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Maxine Aston (See also The Healing of Cassandra) What is CADD? - The easiest way to understand it is to relate it to Seasonal Affective Disorder (SAD). SAD is caused by sunlight deprivation; this can cause a neurochemical imbalance in the brain. The symptoms of SAD usually occur regularly each winter, starting between September and November and continuing until March or April. A diagnosis can be made after three or more consecutive winters where the symptoms, including a number of the following, continue to recur. Sleep problems: Usually desire to oversleep and difficulty staying awake but in some cases, disturbed sleep and early morning wakening Lethargy: Feeling of fatigue and inability to carry out normal routine Overeating: Craving for carbohydrates and sweet foods, usually resulting in weight gain Depression: Feelings of misery, guilt and loss of self-esteem, sometimes hopelessness and despair, sometimes apathy and loss of feelings Social problems: Irritability and desire to avoid social contact Anxiety: Tension and inability to tolerate stress Loss of libido: Decreased interest in sex and physical contact Mood changes: In some sufferers, extremes of mood and short periods of hypomania (over activity) in spring and autumn. Most sufferers show signs of a weakened immune system during the winter, and are more vulnerable to infections and other illnesses. SAD is very, very real! However where SAD is about sunlight deprivation - CADD is about emotional deprivation! The CADD sufferer experiences similar symptoms to those of the SAD sufferer. However there is a more damaging effect upon the CADD sufferer insofar as it is another human being, they probably love, who is responsible, usually unintentionally, for their emotional deprivation - this can be a partner or a parent. The fact that it is unintentional is only realised when the reason for their behaviour is discovered either by self-diagnosis or diagnosis by a professional. Living in a relationship where Asperger syndrome is undiagnosed or denied will often result in the non-AS partner being blamed. CADD is likely to be at it's height as the non-AS partner (whether male or female) find themselves in a position of not being believed by either the AS person or other people around them. It is these feelings of confusion, aloneness and desperation that have resulted in the name Cassandra being applied to the condition. My research strongly indicates that CADD can develop as a consequence of being in an intimate relationship with an adult with Asperger syndrome or a disorder that produces a low emotional/empathic quotient or Alexithymia, a Greek term meaning literally without words for feelings (Parker, Taylor and Bagby 2001). Alexithymia levels found in Autistic Spectrum Disorders are [85%] (Hill, Bethoz and Frith 2004), Anorexia Nervosa [63%] and Bulimia [56%] (Cochrane, Brewerton, Wilson and Hodges 1993), Major Depressive Disorder [45%] (Honkalampi et al. 2001), Posttraumatic Stress Disorder [40%] (Shipko, Alvarez and Noviello 1983), Panic Disorder [34%] (Cox, Swinson, Shulman and Bourdeau 1995). The prevalence of Alexithymia is highest in people with an Autistic Spectrum disorder (85%) which is further hindered by a lack of theory of mind (Beaumont and Newcombe 2006). Asperger syndrome is a neurological difference in the wiring of the brain and it cannot be cured. CADD is a secondary disorder which is based upon the situation a person is in and is transitional - it is a consequence of the relationship and is NOT a personality disorder. The effects of CADD can be eliminated or reduced with the realisation of the cause but only if both partners accept it. Acceptance allows for steps to be taken to restore the lack of emotional input the CADD sufferer has been experiencing. From this some couples are then able (if the diagnosis is accepted) to relate the problems they are struggling with, to Asperger syndrome and not each other. Emotional reciprocity, love and belonging are essential human needs, if these needs are not being met and the reason why is not understood, then mental and physical health may be affected. Awareness and understanding can eliminate this. CADD is a consequence of the situation a sufferer is in, therefore it is possible to find ways to rectify this. Some relationships, where one partner has AS, can work if both partners understand their differences and work on developing a better way, a different way, of communicating. Where they show emotional expression and loving that works for both of them. Achieving this is dependent on the couple's relationship, the level of commitment and the total acceptance of the presence of Asperger syndrome by both partners. Just as sunlight restores the balance in SAD - emotional input and understanding can restore the balance in the person affected by CADD. However if the adult, affected by AS, is unaware or in denial of Asperger syndrome, it is more than likely the affects of CADD will continue. References Beaumont,R. and Newcombe, P. (2006) Theory of mind and central coherence in adults with high-functioning autism or Asperger syndrome, Autism: The International Journal of Research & Practice 10.(4) 365-382 Cochrane, C.E., Brewerton, T.D., Wilson, D.B. & Hodges, E.L. (1993) 'Alexithymia in eating disorders.' International Journal of Eating Disorders 14, 219-222 Cox BJ, Swinson RP, Shulman ID, Bourdeau D (1995): Alexithymia in panic disorder and social phobia. Comprehensive Psychiatry 36, (8)195-198 Hill, E., Berthoz, S., & Frith, U (2004) 'Brief report: cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives.' Journal of Autism and Developmental Disorders 34, (2) 229-235. Honkalampi, K., Hintikka, J., Laukkanen, E., Lehtonen, J. and Viinamäki, H. (2001) 'Alexithymia and depression: a prospective study of patients with major depressive disorder.' Journal of Psychosomatics 42, 229-234. Parker, J.D.A., Taylor, G.J. and Bagby, R.M (2001) 'The relationship between emotional intelligence and alexithymia' Journal of Personality and Individual Differences 30, 107-115 Shipko, S., Alvarez, A., & Noviello, N. (1983). Towards a Teological Model of Alexithymia: Alexithymia and Post-Traumatic Stress Disorder. Psychotherapy & Psychosomatics, 39, 122-126. |
