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.

Liver diseases are becoming increasingly common in India, yet many people are unaware of the difference between fatty liver and hepatitis. While both conditions affect the liver, their causes, treatment, and long-term risks are very different. Understanding these differences is important because untreated hepatitis can, in some cases, lead to liver cancer over time.

Fatty Liver And Hepatitis: What’s The Difference?

Fatty liver disease occurs when excess fat accumulates in the liver. In India, it has emerged as a major health concern due to rising rates of obesity, diabetes, sedentary lifestyles, and unhealthy dietary habits. Studies suggest that nearly one in three Indian adults may have fatty liver disease.

Also read: England Set To Become One Of The First Countries To Eliminate Hepatitis C; Here's How

Why Chronic Hepatitis Can Raise Liver Cancer Risk

One of the biggest concerns with chronic hepatitis, particularly Hepatitis B and Hepatitis C, is its association with liver cancer. The infection can silently persist for years without causing noticeable symptoms. During this period, continuous inflammation may lead to fibrosis (scarring), cirrhosis, and eventually hepatocellular carcinoma, the most common type of liver cancer.

According to the World Health Organization (WHO), chronic hepatitis B significantly increases the risk of liver cancer and remains one of the leading causes of liver cancer-related deaths worldwide.

India’s Silent Hepatitis Burden

India continues to carry a substantial burden of viral hepatitis. WHO estimates indicate that nearly 40 million Indians are living with chronic Hepatitis B infection and between six and twelve million with chronic Hepatitis C infection. Many remain undiagnosed because early disease often causes no symptoms.

Warning signs that should not be ignored include persistent fatigue, loss of appetite, abdominal discomfort, unexplained weight loss, jaundice (yellowing of the eyes and skin), dark urine, or swelling in the abdomen. However, many patients with chronic hepatitis may feel completely healthy until significant liver damage has already occurred.

Can Hepatitis-Related Liver Cancer Be Prevented?

Also read: How Chronic Hepatitis Quietly Progresses To Liver Cirrhosis: Why Early Action Can Save Your Liver

"The good news is that liver cancer arising from hepatitis is often preventable. Hepatitis B vaccination is safe and highly effective. Regular screening, timely antiviral treatment, and periodic liver monitoring can significantly reduce the risk of cirrhosis and liver cancer"- said Dr Ashwin Rajbhoj from M|O|C Cancer Care Pune. Similarly, maintaining a healthy weight, controlling diabetes, exercising regularly, and limiting alcohol intake can help prevent and reverse fatty liver disease in its early stages, he added.

The key message is simple: fatty liver and hepatitis are not the same disease. While fatty liver is primarily linked to lifestyle and metabolic health, chronic viral hepatitis can silently progress to liver cancer if neglected. Early diagnosis and timely treatment remain the best defence against serious liver complications.

By Dr Ashwin Rajbhoj, M|O|C Cancer Care, Pune

Over 57 million people worldwide live with dementia, causing 36.3 million disability-adjusted life years (DALYs) and ranking as the seventh leading cause of death. But when it comes to dementia, memory loss is often the first symptom that comes to mind.

While forgetting birthdays or losing keys are commonly considered early warning signs of dementia, this may not always be the case.

Experts say a person can remember every birthday and anniversary and still have dementia.

What Are The Early Signs Of Dementia?

“Dementia may not begin with memory loss. It can begin with smell, language, personality or navigation,” Dr Priyam Bordoloi, an internal medicine resident from Assam, said in a post on the social media platform X.

1. Loss Of Smell: When Coffee Stops Smelling Like Coffee

Dr Priyam noted that loss of smell can be an early sign, but it is often overlooked because it may be attributed to a viral illness, sinus disease, smoking, medicines or a head injury.

“Persistent, unexplained smell loss may also be an early clue to Parkinson’s disease or dementia with Lewy bodies,” he added.

2. Everyday Words Start Disappearing

It is not simply an occasional tip-of-the-tongue moment. “In primary progressive aphasia, word-finding, grammar or comprehension may worsen while recent memory stays intact,” Dr Priyam noted.

3. The Family Says, “They Are Not The Same”

Changes in personality or behaviour may sometimes appear before memory problems.

“In behavioral-variant frontotemporal dementia, apathy, impulsiveness, loss of empathy or poor judgment may come before memory loss,” Dr Priyam said.

4. A Familiar Route Suddenly Feels New

Families may notice navigation problems even when a person has no obvious memory complaints. “Families ask me, ‘He has driven there for 20 years. How did he get lost?’ When it repeats, I look beyond forgetfulness,” Dr Priyam said.

He noted that visuospatial dysfunction can appear early in dementia with Lewy bodies or posterior cortical atrophy.

One Odd Symptom Does Not Necessarily Mean Dementia

Dr Parveen Yograj, a general surgeon from Jammu, added that one unusual symptom alone means little.

"A new, persistent and progressive pattern that disrupts daily life and is noticed by loved ones is what demands attention," he said on X.

How Can Dementia Risk Be Reduced?

Dr Yograj said several lifestyle measures may help protect brain health and reduce the risk of cognitive decline.

• Exercise Regularly: Regular aerobic exercise along with strength training can boost brain blood flow and build cognitive reserve.
• Follow A Brain-Healthy Diet: A Mediterranean or MIND diet, rich in vegetables, berries, nuts, olive oil and fish, can support vascular health.
• Prioritize Good Sleep: Solid sleep helps clear toxic brain waste and supports overall brain health.
• Keep Blood Pressure, Sugar And Cholesterol In Check: Managing blood pressure, blood sugar, cholesterol and weight can help reduce the risk of vascular dementia.
• Stay Socially And Mentally Active: Stay socially connected and mentally engaged by talking with others, reading, learning new skills and playing games.
• Quit Smoking And Limit Alcohol: Avoiding smoking, limiting alcohol and treating hearing loss early can also support long-term brain health.

Organ transplantation can offer patients with end-stage organ failure a new opportunity for a longer, healthier, and more independent life. However, transplantation is not the end of treatment—it marks the beginning of a lifelong commitment to maintaining the health and function of the transplanted organ.

Successful long-term outcomes depend on close collaboration between the organ recipient, living donor, transplant team, and family. Regular medical follow-up, adherence to prescribed medications, a healthy lifestyle, and early recognition of warning signs are essential for both recipients and living donors.

Care After Organ Transplantation

1. Strict Adherence to Immunosuppressive Medications

For most solid-organ transplant recipients, lifelong immunosuppressive therapy is required to prevent the immune system from attacking the transplanted organ.

Medications such as tacrolimus, cyclosporine, mycophenolate, corticosteroids, and other immunosuppressive agents may be prescribed depending on the type of transplant and the individual patient's condition.

Recipients should:

• Take medications exactly as prescribed and at the recommended times.

• Never stop or reduce immunosuppressive medication without consulting the transplant team.

• Avoid missing doses.

• Inform their transplant physician before starting any new medication.

Even seemingly minor changes in medication can affect drug levels and may increase the risk of acute or chronic rejection.

Also read: World Organ Donation Day 2026: Too Old Or Too Sick To Donate Organs? Doctors Bust Key Myths

2. Regular Follow-Up and Laboratory Monitoring

Regular follow-up with the transplant team is an essential component of lifelong transplant care.

Depending on the transplanted organ and individual circumstances, monitoring may include:

• Kidney and liver function tests

• Complete blood counts

• Immunosuppressive drug levels

• Blood pressure and blood glucose monitoring

• Urine examination in kidney transplant recipients

• Imaging or other investigations when clinically indicated

These evaluations help detect rejection, infection, medication toxicity, or deterioration in graft function at an early stage, sometimes before symptoms become apparent.

Also read: US HHS Action Against Kentucky Organ Donation Group Raises Questions About Transplant Safety

3. Recognizing Warning Signs

Transplant recipients should promptly contact their transplant team if they develop symptoms such as:

• Unexplained or persistent fever

• Chills or significant weakness

• Reduced urine output, particularly after kidney transplantation

• Swelling or sudden weight gain

• Breathlessness or persistent cough

• Persistent pain over the transplant site

• Persistent vomiting or diarrhoea

• Unexplained changes in blood pressure or blood sugar

Because immunosuppressive medications reduce the body's immune response, infections may develop more easily and may sometimes present with subtle symptoms. Early medical assessment is therefore important.

4. Infection Prevention

Transplant recipients are more susceptible to infections, particularly during periods of intensive immunosuppression.

Important preventive measures include:

• Practising regular hand hygiene

• Avoiding close contact with individuals who have contagious infections

• Following appropriate food-safety precautions

• Drinking safe and hygienic water

• Maintaining good personal hygiene

• Keeping vaccinations up to date as advised by the transplant team

• Seeking medical advice promptly if symptoms of infection develop

Recipients should also follow the specific infection-prevention recommendations provided by their transplant centre.

5. Healthy Nutrition and Lifestyle

A balanced and nutritious diet is an important component of long-term transplant health.

Recipients should aim to:

• Maintain a healthy body weight

• Eat a balanced diet rich in vegetables, fruits, whole grains, and appropriate sources of protein

• Maintain adequate hydration unless fluid restriction has been advised

• Limit excessive salt, sugar, and processed foods

• Exercise regularly according to their medical condition and physician's advice

• Avoid smoking and tobacco products

• Avoid excessive alcohol consumption

Certain foods, supplements, and herbal preparations may interact with immunosuppressive medications. No dietary supplement, herbal preparation, or over-the-counter medication should be started without discussing it with the transplant team.

Also read: AIIMS Performs Second Dual Kidney Transplant Using Organs From 70-Year-Old Donor: How It Can Expand Donor Pool?

Post-Donation Care for Living Organ Donors

Living organ donation is a remarkable act of generosity. However, protecting the donor's long-term health remains the highest priority.

After donation, the donor should remain under appropriate medical supervision and follow the recommendations of the transplant and surgical team.

1. Recovery After Donation

The recovery period varies depending on the type of donation and the individual's overall health.

Donors should:

• Follow wound-care instructions carefully.

• Take prescribed medications as directed.

• Get adequate rest during the initial recovery period.

• Gradually resume physical activity as advised.

• Avoid strenuous exercise and heavy lifting until medically cleared.

• Return to work and normal activities progressively.

The recovery process should be individualized rather than based solely on a fixed timeline.

2. Long-Term Health After Kidney Donation

Most carefully selected kidney donors can lead healthy, active lives with a single functioning kidney.

Long-term health recommendations include:

• Maintaining a healthy body weight

• Exercising regularly

• Eating a balanced diet

• Staying adequately hydrated

• Avoiding tobacco

• Avoiding unnecessary use of potentially kidney-toxic medications, particularly certain painkillers such as NSAIDs

• Monitoring blood pressure

• Periodically checking kidney function and urine as recommended

Living donation should never mean that donors stop looking after their own health. The donor's well-being remains a lifelong priority.

Any new or persistent symptoms should be reported to a healthcare professional.

Also read: India Records 20,138 Organ Transplants In 2025; Deceased Donor Transplants Reach 3,526

3. Emotional and Psychological Well-Being

Transplantation and organ donation can have a significant emotional impact on both recipients and donors.

Recipients may experience anxiety related to rejection, medication, financial concerns, or the uncertainty associated with transplantation. Living donors may also experience emotional changes during the recovery period.

Maintaining open communication with family members and the transplant team can be extremely helpful. If persistent anxiety, depression, sleep disturbances, or emotional distress develops, professional psychological or psychiatric support should be sought.

4. The Importance of Lifelong Follow-Up

The success of organ transplantation depends not only on the surgical procedure but also on long-term post-transplant care.

For recipients, medication adherence, regular monitoring, infection prevention, and a healthy lifestyle are essential to preserving graft function.

For living donors, appropriate postoperative recovery, long-term health monitoring, and healthy lifestyle practices help ensure that they continue to live healthy and fulfilling lives after donation.

The transplant may be a single surgical event—but maintaining the gift of life is a lifelong journey.

With appropriate medical supervision, adherence to treatment, healthy lifestyle choices, and timely attention to warning signs, organ recipients can protect the health of their transplanted organ, while living donors can continue to enjoy a healthy and active life after their selfless contribution.

By Dr. Pragnesh Desai, Senior Director & HOD – Urology, Renal Transplant, Robotics & Uro-Oncology, Yatharth Super Speciality Hospital, Noida Extension