Further Reading

Are more people "almost" crazy then we realize?

Hello, Dr. Peele;

I just visited and enjoyed browsing through your Addiction Site.

I recently read Dr. John Ratey's book Shadow Syndromes, with its theme that common behavioral problems are milder forms of more severe disorders (e.g., nerdy geekiness and social gawkiness are species of autism). I'm very suspicious of the whole biopsychiatric, drug-therapy oriented approach to these problems; a suspicion learned in part from reading your books. I did however find Ratey's book intriguing and well written and it led me to Temple Grandin's fascinating account of life as a self-defined autistic adult (Thinking in Pictures). Ratey is quite adamant that all these conditions are due to known biochemical dysfunction; including sexual addiction, on which he presents a case history (patient being a compulsive porn viewer). I'm curious; have you read Ratey, and if so what is your slant on his work?

Joseph L. Ebbecke

Dear Joseph:

It's ironic that — now that record numbers of Americans are classified as suffering from alcohol dependence, depression, manic depression, social anxiety, OCD, ADHD and other disorders (e.g., multiple personalities) — that one of the major thrusts in the mental health field is to alert people that, just because they don't qualify for one of these psychiatric diagnosis, they nonetheless are not normal. One example of this movement is "dysthymia," which according to Jane Brody, health writer for The New York Times, affects more than 7 million Americans. Dysthymia is a "little-known and often medically ignored yet treatable emotional disorder" consisting of a "mild but chronic depression."

Shadow Syndromes is the embodiment of this view of "almost-disease diseases." In Ratey's view, for each diagnosed case of mental illness, there are layers of ordinary people suffering from an unnoticed milder version of the same ailment. Ratey himself decided that he had shadow ADHD due to his inability to free associate in therapy. Whereas autism and ADHD are often diagnosed in people who fail to function adequately, their shadow varieties strike Harvard faculty and computer jocks and engineers! For Ratey, who is active in the diagnosis and treatment of ADHD, shadow syndromes require the same attention as the more obvious conditions found among people in mental institutions.

In fact, we could turn this whole idea on its head — that many of us have similar experiences to the mentally ill but were not derailed from life because of it could inspire the mentally ill. One example is that quite a number of people experience visions and hallucinations but don't regard themselves as mentally ill, and function as ordinary citizens! (One fascinating study of such people in the Netherlands, by Marius Romme and Alexandre Escher, "Hearing voices," Schizophrenia Bulletin, 15:209-216, 1989, asked such people how they coped with voices they heard.) Instead of this empowering and liberating message for the disordered that their experience is not so different from that of normal individuals, shadow syndromes instead tells everyone they are shade away from mental illness, and that we should all regard ourselves as dysfunctional and disabled.

My question is why in today's society people welcome this message, when they previously read One Flew Over the Cuckoo Nest and other fiction and nonfiction accounts of people who were declared mentally ill, but either did not deserve or else escaped the diagnosis.