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.

Indians are facing an increasing burden of heart diseases, and mortality is rising faster compared to other countries. A top US cardiologist has now shared the major risk factors that range from genetics to obesity to pollution.

Cardiovascular diseases (CVDs) cause nearly 31 per cent of all deaths in India, according to the latest Sample Registration Survey (SRS) 2021-2023 data from the Registrar General of India, released in September 2025.

The SRS report highlighted cardiovascular diseases as the leading cause of death, especially among adults over 30.

Speaking exclusively to HealthandMe, Dr. Sripal Bangalore, Professor of Medicine at New York University School of Medicine, highlighted the key reasons why India is seeing a huge burden of heart diseases.

"I think it’s a combination of traditional and non-traditional risk factors. Globally, we are seeing the burden of obesity increasing, and specifically in India, genetic factors and non-traditional risk factors also play a role," Dr. Sripal said.

"There is a growing investigation into lipoprotein(a) and other causes of cardiovascular disease (in India). Obesity is a major risk factor, and I’m sure stress and pollution also add to it, with more and more data supporting these links," he added.

Data from the World Heart Federation showed that heart disease kills 28.6 lakh Indians every year. In the recent past, India has also been seeing a significantly higher rate of heart attacks and related deaths, even in children as young as 12 years old.

Also read: AHA’s New Dyslipidemia Guidelines Stress Early Screening, Lifestyle Management

What Factors Are Driving This Trend

"I think we need to know that part of it tends to be non-traditional, because in the Western world most of it is explainable by traditional risk factors like hypertension, diabetes, and hypercholesterolemia," Dr. Sripal said.

"What we see in India is that it is less about those risk factors, but more about non-traditional ones, including potentially genetic factors and lipoprotein(a)," the doctor added.

The Indian-origin interventional cardiologist also cited lifestyle factors such as stress and pollution that are significantly adding to the increased risk of cardiovascular events in the country.

AHA 2026 Cholesterol Guidelines: Relevance For India

Recently, the American Heart Association (AHA) released cholesterol guidelines, which stressed the importance of early screening, starting with teenagers.

The guidelines call for early intervention through early screening and healthy lifestyle changes, starting from childhood.

It recommends:

• Children (9-11 years): Cholesterol screening if never done before.
• Adults (30-79 years): Evaluate 10- and 30-year ASCVD risk to determine the need for early intervention

"India is a good example where LDL levels (bad cholesterol) may not be very high, like in the Western world. Many times, HDL cholesterol (good cholesterol) tends to be lower, and there are other risk factors, including lipoprotein(a), which seems to be elevated here," Dr. Sripal said.

How To Improve Heart Health

The doctor also explained whether overall diet quality matters more than just cholesterol intake.

"Diet adds to the totality of everything that we do, including increasing the risk of obesity. Cholesterol may explain some part of it, but having a heart-healthy diet is critically important," Dr. Sripal said.

The cardiologist highlighted the need to increase the intake of fruits and vegetables, as consuming natural foods is critically important.

Importantly, he also emphasized at least making sure that you have a lipid panel to check your cholesterol levels.

"We are assuming that you are staying healthy and not smoking. Checking blood pressure, it depends on your age, but at least once a year, checking your lipid panel would be critically important," Dr. Sripal told HealthandMe.

As a cardiologist, he shared that to boost heart health, the key is

• to make sure that you lead a healthy lifestyle,
• stay away from smoking,
• increase physical activity,
• reduce stress.

"Pollution is one factor, and I think we can all do our part to make sure that we don’t contribute more to environmental pollution," he noted.

While India’s Ministry of Environment, Forest, and Climate Change (MoEFCC) enforced a nationwide ban on identified single-use plastic (SUP) items from July 1, 2022, a new survey showed that violations continue to persist across major cities in the country, raising significant health and environmental risks.

The survey of 560 locations by Toxics Link -- an Indian environmental research and advocacy organization -- showed that 84 percent of sites across Delhi, Mumbai, Guwahati, and Bhubaneswar still use or sell banned plastic items.

Bhubaneswar recorded the highest availability of banned SUPs at 89 percent of survey locations, followed by Delhi at 86 percent, Mumbai at 85 percent, and Guwahati at 76 percent.

The survey noted that high use among street food vendors, juice shops, coconut water sellers, vegetable vendors, and ice cream parlours.

"The continued presence of banned plastic items in a majority of locations suggests that enforcement remains inconsistent,” said Ravi Agarwal, Director of Toxics Link.

“Unless implementation improves and the supply of these products is controlled, the ban will not effectively address plastic littering and pollution,” he added.

How Plastics Can Harm Your Body

Plastic carry bags, disposable plastic cutlery, cups, plates, and straws often contain chemicals like BPA and phthalates, which can interfere with the body’s hormonal balance.

BPA is an industrial chemical used to make certain plastics and resins, and its exposure has been linked to several health conditions, including an increased risk of high blood pressure.

Phthalates, another group of chemicals used to make plastics more flexible, have been found to disrupt the endocrine system, leading to potential health issues.

Also read: Your Kids’ Fast-fashion Clothing May Be Laced With High Levels of Toxic Lead

Studies have proven that BPA and phthalates can mimic the body’s hormones, particularly estrogen. This interference can disrupt the normal functioning of the cardiovascular system, leading to increased blood pressure.

Plastics also contain some highly toxic chemicals, such as flame retardants, per- and polyfluoroalkyl substances (PFAS), that can migrate into the environment and into human bodies.

According to a report by WWF, an average person could be ingesting approximately 5 grams of plastic every week.

Scientific studies have proven that the health effects of plastics include cancer or changing hormone activity (known as endocrine disruption), which can lead to reproductive, growth, and cognitive impairment.

Recent evidence also indicates that humans constantly inhale and ingest microplastics through contaminated seafood, including fish and shellfish.

In addition, microplastics have been found in tap water, bottled water, and even commonly consumed beverages, such as beer and salt.

How to Reduce the Disease Risks?

The UNDP urges individuals, organizations, and governments to work together to

• manage plastic waste,
• reduce plastic usage,
• transition to a more sustainable and resilient environment.

Other options include

• Opting for BPA-free and phthalate-free options
• Switching to reusable water bottles, plates, and cutlery made from glass, stainless steel, or other safe materials can significantly reduce exposure to harmful chemicals.
• Avoid exposing plastic bottles or lunch boxes to high temperatures, as heat can accelerate the leaching of chemicals into the water.

While a weakened immune system and fear of complications once denied people with HIV access to organ transplants, doctors at a Delhi hospital have now challenged the idea with a successful kidney transplant surgery on a 43-year-old HIV-positive patient from Ethiopia.

According to the team of doctors from the Max Super Speciality Hospital, Patparganj, who successfully performed the complex living donor kidney transplant, advancements in antiretroviral therapy and transplant protocols have made such procedures increasingly safe in carefully selected cases.

“HIV is no longer a barrier to organ transplantation when managed appropriately,” said Dr. Ravi Kumar Singh, Senior Consultant, Nephrology and Transplant Physician at Max Hospital, Patparganj.

“With strict selection criteria and coordinated multidisciplinary care, patients with well-controlled HIV can achieve outcomes comparable to the general transplant population.”

Also read: India Identifies 219 Districts As Priority For Intensified HIV/AIDS Interventions

Kidney Transplant In HIV Positive Patient

The patient, who had been living with HIV for 10 years, developed end-stage renal disease 3 years ago and has been dependent on regular dialysis since then.

Before the surgery, the patient underwent extensive evaluation to ensure optimal control of HIV, including a stable immune profile and undetectable viral load.

The patient’s 33-year-old wife donated one of her kidneys. Compatibility testing confirmed matching blood groups and a negative cross-match, enabling the team to proceed with the transplant.

“Kidney transplantation in patients with HIV requires a highly meticulous and coordinated approach, given the complexities of balancing immunosuppression with ongoing antiretroviral therapy,” said Dr. Paresh Jain, Senior Director, Urology, Robotic Surgery & Renal Transplant.

“In this case, careful pre-transplant evaluation, precise surgical execution, and close post-operative monitoring were critical to ensuring a successful outcome. This procedure reflects how advances in transplant science and surgical expertise are enabling us to safely expand access to life-saving transplants for patients who were once considered high-risk,” he added.

Following the transplant, the patient has shown encouraging recovery, has been taken off dialysis, and is gradually returning to normal daily activities, the doctors said. The patient also continues on a carefully monitored regimen of immunosuppressive and antiretroviral therapy, they added.

Also read: India's Silent Crisis: Why We Must Embrace Deceased Donor Organ Transplantation

Can People With HIV Get A Transplant?

With advancements in antiretroviral therapy (ART), enabling people to live longer, HIV has now become a chronic, manageable condition. However, the HIV positive patients are now more likely to die from end-stage organ disease than from AIDS-related infections.

As per the US National Institutes of Health, people with HIV can successfully donate or receive transplanted organs with reasonable success rates.

However, health care providers must consider and monitor potential drug interactions, kidney and liver function, and HIV viral suppression in people with HIV receiving a transplant.

Further, the NIH advised HIV positive patients to continue taking all prescribed HIV medicines before and after transplant.