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.

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.

After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.

The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.

Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.

Being aware of personal and family cancer risk may be a critical component in women's knowledge and empowerment to make appropriate screening, prevention and treatment decisions.

Cancer treatment is fast evolving. Doctors are now focusing more on the person than the location or type of cancer and are considering the personal attributes of the patient and the disease. Genetic/genomic testing can complement this and can offer something more that could inform personalised cancer care.

Genetic testing: Knowing your inherited risk

Genetic testing screens for changes in the genes that could be passed down from parents. Some genetic mutations passed down from parents can make a woman more likely to get breast or ovarian cancer.

Having such a genetic change does not mean that a woman will develop cancer. This information will help her and her doctor discuss screening, monitoring and preventive action (if applicable) to reduce her risk.

This information may be useful for family members who could be at risk and should talk to their health care provider about their own risk.

Genomic testing: Understanding the cancer better

There is a difference between genetic testing and genomic testing. Genetic testing is usually performed on blood or saliva to look for inherited changes or genetic predisposition. Genomic testing is usually performed on the tumour or blood to identify its molecular features to enable better understanding of its biology and biomarkers.

Cancer is not one disease and even two patients with the same type of cancer can have different biological characteristics, which can help doctors decide on the treatment and options that may be suitable for an individual patient.

Genomic testing could help to pinpoint features of a tumour that can be used to consider particular targeted treatments or other methods. But not all of them will be suitable or available to all patients based on the results of testing.

Why Awareness About Health Issues Is Important

For women, knowing their family history and discussing any concerns with a doctor can be an important starting point. Genetic or genomic testing should not be done simply because it is available. A specialist may recommend testing based on factors such as family history, age at diagnosis and the type of cancer involved.

It is also important to understand test results correctly. Genetic counselling and discussions with an oncology specialist can help women understand what their results mean and what they do not mean.

Ultimately, genetic and genomic testing is not about predicting the future with certainty. It is about giving patients and doctors more information to make better-informed decisions.

As cancer care moves towards greater personalisation, the freedom to know your risk can become a powerful part of taking control of your health—helping women move from fear and uncertainty towards awareness, informed choices and personalised care.

(Dr. Jyoti Wadhwa, Principal Lead, Medical & Precision Oncology, Apollo Athenaa Women’s Cancer Center)

World Mosquito Day, observed on August 20, raises awareness about mosquito-borne diseases such as dengue, malaria, Zika, yellow fever, and chikungunya and the health risks they pose.

Among these diseases, dengue remains a major public health concern, affecting people across regions worldwide throughout the year.

Dengue Cases: The Latest Numbers

• Global: More than 1.5 million dengue cases and over 500 dengue-related deaths have been reported globally since the beginning of 2026, as of July 31.
• Americas: 1,373,756 cases had been reported as of epidemiological week 26, updated July 23. Of these, 28.9% were laboratory-confirmed, according to WHO PAHO.
• South-East Asia: WHO SEARO bulletins published in June and July reported dengue in Bangladesh, Bhutan, India, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste since July 2025.
• India: 22,938 cases had been reported in 2026 as of June. June recorded 6,625 cases, up from 3,747 in May — a 77% increase.

Also read: India’s First Approved Dengue Vaccine: Takeda’s QDENGA Protects Against All Four Virus Serotypes

Why Can Dengue Affect the Kidneys?

Dengue is typically associated with high fever, joint pain, and low platelet counts. However, severe dengue can affect the kidneys and lead to acute kidney injury (AKI).

Speaking to HealthandMe, nephrologists said kidney problems may not always cause symptoms early on, making monitoring particularly important in severe dengue.

Dr. Anupam Roy, Additional Director - Nephrology and Kidney Transplant, Aakash Healthcare Multi-Speciality Hospital, Dwarka, said that recovering from dengue requires careful fluid management, particularly in severe cases.

It is because the kidneys regulate fluids and electrolytes, and changes in circulation caused by dengue can temporarily disrupt their function.

Fever, vomiting, and poor fluid intake can cause dehydration, while severe dengue can cause plasma leakage. Both too little and too much fluid can create problems, making medical supervision important. In hospital, healthcare professionals monitor urine output and signs of dehydration, particularly in patients with complications or underlying health conditions.

After the acute phase, patients should gradually resume eating and drinking according to medical advice. Excessive fluid intake and self-medication should be avoided, particularly when medicines could place additional stress on the kidneys.

“So, it is the quantity issue that must be tackled,” Dr. Roy said.

Signs of Kidney Problems

Read More: Dengue Serotypes Shifting In Young Adults: How India's Indigenous Vaccine Could Help Prevent Severe Disease

According to Dr. Manoj Arora, Consultant Nephrologist, NephroPlus, a network of dialysis centers, warning signs include:

• Decreased urination
• Swelling of the face or legs
• Dark or foamy urine
• Increased blood pressure
• Unusual tiredness
• Nausea
• Breathing problems

Some symptoms can overlap with severe dengue, including continuous vomiting, severe stomach pain, and bleeding.

Who Is at Higher Risk?

Kidney injury is more likely in people with severe dengue or shock. Older people and those with diabetes, hypertension, obesity, or existing kidney problems may also face higher risk.

Seek medical attention for a drastic reduction in urine, new swelling, blood in the urine, worsening breathlessness, confusion, or continuous vomiting.

In hospitalized patients, monitoring is important when creatinine rises, electrolyte levels fluctuate — particularly potassium — or urine output continues to change.

How Can Kidney Damage Be Prevented?

Early recognition and appropriate management are key. Doctors may monitor:

• Fluid balance
• Urine output
• Kidney function
• Electrolyte levels
• Potentially harmful medications

Do not self-medicate or increase fluid intake without medical advice, particularly during severe dengue.

How to Reduce Your Risk of Dengue

Reducing mosquito exposure and preventing mosquito breeding can help lower the risk of dengue.

• Eliminate stagnant water
• Use mosquito repellents
• Use bed nets
• Keep mosquitoes out
• Wear protective clothing
• Check your surroundings regularly.