Chronic Illness and Your Nervous System: Understanding the Polyvagal Theory
- rosetakelli
- Oct 9
- 6 min read
Updated: Oct 10
If you live with a chronic illness, you know the daily reality is a constant battle—not just against physical symptoms, but also against pervasive anxiety, exhaustion, and a feeling of being constantly "on guard." The title of "Lupus Warrior" often feels less of a motivating mantra and more of a full-body battle to "FIGHT! FIGHT! FIGHT!"
But what if your physical and emotional struggle is also a conversation your body is having with your nervous system? Is it healthy to always be in "fight mode?"
The Polyvagal Theory, developed by Dr. Stephen Porges, offers a revolutionary way to understand this mind-body connection. It explains how your autonomic nervous system (ANS) automatically responds to cues of safety and danger, and how chronic illness can hijack this system, leaving you in a persistent state of defense. Sound familiar?
The Three States of Your Nervous System
The Polyvagal Theory views your ANS as having a hierarchical system with three main pathways, or "states," which your body shifts between based on its assessment of your environment—a process called neuroception (the subconscious detection of your brain deciding what is safe and what is a threat). For instance, if you feel a new pain in your chest and your heart starts to race as your mind tries to assess if this is pleurisy, a blood clot... or just indigestion. Catastrophizing isn't a choice most of the time; your body is wired to constantly transition you through different phases (states) as you navigate through life to keep you alert and alive.
1. The Ventral Vagal State (Safety & Connection) 🟢
This is your ideal state—the "social engagement system." It's supported by the myelinated Vagus nerve, which helps you feel safe, calm, and connected.
Physical state: Slow, regulated heart rate, open posture, efficient digestion, easy breathing.
Emotional state: Calmness, curiosity, social engagement, and emotional regulation.
2. The Sympathetic State (Fight or Flight) 🟡
When your neuroception detects a manageable threat, your body shifts here. This is your body's "mobilization" defense system.
Physical state: Increased heart rate, muscle tension, shallow breathing, heightened alertness, adrenaline release (preparing to run or fight).
Emotional state: Anxiety, panic, anger, hypervigilance.
3. The Dorsal Vagal State (Freeze or Shutdown) 🔴
This is an older, primitive survival state. When a threat is perceived as inescapable or life-threatening (too much for Fight/Flight to handle), your system may hit the brakes completely, leading to "immobilization."
Physical state: Low energy, slowed heart rate, limpness, numbing, and digestive shutdown.
Emotional state: Dissociation, depression, numbness, hopelessness, or emotional withdrawal.
How Chronic Illness Impacts Your Vagal Nerve
Chronic illness—whether it's an autoimmune disorder like lupus, chronic pain, or chronic fatigue—is, to your nervous system, a state of constant, internal threat. This internal danger signal creates a cycle of dysregulation. Once again...sound familiar?
Chronic Inflammation: A Constant Danger Signal
The vagus nerve is a bidirectional communication highway between your brain and your major organs, including your immune system.
The Vagal Brake is Weakened: The Ventral Vagal system usually acts as a brake on the stress and inflammatory response. Chronic stress and the persistent physiological signals of illness (pain, fatigue, digestive issues) can compromise the "vagal tone" of this system, making it less effective.
Inflammation Escalates: The body's inflammatory response, while essential for fighting illness, becomes chronic and over-reactive. This sustained inflammation itself acts as a cue of danger, constantly signaling to the brain that the body is unsafe.
Immune-Nervous System Crosstalk: This constant biological stress leads to a cascade of stress hormones and inflammatory molecules (cytokines). This is the basis of Psychoneuroimmunology (PNI), showing that the physical experience of illness is inseparable from the nervous system's response.
Living in Defense Mode (Sympathetic & Dorsal Vagal)
A chronically ill body often finds itself stuck in defensive states because the internal cues of illness are relentless.
Chronic Pain and Sympathetic Overdrive: Persistent pain can keep the nervous system locked in a Sympathetic ("Fight/Flight") state. This leads to common chronic illness symptoms like muscle tension, heightened anxiety, insomnia, and hypervigilance to every ache or new symptom.
Chronic Fatigue and Dorsal Vagal Shutdown: For many with conditions like Chronic Fatigue Syndrome, Fibromyalgia, or Reflex Sympathetic Dystrophy, the system eventually can move into the more primitive Dorsal Vagal ("Freeze") state. This is an energy-conservation strategy, manifesting as extreme exhaustion, brain fog, depression, numbness, and dissociation.
Finding a Path Back to Safety
The hopeful news of the Polyvagal Theory is that the nervous system is neuroplastic—it can be rewired. Healing involves intentionally sending cues of safety to your nervous system to reactivate the Ventral Vagal system.
This approach, known as Polyvagal-Informed Therapy or Somatic Therapy, focuses on interventions that work with your body's physiology, not just your thoughts.
Practical Vagal-Regulating Techniques
Deep, Diaphragmatic Breathing: Slow, extended exhales stimulate the vagus nerve and signal safety to the body, helping to calm heart rate and respiration.
Sound and Vocalization: Humming, gargling, and singing engage the muscles in your throat and face that are directly connected to the Ventral Vagal complex.
Mindful Movement: Gentle movement like rocking or slow stretching can help "unstick" the Freeze response and release stored defensive energy.
Social Connection: Safe, positive interactions with trusted people (including a therapist) are one of the most powerful cues of safety, helping to exercise and strengthen the Social Engagement System. - "We are wired for connection and, in order to help us survive, our bodies are designed and prepared for observing, processing, and responding to our environment." - Jodi Clarke, MA, LPC/MHSP
Understanding the Polyvagal Theory shifts the narrative of chronic illness. Your anxiety and exhaustion aren't just mental weaknesses; they are biological survival responses gone awry.
This discussion also leads to a deeper, much larger conversation about how the labels we are given, i.e., "Warrior" or "Superhero," can also (in some) perpetuate this dysregulation of the nervous system. Obviously, during a crisis, your body's autonomic nervous system overrides, and the fight, flight, or freeze response does what it needs to do to keep you alive. However, the point I am trying to make is, you cannot live in that activated response for the duration of your illness. It is a temporary crisis or trauma response, not a permanent one.
In my personal lupus journey, I have noticed that identifying myself as a "warrior" for the rest of my chronic illness journey or being labeled as such can trigger my neuroception into fight or flight. Leaving me constantly on alert and exhausted. So I have decided that it doesn't serve me anymore. You may feel differently, and that is ok.
You can read more on that here.
By consciously introducing signals of safety, you can begin to gently guide your nervous system out of defense mode and into a state that supports rest, digestion, and, ultimately, healing.
Remember, your body is the only created being that will be with you from your first breath until your last. It is the most important thing you have to take care of.
Compiled By:
Kelli Roseta
**All resources provided by this blog are for informational purposes only, not to replace the advice of a medical professional. Kelli encourages you to always contact your medical provider with any specific questions or concerns regarding your illness. All intellectual property and content on this site and in this blog are owned by morethanlupus.com. This includes materials protected by copyright, trademark, or patent laws. Copyright, More Than Lupus 2025.
Resources:
Polyvagal Theory and Chronic Illness/Trauma
Title | Source Type | Link |
Polyvagal Theory: Current Status, Clinical Applications, and Future Directions | Academic Article (PMC) | |
What is Polyvagal Theory? | Organizational Resource | |
Polyvagal Theory: A Science of Safety | Academic Article (PMC) | |
The Polyvagal Theory and Healing Complex PTSD | Professional Blog/Resource | |
Polyvagal Theory: Understanding the Nervous System and Trauma | Professional Resource |
Chronic Pain and Polyvagal Theory
Title | Source Type | Link |
Polyvagal Theory and Chronic Pain and Symptoms | Professional Blog/Resource | |
Polyvagal Theory And Chronic Pain: Exploring Treatment Options | Educational Article | |
Polyvagal theory and pain care | Educational Webinar/Resource |
Autoimmune Disease, Inflammation, and the Vagus Nerve
Title | Source Type | Link |
Assessing the therapeutic potential of vagus nerve stimulation in autoimmune diseases: A systematic review | Academic Article (PMC) | |
The Interplay between Autonomic Nervous System and Inflammation across Systemic Autoimmune Diseases | Academic Article (MDPI) | |
Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders | Academic Article (PMC) | |
PTSD - Whole Health Library (includes mention of autoimmune comorbidities) | Government/Health Resource |
Limbic and Vagal Dysfunction/Retraining
Title | Source Type | Link |
Limbic and Vagal Dysfunction | Clinic Blog/Resource | |
The Efficacy of Limbic System Retraining and Neuroplasticity in the Management of Chronic Pain and Disease: A Systematic Review | Academic Thesis/Review | |
How You Can Repair Your Vagus Nerves | Clinic Resource | |
Limbic System Dysfunction - Symptoms and Therapy | Clinic Resource |
이 글을 읽으면서 만성 질환으로 인한 신체적·정신적 긴장이 얼마나 우리 신경계에 영향을 주는지 새삼 느꼈어요. 글에서 소개된 Polyvagal Theory 기반의 호흡, 소리, 느린 움직임, 안전한 사회적 연결 같은 방법들은 정말 유용하네요.
저도 요즘 만성 피로와 긴장 완화를 위해 허니룸 대구마사지를 가끔 이용하는데, 깊은 근육 이완과 부드러운 터치가 신경계를 안정시키고, 글에서 말한 Ventral Vagal 상태를 촉진하는 느낌을 많이 받았어요. 마사지 후에는 몸이 훨씬 편안하고, 호흡도 자연스럽게 깊어져서 마음까지 안정되는 경험을 할 수 있었습니다.
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