., 2023), IBS (Quan & Zhou, 2026), and more.
Our nervous systems are made to move fluidly between states of action and rest, but our modern lifestyle often tips the scales too far toward stress. The good news is that the vagus nerve is not fixed. The vagus nerve and our parasympathetic nervous system is dynamic, responsive, and trainable. Whether through the simple rhythm of a slow exhale, regular exercise, the ancient wisdom of bitter herbs and acupuncture, or the warmth of meaningful human connection, we have an array of tools to strengthen this vital nerve and restore balance to our autonomic nervous system. Emerging technologies like non-invasive vagus nerve stimulators add yet another promising option to this growing toolkit. What ties all of these approaches together is a central truth: small, consistent actions can create lasting shifts in how our bodies respond to stress, recover from challenge, and engage with the world around us. By understanding and supporting our vagus nerve, we move beyond simply managing symptoms and toward building a foundation of resilience.
Want to learn more about how you can support your nervous system and overall health?
I invite you to schedule a call with me or one of the other Neighborhood Naturopathic and Primary Care providers.
See you in clinic,
Dr. Downs
Resources:
Austelle , C., O’Leary , G., Thompson , S., Gruber, E., & Kahn, A. (2002). Potential mechanisms of action of vagus nerve stimulation for depression. Vagus Nerve Stimulation, 77–94. https://doi.org/10.3109/9780203627105-9
Casanova-Lizón, A., Manresa-Rocamora, A., Flatt, A. A., Sarabia, J. M., & Moya-Ramón, M. (2022). Does exercise training improve cardiac-parasympathetic nervous system activity in sedentary people? A systematic review with meta-analysis. International Journal of Environmental Research and Public Health, 19(21), 13899. https://doi.org/10.3390/ijerph192113899
Chung, Y.-M., Lou, S.-L., Tsai, P.-Z., & Wang, M.-C. (2019). The efficacy of respiratory regulation on parasympathetic nervous system appraised by Heart Rate Variability. Journal of Medical and Biological Engineering, 39(6), 960–966. https://doi.org/10.1007/s40846-019-00472-z
Geisler, F. C. M., Kubiak, T., Siewert, K., & Weber, H. (2013). Cardiac vagal tone is associated with social engagement and self-regulation. Biological Psychology, 93(2), 279–286. https://doi.org/10.1016/j.biopsycho.2013.02.013
George, M. S., Ward, H. E., Ninan, P. T., Pollack, M., Nahas, Z., Anderson, B., Kose, S., Howland, R. H., Goodman, W. K., & Ballenger, J. C. (2008). A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders. Brain Stimulation, 1(2), 112–121. https://doi.org/10.1016/j.brs.2008.02.001
Hamvas, Sz., Hegyi, P., Kiss, Sz., Lohner, Sz., McQueen, D., & Havasi, M. (2023). Acupuncture increases parasympathetic tone, modulating HRV − systematic review and meta-analysis. Complementary Therapies in Medicine, 72, 102905. https://doi.org/10.1016/j.ctim.2022.102905
McMullen, M. K., Whitehouse, J. M., & Towell, A. (2015). Bitters: Time for a new paradigm. Evidence-Based Complementary and Alternative Medicine, 2015, 1–8. https://doi.org/10.1155/2015/670504
Quan, Y., & Zhou, T. (2026). Efficacy and mechanisms of vagus nerve stimulation in Irritable bowel syndrome: A comprehensive literature review. Frontiers in Immunology, 17. https://doi.org/10.3389/fimmu.2026.1769070
Song, D., Li, P., Wang, Y., & Cao, J. (2023). Noninvasive vagus nerve stimulation for Migraine: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1190062
Stavrakis, S., Chakraborty, P., Farhat, K., Whyte, S., & Morris, L. (2019). Vagus nerve stimulation in treatment of postural orthostatic tachycardia syndrome. Case Medical Research. https://doi.org/10.31525/ct1-nct03930914