Fallout Show Explains How Ghouls Go Feral

thegamer.com:

Ghouls have been part of the Fallout world since the first game in 1997. But despite being a series mainstay, we never learned how a ghoul goes from having all of their senses intact to turning completely feral.

Now, the Fallout show has provided us with an answer. It's a pretty big change to the lore and one that will affect players if future games have ghoul companions. It could also have a huge impact on whether or not we get to play as a ghoul in the future, as many players have requested.

Light spoilers for the Fallout series ahead.

From the very first episode of the Fallout show, we see a ghoul using RadAway. This continues throughout the series, as one of the main characters, simply known as The Ghoul for the most part, has to take the drug regularly, something we've never seen from ghouls in the games. In fact, they're known for their immunity to radiation, but this only appears to be true to a certain extent.

Without getting into specifics, we do later find out that not taking RadAway frequently enough will turn a ghoul feral. After this, they become the mindless zombies that we encounter as enemies in the games, losing all sense of who they once were.

We've never been given a definitive explanation as to what turns a ghoul feral in the Fallout games, but there have been vague implications on how the process could start. Fallout 3 suggested that ghouls who isolate themselves are more prone to going feral, hinting that there's a psychological element to the transformation. Elsewhere, an NPC would tell you that too much radiation can do this to any ghoul, but this was never confirmed either way.

If the games stick with the show's explanation, then it makes the survival of pre-war ghouls all the more impressive. Not only do they have to survive a wasteland full of creatures and people that want to tear them apart, but they'll have to maintain a steady supply of RadAway - something humans will want to keep on hand too.

There is one contradiction