From the viewpoint of polyvagal therapy, depression is perceived as more than a set of psychological symptoms, as outlined in the DSM–5 by the American Psychiatric Association (2013). It's also seen as a physical state deeply intertwined with the nervous system, particularly through the lens of the polyvagal theory which emphasizes the vagus nerve's role in managing emotions.

Understanding Depression through Polyvagal Theory:

• Linking Depression to the Dorsal Vagal State:

  • Schwerdtfeger & Friedrich-Mai (2009) have highlighted that typical symptoms of depression, such as fatigue and social isolation, are consistent with a 'dorsal vagal state', indicative of reduced parasympathetic activity, where the body’s relaxation mechanisms are less active.

• Redefining Depression as Social Disengagement:

  • Dr. Porges, noted in his PESI (2011) seminar, suggests that the core of depressive symptoms – reduced movement and emotional expression – is better understood as a withdrawal from social engagement and a sign of diminished vagal tone, challenging traditional views of depression.

• Social Interaction and Heart Rate Variability (HRV):

  • In their investigation, Schwerdtfeger et al. (2009) found that individuals with depression showed higher vagal tone, and thus improved social interaction, only in the presence of close relationships. This points to the importance of safe, trust-building interactions for enhancing cardiac vagal tone.  In depression, connectivity between the Default Mode Network (DMN) and areas related to emotions and motivation decreases. The DMN, crucial for self-reflection and daydreaming, becomes overactive in depression, leading to rumination. Polyvagal Theory suggests enhancing frontal vagal tone to counteract DMN overactivity, promoting relaxation and positive social interactions, potentially reducing rumination and depressive symptoms. 

• Therapeutic Use of Dance/Movement:

  • Emphasized by Devereaux (2017a) and Karkou et al. (2019), dance/movement therapy aligns with polyvagal theory by focusing on crafting a secure, empathetic space. This approach allows patients to gradually engage their bodies and emotions, supporting recovery from depressive states.

• Non-Verbal Communication in Therapy:

  • Particularly effective in dance/movement therapy, as per Karkou et al. (2019), is the facilitation of non-verbal expression, aiding individuals in depression to bridge the gap between their physical sensations, emotions, and thoughts.

In essence, polyvagal theory reshapes our understanding of depression from being merely a mental or emotional condition to a state characterized by physiological changes, particularly in social engagement and vagal tone. Therapies like dance/movement therapy, which foster a safe, understanding environment and encourage reconnecting with the social engagement system, prove beneficial in treating depression. They focus on restoring a sense of physical and emotional integration and social connectedness.

Depression is cacracterized by a dorsal vagus activation that blocks the body as in a state of cronic tiredness. As Porges noted, it  is better understood as a withdrawal from social engagement and a sign of diminished vagal tone.

A possible protocol for depression is using magnetic passes in order to activate the ventral vagus through body awareness

Finally resorting to mesmeric polyvagal crisis to unblock specific memories can help to chage the attitude of the client