Grisi siknis (in Miskito language, from English, means "crazy sickness") is a contagious, culture-bound syndrome that occurs predominantly among the Miskito people of eastern Central America, and affects mainly young women. It is also known as "grisi munaia", "Chipil siknis", and "Nil siknis". More recently, cases occurring amongst people of Spanish descent have also been reported.
Grisi siknis in relation to culturally bound syndromes Joseph Westermeyer, head of psychiatry at the University of Oklahoma, states that a culturally bound syndrome is defined as "certain trance-like disturbances [that] occur with unusual frequencies in certain societies". These syndromes, he says, actually occur in a wide variety of cultures separated by great distance that have similar symptoms including "fear, anxiety, amnesia, aimless escape, psychophysiological symptoms, social withdrawal, behavioral deviance and nondirected violence". However, these symptoms are not confined to culturally bound syndromes, as others, such as "personality disorder, neurasthenia, crisis/judgment disorders, organic brain syndromes, drug-induced delirium, major depression, mania, schizophreniform and schizophrenia" might constitute the true psychiatric diagnosis." Because of these cross-cultural symptoms, it is argued that these syndromes are not necessarily unique". and that applying the term ‘culturally bound’ to them hampers science's ability to explore them on the same level as other psychological problems. Outbreaks of these symptoms are sporadic and epidemic." Some culturally bound syndromes, in addition to grisi siknis, include:
Amok: Among Malay, Indonesian or Pacific Islander males Anthropophobia in Japan
Cathard in Polynesia Chakore among Ngawbere of Panama Falling-out, among African-Americans or in the Bahamas Fits in India Frenzy witchcraft (among the Navajo) Indisposition (disease) in Haiti Koro among Asian males Latah among Southeast Asian females Mal de pelea in Puerto Rico Pibloktoq or arctic hysteria among Inuit Resignation syndrome among refugees in Sweden Wild-man behavior in New Guinea Although grisi siknis behaves like a virus, researchers have not been able to trace anything irregular in the blood samples of victims. According to the American Psychiatry Association, pibloktoq, "frenzy" witchcraft, chakore and amok, are all, like grisi siknis, classified as "running" syndromes, in that they contain "sudden high-level activity, [a] trance-like state, potentially dangerous behavior in the form of running [and] exhaustion, sleep [and/or] amnesia". It is generally applied to purposeless roving. In addition, Dr. Richard Castillo, as quoted by Dr. C. George Boeree, believes that amok (with very similar symptoms to grisi siknis), pibloktoq, latah, "falling out", "indisposition", and the "fits" are all related to impulse control disorders, and thus are associated with trichotillomania, compulsive gambling, pyromania, and kleptomania in Western medicine.
Grisi siknis in relation to Western medicine According to the American Psychiatric Association, a Western medical condition similar in many aspects to culturally bound syndromes, particularly the "running" syndromes, of which grisi siknis is part, is dissociative (or psychogenic) fugue. In any fugal state, a person appears normal, but has amnesia or identity forgetfulness. Dissociative fugue is distinguished by impulsive travel and amnesia, identity uncertainty, stress, and impediment to normal social function, all of which must not be influenced by substance intake. It is most often related to intense emotional stress and occurs randomly. However, some argue that "running" syndromes are really not dissociative fugue, and have no proper Western medical classification. Others contend that associating culturally bound symptoms with known ailments severely limits the discovery of new psychiatric disorders in folk culture. Edgardo Ruiz, PhD at the University of Pittsburgh argues that grisi siknis does not correlate with Western scientific cultural perspectives, and the cross-cultural translation of symptoms is an inaccurate device wherewith to understand the disease.
Signs and symptoms Symptoms of grisi siknis vary, but there is a distinct set of central characteristics. Most of the victims are young girls from 15 to 18 years old. The attacks are prefaced by headaches, dizziness, anxiety, nausea, irrational anger and/or fear. During the attack, the "victim loses consciousness" and falls to the ground, subsequently running away, which running Dennis calls "perhaps the most distinctive defining characteristic of grisi siknis behavior". The victim may view other people as devils, feel no pain for bodily injuries and have absolute amnesia regarding their physical circumstances. Some grab machetes or broken bottles to wave off unseen assailants. Other victims are reported to have performed superhuman feats, vomited strange objects such as spiders, hair and coins and spoken in tongues. In some cases the semi-conscious victim will speak the names of the next to be infected, although it is not always accurate. It is still highly contagious. During attacks, victims report mental visions in which devils or evil spirits come for them, and have sex with them. These visions also include anything from horrifying nightmares to pleasant experiences, and many anthropologists claim these are sexual experiences. This is a disputed fact, as not all cases involve sexual encounters. Attacks occur anywhere from multiple times a day to rarely when one is infected with grisi siknis. A person typically remains with the disease for several months to a year without medical attention, although some cases have been documented to recur for much longer.
Causes
Miskito theories Miskito tradition, according to Dennis, holds that grisi siknis is caused by possession by evil spirits. This belief stems from the combination of traditional Native American animism. and Miskito Christian idea of the devil. When epidemic outbreaks of the disease occur, the Miskito hold that it is the result of an imbalance with spirits, says Nicola Ross, a reporter for The Walrus magazine, which predicament they believe to be caused by a dilman or evil sorcerer.
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