Bitcoin's fourth-quarter performance has deteriorated, marking its worst showing since 2018. November's losses have wiped out most of the quarterly gains, resulting in a 15.13% net loss. Nearly 99% of short-term holders are currently experiencing losses, and $3 billion has exited Bitcoin ETFs this month. The potential for a sell-off looms as 592,000 BTC are at risk due to loss-driven selling pressures. The market sentiment has shifted to 'extreme fear,' as indicated by the fear and greed index, suggesting that weakening buying support could lead to further price corrections.