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.

A migraine attack is characterised by nausea, vomiting and sensitivity to light and sound. But early symptoms may surface long before the headache itself. Signs like fatigue, mood changes, food cravings and difficulty focusing may appear hours or even days before the pain.

The symptoms that occur during the attack reflect a complex neurological process that involves several interconnected brain networks, rather than just a headache.

A new Lancet Seminar review, looks deeper into how migraine develops, why its symptoms extend beyond head pain and how the better understanding of its biology are affecting treatment.

The study authors describe migraine as a chronic neurovascular disorder shaped by genetic susceptibility and interactions between the brain’s sensory networks, nerves, and blood vessels.

What Happens In The Brain During A Migraine Attack?

Also read: These Yoga Asanas Could Cure Your Migraine

Migraine is the result of the interaction of multiple systems responsible for processing sensory information and transmitting pain. Researchers are focusing more on other factors that drive migraine rather than just blood vessel narrowing or widening.

An important concept is the trigeminovascular system, which is a network involving the trigeminal nerve, tissues sensitive to pain that surrounds the brain and blood vessels. When this system gets activated, the patient experiences the peculiar head ache.

Chemical messengers called neuropeptides also play a key role. One of the most important is calcitonin gene-related peptide (CGRP), which participates in pain signalling in migraine. Treatments that target CGRP is an important development in migraine treatment and management.

The condition also involves changes in how the brain processes sensory information. This explains why light, sounds or smells can become intolerable during an migraine attack, and why some patients experience nausea, dizziness or difficulty concentrating along with severe headache.

Not an isolated abnormality triggering every symptom, migraine involves interactive neurological and vascular processes whose contributions can vary between individuals and across different phases of an attack.

Symptoms May Begin Before The Headache

Also read: Saba Ali Khan Opens Up About Brain Tumour: Can It Go Unnoticed If You Walk, Talk And Work Normally?

Migraine attacks typically occurs through several phases mostly:

1. Prodrome: Hours or days before the pain

The earliest phase can involve fatigue, yawning, mood changes, food cravings, neck stiffness and difficulty concentrating. The involvement of brain regions linked with homeostasis, including the hypothalamus, may help explain why an approaching attack can affect sleep, appetite, mood and other bodily functions.

2. Aura: Temporary neurological symptoms

Some people experience an aura before or during the headache. This can include flashing lights, zigzag patterns, blind spots, tingling or temporary difficulties with speech. Aura is associated with a phenomenon called cortical spreading depression, a wave of changing electrical activity that moves across the brain’s cortex.

3. Headache: Pain and sensory sensitivity

During the headache phase, activation of the trigeminovascular system contributes to pain signalling. Patients may experience moderate-to-severe, often throbbing pain, alongside nausea, vomiting and sensitivity to light, sound or smells.

Movement can aggravate the pain, making routine activities difficult. The headache phase can last several hours to as long as 72 hours.

4. Postdrome: After the pain subsides

The end of an attack does not necessarily mean the attack is over. Some people experience exhaustion, dizziness, body aches and difficulty concentrating for hours or days afterwards. These phases can overlap, and their timing and severity differ from person to person.

The Lancet review also highlights the role of genetic and epigenetic factors that contribute to migraine risk. They interact with complex neurological networks, helping explain why some people experience occasional attacks while others develop frequent or chronic migraine.

Episodic migraine is characterised by fewer than 15 headache days per month. Chronic migraine involves headaches on at least 15 days per month for more than three months, including migraine features on at least eight days each month.

Breast cancer is the most common cancer among women in India. According to various estimates, it accounts for about 26% of all cancers diagnosed among women, with nearly 2,00,000 new cases estimated in India each year.

Family history is not the only risk

Family history is an important risk factor, as some women inherit genetic changes that can increase their risk of developing breast cancer. Hereditary breast cancers can result from inherited genetic susceptibility, including mutations in high- or moderate-penetrance genes. BRCA1 and BRCA2 are among the best-known genes associated with hereditary breast cancer. Therefore, knowing family history is important.

But the absence of a family history does not mean that women are free from risk. In fact, around 80-85% of breast cancer cases occur in women with no known family history. These are generally referred to as sporadic cases.

The risk factors

Breast cancer risk factors can broadly be divided into those that cannot be changed and those that can potentially be modified.

Among the non-modifiable factors are age and certain reproductive and hormonal factors. Longer lifetime exposure to hormones such as oestrogen and progesterone can increase breast cancer risk. Early menstruation, later menopause and having a first pregnancy at a later age are some factors associated with longer hormonal exposure.

Potentially modifiable risk factors are largely lifestyle-related and include alcohol consumption, physical inactivity, excess body weight (particularly after menopause) and tobacco exposure. Maintaining a healthy weight, staying physically active, avoiding tobacco and limiting alcohol can help reduce the risk.

Also read: Amanda Peet’s Breast Cancer Wasn’t A Lump: What Was Her First Sign?

Five signs that should never be ignored

The five important warning signs include:

• A new, hard lump in the breast or armpit, particularly if it is increasing in size.
• A change in the size or shape of one breast, especially when it creates a new difference in breast symmetry.
• Unusual nipple discharge, particularly spontaneous discharge that is clear or bloody.
• Changes involving the nipple, such as a newly inverted nipple.
• Changes in the breast skin, including thickening, dimpling, puckering or a change in its appearance or texture.

These signs do not automatically mean cancer. But they should not be ignored.

Also read: Mammogram May Spot Hidden Heart Risk That Doctors Miss In Women

Get checked if you notice a change

If you notice any of these signs, particularly a new or persistent change in your breast, do not ignore it or try to diagnose it yourself. Seek medical evaluation promptly. A doctor will assess the breast and, if necessary, recommend what is known as a triple assessment: a clinical examination, breast imaging such as ultrasound or mammography, and tissue diagnosis when required. In selected cases, an MRI may also be recommended.

Tissue sampling may involve Fine Needle Aspiration Cytology or a core/true-cut biopsy. Together, these assessments help determine whether a breast abnormality is benign or malignant. It is important to distinguish this from screening. Screening is done in women who do not have symptoms, with the aim of detecting breast cancer at an early stage. When a woman has a symptom or notices a new breast change, she needs diagnostic evaluation rather than simply screening.

Don't panic: most breast lumps are benign

Finding a lump can understandably cause anxiety. However, most breast lumps, particularly in younger women, are benign. Common causes include fibroadenomas, breast cysts and fibrocystic changes.

Fibrocystic changes are often influenced by hormonal fluctuations. A lump may become more prominent or painful one to two weeks before menstruation and become smaller or less uncomfortable after the period. Some women may also experience a feeling of heaviness or tenderness in the breast.

An injury to the breast can also result in tissue damage and inflammation, producing a lump-like area. Therefore, a lump should not be assumed to be cancer, but neither should it be dismissed without appropriate evaluation.

Early detection can make a significant difference in the successful management of breast cancer. Women should remember that having no family history does not mean they are not at risk. At the same time, a breast lump or other change does not necessarily indicate cancer. The key is to know your own breasts, be aware of the warning signs and seek timely medical evaluation whenever a new or persistent change is noticed.

By Dr Megha B - Surgical Oncologist in Trichy - Breast, GI & Cancer Surgery Specialist, Kauvery Hospital

ADHD may be less about an inability to pay attention and more about difficulties sustaining engagement with tasks, according to a US psychiatrist who has questioned whether the condition's name adequately captures its symptoms.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects attention, executive function, impulse control, and activity levels. It typically begins in childhood, with symptoms appearing before age 12, and frequently persists into adulthood.

What Are The Symptoms Of ADHD?

According to the National Institute of Mental Health, ADHD symptoms fall into two primary categories:

Inattention: Difficulty sustaining focus, missing details, making careless mistakes, forgetfulness in daily routines, and struggling to stay organized.

Hyperactivity and impulsivity: Fidgeting, excessive talking, restlessness (including internal restlessness in adults), interrupting others, and acting without thinking.

However, Dr. Awais Aftab, a psychiatrist in Cleveland, Ohio, and clinical associate professor of psychiatry at Case Western Reserve University, has questioned whether the term “attention deficit” adequately captures the condition.

“The condition’s name notwithstanding, ‘attention deficit’ may be the wrong conceptual framing for ADHD,” he wrote in an article in The New York Times.

Also read: ADHD: Your Pupils May Explain How The Brain Handles Attention, Says New Indian Study

ADHD May Be More About Sustained Engagement

Aftab argued that ADHD may involve difficulties with the brain's ability to assign importance to a task and sustain the effort needed to complete it, rather than simply an inability to filter out distractions.

People with ADHD can often concentrate on activities that interest them. The difficulty may arise when they need to maintain attention and effort over time, particularly when tasks are repetitive or offer little immediate reward.

“If attention is about the mind homing in on what’s relevant in a given moment, engagement is about keeping that spotlight pointed at the same target over time,” Aftab wrote.

His argument offers a different way of thinking about some of the everyday challenges associated with ADHD, including starting tasks, staying organized, and following through on activities that require sustained mental effort.

What Do ADHD Medications Do?

ADHD is often treated with stimulant medications, such as Adderall, which can help reduce symptoms and improve attention and impulse control.

Aftab argued that the effects of these medications may extend beyond attention itself.

“Stimulants create what looks like improved attention and focus, but they really do so by enhancing the salience of mundane activities – tricking the brain into assigning greater worth and significance to things like math homework and laundry,” he said.

Citing a study published in Cell that examined the effects of stimulants on the brain, Aftab suggested that the medications' effects on brain networks could support a broader understanding of ADHD. However, findings about how stimulants affect the brain do not, by themselves, establish that ADHD is primarily a problem of motivation or task engagement rather than attention.

Aftab also suggested that some patients may rely on medication to keep up with lifestyles that are not suited to their needs. This raises broader questions about how treatment, daily demands, and individual needs intersect, rather than suggesting that medication is unnecessary.

He also emphasized evidence linking ADHD medication use with lower risks of adverse outcomes, including death, self-harm, transport accidents, criminality, and addiction-related problems.