Post covid stress disorder: what they are, why they come, how to treat them

Millions of people in the world suffer from post-traumatic stress disorders caused by trauma that their nervous system cannot overcome and integrate such as the “Long Covid or Post Covid”.

Typical symptoms that patients present with are:

• chronic fatigue
• insomnia
• chronic pain and muscle tension
• stiffening of joints
• joint pain and inflammation
• bruxism
• temporomandibular joint tension
• dysautonomia and difficulty in digestion
• constipation, lack of appetite or compulsive bouts of hunger
• irritability
• mood swings
• depression
• panic attacks
• mental clouding
• difficulty in concentration
• inefficiency

The reasons for these symptoms are explained by the polyvagal theory, which Dr. Steven Porges presented to the scientific community in 1994. According to this theory, the vagus nerve, the tenth cranial nerve, called “vagus” from Latin because it arises from the brain and literally wanders throughout the body innervating all the organs it encounters from its exit from the foramen magnum until it reaches the intestines, is composed of two distinct branches that function independently and distinctly.

1. The first branch originates from the dorsal nucleus of the vagus and descends directly to the stomach and intestines. It is the oldest branch, evolutionarily speaking, and is also the simplest since it is not covered with myelin. Reptiles, simple vertebrates, and mammals have it.
2. In mammals, at the 30th week of gestation of the foetus, some brain cells migrate anteriorly from the dorsal nucleus of the vagus to the nucleus ambiguus and give rise to the anterior branch of the vagus. This branch evolutionarily speaking is more modern, innervates some muscles of the face, lungs and heart, is covered with myelin is exclusive in mammals and is responsible for social interactions.

Only 20 percent of the vagus nerve fibers are afferent and travel from the brain to the organs while 80 percent are efferent i.e., they go from the organs to the brain. Therefore, according to the polyvagal theory there is a bidirectionality of stimuli that can occur from the brain to the body and vice versa (psychosomatic vs somatopsychic).

Why did mammals develop the second branch of the vagus nerve?

From an evolutionary point of view, reptiles have developed only the posterior branch of the vagus nerve, and since their brains require little oxygen, when they feel they are in great danger they feign death, their bodies completely shut down, showing any predators an apparent death. This state of thanatosis and/or “freezing” causes all muscles to stiffen, the heart rate to decrease and consequently less oxygen circulates, and they shed any excrement superfluous to momentary survival by evacuating urine and faeces. In this way, since predators prefer to feed on live animals, the chances of survival increase. However, we can observe the phenomenon of thanatosis (apparent death) in all animal species that use it as a technique to escape predators, particularly in invertebrates such as ants and bees, in reptiles such as lizards and snakes, in some birds, crustaceans and seahorses, frogs, and even in some mammals first and foremost the opossum.

Vertebrates, such as for example fish, have developed along the spine the sympathetic nerve chain that counteracts the action of the parasympathetic nerves of which the vagus nerve is the main one giving rise to the fight/flight reaction in case of danger. This reaction is less drastic than the previous one although autonomous.

Finally, mammals also created the anterior branch of the vagus nerve to counteract the overreaction to danger created by the previous reactions because their brains need more oxygen than reptiles and simple vertebrates. Therefore, their autonomic nervous system needs a control system to inhibit the overreaction of “freezing,” which if prolonged would lead to damage to the brain and the whole organism.

The anterior branch of the vagus is also responsible for social reactions among mammals, in that either from facial expression, tone of voice, or postural attitude we can quickly realize whether we are facing danger or instead can socialize with another mammal.

For example, if we observe a dog growling and barking or a human being raising his or her voice, our nervous system automatically goes into alarm and we prepare to face danger, whereas if we see a wagging dog approaching or when we listen to a mother speaking softly to her child automatically our nervous system becomes reassured, calms down, and we are ready to eventually interact.

Wherever we are, our nervous system automatically assesses risks and if it does not feel safe, it does not make us feel calm. For this reason, no physical or behavioural therapy can be effective if the patient does not feel safe where they are or with the practicing therapist. This is especially the case with patients who have experienced psychophysical trauma. In the polyvagal theory this is called the process of neuroception.

For example, a person who was bitten by a dog as a child often does not like to be approached by dogs, even those that wag their tails and appear harmless to others, or again a person who has experienced violence does not like to be touched and shuns any kind of physical therapy, even massages that other individuals find very relaxing.

Individuals suffering from post-traumatic stress disorder live in constant stress, and since they always remember the traumas, they have suffered, create a phenomenon of “dissolution,” where their autonomic nervous system progressively shifts to primitive circuits i.e., constantly progressively activating first the fight/flight state, then the “freeze” state.

For example, in individuals who suffer from somatosensory tinnitus, their nervous system thinks they are always in danger, activating the middle ear muscles that become hypersensitive to low-frequency sounds, altering the otoemissions in the middle ear, to identify any movement that could be potentially dangerous.

To be able to calm the autonomic nervous system of those suffering from post-traumatic stress disorder, first, it is necessary for the person to feel that he or she is in a safe environment and for the therapist to stand before the patient in a relaxed, reassuring state, to speak in a calm prosodic voice, and to show empathy and compassion toward the patient.

At this point, once the patient’s neurosensory state permits, the therapist can move on to phase two.

Phase two consists of the various therapies that may be helpful to the patient, which are intended to inhibit the excessive stress response of the autonomic nervous system.

The therapies will have to create certain rituals in patients that will change their posture and vocalization.

Chiropractic care based on functional neurology and our personalised holistic approach, which we have developed and have been teaching for a few years now only in the United States, is aimed at inhibiting the excessive vasovagal response, eliminating dural meningeal tension, and balancing and re-educating the autonomic nervous system and its associated organs. For these reasons we have found significant benefits on patients suffering from chronic stress disorders such as Long Covid.

But, as we have seen above even though most patients like to be treated by our holistic approach method which they find very gentle compared to the classic noisy chiropractic adjustment, which frightens them and to which they have often reacted badly, some patients do not want to be touched at all and prefer another therapeutic approach.

For this reason, we have also begun to collaborate with a group of professional therapists in treating trauma with voice that brings together American and European psychologists and speech therapists. They too are using Dr Porges’ theories to create a joint and synergistic movement with the aim of being able to help as many people as possible heal naturally from post-traumatic stress disorders and achieve full health.

To book an appointment at our Milan office:

Tel: +39 02 89.40.49.90
WhatsApp: +39 393 81.04.359
Email: segreteria@studiomazzinisrl.it

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