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.

Scientists have discovered a previously unknown mechanism that could explain why high cholesterol diet makes it challenging for the liver to remove bad cholesterol from the bloodstream. Researchers have also identified an experimental drug that blocks this process, offering a new method for treating high cholesterol.

The findings are published in the journal Nature by researchers from the University of California San Diego School of Medicine. Their experiments showed that blocking a specific enzyme called cathepsin A (CTSA) helped retain the liver's ability to clear low-density lipoprotein (LDL), commonly known as bad cholesterol.

In mice, inhibiting this enzyme stabilised LDL receptors in liver cells, reducing LDL cholesterol.

"We've known for a long time that a high-cholesterol diet reduces the liver's ability to clear cholesterol from the blood, but we didn't fully understand why," said senior author Alan Saltiel, professor of medicine at UC San Diego School of Medicine. "This new discovery explains a critical piece of that puzzle."

More About The Experiment

The liver plays a key role in regulating cholesterol levels. It uses LDL receptors located on the surface of liver cells to capture LDL cholesterol from the bloodstream.

When fewer of these receptors are available, the liver becomes less efficient at removing LDL cholesterol, allowing it to increase in the bloodstream. The researchers discovered that consuming high amounts of dietary cholesterol activates a protein called Ral. This increases the activity of CTSA, an enzyme that breaks down LDL receptors.

As these receptors are lost, the liver's ability to clear bad cholesterol declines. When researchers blocked CTSA using a small molecule inhibitor, LDL receptors became more stable and LDL cholesterol levels decreased dramatically in mice.

Also read: Recreational Drugs, Steroids & Birth Control: Expert Explains Why Strokes Are Arriving Decades Earlier

Experimental Drug That Can Help Lower Cholesterol

The discovery has sparked interest as researchers have identified an experimental drug that targets CTSA. The drug was originally developed as a possible treatment option for heart failure. Although its development for that purpose was discontinued for other reasons, it had already completed a Phase 1 clinical trial, which evaluated its safety in humans.

This previous test could help researchers move towards studying its ability as a cholesterol treatment. However, the drug has not yet been shown to lower LDL cholesterol in humans.

"There's still a real need for new cholesterol-lowering options, since some people can't get to safe levels even with the drugs we have now," Saltiel said.

He added, "This new pathway we discovered is completely separate from anything that existing drugs target, so it gives us a new opportunity to fill that gap."

The researchers hope to test the experimental CTSA inhibitor in a Phase 2 clinical trial to determine whether it can safely and effectively lower cholesterol in people. If successful, the approach could offer another option for people who struggle to control LDL cholesterol despite using existing treatments.

Saltiel said, "Luckily, there's an experimental drug sitting on the shelf that's already been shown to be safe in humans."

"We hope to test whether this might be effective by conducting a clinical trial -- which could potentially bring a new treatment option to patients much sooner than would have been expected."

Irritable bowel syndrome (IBS) is often characterised by digestive symptoms like abdominal pain, bloating, constipation and diarrhoea. However, the condition involves more than the digestive system.

A new review published in The Lancet explains how interactions between the gut and brain, changes in the gut microbiome, immune activity and the body's response to pain can contribute to the development of symptoms.

The review, titled Irritable bowel syndrome and related disorders of gut-brain interaction, brings focuses on biological and psychological evidence behind IBS. Researchers describe it as a disorder of gut-brain interaction, in which signals between the digestive system and the central nervous system affect gut function.

The authors also discuss chronic constipation and functional diarrhoea, which belong to the bigger group of disorders related to gut-brain interaction. These conditions may affect an estimated 20% of the global population.

What Is The Gut-Brain Connection In IBS?

Also read: Olympian Ciara Mageean Dies At 34 After Bowel Cancer Battle: Warning Signs In Young Adults

The gut and brain communicate continuously through a complex network that involves the central nervous system, autonomic nervous system, enteric nervous system and hypothalamic-pituitary-adrenal (HPA) axis.

The brain can influence intestinal movement, secretion and sensitivity, while signals from the gut can affect how the brain processes pain and other sensations.

In people with IBS, this communication may become disrupted. The result can be changes in bowel movements, more sensitivity to normal digestive processes and abdominal discomfort.

The authors said, “These central and peripheral mechanisms can act in an integrated way to cause IBS symptoms, via the gut-brain axis.”

For instance, a person with IBS may experience pain or bloating even when the amount of gas or intestinal movement would not cause discomfort in someone without the condition. This is due to a condition called visceral hypersensitivity, in which the nerves supplying the digestive organs become unusually sensitive to internal sensations.

The review explains that changes in both peripheral mechanisms within the gut and central mechanisms involving the brain can contribute to symptoms.

Gut Bacteria And Inflammation May Contribute To IBS

Also read: Can Coffee Trigger Irritable Bowel Syndrome?

The gut microbiome, which consists of microorganisms living in the digestive tract, is another important part of the gut-brain connection.

Changes in the composition and activity of gut bacteria may impact intestinal function, immune responses and communication with the nervous system. The review identifies the following:

• Gut infections: Gastrointestinal infections can trigger IBS symptoms in some people, even after the initial infection has subsided.
• Altered gut microbiome: Changes in intestinal bacteria may affect digestion, immune activity and gut function.
• Increased intestinal permeability: Changes in the intestinal barrier may allow substances to pass through more easily, potentially contributing to immune activation.
• Low-grade inflammation: Mild inflammation in the intestinal lining and changes in immune function may contribute to symptoms.
• Abnormal gut movement: Changes in gastrointestinal motility can cause food and waste to move through the digestive tract too quickly or too slowly.
• Visceral hypersensitivity: Increased sensitivity in the gut can make normal digestive processes feel painful.

Mental Health And IBS

Psychological health is another component of the gut-brain axis. Stress, anxiety and other psychological difficulties can influence how the brain processes pain and communicates with the digestive system.

The HPA axis, which helps regulate the body's response to stress, plays a role in this process . Changes in stress levels can affect gut movement, secretion and sensitivity.

Currently, there is no single biomarker that can diagnose IBS. Doctors assess symptoms, medical history and clinical findings, while using tests to rule out other conditions.

The review highlights that some underlying mechanisms can already be measured through approved tests and questionnaires. These include abnormal bile acid metabolism, accelerated movement of contents through the colon and psychological conditions.

Does a patient’s chances of serious outcomes differ if they are treated by a female doctor? A recent study looks into this hypothesis to ascertain the difference between chances of a patient dying under a male and a female doctor.

According to the study, hospitalised patients treated by female doctors have a lower risk of dying within 30 days. They are also less likely to be re-hospitalised than those treated by male doctors. The study is published in JAMA Network Open.

"Past research has largely focused on surgical patients and the admitting physician only. Our findings add to the growing body of research examining the relationship between physician sex and patient outcomes, broadening the evidence beyond surgical care to a wider range of medical conditions and other physicians," says Dr. Angela Jerath, an ICES scientist, and Associate Professor, Department of Anesthesiology & Pain Medicine at the University of Toronto's Temerty Faculty of Medicine.

After analysing the health records of 958,150 adults admitted to hospitals in Ontario, Canada, between 2008 and 2022, researchers found that the 30-day mortality rate was 12.3% among patients treated by female physicians, compared to 13.7% among those treated by male physicians.

The findings also show a small difference in hospital readmissions. The 30-day readmission rate was 18.6% for patients treated by female doctors and 18.9% for those treated by male doctors.

The researchers examined outcomes across seven common medical conditions, including heart attacks, pneumonia and other acute illnesses.

They also considered the number of hospital days during which patients received care from female doctors, recognising that several doctors may be involved in a patient's treatment during an admission.

Patients Treated By Female Doctors Are Less Likely To Die In A 30-Day Period

Also read: Manosphere Is A Public Health Concern: Lancet Report Says Online Misogyny Harms Men's Mental Health

After accounting for patient, physician and hospital characteristics, treatment by a female physician was linked with 12% lower adjusted odds of death within 30 days compared to treatment by a male physician.

The researchers also found that for every 10% increase in the proportion of hospital days managed by female physicians, the adjusted odds of 30-day mortality decreased by 7%. This was observed for most medical conditions that were studied. Atrial fibrillation was the only exception.

The difference in mortality was also seen at longer follow-up periods. Patients treated by female physicians had lower mortality at 90 days and one year.

The findings were observed among both male and female patients. Female patients treated by female physicians had the lowest adjusted 30-day mortality rate in the analysis.

Why Patients May Have Better Outcomes With Female Doctors?

The study did not establish why patients treated by female physicians experienced better outcomes. However, the researchers discussed possible differences in clinical practice and communication.

Female physicians may be more likely to engage in patient-focused communication, spend more time with patients, follow clinical guidelines and involve colleagues in decision-making.

These practices could influence how symptoms are studied, treatment decisions are made and coordinated during hospitalisation.

"The goal is not to favour one group of physicians over another but to identify practices and behaviours that may help improve care across the health system," says Jerath.

"An important strength of this study is that, unlike surgical care, patients admitted to hospital for medical conditions are generally assigned physicians based on rotating schedules rather than patient or referring physician preferences, helping to minimize referral bias."