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.

The relationship between chronic stress and liver health is a complex physiological loop driven largely by cortisol, the body’s primary stress hormone. While the liver is often viewed as a detox organ, it is highly responsive to hormonal signals, especially during prolonged stress. But at a time when competition is at its all-time peak in every aspect of life, be it work or school, it is a no-brainer that stress levels are peaking across age groups. That being said, Dr. Tushar Madake, Consultant, Department of Transplant Hepatology at Ruby Hall Clinic, Pune, spoke about the impact of high cortisol on the liver.

What is cortisol?

When stress becomes chronic, the adrenal glands continuously release cortisol. The liver, rich in glucocorticoid receptors, responds by shifting into a survival mode. In short-term situations, this helps by releasing glucose into the bloodstream for quick energy. However, when stress persists without physical activity, this constant signal disrupts normal metabolism.

The impact of high cortisol levels

One major effect is increased glucose production, where the liver generates sugar from non-carbohydrate sources. Over time, this leads to consistently high blood sugar and forces the pancreas to produce more insulin, eventually contributing to insulin resistance. At the same time, cortisol promotes the release of fatty acids into the bloodstream. The liver absorbs these fats but struggles to process and export them efficiently, leading to elevated triglycerides and unhealthy cholesterol levels.

How does stress affect the liver?

Stress also drives fat storage in the abdominal region and within the liver itself. This can result in fatty liver disease, even in individuals without poor dietary habits. As fat accumulates, inflammation follows. Liver immune cells release inflammatory substances, creating oxidative stress that damages liver cells. Additionally, when the liver is overloaded with managing excess glucose and fat, its ability to detoxify the body declines. Hormone balance, toxin clearance, and medication metabolism are all affected.

Stress can also impair bile flow, which is essential for fat digestion and toxin removal. Reduced bile movement further worsens internal imbalance. Ultimately, chronic stress keeps the liver in a constant state of overdrive, leading to long-term metabolic strain, inflammation, and gradual liver dysfunction.

Fatty liver disease, as a term, has been used for several years to describe a state of excess fat accumulation in the liver. However, the perception is changing—once known as non-alcoholic fatty liver disease (NAFLD), the condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The new term, according to leading diabetologist Dr V Mohan, offers more clarity because fatty liver is often associated with alcohol intake. However, even people who do not drink alcohol can develop this condition, and it has a metabolic angle to it. Despite the new name, the concern around fatty liver disease remains the same—can it be reversed?

Can MASLD be reversed?

In an interview with Health and Me, Dr Tushar Madake, consultant in the Department of Transplant Hepatology at Ruby Hall Clinic in Pune, spoke about the new name for fatty liver disease and why the metabolic angle is important.

Fatty liver disease may have a new name, but the concern around it has not changed. The current medical nomenclature identifies this as steatotic liver disease (SLD), with the previously identified NAFLD referred to as metabolic dysfunction–associated steatotic liver disease (MASLD). This classification places emphasis on the true source of the disease—metabolic health—and not necessarily alcohol intake.

Symptoms and diagnosis of MASLD

One of the reasons why fatty liver disease is challenging to diagnose is the fact that it does not exhibit noticeable symptoms in its early stages. The organ functions without issues, and individuals might not suspect a problem. Unlike common assumptions, this condition affects people who are not necessarily overweight or who consume alcohol.

Some of the early symptoms include constant fatigue, an increase in abdominal fat storage, and a feeling of heaviness in the upper right quadrant of the abdomen. Changes in the skin, such as discolouration around the neck and armpits and skin tag development, can also be among the symptoms of the condition. Individually, these signs do not necessarily indicate any cause for concern. However, when present together with metabolic issues such as type 2 diabetes, obesity, high levels of cholesterol, and high blood pressure, they might signify liver impairment in the early stages.

Therefore, early diagnosis and monitoring are crucial. If you have these risk factors or experience these symptoms, it is recommended that you undergo tests for liver dysfunction and ultrasonography. In some cases, you may also need to undergo a scan, for instance, a FibroScan, for early detection of liver fibrosis.

Reversing MASLD is possible

Dr V Mohan, one of India’s leading diabetologists, said, “The encouraging news is that early-stage fatty liver is not a permanent condition. With consistent lifestyle changes, reversal is possible. Weight loss, regular physical activity, reduced intake of refined carbohydrates and fats, and higher protein consumption can all contribute to improved liver health.”

Many people follow what appears to be a reasonable eating pattern—meals at irregular hours, a light breakfast skipped in the name of time, and dinner pushed late into the evening. Yet the body, particularly the liver, does not respond well to such improvisation. What feels like a manageable routine on the surface can quietly accumulate into something more serious over months and years. The liver needs a consistent flow of nutrients to do its job, which includes managing blood sugar, breaking down fats, and supporting digestion. Long gaps between meals disrupt that rhythm.

Dr Babu U V, Director of R&D, Research & Development Centre, Himalaya Wellness Company, in an interview with Health and Me, spoke about the early symptoms of liver damage and explained how herbs can play a role in reversing it.

Symptoms of Early Liver Damage

Before most people realise that something is wrong with their liver, they may already be experiencing symptoms that indicate potential liver issues. These symptoms may include fatigue, bloating, digestive discomfort, or feeling heavy after eating. Most of the time, these signs are dismissed as minor concerns.

When these issues are ignored or go unnoticed, it becomes difficult to recognise that the liver may be weakened by stress and not functioning optimally. If these problems persist over time, fat can begin to accumulate in the liver, along with other types of metabolic imbalances throughout the body.

To restore balance in the body, small changes in daily habits can lead to significant improvements. For example, eating at regular intervals helps the body maintain a consistent metabolism. Similarly, having lighter dinners and avoiding late-night eating can support better digestion and metabolism of food.

Herbs That Strengthen Liver Health

Some herbs commonly used in Indian households and traditional medicine may help support the liver’s healing process, especially when it is under stress.

1. Bhumi Amla (Bhumyamalaki) has been used for centuries in traditional remedies for liver health. It supports the body’s natural detoxification processes and liver function.
2. Punarnava is another well-known herb that promotes both liver and kidney health. It is believed to help reduce inflammation and restore balance in the body.
3. Turmeric (Haldi), found in almost every Indian kitchen, has anti-inflammatory and antioxidant properties. It supports metabolism and helps the body respond to oxidative stress.
4. Chicory (Kasani) has long been associated with liver support. It helps the body manage toxin-related stress and supports overall liver function.

Each of these herbs works in different ways—some aid digestion, while others help neutralise free radicals and reduce oxidative stress—thereby supporting a healthier lifestyle.

The liver is highly resilient; however, it requires consistent care. An irregular dietary pattern may not affect the liver immediately, but over time it can have a significant impact. Paying attention to simple habits—such as when and how you eat—and choosing foods that support liver health can go a long way in maintaining optimal liver function over the long term.