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How to understand ME/CFS using the Polyvagal Theory

Did you know that we often cycle through 3 different states of our autonomic nervous system? You may have heard of the traditional 2 states (parasympathetic and sympathetic) or fight/flight and rest/digest, but did you know it is a little more nuanced than that? Stephen Porges came up with the Polyvagal theory, which makes a lot more sense to me and my body- I don't know about you?


These are functions of our autonomic nervous system- the part of us that is in charge of breathing, digestion, heart rate and all the other things that keep us alive without having to think about! Without them we wouldn't survive for very long- this system is here to keep us safe and connected and out of danger.


The 3 different states we cycle through, according to the Polyvagal theory (Stephen Porges), are Ventral vagal, sympathetic and dorsal vagal. Our vagus nerve is the largest cranial nerve and innervates our lungs, heart and visceral organs. It is divided into two parts- the ventral (connected) and dorsal (shutdown) pathway.


You can think of this as an autonomic ladder and how we move up and down- our optimal state is at the top in a connected ventral state.

Read on for more detail on these states


Polyvagal Theory Chart


Our Ventral State

The newest part of our ANS, we are socially connected, we feel safe and open.

We see the bigger picture of the world and can safely interact with it. We're organised, we look after ourselves, we feel productive and a healthy sense of control.

Physically we might experience:

- A regulated heart rate and blood pressure

- Full, deep and relaxing breaths

- A healthy immune system able to fend off illnesses

- Healthy and good digestion

- Good sleep

- A general sense of wellbeing


Our Sympathetic State

There is a sense of unease or danger, an urge and an energy to react- we go into action mode or fight/ flight. We're on the lookout for what our instinct told us is dangerous- the world doesn't feel safe, people aren't friendly and we need to protect ourselves. We may struggle with anxiety, panic attacks and struggle to focus.

Physically we might experience:

- Heart disease and high blood pressure

- High cholesterol

- Short and shallow breathing

- A weaker immune system

- Chronic pain or tension around our neck & shoulders

- Weight gain

- Brain fog or a bad memory

- Sleep problems

- Stomach problems



Our Dorsal State

The oldest pathway and the path of last resort- the feeling when we are trapped and have no other escape options, we shut down, we disconnect. We switch off from the world around us, we struggle to feel and we see the world as a dead and dark place. Our mind and body has gone into conservation mode- "I can't feel pain if I disconnect from it"

Physically we might experience:

- Low blood pressure (POTS)

- Type 2 diabetes

- Weight gain

- Chronic fatigue

- Fibromyalgia

- Stomach problems

- Memory issues

- Depression

- Isolation

- Dissociation and problems looking after ourselves


Comment below if you relate to any of these states!


Look out for my next blog on how we can use this information to help manage our chronic conditions!


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