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.

Delhi-NCR witnessed unexpected showers in the city this year in the month of April. Before the heatwave could get as severe as it usually is every season, there were a few days where the national capital witnessed refreshing showers—but as it turns out, these showers often increase the risk of diseases like malaria. Yes, unexpected showers may bring temporary relief from heat, but they also quietly reset the risk for diseases like malaria. The concern today is not just rainfall, but how changing climate patterns are shifting the timeline of disease transmission—often weeks before the monsoon fully arrives.

Ahead of World Malaria Day, Dr Suranjit Chatterjee, Senior Consultant-Internal Medicine, Indraprastha Apollo Hospital, Delhi, spoke about the effects of such unexpected rains ahead of the monsoon season.

Has the malaria pattern changed?

Malaria has long been seen as a monsoon-linked illness, but that pattern is changing. Intermittent rainfall, rising temperatures, and increased humidity are now creating ideal breeding conditions much earlier in the year. Even a short spell of rain can lead to water accumulation in urban areas—on terraces, construction sites, in clogged drains, and in poorly managed storage spaces. These become hidden breeding grounds for mosquitoes, accelerating their life cycle and increasing the risk of early transmission.

When should you get tested for malaria?

From a healthcare perspective, this shift is significant. The first fever after early showers is often overlooked or dismissed as a seasonal viral infection. However, malaria in its early stage can closely resemble common viral illnesses, presenting with symptoms such as fever, chills, headache, body ache, and fatigue. This overlap frequently delays diagnosis. Any fever that persists beyond 2–3 days, recurs, or does not respond to basic treatment should be tested promptly. Early detection remains critical to preventing complications.

What are the symptoms of malaria?

Early malaria can look like a common viral fever. The symptoms of the disease are:

1. Body aches
2. Fever
3. Chills
4. Weakness
5. Headaches

Malaria prevention matters

Waiting for the monsoon to begin preventive action is no longer effective. The response must start with the first signs of rain. Clearing drains, eliminating stagnant water, monitoring construction zones, and ensuring proper waste management are essential early steps. At the household level, covering water containers, maintaining clean terraces, and regular checks for water accumulation can significantly reduce risk. Some of the key precautions to take against malaria are the following:

1. Use a mosquito repellent before going outdoors
2. Wear long sleeves and light coloured clothes
3. Use bed nets
4. Avoid keeping the windows open, especially in the evening
5. Standing water are breeding ground for malaria; avoid water sit in coolers or pots for too long

A year-round public health priority

World Malaria Day serves as a reminder that malaria prevention is not seasonal—it is continuous. In an era of unpredictable weather patterns, cities and communities must adapt quickly. Acting only when cases begin to rise means reacting too late. The real shift lies in recognising that prevention must begin with the first unexpected shower, not the peak of the monsoon.

Urgent action is required to strengthen diagnostics and vaccines to address gaps in dengue treatment, public health experts said.

The experts, including scientists and policymakers, were speaking at a day-long dialogue hosted in New Delhi by the Drugs for Neglected Diseases initiative (DNDi) in collaboration with the Translational Health Science and Technology Institute (THSTI), the Ministry of Health and Family Welfare, and the WHO South-East Asia Region.

The convening assumes significance ahead of the monsoon season, which historically sees a rise in Aedes aegypti mosquito populations and dengue transmission across health systems in South and South-East Asia.

"The WHO South-East Asia Region alone accounts for more than half of the global dengue burden, with 1.3 billion people living at risk across 10 endemic countries," said Dr Catharina Boehme, Officer in charge, World Health Organization, South-East Asia Regional Office.

Dr. Boehme called the rising burden of dengue both an economic crisis and a social crisis. She noted that beyond health system costs, dengue often leads to "lost productivity, lost wages, lost futures".

"To change this trajectory, we must close the gap on diagnostics, on vaccines, on therapeutics, and on health system resilience," Dr. Boehme said.

Also read: New dengue vaccine over 80% effective, prevents severe disease for up to 5 years

India Advancing in Dengue Fight, Gaps Remain

India reported over 2.89 lakh dengue cases in 2023, though experts believe the actual burden could be significantly higher due to underreporting and surveillance gaps.

Taruna Madan Gupta, Scientist G and Head, Development Research Division, ICMR, called dengue an "unequivocally a national health priority for India."

Gupta noted that "India is advancing on multiple fronts—from strengthening public health systems to enabling public-private partnerships, including Phase III trials of an indigenous tetravalent dengue vaccine with over 10,000 participants, and regulatory progress on global vaccines".

However, the expert flagged a critical gap, which is "the absence of an effective therapeutic" for the mosquito-borne disease.

The experts noted that even though there are improvements in surveillance and scientific understanding, patients still lack access to specific treatment options.

“Addressing this gap requires sustained commitment from governments, funders, and partners," said Dr Sanjay Sarin, Continental Lead Asia and Director South Asia, DNDi.

What Is Dengue?

Dengue fever is a viral disease transmitted by Aedes mosquitoes, which are most active during the daytime. Dengue fever typically has minor or no symptoms, but it can occasionally result in severe sickness, hospitalization, and even death.

Common Symptoms include:

• Sudden onset of high-grade fever.
• Intense headache
• Severe muscle, joint, or bone pain.
• Skin Rash that often appears 2–5 days after the fever starts
• Nausea and Vomiting
• Fatigue

It estimates that:

• About 390 million dengue infections occur annually worldwide
• Nearly 100 million people develop symptoms each year

These vaccines are designed to protect against all four serotypes of the virus, with a focus on reducing severe disease and hospitalizations.

In today’s fast-paced, wellness-driven world, looking fit does not always translate to being reproductively healthy. Currently, even fit and active individuals are facing fertility challenges due to hidden hormonal and metabolic imbalances. Hence, it is necessary to focus on reproductive health. Dr. Meenu Handa, Director of Fertility & Head Academic of Reproductive Medicine, Motherhood Hospitals, Gurgaon, decoded the link and listed some of the common fertility issues that most people overlook.

Now, a large number of people are opting for various activities such as yoga, Zumba, Pilates, the gym, and kickboxing to stay fit. Those who are health-conscious are also maintaining an optimum weight with a proper diet. These habits, in turn, can help to ensure good fertility. Shockingly, many people who are perfectly fit and fine on the outside may also struggle with fertility problems. Yes, that is right! This is also a common occurrence nowadays. Couples are panicking as they seem to adhere to a well-balanced lifestyle but still fail to conceive. So, this can be referred to as “invisible fertility issues," where underlying hormonal or metabolic imbalances silently affect reproductive health.

Decoding invisible fertility issues

Dr Handa said that many men and women who exercise regularly may suffer from issues such as hormone imbalance, fluctuating insulin levels, poor thyroid function, and compromised reproductive organ health. Conditions like polycystic ovary syndrome (PCOS), thyroid disorders, insulin resistance, and even chronic stress can exist without obvious physical signs and can take a toll on fertility. The expert also shared some of the common hidden infertility issues.

Even couples who are physically fit today often deal with high mental stress due to demanding jobs and poor work-life balance. This ongoing stress can quietly disturb hormonal balance in the body. Increased cortisol levels may affect ovulation in women and sperm production in men and, over time, can impact egg and sperm quality—making natural conception more difficult. That is why managing stress is just as important as staying physically fit when planning a pregnancy.

Women may have issues like poor ovulation, compromised egg quality, or hormonal imbalance, even if their menses tend to be regular. In some cases, even subtle symptoms like fatigue, acne, hair fall, or mood swings may be overlooked but can signal deeper hormonal concerns. Men can struggle with low sperm count, which can affect their fertility. Even insufficient sleep, excessive exercise, or extreme dieting can increase the chances of hormonal imbalance and fertility issues. It is necessary to consult an expert and seek timely help. Pollution and lifestyle stress also contribute to the trend.

Couples should not just plan a pregnancy because they are fit and exercise daily. Pregnancy should not rely only on outward fitness as a sign of reproductive health. Regular health check-ups, including hormone tests and fertility assessments, can help identify hidden issues early.

Follow these tips

1. Couples should eat a well-balanced diet, exercise daily, stay stress-free by practicing yoga and meditation, and get enough rest.
2. It is also imperative to maintain blood pressure and blood sugar levels within the recommended range, include healthy fats and proteins in the diet, avoid overtraining, and manage stress through relaxation techniques like yoga or meditation, which can support hormonal balance.
3. If a couple is unable to conceive even after 6–12 months of trying (depending on age), a detailed fertility evaluation is recommended.
4. Seeking timely medical advice is equally important if conception is delayed.
5. Couples who find it challenging to conceive may be advised to use ARTs, such as in vitro fertilisation (IVF).

So, awareness, balanced lifestyle choices, and timely medical support can make a huge difference in improving fertility outcomes.