A recent report presented the absolutely astounding story of a 74 year old woman in Scotland who appears never to have experienced fear or anxiety, and feels little if any pain.

https://www.nytimes.com/2019/03/28/health/woman-pain-anxiety.html

It is not entirely understood how, but throughout her life, she has experienced no anxiety, and little if any fear.  This alone is remarkable.

At the same time,  her body seems not to create pain either.  The downside to lack of pain is that the protective function of pain is absent, and so she has experienced many more burns and cuts than someone who would wince and withdraw to avoid an injury.

But another curious feature of her biology is that her burns and cuts heal much faster than usual, and produce much less scar material.

Investigations of her genetics have revealed that she has a variant of a gene that manages an enzyme called FAAH, which stands for Fatty Acid Amide Hydrolase (FAAH).  There are many compounds in our body that are in the category of fatty acid amides, and this enzyme acts on most of them.  One in particular may be related to this woman’s remarkable experiences, it’s the fatty acid amide called andandamide.  Andandamide is a chemical the body makes that in the brain appears to have an impact on matters such as anxiety, fear, pain and pleasure.  It was named using the Sanskrit word ananda,which means joy, bliss, and delight.   The enzyme FAAH clears out andandamide, so the more FAAH you have, the less andandamide.

The woman in Scotland has very little FAAH, and so it is thought her mind sustains a higher level of andandamide than usual, and this may explain why she has no anxiety or pain or fear.

Another curious property of andandamide is that it seems to work on the cannabinoid receptors of the brain.  These are the structures that get excited by use of marijuana, by exposure to THC, specifically.  There is no surprise that the mind has its own natural system to align with the impact of the  drug THC.  After all, morphine and all opioids work by activating the endorphin receptor, making endorphin the human-made analogue to opioids.  Alcohol appears to activate the same receptor as the benzodiazepines: Ativan, Xanax, and Valium.

One down side of stimulation with andandamide seen in animal experiments, but not the Scottish woman, is harm to memory, give an animal enough and it will actually destroy their hippocampus, a key structure for memory in the brain.

To my mind, a most striking observation of this woman’s life is that she is fine.  We speak often about the positive properties of anxiety.  It helps motivate people to do their work: “I have a test next week, better study now.”  But here is a person essentially living a life freed completely of the grip of anxiety.  My own suspicion is that anxiety has its highest benefit in high risk situations.  Imagine Stone Age people out in the rain, and there is a cave.  The anxious people may hesitate a bit more to see if a bear is there, those without anxiety may be more likely to run in and get eaten.

But in a peaceful, prosperous country such purposes to anxiety may no longer be needed.   This woman teaches us that a life free of anxiety and fear can be quite wonderful.

BOTTOM LINES

1.  It continues to be a struggle, even a mystery, but evidence continues to accumulate that so many of our experiences, including emotions such as fear and anxiety, are the product of structures in our brain responding to electrical signals often under the control of various chemicals.
2.   The case of the 71 year old Scottish woman is a dramatic example.  A gene, the FAAH gene, is weak, so she makes less FAAH enzyme, this increases the activity of the neurotransmitter andandamide, and she lives her life nearly free of any experience of anxiety or fear.   She also feels very little pain if any, and heals her burns and cuts rapidly with little scar tissue.
3.   The FAAH gene helps manage the system of electrical receptors that respond to the cannabis compound THC.  This does not mean use of marijuana is a great idea to reduce anxiety.  The same system, when overly activated can impair memory function, and we do know that use of marijuana in adolescence carries the risk of lifelong impairments in thinking.
4.  So interesting to see fear and anxiety connected, and to see pain part of these experiences, too.

As we learn more of the systems of the mind, the day grows nearer when people will find ways to control how we feel and think.  This could be good news as we increase our ability to relieve the burden of harmful emotions, it could be bad news if those in power find a way to yield this new technology.

To your health,
Dr. Arthur Lavin