Nerves-Nervios

Overview


Nerves (also known as nervios in Spanish-speaking countries) is a folk illness that has been documented in disparate regions around the world including the United States (specifically in Appalachia and among Latino/a immigrants), Guatemala, Costa Rica, Puerto Rico, Newfoundland, Iran, Italy, Mexico, and Ireland.[1] Though not recognized as an illness by biomedical physicians, nerves is often associated with feelings of anxiety and depression and is described by anthropologists as a mechanism for the expression of distress caused by social conditions.

Health Impact


Nerves as a folk illness has been documented in several different areas. In each case, the manifestation of the disease is differs slightly but maintains certain similarities. In most areas, nerves is associated with the physical symptoms of fatigue, headache, weakness, and pains. Certain locations have unique symptoms of nerves, such as seizures among Puerto Ricans, diarrhea in Newfoundland, and hot/cold sensations in Costa Rica.[2] In addition, in most locations nerves is more prevalent among women than among men. For example, in rural Mexico, the prevalence of nervios among women is 20%, while the prevalence among men is only 9%.[3] Although there is overlap among the experience of nerves in different countries, cases of nerves are influenced by the cultural context of each specific location.
Though considered a folk illness, some researchers are hesitant to consider it a “culture-bound syndrome” because it is seen in so many different geographic areas and cultural areas. Though the symptoms and experience of nerves might differ between regions, the risk factors for developing nerves tend to be more uniform: stress , grief, and/or conflict.[4]
Nerves is of great importance to questions of mental health because of its overlap with the biomedical categories of anxiety, depression, and panic disorders. In addition, folk illnesses such as nerves are often treated with a combination of folk remedies and biomedical medications. Understanding the interaction between folk illness and biomedical mental illness is vital for comprehensive treatment in areas where nerves is a recognized health disorder.[5]


Medical Anthropology Research


Nerves is characterized by anthropologists as an idiom of distress. Idioms of distress are socially-acceptable coping mechanisms that are manifestations of anxiety, powerlessness, insecurity, and anger.[6]

Example from the US, Guatemala, and Mexico

Baer et al[7] did a comparative study of the experience of nerves in Mexican-Americans in Texas, Puerto Ricans in Connecticut, ladinos (non-indigenous Guatemalans) in rural Guatemala, and urban Mexicans in Guadalajara. Despite the varying geographic and ethnic composition of the groups, there was a great deal of agreement about the causes, effects, and distribution of nerves. For example, a majority of the participants at the 4 sites stated that nerves usually occurs in women and people of weak disposition. They also commonly noted that experiencing a stressful situation (such as being in an accident) can cause nerves and that symptoms include sadness, hopelessness, crying, and headache among other things. However, only Guatemalans reported a connection between physical conditions such as being exposed to drafts as a possible cause of nerves. Additionally, Mexican and Guatemalan respondents reported that untreated nerves can lead to diabetes. This nuanced understanding of the definitions of and experiences with nerves is an interesting contribution of medical anthropology to the understanding of this folk illness.

Example from Appalachia

Marylin K. Nations, Lina A. Camino, and Frederic B. Walker[8] studied the prevalence and experience of nerves in Appalachia. In this rural area, nerves is experienced as a response to “life drama” such as financials hardships, relationship problems, and other stressful situations. 70% of people who experience nerves in Appalachia attempt to self-treat their symptoms with things like prayer, relaxation, and making efforts to ‘stay busy’. Half of the people interviewed would sooner consult trusted family members or community members rather than a medical doctor to get advice on how to treat nerves. Individuals who do consult biomedical doctors get treated with ‘nerve pills’, which is the folk term for sedatives such as Valium. This study of nerves in Appalachia found that people who reported suffering from nerves experience higher levels of stress (according to the Holmes-Rahe Stress Scale[9] ) than individuals who reported not having nerves. This legitimizes the disorder as more than a culture-bound syndrome because it shows that it is connected to the biomedical evaluation of stress and anxiety.

Applied Work


Much of the research done on nerves has not had an applied focus. Most research on nerves emphasizes the importance of understanding the overlap between nerves and biomedically recognized illness categories such as depression, anxiety, and stress, but does not provide a mechanism for relieving the health burden of the disorder.

Further Reading


Guarnaccia, Peter J, Melissa Rivera, Felipe Franco, and Charlie Neighbors
1996 The experiences of ataques de nervios: Towards an anthropology of emotions in Puerto Rico. Culture, Medicine & Psychiatry 3:334-367

Low, Setha M.
1985 Culturally Interpreted Symptoms or Culture-Bound Syndromes: A Cross-Cultural Review of Nerves. Social Science and Medicine 2:187-196.

The Holmes and Rahe Stress Scale: http://www.mindtools.com/pages/article/newTCS_82.htm, accessed April 27, 2012.

References


  1. ^ Low, Setha M. 1985 Culturally Interpreted Symptoms or Culture-Bound Syndromes: A Cross-Cultural Review of Nerves. Social Science and Medicine 2:187-196.
  2. ^ Low, Setha M.
    1985 Culturally Interpreted Symptoms or Culture-Bound Syndromes: A Cross-Cultural Review of Nerves. Social Science and Medicine 2:187-196.
  3. ^ De Snyder, V. Nelly Salgado, Ma. De Jesus Diaz-Perez, and Victoria D. Ojeda 2000 The Prevalence of Nervios and Associated Symptomology among Inhabitants of Mexican Rural Communities
  4. ^ Baer, Roberta D., Susan C. Weller, Javier Garcia de Alba Garcia, Mark Glazer, Robert Trotter, Lee Pachter, and Robert E. Klein. 2003 A Cross-Cultural Approach to the Study of the Folk Illness Nervios. Culture, Medicine and Psychiatry 27: 315–337
  5. ^ Weller, Susan C.; Baer, Roberta D.; Garcia de Alba Garcia, Javier; Salcedo Rocha, Ana L. 2008 Susto and Nervios: Expressions for Stress and Depression. Culture, Medicine & Psychiatry 32(3):406-420
  6. ^ Nichter, Mark. 2010 Idioms of Distress Revisited. Culture, Medicine, and Psychiatry 34:401-416
  7. ^ Baer, Roberta D., Susan C. Weller, Javier Garcia de Alba Garcia, Mark Glazer, Robert Trotter, Lee Pachter, and Robert E. Klein. 2003 A Cross-Cultural Approach to the Study of the Folk Illness Nervios. Culture, Medicine and Psychiatry 27: 315–337
  8. ^ Nations, Marylin K., and Linda A Camino and Frederic B. Walker. 1988 “Nerves”: Folk Idiom for Anxiety and Depression? Social Science and Medicine 26(2):1245-1259
  9. ^ The Holmes and Rahe Stress Scale: http://www.mindtools.com/pages/article/newTCS_82.htm, accessed April 27, 2012.