Culture and Mental Health


What is culture? The way we bond and connect with others, gender expressions and sex orientations, our foods and cuisine, our entertainment — ranging from music to tv shows to the magazine we read — our language and political and spiritual beliefs (or lack of thereof) all influence our mental health. They help us understand ourselves, each other and the world around us. These cultural factors also shape how we express or experience mental health symptoms, ranging from day-to-day stress to traumatic experiences.

In fact, there are many culture-bound syndromes in which certain cultural groups experience the same “syndrome,” which is unique to such groups.

One example is ataque de nervios, which is an expression of distress reported by predominantly Latin American and Hispanic individuals. It can happen in up to one out every 10 Hispanics living in the U.S., and up to one in every three persons in Latin America, according to the 2009 study “Ataque De Nervios as a Marker of Social and Psychiatric Vulnerability” published in the International Journal of Social Psychiatry.

Ataque de nervios can look very different from person to person and may include:

  • Shortness of breath
  • Heart rate or chest tightness
  • Crying spells
  • Intense fear or worry
  • Brief loss of memory
  • Trembling
  • Dizziness
  • Faint-like symptoms
  • Loss of control
  • Temporary blindness or tunnel vision
  • Feeling as though reality is distorted, or feeling out-of-body experiences

Not all that experience ataque de nervios experience all these symptoms; and experiencing some – or all – of these symptoms does not necessarily indicate ataque de nervios. Some of these symptoms may be related to other mental health problems. Furthermore, ataque de nervios can help an individual cope with distress, as some people feel better after the attack is over despite its strong effect on mood amid its presence.

Why do we experience ataque de nervios?

Culture appears to be one reason why people experience ataque de nervios. This does not mean that any culture is to be blamed for ataque de nervios (or any mental health problem), rather that our culture constantly shapes the way we experience every day and major life stressors.

There are other reasons that can cause ataque de nervios. For example, during the attack, some people may strongly fear the attack itself and develop a fear of having future ataques. In turn, they may avoid doing or thinking about things, events, people or settings that caused the first ataque de nervios. Unfortunately, this is not a helpful strategy as it can cause future ataque de nervios to be even stronger.

Nonetheless, there is still much work needed to find all reasons that cause people to experience ataque de nervios. If you occasionally experience ataque de nervios or its symptoms, be reminded that these are normal bodily and mind expressions of distress or fear. On the other hand, if you frequently experience distress or a difficult time with these symptoms (or any other), please consult with your healthcare provider.

Other culture-bound syndromes

Nervios, unlike ataque de nervios, refers to heightened worry and emotional distress during difficult periods of time. People experience dizziness (mareos), vertigo, headaches, crying and difficulty concentrating. The nervios can be long lasting, unlike the ataque de nervios, and are also means of the body and mind to express distress.

Per the Center for Substance Abuse and Treatment, susto is another idiom of distress that occurs when a person experiences an intense stressful or fearful situation. The person feels strong feelings of sadness and general sickness. Susto can have various names like “espanto” or “perdida del alma.” The latter translates to “loss of the soul,” which reflects the intensity of the fearful emotions. People with susto may also experience difficulties sleeping or bodily aches.

Message to the Public

Distress is a normal part of life, and healthy expressions of it can be a helpful way to cope. If you are feeling distress related to ataque de nervios, its symptoms, or any other mental health concern, we encourage you to seek help from your healthcare provider. You can reach out to the resources below for help or to learn more about culture and mental health.


Learn more about ataque de nervios:

Mental Health Resources:

Texas Tropical Behavioral Health Crisis Hotline: 1-877-289-7199

Lifeline prevention number: 1-800-273-8255 (TALK)

(Co-Authors include Dr. Mercado’s Mental Health Lab at UTRGV: Andy Torres, Frances Morales, Amanda Palomin, Sandra Chapa, & Marcos Valdez)