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.

Diabetes at 35 and diabetes at 60 are not the same. As we grow older, the way diabetes presents, the complications we worry about and even the way we treat it can change. This is why diabetes care after 60 needs to look beyond a single blood test.

HbA1c remains an important measure of average blood sugar over the previous few months. But for an older adult, it cannot be the only measure of good diabetes care.

Diabetes Symptoms Can Be Silent in Older Adults

One of the challenges with diabetes in older people is that symptoms may not always be obvious. A person may not experience the typical excessive thirst, frequent urination or unexplained weight loss, even when blood sugar levels are high.

At the same time, older adults can be more vulnerable to diabetes-related complications affecting the eyes, kidneys, nerves, heart and blood vessels. Vision problems are particularly important because loss of vision can directly affect mobility, confidence and independence.

This makes regular screening essential, even when a person feels completely well.

The Same HbA1c Target Does Not Suit Everyone

There is no single HbA1c cut-off that is appropriate for every older adult. Treatment goals need to consider age, overall health, cognitive function, physical function, existing complications and the person's ability to manage treatment independently. Current diabetes standards specifically recommend individualising glycaemic goals in older adults.

For example, a healthy 65-year-old who is active and independent may have very different treatment goals from an 80-year-old who is frail, has multiple medical conditions or needs help with daily activities.

The goal should be good blood sugar control without causing unnecessary harm, particularly hypoglycaemia.

Treatment After 60 May Need to Be Different

As people age, kidney function can change, meals may become irregular and multiple medicines may be prescribed for different conditions. These factors can increase the risk of low blood sugar and make complex treatment plans harder to follow.

Therefore, doctors may need to review medicines regularly and simplify treatment when appropriate. The focus should be on finding a treatment plan that is effective, safe and practical for that individual.

Look Beyond Blood Sugar

A comprehensive diabetes review in an older adult should also consider:

• Eye and retinal health
• Kidney function
• Blood pressure and cholesterol
• Foot and nerve health
• Risk of hypoglycaemia
• Nutrition and unintended weight loss
• Muscle strength and mobility
• Memory and cognitive function
• Risk of falls
• Ability to take medicines and manage diabetes independently

The aim is not simply to produce a better HbA1c report. It is to prevent complications while helping the person remain active and independent.

Nutrition and Exercise Should Protect Independence

Older adults with diabetes need adequate nutrition, particularly protein and other nutrients needed to maintain muscle mass. Excessive dietary restriction can sometimes do more harm than good.

Physical activity is equally important. Walking, strength exercises and balance activities, when medically appropriate, can help maintain mobility and reduce the risk of losing independence.

Growing Older Well With Diabetes

Diabetes management after 60 should be personalised and regularly reassessed. What is appropriate at 60 may not be appropriate at 75 or 85.

As we mark the International Day of Older Persons, the message is simple: living well with diabetes in later life is about much more than achieving a particular HbA1c.

We need to treat the person, not just the number — protecting their health, safety, dignity and independence as they grow older.

By Dr. Uthra S, Senior Consultant, Dr. Mohan’s Diabetes Specialties Centre

Changes in voice pitch, volume or clarity in older adults could be an early warning sign of cognitive decline, according to a new analysis.

The study, published in the Journal of Voice, found that older adults who experienced a decline in voice quality had a higher risk of cognitive impairment or dementia than those without a voice disorder.

Voice Disorders And Higher Dementia Risk

The study tracked the health of more than 833,000 older Americans. Researchers found that people with a voice disorder had a 58% higher risk of cognitive impairment or dementia than those without voice problems.

The risk was even higher among people who had both a voice disorder and hearing loss, a well-recognized risk factor for Alzheimer’s disease.

Who Should Worry?

Also read: Brain Health After 40: How Diabetes, Menopause And Early Detection Affect Dementia Risk | World Alzheimer’s Day

A brief episode of hoarseness does not mean that a person is developing dementia.

However, persistent or noticeable changes in the voice, particularly when accompanied by hearing loss, may warrant a medical evaluation and, where appropriate, an assessment of cognitive health.

“We found the strongest link with dementia among patients experiencing a voice disorder and hearing loss,” said study author Dr. Robert Sataloff, a professor and chair at Drexel University’s College of Medicine.

“Importantly, we found that those with a voice disorder and no hearing loss were at greater risk than patients who experience hearing loss only. It may be valuable for many of these patients to talk with an otolaryngologist who can arrange a cognitive assessment to help patients develop an appropriate care plan.”

Why Voice Changes Can Signal Cognitive Decline?

Read More: Muscle Loss In Middle Age May Signal Dementia Risk, Study Finds

The researchers speculate that voice disorders may contribute to cognitive decline by limiting social interaction, which can also be affected by hearing loss.

People who have difficulty speaking or hearing may avoid social gatherings or group activities because they feel embarrassed or uncomfortable about their limitations. However, social engagement can help keep the ageing brain active by providing ongoing mental stimulation.

“If you have a voice disorder that impacts how your voice sounds or if it’s painful when you attempt to talk or sing, it’s only natural to participate less often in brain-supporting social or other engaging activities,” Dr. Sataloff said.

Speaking less may mean less social and cognitive stimulation, which could potentially contribute to dementia risk. However, the researchers also noted another possibility: changes in the brain associated with dementia could themselves contribute to voice problems. However, this has not been directly studied.

Voice Problems Can Have Treatable Causes

Most people with voice disorders will not go on to develop Alzheimer’s disease. Voice changes can have several other causes, including thyroid problems and cysts on the vocal cords, some of which can be treated effectively.

Speech therapists can also help people with impaired speech communicate more effectively and confidently.

Seeking medical attention for persistent voice changes can therefore help identify treatable causes and determine whether further evaluation, including a cognitive assessment, is needed.

As the 2026-27 flu season begins in the US, doctors are reminding people that influenza can cause more than just cough, fever and a runny nose. Symptoms can come on suddenly and affect the entire body, with some patients also developing gastrointestinal symptoms.

During the 2025-2026 flu season, influenza caused at least 32 million illnesses, 390,000 hospitalizations and 24,000 deaths in the US, according to preliminary data from the Centers for Disease Control and Prevention (CDC).

According to the World Health Organization, from February through August 2026, influenza A(H1N1)pdm09, A(H3N2) and influenza B viruses circulated across regions. Influenza A viruses predominated in most regions, while influenza B dominated in Northern and Western Africa, North America and Eastern Asia.

While it is too early to know what the season ahead will look like, knowing the range of flu symptoms can help people recognize the infection. These include the classic symptoms of sudden fever, chills, body aches and extreme fatigue, as well as vomiting and diarrhea in some children.

Flu Symptoms Can Come On Suddenly

Also read: WHO Sets 2027 Flu Vaccine Strains; US States Can Now Order Free COVID Shots For Kids

Influenza commonly affects the nose, throat and lungs, but its symptoms can be widespread.

The most common symptoms include:

• Fever

• Chills

• Body aches

• Extreme fatigue

• Headache

• Sore throat

• Runny or stuffy nose

• Cough

Family physician Carlos Galindo at Texas Health Family Care said fever, chills and body aches are the classic flu combination. People may also develop a sore throat, runny nose and headache, according to the American Medical Association.

Unlike the gradual tiredness that can accompany a cold, flu-related fatigue can be intense.

Galindo described it as significant lethargy and malaise, with some patients feeling completely drained.

Watch For Severe Body Aches And Fatigue

One of the key features doctors want people to recognize is how quickly influenza can make someone feel unwell.

Family physician Christopher Zipp of Atlantic Health in Morristown, New Jersey, said flu symptoms can develop over just a few hours, with fever, chills and body aches appearing suddenly.

However, flu symptoms can overlap with those of other respiratory infections, so symptoms alone cannot always confirm that someone has influenza.

Read More: Fall Vaccines 2026: US Doctors Issue COVID, Flu And RSV Jab Guidance

Children Can Have Vomiting And Diarrhea

Flu symptoms can also differ between children and adults. While fever, chills, body aches and respiratory symptoms are common, children may also develop gastrointestinal symptoms such as vomiting and diarrhea.

These symptoms can occur alongside cough, sore throat or other signs of respiratory infection.

When Can Flu Become Serious?

For most people, influenza is an unpleasant but temporary illness. However, it can sometimes lead to complications such as pneumonia and hospitalization, particularly in people with underlying health conditions.

Symptoms that become severe or worsen rather than improve warrant medical attention, especially among people at higher risk of complications.

In the US, many flu cases are seen between January and March, although influenza can circulate outside the peak season as well.

Doctors generally recommend flu vaccination around September or October to build protection before activity increases. It takes about two weeks for the body to develop protection after vaccination. Flu vaccination has been shown to reduce flu-related doctor visits by about 40% to 60%.