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.

Every year on July 1, India celebrates National Doctors' Day. This year's theme, "Honor the Calling," is a timely reminder that medicine is not merely a profession—it is a lifelong commitment to service, sacrifice, and human compassion. Behind every consultation, emergency intervention, surgery, and diagnosis is a doctor who has spent over a decade training to save lives. Yet, at a time when healthcare has achieved remarkable advances, trust in doctors appears to be facing one of its greatest tests.

India's Healthcare Landscape

India today has nearly 14 lakh registered doctors, giving the country a doctor-population ratio better than the World Health Organization's recommended benchmark of 1:1000. Yet numbers alone do not tell the full story. India continues to grapple with unequal access to healthcare, overburdened public systems, and significant shortages of specialists in rural and semi-urban regions.

At the same time, the demands on doctors have never been greater.

A physician today is expected to be a clinician, counsellor, communicator, technologist, administrator, and often crisis manager—all at once. Every day, doctors make decisions that can determine whether a patient recovers, survives, or faces lifelong complications. Despite this responsibility, public perception of doctors is increasingly shaped by isolated incidents rather than the reality of millions of successful patient interactions that occur every day.

Rising Workplace Violence and Burnout

The truth is that the overwhelming majority of doctors enter medicine for one reason—to heal.

Yet, increasingly, they do so under immense pressure. According to studies published in leading medical journals and data referenced by the Indian Medical Association, more than 75% of doctors in India have experienced some form of workplace violence, ranging from verbal abuse and intimidation to physical assault. In many cases, the perpetrators are distressed family members struggling to cope with grief, uncertainty, or unexpected outcomes. The impact extends beyond personal safety.

Studies have also shown that over 80% of doctors report significant workplace stress and burnout, fueled by long working hours, rising patient loads, medico-legal concerns, and fear of violence.

The Growing Trust Deficit

No profession can function effectively when fear becomes part of the workplace. Compounding the challenge is a growing trust deficit. Research indicates that nearly 80% of patients search online after visiting a doctor, often seeking validation or clarification about diagnoses and treatments. While informed patients are welcome, the trend also reflects a lack of trust in the healthcare provider, which used to be one of the basic things in the past, and a communication gap that healthcare must urgently address.

Healthcare Has Changed Dramatically

Healthcare itself has changed dramatically. Over the last two decades, advances in neonatal care, robotics, minimally invasive surgery, fertility treatment, artificial intelligence, and precision medicine have transformed once unimaginable outcomes. Patients today have access to world-class healthcare technologies that were unavailable a generation ago.

However, as healthcare has become more specialized and hospital-centric, something valuable has been lost—the enduring relationship between a patient and a trusted family physician.

Why Family Doctors Still Matter

For decades, family doctors formed the backbone of healthcare. They understood not only diseases but also the people behind them. They guided families through preventive care, chronic illnesses, pregnancies, childhood illnesses, and ageing. They represented continuity, trust, and reassurance.

Today, many patients enter the healthcare system only when illness strikes, often bypassing primary care altogether. The result is a system that excels at treatment but frequently misses opportunities for prevention.

This shift has also led to a common misconception—that doctors are responsible for rising healthcare costs. In reality, healthcare expenses are driven by multiple factors, including technology investments, infrastructure, regulatory requirements, advanced diagnostics, and operational costs. Doctors are often the most visible face of a much larger ecosystem and therefore become the easiest target for public frustration.

Rebuilding Trust in Healthcare

The answer lies not in assigning blame but in rebuilding trust. India must strengthen primary healthcare, invest in family medicine, promote preventive care, and create safer working environments for healthcare professionals. Hospitals and healthcare providers must also focus on improving communication, transparency, and patient engagement. Trust is the most powerful medicine in healthcare. Without it, even the best technology cannot deliver its full promise.

Honoring the Promise of Medicine

This National Doctors' Day, as we honor the calling, let us remember the countless doctors who work through nights, weekends, emergencies, and personal sacrifices to care for others.

They are not defined by headlines or stereotypes.

They are defined by the lives they save, the families they comfort, and the hope they restore every single day.

Medicine is not merely a profession. It is a promise—and that promise deserves our trust, respect, and protection.

(By Dr R Kishore Kumar, President- National Neonatology Forum, Karnataka Chapter. The author is also the Founder Chairman & Senior Neonatologist & Paediatrician at Cloudnine Group of Hospitals.)

Every year, National Doctors' Day is observed on July 1 to commemorate the birth and death anniversaries of Dr. Bidhan Chandra Roy, a renowned physician, freedom fighter, and educationist.

The National Doctors' Day 2026 theme is "Behind the Mask: Who Heals the Healers?" This year's theme highlights the importance of supporting the mental, emotional and physical well-being of doctors who dedicate their lives to caring for others.

On the occasion of Doctors' Day, HealthandMe spoke to medical experts who highlighted the growing concern over violence against healthcare workers. They warned that such incidents not only endanger doctors but also weaken the entire healthcare system.

The experts stressed that violence affects patient care, lowers morale among healthcare professionals and erodes trust between doctors and patients.

Their concerns are supported by recent research highlighting the scale of workplace violence faced by doctors in India.

A 2026 study published in the National Medical Journal of India, researchers from the Institute of Human Behaviour and Allied Sciences (IHBAS), and Dr. Ram Manohar Lohia Hospital, and Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) found that 80.2 per cent of doctors in India reported having faced or witnessed workplace violence.

Verbal abuse was identified as the most common form, followed by physical and sexual violence. The incidents affected doctors' mental health, with the impact lasting from several weeks to as long as a year.

The study also found that two-fifths of doctors sustained physical injuries, including 7.8 per cent who suffered grievous injuries.

More worryingly, only about one-third of doctors reported such incidents to hospital authorities or professional medical bodies. Even when complaints were made, no action was taken in nearly half the cases, suggesting gaps in institutional accountability.

Why Violence Against Doctors Happens

Also read: Violence Against Doctors Is A National Concern, Says IMA Dilip P. Bhanushali

According to Dr Ishwar Gilada, Secretary General People's Health Organisation, India, several factors contribute to violence against doctors.

These include "high patient expectations, poor clinical outcomes, inadequate communication between doctors and patients, an overburdened healthcare system, high out-of-pocket medical expenses, weak security, misinformation, 'Mr. Google' providing false information, and limited accountability for perpetrators".

Dr. Tejinder Singh, Senior Consultant, Medical Oncology, Apollo Cancer Centres, Apollo Hospitals, Navi Mumbai added that anger and frustration arising from a patient's condition can sometimes fuel violent behavior, but emphasized that respect and meaningful dialogue are essential.

Impact On Patients And The Healthcare System

The experts said violence against healthcare workers has consequences that extend far beyond individual doctors.

Dr. Rajeev Jayadevan, former President of the Indian Medical Association (IMA) Cochin and Convener of the Research Cell, Kerala told HealthandMe that healthcare workers—including doctors, nurses, technicians and other staff—cannot give their best to patients if they are working under the threat of violence.

Dr. Gilada told HealthandMe that violence affects emergency care, lowers doctors' morale, increases attrition among healthcare professionals and encourages defensive medicine, where doctors order more tests to safeguard their own interests. He also warned that such incidents contribute to an erosion of trust between doctors, patients and the healthcare system.

Dr. Tejinder described violence against doctors as violence against the healthcare system itself, saying it creates a harmful atmosphere that ultimately affects patient care.

Not Every Poor Outcome Is Medical Negligence

Dr. Rajeev said there is often a perception that a poor outcome for a patient is the fault of the doctor or the hospital. He stressed that many adverse outcomes are part of the complex disease process within the body and can occur despite the best possible treatment.

Dr. Tejinder told HealthandMe that doctors are also human and that medical science cannot guarantee that every patient's problem can be cured, even when doctors do their best.

What Is The Solution?

The experts proposed multiple measures to reduce violence against healthcare workers.

Dr. Gilada called for stronger legal protection, saying the Healthcare Protection and Clinical Services Act (Prevention of Violence Act) 2025 should be passed into law. He also recommended improving doctor-patient communication, strengthening hospital systems and increasing public awareness through collaboration among healthcare agencies, patients, communities, government bodies and law enforcement agencies.

Dr. Rajeev said hospitals should establish effective grievance redressal systems so that patients' concerns can be addressed before they escalate into violence. He also said healthcare establishments should be declared peaceful zones where violence is prohibited.

Dr. Tejinder urged patients and families to maintain open dialogue with doctors, emphasizing that doctors and patients ultimately share the same goal—the well-being and betterment of the patient.

Preventive healthcare through early screening, healthier lifestyles and greater public awareness is crucial to reducing the burden of both communicable and chronic diseases, doctors said ahead of National Doctors' Day.

National Doctors' Day is observed in India on July 1 to honor the contributions of medical professionals.

Shift Focus On Prevention

Speaking at an event organized by the Illness to Wellness Foundation, Rajesh Bhushan, former Secretary, Ministry of Health and Family Welfare, said India has made significant strides in expanding access to healthcare and strengthening its treatment infrastructure.

"The next phase of our healthcare journey must focus equally on prevention," Bhushan said.

He stressed that preventive healthcare should become a national priority, supported by regular screening, early diagnosis, healthier lifestyles and greater public awareness.

"Preventive healthcare is not only a public health priority but also an economic imperative for building a healthier and more productive nation," he added.

India Faces A Double Burden

Also read: National Doctors' Day 2026: Stronger Protection Against Violence In Healthcare Need Of The Hour, Say Doctors

Prof. (Dr.) Nirmal Kumar Ganguly, former Director General of the Indian Council of Medical Research (ICMR), said India is battling both infectious diseases and a rapidly growing burden of lifestyle-related illnesses.

"One of the biggest health challenges India faces today is the growing burden of obesity, which is the root cause of many major non-communicable diseases. Preventive healthcare is the most effective way to address both communicable and non-communicable diseases."

India continues to report a high burden of communicable diseases such as tuberculosis, malaria, dengue, cholera, typhoid, HIV/AIDS, hepatitis B and hepatitis C, which together account for about 27.5% of the country's disease burden.

At the same time, non-communicable diseases—including obesity, diabetes, hypertension and cancer—are rising rapidly. Around 60% of all deaths in India are caused by NCDs, with nearly 70% of their risk factors linked to unhealthy lifestyles.

Prevention Can Improve Quality Of Life

Prof. (Dr.) G. C. Khilnani, Chairman, PSRI Institute of Pulmonary, Critical Care & Sleep Medicine, said preventive healthcare should become part of everyday life through regular health check-ups, balanced nutrition, physical activity, vaccination, good hygiene and timely medical consultation.

Dr. Yash Gulati, Padma Shri awardee and Senior Consultant Orthopaedic and Joint Replacement Surgeon at Apollo Hospitals, New Delhi encouraged people to treat preventive healthcare as a lifelong commitment rather than an occasional health check-up.

"Every step taken towards prevention today reduces the burden of disease tomorrow."

How To Prevent Diseases

Doctors said adopting a prevention-first approach can significantly reduce the risk of both communicable and chronic diseases. They recommended:

• Going for regular health screenings to detect diseases early.
• Exercising regularly, including walking, yoga or other physical activities.
• Eating a balanced diet rich in fruits, vegetables, whole grains and fiber.
• Maintaining a healthy weight to reduce the risk of obesity, diabetes and heart disease.
• Getting adequate sleep and manage stress through meditation or relaxation techniques.
• Staying up to date with vaccinations to prevent infectious diseases.
• Maintaining good hygiene, including frequent handwashing and access to safe drinking water.
• Seeking timely medical advice instead of waiting for symptoms to worsen.