Customer Reviews

Shadow Syndromes: Recognizing and Coping with the Hidden Psychological Disorders That Can Influence Your Behavior and Silently Determine the Course of Your Life

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What some cynics will have you believe is that everyone is a little quirky, and that you should just accept that. Personally, I think that's a laugh. It's true ignorance shining through. The unwillingness to have an open mind and truly accept that there just might be biological reasons for behavior.

I began reading about anxiety disorders years ago, because my wife was having true panic attacks. When my son was born 7 years ago, we knew we would have to keep an eye on him. Now, as a first grader, we're seeing signs of behavior that don't make sense. They aren't just as simple to brush off as saying "he's just being a boy". So I've been reading more about bipolar, ADHD, ADD, and other conditions.

In reading about some of the mental disorders, I was intrigued by the recent acknowledgement of adult ADD. I read the symptoms, and had to face the cold reality that they really fit me. I'm 41 years old with a BA, MS and I'm halfway through my MBA. I've done well in my career and I've been married for 13 years to the same person. By all rights, I'm pretty normal. But I have always been a terrible procrastinator. I've read books on the subject and tried...REALLY tried...to help myself get organized and on track. Nothing I've ever done has helped. As an example, I had a report to write for work last fall. The CEO wanted me to do this. I knew what needed to be done. I knew how to get the research. I knew what the final presentation should look like. I had 5 weeks to prepare. I would sit at my desk, tell myself I wasn't going to get up until I had a good chunk of it done...and then surf the internet. Or work on another project. Or enter addresses in my Palm Pilot. I was distracted by every noise, every conversation in the hallway...even though I had a financial stake in the outcome (my job!).

These things happen all the time, and they have for over 25 years. I've always said they're just part of my personality. A reviewer below wants you to believe that this book is worthless. I can tell you from first hand experience, this book has helped me understand that there may be a biological answer to what I thought was "just my personality". I believe, as one of the authors states, that it is my duty as a husband and father to explore the possibility that I have ADD in a mild form, and seek treatment. If that means I take a pill, so be it. I take a pill for my cholesterol, wear contacts for my eyes, so why wouldn't I treat this as I treat those other bio-conditions?

If you think, just maybe, that you have a hint of one of these conditions, spend the bucks and the hours and read this book. Those of us with "shadow symptoms" are less likely to get diagnosed, because we're not as obvious. We need to help ourselves a little. Ignore the skeptics and cynics...make the decision yourself.

I read this book because our child had just been diagnosed with one of the "Shadow Syndromes," Asperger Disorder. As so often happens with childhood-onset brain disorders, he has symptoms that are a mixture of various disorders -- major depression, anxiety, obsessive-compulsive disorder. (These are hereditary disorders when appearing in one so young.) After reading this book, so many elements of our son's puzzling behavior, and the milder symptoms present in my husband and myself are more understandable. If you or your loved ones have mild forms of more serious brain disorders, this book is for you. I had an "aha" experience at every chapter. Our policy is not to buy any book unless we have already read a copy from the library and know that we will refer to it again and again -- that it is truly useful. This book fits that criterion. Read it.

I was diagnosed with one of the disorders discussed in this book. "Shadow Syndromes" has helped me realize that there ARE good things about these "disorders". There IS a purpose to all the suffering I and my family experienced before my diagnosis as well as the hard work that has been required since diagnosis.

I accept that my out of control biochemistry will require medication so long as I live in a modern world that has little ability to tolerate someone who lives out of step with the current drum. The need to be able to provide for my family in a time-clock world means I must conform to some degree. However, the knowledge that I have my own contributions to make helps me to hold on to those parts of me that have been enhanced by my "disorder".

I have much work ahead of me. While meds are not the only answer, they seem to buy me the time I need to work with a therapist on other strategies for coping.

This book has been an incredible ecouragement to my loved ones and to me.

This book clarifies many aspects of our personalities, helping us to understand why many mental disorders are just one extreme in a continuous range of types, and provides some hints as to why many of those types have advantages and disadvantages that would explain why such a range of personalities ought to exist.
I especially enjoyed their theory about how a smaller cerebellum could explain a number of different symptoms of a nerdy (mildly autistic) personality. I suspect it isn't exactly right, but it explains a good deal more than any alternative I've seen.
One warning - this isn't very valuable as a self-help book. It should be read mainly to improve your understanding of the human mind, not as a means of changing it.

This is an absolutely fascinating book. The idea that there are "mild" forms of mental illness, which we may all have pieces of, is extraordinarily useful in understanding myself and others.

The book absolutely cries out for a bibliography. I would guess that the authors prepared one, and that the publishers omitted it. It is an absolute necessity which I trust the publishers will remedy immediately.

Shadows Syndromes is a worthy read, in that it does a good job of highlighting the major disconnect between diagnostic categories and reality. While the DSM model has its uses (research and billing being the only two I can think of right now), it also serves to reify the notion that mental illnesses are precise, discreet disorders. Any one with an ounce of clinic experience will tell you that real cases don't fit neatly into categories. The diagnostic questions sometimes help think through and organize the presenting concerns, signs and symptoms. But often the debate over whether someone is suffering from a pure mood disorder versus PTSD versus character pathology serves as a distraction. Or , another classic example: spinning wheels arguing whether a patient is an addict with psychiatric symptoms secondary to drug abuse or are they actually someone with a primary psychiatric diagnosis who is using substances to self-medicate their mental illness. It's a meaningless exercise based on an overly simplistic model. But that one does matter because insurance companies consider one of those scenarios worth paying to treat and the other worthy only of their contempt.

In reality, just like any other organ in the body, the brain mediates a number of functions. It is responsible for mood regulation, memory, sustaining attention, shifting attention, interpreting social cues, integrating sensory information, regulating motivation of all manner of behaviors, and impulse control, to name a few. We all have various strengths and weaknesses, and we all fall somewhere on a bell-shaped curve for performance of each of these various tasks. People who shake out on the extremes ends in one particular area probably look like textbook definitions of specific illnesses (a "pure" mood disorder with no other comorbidities). That's rare. Looking at it even just from this sort of statistical model, one would expect that, for any given disorder, the number of people who unmistakably qualify for a specific diagnosis would be just a fraction of those who almost qualify. These "subclinical" cases are what Drs. Ratey and Johnson refer to as "shadow syndromes." They go a step further and assert that these people actually suffer more from mental illness, because they slip through the cracks. They are not quite sick enough to find themselves needing treatment, but they are impaired by their symptoms.

It's an important perspective that is explained in simple, readable terms in the first part of the text. The second part then breaks the shadow syndromes down into specific "mild" mental illnesses based on the traditional categories. So just imagine how densely the comorbidities can layer now. Is there anyone motivated to pick up this book that won't conclude that they have masked depression, are slightly bipolar, have a subthreshold intermittent rage disorder, mild attention deficit disorder, a touch of "autistic echoes" and are a shadow addicts? Then what are the implications? Does everyone need to be in therapy? Does everyone need to be on a finely tuned psychopharmacological regimen and a behavior plan?

I recommend this book, I think it's well-written and thought provoking. It does succeed in explaining complex issues in a way that is understandable to people outside the field without being simplistic or dull to people within the field. That's a tough line to walk. And I like the emphasis on blurry boundaries to disorders, and the overall message of understanding how your brain works, what your relative strengths and weaknesses are and how to make the best of things. But I worry that the take-home message for many will be to feel these diagnostic categories expanding, billowing out of their margins, pathologizing every aspects of our humanity as it envelopes us. While it gets at the true complexity of these disorders, it also does so with the bias that mental illness primarily a Biological phenomenon. Perhaps this is to combat social stigma and people's assumptions that these deficiencies are due to personal weakness (or- just as damaging- all to be blamed on bad mothering). Or perhaps, it's that, as we learn more about these disorders (which we are doing at a rapid rate thanks to the new abundance of genetic data and advances in brain scanning that lets investigators see brain regions light up as they work), we learn more about the biological aspects, since that is what we are looking for and trained to interpret. So, now the authors expand the scope of these diagnoses and therefore lead us to the conclusion that more people could benefit from psychopharmacologic treatments. It's a nice book to recommend to your patients if you take only self-pay patients and only do psychopharm visits. But it skims over the real beauty of psychiatry, the reason it is the most intellectually challenging field in medicine and the most rewarding specialty to practice, which is the multifactorial, composite nature of everything our brain is and does at any moment. No doubt the genetics shape the brain, as does the metabolic and endocrine factors in the uterine environment during development, as does nutritional factors, and then near infinite environemental variables acting constantly on each individual. From things as foundational as the fit in temperament between primary caregiver and baby, all the way out to religion and culture. From the preconscious memories of the earliest childhood experiences all the way out to this morning's headline news.

You can take the best brain in the world, if there is such a thing, but I guarantee the individual possessing it will be no healthier than the families, systems, and societies they inhabit.

So thumbs up for a great read, and a perspective that broadens our view of the mind and mental illness. Too bad they interpret the new landscapes with tunnel vision, but it's to their credit that they left me wanting more.

When one has suffered as intensely and for as long with many of the mental disorders described in this book--both major and mild--as I and 4 generations in my family have, FERVENT applause goes to Dr. Ratey for his elegant work. I can attest to his astonishing expertise and extraordinary compassion in this practical, uplifting, fascinating book. The authors make it look easy, but don't be deceived by the lack of jargon. The data is sound. Perhaps your interior life isn't as "interesting" as mine (bipolar II (hypomania), OCD, ADD, a soupcon of autism, a touch of Tourette's, and an eating disorder). You will still learn a lot and enjoy the process. I gained more profound personal insights in one brisk reading of Shadow Syndromes than I did in the last 40 years of slogging from crisis to crisis. Seeing some answers to my deepest, scariest questions about my conditions both moved and elated me. If the truth makes you free, then I am soaring right over the rainbow!

As a physician who treats several patients with ADHD, as a father, and as one who just recently diagnosed ADHD in both myself and my son simultaneously, I cannot praise too highly the importance of the recognition and the legitimization, both clinically and morally, of the formes fruste--or variations--of these acknowledged disorders. The authors have done a remarkable job of a difficult subject--formes fruste--a notion not clearly understood even by competant physicians. An example of the difficulty is given by a thoughtful reviewer, who wrote: "there are still no objective biochemical tests for the presence of such disorders" and who concludes "If the diagnosis is still based on talk and history, rather than chemistry, the causal connection assumed by the authors between chemistry and disorder must be regarded with skepticism." This is the only criticism worthy of debate--but it is still wrong:The author mistakenly assumes that stand-alone biologic criteria (as parametric measures) are the sine qua non for objective diagnosis. This is simply untrue. It is sufficient to demonstrate that signs and symptoms cluster together in certain people in a manner that would not be predicted from chance and chance alone. If one of the measures is biologic (e.g. PET scan--Zimetsky's work) this adds a luster of credibility to the eventual diagnosis. But the converse is not true: the absence of a distinct biologic measure does *not* invalidate the diagnosis. Recognition of this concept expands the treatment armamentarium to include, where indicated, specific medications. Moreover, the very nature of the psychotherapy will change if biologic influences are strongly suspected.Failure on the part of the medical profession to understand this can be reversed by an enlightened public. Failure to act appropriately can result in tragedy. This is especially true when children suffer during their socialization and educational years. I know of what I speak.The only criticism I would make is that the authors did not include a bibliography.

I heard John Ratey speak at a conference on ADD, and had to read this book. He provides fascinating insight into the brain and the origins of mental health disorders. When you read this book you may recognize yourself or other people in your life. Little quirks in personality will suddenly make sense to you. Addictions may be better understood as self-medicating as he explains the effects drugs have on different areas of the brain.
If you are at all interested in mental health issues, you have to read this book. It could change your perception of mental illness.

EVERYONE should read this book! It is a book for those persons who have always felt mildly out of sync with others and also for family members who have someone in the family who suffers from depression or who is manic depressive. There is a wonderful section on obsessive compulsive disorder and also those who are ADD. It is a value for the money. Buy it and read it. You will be glad you did.