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.

In a shocking viral trend, women in Kenya are reportedly inserting cetirizine, an allergy medication, into their vaginas in an attempt to achieve vaginal tightening and enhance sexual pleasure.

The practice has prompted warnings from pharmacists and health authorities, who caution that the drug is not meant for vaginal use and could pose health risks.

The Pharmaceutical Society of Kenya (PSK) has warned against the practice, stating that the medicine is not intended for vaginal use.

"Cetirizine is an allergy medicine, taken by mouth. It is not approved or tested for any other purpose, and definitely not for vaginal use," the PSK said in a statement issued on Thursday.

It advised women who had tried the practice to stop and seek medical attention if they experienced pain, bleeding, burning, itching, unusual discharge or fever.

What Is The Cetirizine Vaginal Tightening Trend?

Also read: Is Your Allergy Medicine Safe? FDA Recalls Antihistamine Tablets Over Life-Threatening Contamination Concerns

Posts circulating on Kenyan social media, particularly TikTok, claim that cetirizine can reduce vaginal moisture and create a sensation of tightness during sex, BBC reported.

The claims have sparked online debate, with some users endorsing the practice and others questioning its safety.

The trend has also reportedly increased demand for the drug, with local media reporting price rises and shortages at some pharmacies in Nairobi.

What Is Cetirizine And Why Is Its Misuse Dangerous?

Cetirizine is an oral antihistamine used to relieve allergy symptoms such as sneezing, runny nose, itchy eyes and hives.

Kenya's Pharmacy and Poisons Board (PPB) clarified in a public safety alert issued on November 4 that cetirizine is used to treat allergic rhinitis and urticaria. It is intended for oral use and should be taken only as directed by a healthcare professional.

The Board stressed that "the drug is not approved for vaginal use or tightening and that no established scientific evidence supports such claims".

On the other hand, inserting the tablets may cause vaginal irritation, burning, soreness, pain and discomfort. It may also disrupt the vagina's natural protective environment and increase infection risk.

The PSK cautioned against confusing dryness with tightening.

"Dryness is not tightness... instead, it may increase friction, discomfort, and the risk of tissue injury," it said.

Taking more than the recommended cetirizine dose can also cause excessive sleepiness, dizziness, restlessness, confusion, shaking, a rapid heartbeat and difficulty passing urine, the PPB warned.

Kenya's Health Ministry Raises Concern

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Kenya's health ministry had also flagged the trend a day earlier. Ouma Oluga, a senior health official, expressed concern that social media users were dismissing medical warnings without considering the consequences, the BBC reported.

He suggested that authorities could introduce a system to monitor medicine distribution and purchases to identify potential misuse. No formal decision has been announced.

Pharmacists Warn Of Shortages And Misuse

The PSK said it had received reports of increased cetirizine demand, rising prices and shortages at some pharmacies.

It urged retailers not to exploit the trend, warning that people who need the drug for allergies could struggle to access it. Pharmacists were also advised against knowingly dispensing medicines for misuse.

The PPB urged women not to insert cetirizine or other oral medicines into the vagina and to consult healthcare professionals about vaginal dryness or sexual health concerns rather than follow unverified online advice.

Delhi's air quality remained in the Very Poor category on Thursday, with an AQI of 369 as pollution levels continued to rise across the Capital. With Diwali celebrations with firecracker fuel smoke to an already polluted city, concerns about respiratory health are mounting. The timing is alarming as it also coincides with the flu season, when respiratory infections are also circulating.

While air pollution and influenza both affect the respiratory system, it can put additional stress on the lungs. Pollutants can irritate the airways, trigger inflammation and weaken the lungs' natural defence mechanisms, while the influenza virus infects the respiratory tract.

Together, they can aggravate respiratory symptoms and make breathing more difficult, especially in people with pre-existing lung conditions.

According to Dr. Arup Halder, Consultant Pulmonologist at CK Birla Hospitals, CMRI Kolkata, prolonged exposure to air pollution can weaken the respiratory system's immunity.

“Exposure to air pollution, especially for long durations, can weaken the respiratory system's immunity. Fine particulates can become lodged in airways and damage the mechanisms the body has to protect itself. This makes respiratory infections much more likely, especially if viral in nature,” he told HealthandMe.

Dr. Suresh Sagadevan, Senior Interventional Pulmonologist at Gleneagles Hospital, Chennai, told HealthandMe that pollution can also interfere with the lungs' natural cleaning mechanisms.

He said that the respiratory tract contains tiny hair-like structures called cilia, which help remove dust and germs. Polluted air can affect their functioning, making it easier for respiratory viruses to infect the airways. However, pollution does not directly cause influenza nut it can compromise the respiratory system's ability to defend itself against such infections.

What Happens When Particulate Matter And Flu Affect The Lungs Together?

Also read: Delhi Air Pollution: Feeling Anxious As AQI Rises? Experts Explain The Mental Health Toll Of Breathing Toxic Air

Particulate matter and influenza together can intensify inflammation in the respiratory system.

Fine particulate matter, like PM2.5, can penetrate deep into the lungs. It can cause inflammation and oxidative stress. At the same time, influenza viruses infect the cells lining the respiratory tract.

"When both exposures occur together, the existing inflammation can become more intense, potentially worsening coughing, breathing difficulty and airway irritation. In simple terms, the lungs are dealing with two different stresses at the same time," said Dr. Sagadevan.

Dr. Halder added that PM2.5 can also interfere with the body's ability to ward off irritants from the respiratory tract, while influenza can make breathing challenging.

Facing both together can be challenging for people whose respiratory or immune systems are already compromised.

Can Diwali Pollution Make Flu Symptoms Worse?

Also read: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Firecracker smoke can aggravate an already infected and overwhelmed respiratory system. People with flu may experience excessive coughing, wheezing, chest tightness and breathlessness when they get exposed to high levels of pollution.

"Increased Diwali-related pollution will definitely worsen respiratory symptoms for individuals with the flu, especially during this period. The gases and particulate matter from firecracker smoke can lead to chest congestion and difficulty in breathing. In some cases, the pollution can worsen existing asthma and other lung-related conditions and trigger respiratory issues," said Dr. Halder.

Dr. Sagadevan said that people with asthma, chronic obstructive pulmonary disease (COPD) and other pre-existing respiratory conditions need to be particularly careful by limiting exposure.

Who Is Most Vulnerable When Flu Season Coincides With High Pollution?

Certain groups of people may face a greater risk when respiratory infections coincide with elevated pollution levels. These include:

• Children: Their lungs are still developing, making them more vulnerable to air pollution.

• Older adults: Age-related changes can reduce respiratory capacity and make it harder to cope with added stress on the lungs.

• Pregnant women: They need to take extra precautions against respiratory infections and environmental pollutants.

• People with asthma or COPD: Pollution can trigger flare-ups, worsen airway inflammation and aggravate breathing difficulties.

• Immunocompromised individuals: A weak immune system can make it harder to fight infections and increase the risk of severe illness.

Dr. Halder explains that older adults and people with weak immunity may be more susceptible to more serious flu symptoms. Meanwhile, those with existing lung conditions may experience worsening respiratory symptoms even with short periods of pollution exposure.

Pollution Effects Vs Flu: Symptoms

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

Pollution-related respiratory irritation and influenza can lead to similar symptoms, making it difficult to distinguish between the two. However, their onset and symptoms can differ.

Pollution-related irritation develops shortly after exposure to polluted air. Common symptoms include:

• Throat irritation or discomfort
• Burning or watering eyes
• Dry cough
• Sneezing
• Wheezing
• Chest discomfort

Flu, on the other hand, is a viral infection that mostly causes a sudden onset of symptoms, including:

• Fever
• Body aches and muscle pain
• Headache
• Fatigue
• Cough
• General weakness

"However, both can occur together, and symptoms may overlap. Persistent fever, worsening breathlessness or significant weakness should prompt medical evaluation," says Dr. Sagadevan.

Dr. Halder also recommends consulting a medical professional when symptoms make it difficult to determine whether the problem is pollution-related irritation or an infection.

How To Protect Your Lungs During Diwali And Flu Season

Reducing exposure to polluted air and taking precautions against respiratory infections can help protect lung health during the festive season.

Both doctors recommend the following measures:

1. Limit outdoor exposure: Avoid spending long periods outdoors, especially after firecracker bursting and during periods of heavy smoke.

2. Wear a well-fitting N95 mask: If you need to step outside when pollution levels are high, use a properly fitted N95 mask to reduce exposure to fine particulate matter.

3. Keep windows closed: Close doors and windows during periods of heavy smoke to limit the entry of outdoor pollutants. Ventilate indoor spaces when outdoor air quality improves.

4. Avoid outdoor exercise: Vigorous physical activity increases the amount of air you breathe in, increasing exposure. Avoid exercising outdoors when air quality is poor.

5. Avoid firecrackers and second-hand smoke: Staying away from firecracker smoke can reduce exposure to harmful pollutants.

6. Get vaccinated against influenza: Stay up to date with flu vaccinations to reduce the risk of influenza and its complications.

7. Maintain hand hygiene: Wash your hands regularly for infection prevention.

8. Seek medical attention: Do not ignore worsening fever, cough, wheezing or breathing difficulties, especially if you have an existing respiratory condition.

Dr. Sagadevan concludes, "Air pollution and influenza can independently affect respiratory health, but their coexistence can place additional stress on the lungs. During the festive season, protecting our lungs through pollution avoidance, vaccination and timely medical care should be a priority."

Metformin is the first-line treatment for type 2 diabetes in adults and children aged 10 years and above. The drug has also found applications in managing Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS). But a recent study says that it may have some potential use in a non-metabolic health condition: Long COVID.

Researchers found that people who were prescribed metformin shortly after testing positive for COVID-19 had a significantly lower risk of developing Long COVID than those prescribed other medications.

How Was The Study Conducted?

Also read: 'It’s The Best-Studied Vaccine In Human History': Former CDC Adviser Busts Common Myths About COVID Vaccines

The study, titled Metformin at the Time of COVID-19 Infection and Risk of Long COVID: A Target Trial Emulation Study, was published in the Journal of Medical Virology recently.

Researchers have been exploring metformin's antiviral and anti-inflammatory effects, especially during the early stages of COVID-19 infection. They are specifically investigating if metformin could reduce the risk of Long COVID if taken soon after contracting the infection.

The researchers examined health records of more than 21 million people from the US National COVID Cohort Collaborative (N3C). They identified adults who had tested positive for COVID-19 between March 2020 and September 2023. They compared two groups:

Metformin group: People who received a new prescription for metformin within six days of their documented COVID-19 infection.

Comparison group: People who received prescriptions for other medications, including fluvoxamine, fluticasone, ivermectin or montelukast, during the same period.

The researchers excluded people who were already taking metformin or had conditions like diabetes, PCOS or gestational diabetes that could explain why they were prescribed the drug.

After statistical adjustments to make the groups more comparable, the researchers compared 248 people in each group. They then tracked the development of Long COVID or death over the following 180 days (six months).

Also read: Can Low-Dose Naltrexone Ease Long COVID Symptoms? New Study Examines The Evidence

Can Metformin Help Reduce The Risk Of Long COVID?

People who were prescribed metformin within six days of a COVID-19 infection had a 53% lower relative risk of Long COVID or death compared to those on other medications.

“Metformin prescription within the week following documented SARS-CoV-2 infection was associated with a 53% reduction in LC/D [long COVID or death] over 6 months in this primarily Omicron-infected sample,” wrote the authors, led by researchers from the University of Minnesota Medical School.

The study found that the risk of Long COVID or death within six months was 4.0% in the metformin group as 10 out of 248 people developed symptoms.

In the comparison group, the number was 8.5% as 21 out of 248 people presented symptoms of Long COVID. Overall, the weighted chance of Long COVID or death in patients on metformin or control treatment within six days of diagnosis was 6.3%. The absolute difference between the two groups was 4.5 percentage points.

“These results are also consistent with a recent sequential target trial analysis in the United Kingdom that assessed metformin started within 90 days of infection, HR [hazard ratio] 0.36,” the authors wrote. “The replication of results in clinical trials is important for informing treatment guidelines.”

More About Long COVID

Long COVID refers to symptoms that occur after a SARS-CoV-2 infection and cannot be explained by another diagnosis.

Symptoms may include brain fog, fatigue, cognitive difficulties, breathlessness, sleep disturbances and problems with everyday activities. These symptoms may last for months or even years.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

Some people improve over time, while others experience prolonged illness that affects their ability to lead routine lives.