This is going to be a super-short review; saving my own Emotions for the companion novel (Where Silence Gathers) coming out this summer!
I'll admit, I was skeptical about the personified Emotions, which are a big driving force in the story. However, they were very well done. Think Neil Gaiman's "Sandman" series and you'll understand what the personified Emotions and Elements are like: powerful, strange, a little scary, and very otherworldly.
My favorite thing about this book was how the tone shifted to complement Elizabeth's development. I can't say too much about this without giving away secrets, so just trust me in that just because Elizabeth doesn't feel Emotions doesn't mean you won't when you're reading it.
I would recommend this book to fans of supernatural and paranormal YA fiction, as well as to readers of contemporary/realistic fiction who are just looking for something a little different.