The rare disease that stops us feeling fear

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🗞️ Driving the news: A rare condition affecting the brain's fear centre is shedding light on how humans process fear — and what life is like without it. Individuals with damage to the amygdala, particularly those with Urbach-Wiethe disease, are unable to experience fear in response to external threats
• One such patient, known as SM, has lived decades without fear, offering researchers unique insights into the neurobiology of fear and survival instincts

🔭 The context: Fear is a crucial evolutionary mechanism that helps humans and animals avoid danger. The amygdala, a small, almond-shaped brain region, plays a key role in detecting external threats and triggering the fight-or-flight response
• But research, particularly on SM, reveals that while the amygdala is essential for reacting to external dangers, it is not involved in all fear responses
• In contrast, internal threats — such as elevated CO₂ levels — activate the brainstem, and in the absence of the amygdala, this can lead to overwhelming panic

🌍 Why it matters for the planet: Understanding the neurological pathways of fear may transform how we approach mental health, particularly anxiety and trauma-related disorders
• As climate change, conflict, and economic uncertainty heighten global stress, insights into the fear response can help societies develop more effective, targeted treatments
• The findings also question whether certain emotional responses, while once critical for survival, are now maladaptive in modern life, where physical threats are less common but chronic psychological stress persists

⏭️ What’s next: Scientists will continue exploring the dual fear pathways in the brain to refine therapeutic approaches
• New treatments may focus on moderating exaggerated internal fear responses while preserving healthy risk assessment behaviours
• The case of SM also raises ethical and psychological questions about altering fundamental emotional processes — such as fear — through medical interventions or brain-modulating therapies

💬 One quote: "This primal emotion of fear may actually not be necessary in modern life... it may cause more harm than good," said Justin Feinstein, clinical neuropsychologist and lead researcher on patient SM

📈 One stat: Only around 400 people worldwide have been diagnosed with Urbach-Wiethe disease, a condition that can destroy the amygdala and eliminate the ability to feel fear from external threats.

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