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.

Delhi has issued a public health advisory amid a sharp rise in H1N1, commonly known as swine flu, cases. Health authorities urging residents to follow respiratory hygiene, avoid crowded places and seek medical advice if flu-like symptoms develop.

The national capital has reported more than 1,777 H1N1 cases so far this year, including 114 new infections recorded on August 20 alone, according to the latest health department data. Overall, Delhi has reported more than 2,300 Influenza-A cases in 2026.

The sudden surge has prompted the Centre and Delhi authorities to step up surveillance and hospital preparedness. Health officials have also stressed that people should not panic but take necessary precautions to avoid getting sick.

Delhi Sees A Sharp Rise In H1N1 Cases

According to health department, Delhi had recorded 2,392 Influenza-A cases by August 21, of which 1,777 were H1N1. The tally also included H1 and H3 infections and other Influenza-A strains.

The current number is significantly higher than the corresponding period last year. Public health experts have also described some of the H1N1 cases being seen this season as relatively severe.

Dr Chandrakant Lahariya, a public health expert, said H1N1 is not a new subtype and has been known for years, but the current surge needs to be taken seriously.

Also read: Delhi H1N1 Cases Rise To 1,777: Patients Reporting Diarrhea, Muscle Pain, Drop In Oxygen Levels, Say Doctors

Humid Weather Could Be A Major Factor

Doctors have linked the increase to the seasonal pattern of respiratory infections during the monsoon, when humidity, changing temperatures and increased indoor contact can facilitate the spread of respiratory viruses.

Dr Neetu Jain, senior consultant in pulmonary, critical care and sleep medicine at PSRI Hospital, told PTI, “H1N1 cases are particularly high in Delhi-NCR this year.”

She also said the number of cases was reported to be around six times higher than previous years and noted that high temperatures and humidity may contribute to the increase in flu and other viral infections.

Common Symptoms

H1N1 infection can mimic other viral respiratory illnesses. Common symptoms include:

• Fever
• Cough
• Sore throat
• Runny or blocked nose
• Headache
• Body aches
• Chills
• Fatigue and weakness

Some people recover without complications, but influenza can become serious, particularly in young children, older adults, pregnant women and people with weak immune systems.

Difficulty in breathing, chest pain, drowsiness, low blood pressure, bluish discolouration or worsening of an existing medical condition are among warning signs that need urgent medical attention.

Also read: Human H1N2v Swine Flu Case Detected In China: Should You Worry?

Doctors Advise Against Self-Medication

With flu cases rising, doctors are also urging people not to assume that every fever or cough is H1N1 and start medicines without medical advice.

Dr Jain described H1N1 as a “fairly treatable illness”, while noting that it can become serious in vulnerable people. Antiviral medicines may be prescribed in appropriate cases, along with supportive treatment.

The Delhi government's advisory recommends several basic measures to reduce transmission. People are being urged to wear masks in crowded places, cover their mouth and nose while coughing or sneezing, wash their hands frequently and avoid close contact with people showing respiratory symptoms.

Residents have also been advised not to touch their eyes, nose or mouth unnecessarily and to avoid spitting in public places.

People who develop flu-like symptoms should stay away from others where possible and seek medical advice, particularly if symptoms become severe.

Strenghtening Healthcare System

Authorities have also increased monitoring across the healthcare system. Thirty-five hospitals are under special surveillance, while referral laboratories at AIIMS and the National Centre for Disease Control (NCDC) are available for testing and confirmation.

Hospitals and district health authorities have been asked to strengthen monitoring of influenza-like illness, severe respiratory infections and COVID-19.

Union Health Minister JP Nadda has also reviewed Delhi's preparedness amid the rise in H1N1 cases, with authorities instructed to focus on surveillance, early detection and timely treatment.

Chronic kidney disease is a disease whereby the patient's kidneys progressively lose their capacity to filter wastes and excessive fluids from the blood stream.

Since kidney damage develops slowly, many individuals might not experience any signs in the early stages of the disease. It is therefore critical for individuals to know about the stages of CKD in order to appreciate the significance of kidney monitoring and timely medical intervention.

Stage 1: Mild Kidney Damage

At stage 1, patients' kidney functions will be relatively normal (eGFR level of 90 or more). However, there will be some indication of kidney damage for example presence of protein in urine. Individuals usually show no symptoms. Controlling diseases like diabetes and high blood pressure can delay progression of CKD.

Stage 2: Mild Loss of Function

This CKD stage is indicated by an eGFR level of 60 – 89 as well as kidney damage. There will probably be no symptoms or very mild symptoms at this stage.

Also read: US CDC Says COVID ‘Growing’ In Nearly Every State: What You Should Know

Stage 3: Moderate Loss of Kidney Function

This stage reflects the moderate loss of kidney function and features an eGFR ranging from 30-59. It normally involves two sub-stages that can be either 3a or 3b. Some of the symptoms of kidney failure can be fatigue, swelling of legs or ankles, changes in urination, or hypertension.

Stage 4: Loss of Kidney Function Is Severe

The fourth stage means that there is a severe loss of kidney functionality, which can be measured by eGFR of 15-29. It normally entails such symptoms as vomiting, swelling, tiredness, or changes in appetite. Health specialists discuss the possibilities of treatment of end-stage kidney disease with their clients and prepare them for getting a new kidney.

Also read: US Woman Paralyzed After Potassium Mistakenly Given During Knee Replacement Surgery

Stage 5: Kidney Failure

Stage 5 is indicated by eGFR being below 15 or the inability of kidneys to perform their functions properly. Waste products and extra fluids can accumulate in the blood and cause life-threatening conditions. Depending on the condition of a patient, the treatments may include dialysis, kidney transplantation, or supportive therapy.

Maintaining Good Kidney Function

The progression of CKD may not always be swift and early detection can make all the difference. The management of blood pressure and sugar, heeding medical advice, living a healthy lifestyle and regular medical check-ups can help preserve kidney functions. If anyone experiences consistent swelling, alteration in urinary habits or feels unusually tired among other symptoms, they should visit a Nephrologist.

Obstructive hypertrophic cardiomyopathy (oHCM) remains one of the most misunderstood cardiac conditions, despite being the most common inherited cardiomyopathy. Misconceptions around the disease often lead to fear, delayed diagnosis, and hesitation in seeking appropriate medical care.

While oHCM has historically been associated with sudden cardiac death, particularly in young athletes, advances in diagnosis and treatment have significantly transformed its management. Today, with early diagnosis and appropriate treatment, many patients can lead active and fulfilling lives.

Understanding the facts is essential, not only for patients living with the condition, but also for families, caregivers, and the wider community. Separating myths from medical evidence can help ensure timely diagnosis, informed treatment decisions, and better long-term outcomes.

Understanding oHCM

Obstructive hypertrophic cardiomyopathy (oHCM) is a form of hypertrophic cardiomyopathy (HCM)—an inherited heart muscle disorder caused by genetic mutations that affect heart muscle structure and function. These changes cause the heart muscle to become abnormally thick, most commonly affecting the wall (septum) between the two lower chambers of the heart.

In nearly two-thirds of patients with hypertrophic cardiomyopathy, the thickened heart muscle can block the flow of blood leaving the heart—a condition known as obstructive HCM (oHCM). As a result, the heart must work harder to pump blood throughout the body, often leading to symptoms such as breathlessness, chest pain, fatigue, dizziness, palpitations, or fainting during physical activity.

Myth: A diagnosis of oHCM inevitably leads to sudden death.

Fact: While oHCM was once primarily recognised for its association with sudden cardiac death, advances in medical science have significantly improved patient outcomes.

With timely diagnosis, appropriate medical care, and ongoing monitoring, many people with oHCM can lead active lives with a good quality of life and a near-normal life expectancy. Regular follow-up helps assess disease progression and guides individualized care over time.

Myth: People with oHCM need to avoid physical activities

Fact: Complete avoidance of physical activity is no longer recommended for most patients.

Although high-intensity competitive sports may not be suitable for everyone with oHCM, mild-to-moderate exercise is generally encouraged and offers important cardiovascular benefits. Exercise recommendations should always be individualised after a comprehensive assessment by a cardiologist, taking into account symptoms, severity of obstruction, and overall risk profile.

Myth: Diet and lifestyle are the primary causes of oHCM.

Fact: oHCM is a genetic condition. It is not a lifestyle disease.

Unlike heart conditions caused by high blood pressure, diabetes, or high cholesterol, oHCM develops because of inherited genetic mutations affecting heart muscle proteins. Healthy lifestyle choices remain important for overall cardiovascular health, but they do not cause or prevent the condition itself. Because the disease often runs in families, screening of close relatives may also be recommended.

Myth: Every patient with oHCM will require surgical treatment.

Fact: Surgery is only one of several available treatment options. Care is individualized, and the most appropriate approach depends on each patient's symptoms and clinical condition.

Myth: oHCM cannot go unnoticed.

Fact: The condition can remain silent for years. Some individuals carrying the genetic mutation never develop symptoms, while others experience mild or intermittent symptoms that may be attributed to more common conditions. Typical symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Palpitations
• Dizziness or light-headedness
• Fainting, particularly during or after exercise

Given this variability, individuals with persistent symptoms or a family history of cardiomyopathy or sudden cardiac death should undergo appropriate cardiac evaluation.

Myth: Medication can cure the disease

Fact: Advances in treatment have significantly improved disease management, helping many patients lead healthier and more active lives. While current therapies focus on controlling symptoms and reducing complications, ongoing research continues to expand treatment possibilities.

Treatment aims to reduce symptoms, improve blood flow, minimize obstruction, and lower the risk of complications such as abnormal heart rhythms and heart failure. Long-term follow-up remains an important part of care, allowing treatment to be adjusted as the condition evolves.

Myth: There's no benefit to diagnosing oHCM early

Fact: Early diagnosis can make a significant difference. Because oHCM symptoms often resemble those of other conditions, timely testing is important—especially for those with a family history of the disease. Early detection can help patients access appropriate treatment, manage symptoms effectively, and reduce the risk of complications.

Why Awareness Matters

The understanding and management of obstructive hypertrophic cardiomyopathy have evolved considerably over the past decade. Although it remains a lifelong condition, it is no longer viewed through the lens of fear alone. Advances in medical therapies, improved diagnostic tools, and personalized treatment strategies have changed the outlook for many patients.

By challenging common myths and promoting awareness, more individuals can be diagnosed earlier, receive appropriate treatment, and live healthier, more active lives with confidence.

(Dr. Daljeet Kaur, Cardiac Electrophysiologist at AIG Hospital, Hyderabad)