Stress is an unavoidable part of life, and while it often carries a negative connotation, it is actually a fundamental survival mechanism. When faced with a perceived threat, whether physical or emotional, the body instinctively reacts to protect itself. This automatic response is commonly known as the "fight, flight, or freeze" response. While it serves an essential function in dangerous situations, chronic activation of this response due to daily stressors can have significant consequences for mental and physical health.

The body’s response to stress is rooted in human evolution. When our ancestors encountered a predator, their nervous systems immediately prepared them to either confront the threat (fight), escape to safety (flight), or become still and unnoticed (freeze). While modern-day stressors may not include wild animals, our nervous system reacts similarly to job pressures, financial worries, or social conflicts.

According to the Cleveland Clinic, stress is the body's response to change, activating a physiological reaction that helps us adapt and protect ourselves. While short-term stress can be beneficial, prolonged exposure can lead to an overactive stress response, negatively impacting overall well-being.

The Three Stress Responses: Fight, Flight, and Freeze

1. Fight

The fight response prepares the body for direct action. When triggered, the nervous system releases adrenaline, increasing heart rate, blood pressure, and muscle tension. While this reaction once helped early humans fend off predators, today it manifests as irritability, frustration, or aggression.

For instance, the employee who has experienced too much workload may work extremely long hours just to succeed. In short term, the action may produce good results but mostly ends in burnout, anxiety, and physical illness, for example, tension headache or digestion problems.

2. Fight

The flight response triggers an intense need to remove oneself from a stressful situation. Just as our ancestors would flee from danger, modern individuals may avoid conflict, quit jobs impulsively, or detach from relationships when overwhelmed.

Flight mode is linked with restlessness and anxiety. Individuals may have a sense of needing to get up and go-pacing, changing environments constantly, or avoiding tasks that seem too overwhelming. Someone with a flight response might have the desire to change jobs constantly, relocate constantly, or become reclusive in order to avoid perceived dangers.

3. Freeze

The freeze response occurs when the nervous system perceives a threat as too overwhelming to fight or flee. Rather than taking action, individuals shut down, feeling numb, disconnected, or paralyzed by fear.

Unlike fight or flight, which involve heightened activation, freeze mode slows down physiological functions. A person experiencing freeze mode may feel physically unable to move, struggle to make decisions, or find themselves dissociating from their emotions. This can manifest in situations such as public speaking anxiety, where someone might "blank out" or feel stuck in the moment.

What Happens in the Body During A Stressful Event?

When faced with a stressor, the autonomic nervous system (ANS) activates, triggering physiological changes, including:

• Increased heart rate and breathing: The body pumps more oxygen to muscles and the brain in case action is needed.
• Muscle tension: The body prepares for movement, sometimes causing trembling or stiffness.
• Dilated pupils: Vision sharpens to detect potential threats.
• Dry mouth: Saliva production decreases as the body redirects energy to essential functions.
• Changes in skin tone: Blood flow is directed to vital organs, sometimes making the skin appear pale or flushed.

For those experiencing the freeze response, the body undergoes a different reaction, often reducing heart rate and causing physical immobility rather than heightened activation.

Strategies for Coping and Managing the Stress Response

While the stress response is necessary for survival, frequent activation due to daily stressors can take a toll on health. Recognizing your default response—whether fight, flight, or freeze—can help in developing effective coping mechanisms.

1. Moving to a Safe Space

If possible, changing your environment can help signal to your brain that the threat has passed. Stepping outside for fresh air, finding a quiet place, or distancing yourself from overwhelming stimuli can help regulate emotions.

2. Practicing Controlled Breathing

Deep, slow breathing can be used to counteract the stress response by engaging the parasympathetic nervous system, which promotes relaxation. Techniques such as diaphragmatic breathing or the 4-7-8 method (inhale for four seconds, hold for seven, exhale for eight) can be particularly effective in calming the body.

3. Engaging in Physical Activity

This helps release pent-up energy and aids in the endorphin cascade, natural boosters for our mood.

4. Seeking Social Support

Relieving oneself from stress can come in many ways, but sharing it with trusted friends, a family member, or a good therapist will sure give that psychological boost of hope. Social support is an especially effective way of cushioning people against the stressors that they are subjected to in chronic forms.

When to Seek Professional Help

While occasional stress is normal, chronic activation of the fight, flight, or freeze response can indicate underlying mental health concerns, such as anxiety disorders or post-traumatic stress disorder (PTSD). If stress is affecting daily life—leading to sleep disturbances, difficulty concentrating, or persistent feelings of fear—it may be time to consult a mental health professional.

You pick up a jar on the kitchen shelf and shudder. You take a flight of stairs, and that old pain sinks into your hip. You get up in the morning, and your shoulder feels as though it has been wrung out. You attribute it to age, to a long day on your feet, to just how things are now. But what if your body is trying to tell you something very particular and you have been missing it?

Dr Apoorv Dua, Consultant, Orthopaedics, ISIC Multispeciality Hospital, in an interview with Health and Me, said that this may be a sign of bursitis—a condition that is much more widespread than most people realise, and much more treatable than most people are aware. The expert went on to answer common questions regarding extreme pain that comes with this condition.

What is bursitis?

Bursae are small, fluid-filled sacs located between your bones, muscles, and tendons. Imagine them as the natural cushioning system of the body—shock absorbers that ensure your joints move smoothly and painlessly. Under normal circumstances, you do not even think about them. However, when inflamed, due to repetitive motion, prolonged pressure, injury, or infection, they make their presence known in a very noticeable manner. This is bursitis. Although it most often appears in the shoulder, elbow, hip, and knee, it may occur in nearly any joint in the body.

Who gets bursitis—and why?

This is where the lifestyle connection cannot be overlooked. Bursitis does not discriminate, but it has definite patterns. The weekend warrior who runs ten kilometres on Saturday after sitting at a desk all week. The housewife who spends hours cleaning floors or squatting in the kitchen. The office worker who has been stooped over a computer. The gym enthusiast who does not warm up. The retired teacher who begins a walking routine too vigorously. All these individuals may be silently placing stress on their bursae, and in many cases, bursitis is the eventual outcome.

Age also plays a role—the bursae, like most of our connective tissue, grow weaker with age. Certain medical conditions such as rheumatoid arthritis, gout, and diabetes can increase the risk. However, in many instances, the cause is simply the way we move—or do not move—in our day-to-day lives.

What does bursitis feel like?

A key characteristic of bursitis is pain that is disproportionate to the activity causing it. Reaching overhead, sitting on a hard surface, pressing on your elbow, or walking downhill—these are not dramatic movements, yet with bursitis, they may trigger a sharp, deep, or burning pain that interrupts you mid-action. The affected joint is usually swollen and tender. The area may feel warm to the touch. Movement becomes guarded. Sleep, particularly in cases of shoulder bursitis, can be difficult, as lying on the affected side aggravates the pain.

The challenge with bursitis is that its symptoms can resemble other conditions—tendinitis, arthritis, a muscle strain, or even a ligament tear. Many individuals self-diagnose, self-treat with painkillers, and hope it will go away. Sometimes it does. However, chronic, untreated bursitis may persist for months and, in some cases, lead to complications.

Bursitis diagnosis

A thorough clinical examination is usually the first step. A skilled orthopaedic specialist can identify the affected bursa through specific physical assessments. Imaging, such as ultrasound or MRI, may be recommended depending on the case to confirm the diagnosis, rule out structural damage, or guide treatment.

If infection is suspected—indicated by increased redness, fever, and rapidly worsening pain—fluid may be aspirated from the bursa and tested. Septic bursitis is a serious condition that requires immediate medical attention and is treated differently from the more common non-infectious type.

Bursitis treatment

The encouraging fact about bursitis is that it responds well to treatment, particularly when detected early. Most cases are managed with a combination of rest, activity modification, ice application, and anti-inflammatory medication. Physiotherapy also plays an important role, helping to correct movement patterns, strengthen supporting muscles, and restore the full range of motion.

In more persistent cases, a corticosteroid injection into the bursa may provide rapid and significant relief by reducing inflammation at its source. Surgery is rare and is typically considered only in chronic, recurrent cases that do not respond to conservative treatment.

Prevention is better

In many instances, bursitis is linked to lifestyle—and that presents an opportunity for prevention. Even small changes can help: warming up before exercise, avoiding excessive strain on joints, maintaining a healthy weight to reduce pressure on hips and knees, and ensuring workstations are ergonomically designed.

Pain often becomes background noise—something we get used to, work around, and push through. However, bursitis reminds us that the body communicates with precision. That pain when you pick up a jar, that discomfort on the stairs—it is not simply ageing. It is a signal worth discussing with your doctor.

The bulge that appears when an internal organ pushes through a weakened muscle wall will not recede with rest or medication—it will, in most cases, grow larger and more uncomfortable over time. Surgery is the only definitive treatment. What has changed significantly in recent years is what that surgery looks like and what recovery from it requires.

Dr Rajesh Sharma, Director – General Surgery, Minimal Access & Bariatric Surgery, CK Birla Hospitals, Jaipur, in an interview with Health and Me, spoke about the introduction of robotics in hernia treatment and how it can benefit patients.

How hernia surgeries are becoming less painful

With advances in surgical technology, minimally invasive approaches have significantly improved patient outcomes. One of the most important developments in recent years is robotic-assisted hernia surgery using the da Vinci Surgical System. In robotic surgery, the surgeon operates from a console equipped with a high-definition, three-dimensional, magnified view of the surgical field. The robotic system translates the surgeon’s hand movements into extremely precise movements of miniaturised instruments inserted through small incisions. The system also filters natural hand tremors and provides a greater range of motion than the human wrist, enabling meticulous dissection and suturing.

For hernia repair, these capabilities allow surgeons to perform delicate steps such as accurate defect closure and optimal mesh placement, which are important for the long-term durability of the repair.

Benefits for patients

Robotic hernia repair offers several advantages for patients:

1. Smaller incisions and minimal scarring
2. Reduced postoperative pain
3. Lower risk of wound complications
4. Shorter hospital stay
5. Faster return to normal activities

Because the procedure is minimally invasive, most patients experience earlier mobilisation and quicker overall recovery compared with traditional open surgery. Robotic surgery is particularly useful in complex, recurrent, or large ventral hernias, where precise reconstruction of the abdominal wall is important. While not every hernia requires a robotic approach, the technology expands the surgeon’s ability to perform advanced minimally invasive repairs with improved ergonomics and visualisation.

The future of hernia surgery

The integration of robotic platforms such as the da Vinci system represents a major step forward in modern general surgery. By combining surgical precision with minimally invasive techniques, robotic hernia repair aims to enhance patient comfort, improve recovery, and deliver durable surgical outcomes.

The liver and heart are two of the most vital organs of the body, and although they perform very different functions, they are closely connected. When the liver is not functioning properly, it can place significant stress on the heart and circulatory system of the body.

Liver disease not only affects the digestion process, metabolism, and detoxification but can also trigger serious cardiovascular changes that may go unnoticed in the early stages. Understanding this particular connection is significant for timely diagnosis and better overall care.

The Liver-Heart Connection

The liver helps to regulate the flow of blood, fluid balance, cholesterol metabolism, and inflammation as well. When liver disease develops—whether due to fatty liver, hepatitis, cirrhosis, or alcohol-related damage—all these processes become disturbed.

As a result of the same, the heart may have to work harder to maintain circulation, while blood vessels may also undergo certain changes that impact blood pressure and delivery of oxygen as well.

Changes In Blood Circulation

In well-advanced liver disease, especially cirrhosis, the flow of blood through the liver becomes restricted. This can also increase pressure in the portal vein, a condition known as portal hypertension. At the same point in time, blood vessels in the rest of the body may also widen, causing a drop in effective blood pressure.

To compensate, the heart pumps faster and harder. With the passage of time, this constant strain can weaken cardiac function and even lead to a condition sometimes referred to as cirrhotic cardiomyopathy, where the heart does not respond normally under stress.

Fluid Retention And Heart Stress

Liver disease often causes the body to retain both salt and water. This can also lead to swelling in the legs, abdomen, and surrounding tissues as well. Extra fluid in the body increases the workload on the heart, making it more difficult for it to pump blood in an efficient way. In severe cases, this may also contribute to shortness of breath, fatigue, and worsening cardiovascular strain.

Inflammation And Metabolic Impact

Some of the conditions, such as non-alcoholic fatty liver disease, are also linked with diabetes, obesity, high levels of cholesterol, and high blood pressure – all of which are the major risk factors for heart disease. Chronic inflammation, well-associated with liver damage, may further increase the risk of atherosclerosis and other cardiac complications.