Susto: When the Spirit Leaves the Body

· October 14, 2018

If we ask someone what susto is, they’ll most likely say that it’s a startled response, similar to shock.  Thus, when something scares us, it can shock us, causing us to jump out of fear. We’re talking about a sensation born from the perception of a threat.

If we consult Wikipedia, we’ll find the following definition: “the startle response is a largely unconscious defensive response to sudden or threatening stimuli, such as sudden noise or sharp movement, and is associated with a negative effect”.  In the case of humans, the reaction includes a physical movement away from the stimulus, a contraction of the arm and leg muscles, as well as blinking.

However, it’s not this type of susto we’ll be talking about in this article. There are disorders or cultural concepts of discomfort that are specific to certain cultures or societies. This is the type of the susto we’re referring to.

Susto as a cultural concept of discomfort

Culture-bound syndromes refer to “patterns of aberrant behavior and disturbing experiences, recurring and specific to a particular place”. The natives consider some of these patterns as diseases or as causes of suffering. The natives know most of them by colloquial names, like susto in this case.

These syndromes are categorized as diseases limited to specific societies or cultures. There’s a widespread familiarity of the disease in the culture, but not outside of it. They give a coherent meaning to certain sets of experiences and observations.

A woman with susto.

Susto is a cultural explanation of the discomfort and misfortune prevalent among Latinos in the United States. It also happens to people from Mexico, Central America, and South America. In the Andean region, the natives know susto as espanto.


Caribbean Latinos don’t recognize this concept as a type of disease. So, what is susto? It’s a disease attributed to a frightening event that makes the spirit leave the body.

This split occurs as a result of unhappiness and illness, in addition to the difficulties of playing key roles in society. Symptoms can appear at any moment, from days to years after suffering the frightening incident. In extreme cases, it can lead to death.

We can define susto as a ‘psychological impact’ of varying intensity that results from various factors. Among them, we can find those of a supernatural nature and those caused by natural phenomena and personal experiences that result in unexpected events altogether.

As we can see, susto is a classification of disease with a traditional affiliation. Its characteristics, symptoms, propensity, and treatments have particular connotations in different geographic regions.

What are the symptoms of susto?

There are no specific symptoms that define it. However, the symptoms that people with susto usually mention are lack of appetite, inadequate, interrupted sleep, feelings of sadness, low self-esteem, interpersonal sensitivity, and apathy.

The physical symptoms that accompany susto can be discomfort and muscle aches, cold extremities, paleness, headache, abdominal pain, and diarrhea. The events that cause it are diverse. These events include natural phenomena, animals, interpersonal situations, supernatural entities, among others.

We can define susto as a ‘psychological impact’ of varying intensity that results from various factors. Among them, we can find those of a supernatural nature and those caused by natural phenomena and personal experiences that result in unexpected events altogether.

Somatic diseases are usually chronic and very diverse. Intense fear, often supernatural, can cause a “loss of spirit”, which can cause this disease. In some cases, the people who suffer from susto didn’t experience the traumatizing events personally.

Patients are affected when others (usually family members) are inflicted with sustoOther symptoms include agitation, anorexia, insomnia, fever, diarrhea, confusion, or apathy. Different studies attribute some cases to hypoglycemia and unspecified organic diseases. Specialists also attribute it to generalized anxiety disorders or stress caused by social conflicts or low self-esteem.

man performing ritual susto

Types of susto

So far we’ve identified three types of susto (called cibih in the local Zapotec language). Each of them has different links to psychiatric diagnoses.

Feelings of loss, abandonment, and lack of love by family members characterize interpersonal susto The symptoms that accompany it are sadness, poor self-image, and suicidal thoughts. This type of susto closely resembles major depressive disorder.

Susto may also be the result of a traumatic event. This event plays a fundamental role in the cause of the symptoms and in the emotional processing of the experience. In this case, the diagnosis closely resembles post-traumatic stress disorder.

On the other hand, there’s also the susto whose characteristics include several reoccurring somatic symptoms. For example, the person seeks professional health care from several doctors due to what they’re experiencing. This case resembles a somatic symptom disorder.

As we have seen, susto has different classifications and treatments in which specific elements are recognizable. Although there’s no exact equivalent of this popular disease, it’s a condition that is sometimes confused with others due to the complexity of differential diagnosis. Thus, it could even hide different organic diseases.