Susto, Mal de Ojo and Other Cultural Illness Concepts

What cultural illness concepts are

Researchers use the terms "folk illness," "culture-bound syndrome" or "cultural concept of distress" for ways a community names and explains suffering. They are not the same as diagnoses in a medical manual. This page describes what is already public in research. It does not give any cleansing, healing or protective procedure, and it does not describe ritual practice.

Susto

Susto means "fright." A review of the anthropology literature calls it a widely spread folk illness category that is still not fully understood, with many competing ideas about its biological basis and why it persists. [1] In Michoacán, Mexico, Purépecha healers describe susto together with nervios and locura, and link these to ideas about the soul. [2] These are the community's own frameworks, and a person from the same region may or may not use them.

What researchers measured: in a study in Guadalajara, Mexico, susto was linked to higher stress and depressive symptoms, and nervios was linked more strongly. Most people with depression in the study reported susto, nervios or both. [3] Among Mayan Guatemalan refugees in camps in Chiapas, Mexico, 59% of adults had experienced susto, and it was associated with symptoms consistent with post-traumatic stress, anxiety and depression. [4] This is correlation. It does not show that fright causes a disease or that a treatment works.

Mal de ojo

Mal de ojo, or "evil eye," is a folk illness concept reported by Hispanic caregivers in the US. In a small 1995 Houston survey of 51 caregivers, mostly mothers, 70% had experience with mal ojo, 64% with empacho, 52% with mollera caida and 37% with susto. [5] We found no controlled study of any treatment for mal de ojo. Proper evidence not found. We searched PubMed for the term and found only descriptive survey data.

Empacho and mollera caida

Empacho is understood as a blocked or upset intestine, and mollera caida as a fallen fontanelle in a baby. [5] Medical care matters here because digestive symptoms can have common medical causes. In the UK, the NHS advises calling 111 for a baby under 12 months who is ill, a child who stops feeding while ill, a child under 5 with signs of dehydration, or anyone with bloody diarrhea or vomiting that will not stop. [6] Ask your pediatrician about any baby with these symptoms.

Nervios and ataque de nervios

The Guadalajara authors describe nervios ("nerves") as a cultural construction of chronic distress and susto as one of acute distress. Nervios was reported more often by women. [3] A review of cross-cultural anxiety notes that ataques de nervios (nervous attacks) is included in the DSM-5 list of cultural concepts of distress, as are two other examples. [7] In the Chiapas study, 34% of adults reported ataques de nervios. [4]

Documented harms linked to folk treatments

A pediatric report described rubbing-alcohol (isopropyl alcohol) poisoning in a 4-year-old after a folk treatment for "espanto" (fright). [8] Lead-based folk remedies called azarcon and greta, used for empacho, have been linked to high blood lead levels in Mexico and the US. [9] For safe practice, see limpia and spiritual cleansing and Natural Does Not Mean Safe. If a child may have swallowed something harmful, call Poison Help at 1-800-222-1222 in the US.

Respectful use of these terms

These concepts belong to living communities. Some healing responses are private or ceremonial, and this site does not describe them. See cultural context and respectful representation and the overview of curanderismo.

Questions to bring to a clinician

You can say "my family calls this susto" or "a relative thinks it is mal de ojo," and still ask for a medical exam. Say which teas, products or treatments you have used. Do not stop a prescribed medicine.