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It seems there has been a big increase in the number of children being diagnosed with sensory disorders. One reason may be that kids with sensory issues actually have other diagnoses, such as ADHD, anxiety, PTSD from abuse, and autism, just to name a few examples. Other times, some kids may just be sensitive to some things but not others and don't actually meet the full criteria. It has only recently been added to the psychiatry diagnosis textbook, the DSM-5.

Sensory processing disorders are basically where kids are sensitive to sounds, textures, or other stimuli to the point where it is beyond normal childhood behavior and causing a disruption in the child's life and also in the life of the family. Any of the five senses, taste, touch, smell, sight, and sound can be affected. Often children with sensory issues also have poor fine motor skills or have a hard time with social cues and interactions. They have a hard time regulating their emotions.

One study shows that sensory processing disorders affect 5% to 15% of school-aged children. Another study showed that there may be a biological cause with abnormalities in the white matter of a child's brain that could explain sensory issues.

Some children are hypersensitive to things and may think everything is too loud or too bright. They are the ones who are covering their ears often or have a low pain threshold or are super picky with eating certain textures. They have a hard time focusing and controlling their emotions, and they don't like to be touched. Other children are hyposensitive and they crave input, trying to get more sensory input. They're more likely to have a high pain threshold, put things in their mouths, hug too tightly, invade other people's personal space, or rock and sway.

One big issue is that there is still so much to be learned about sensory processing disorders. Your pediatrician can suspect your child has a sensory processing disorder but cannot actually make the diagnosis. Again, there are so many other brain issues that can present with similar symptoms so it takes a developmental or a behavioral specialist or even a neuropsychologist to get an official diagnosis. Your pediatrician will refer your child to someone who can help do a full and complete evaluation to get the correct diagnosis. The mainstay of treatment for sensory processing disorders is occupational therapy. Occupational therapists can help kids and parents learn ways to manage their sensory needs.

If you have concerns that your child may have a sensory issue, please talk to your child's pediatrician and ask them for a referral to a specialist who can get them the right diagnosis and treatment.

Dr. Jones: If you knew that you had a gene that caused illness in your children, what are your choices? New research into editing genes in human embryos gives us some new choices and new dilemmas. This is Dr. Kirtly Jones from obstetrics and gynecology at University of Utah Health and this is The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: Mutations in the genes we carry cause thousands of diseases. Some of the diseases are manageable and some are deadly. If we knew we had those genes and didn't want our biologic children to suffer those problems, what might be the choices?

Of course, you could toss the genetic dice and just hope that the next baby didn't have the disease. A lot of people do this. They can't afford other options, although the care of what might be a critically ill child has its own costs. Maybe they feel that the options of creating a child aren't in their hands. Maybe the disease they carry isn't life ending but is life limiting. They have to manage with this disease and they figure that the children will as well.

Okay, the next choice might be that you choose not to have biological children. Some people make that choice because the possible outcome of a child with a severe disease is too heartbreaking for them. They may adopt children or remain childless.

Another choice might be to use donor egg or donor sperm depending on whether the dad or the mom has the mutation and make a baby that way. Donor sperm are relatively inexpensive, donor eggs are not. Some people want their own biological children and may search for another path.

Genetic testing of early fetuses in the womb by collecting cells from around the fetus has allowed pregnant women and their partners to know if the fetus carries the abnormal gene. The couple can decide if they want to terminate the pregnancy. This was the only option until about 15 years ago for a couple to try to select a healthy pregnancy. Clearly, it can be heartbreaking for couples to terminate a wanted pregnancy but if they already had a child die from the disease, that option might be preferable.

About 15 years ago, pre-implantation genetic diagnosis became widely available in the U.S. Couples with a known genetic disease can have in vitro fertilization and their early zygotes, very early embryos, can be tested and only the healthy embryos placed in the uterus to hopefully implant and grow. The abnormal embryos can be discarded. In healthy fertile couples with genetic diseases, this technique can be very successful.

Now, this week a multinational group led by a team at Oregon Health Sciences University reported the first successful techniques in editing out a mutation in sperm from a man with genetic heart disease. They were careful and successful in creating what appears to be genetically normal embryos. Although the embryos weren't implanted and were discarded after testing, their new technique opens up new doors and asks some questions.

Wow, this reminds me of typing term papers 50 years ago on a typewriter. When you made a mistake on the page, you could use white out, but it looked bad. You had to start all over. Then came the electric typewriter which let you correct little errors but not big ones. Then magic happened, computers created word processing. You could cut and paste with a click. It would even tell you when you'd made a mistake. It completely transformed written document creation. That in mind, how did this Oregon team do it?

They used a gene editing technique kind of like word processing called CRISPR-Cas 9. A lot has been written about this genetic technique. You can watch it on YouTube, there are TED Talks. It was invented or perhaps we should say discovered by two women scientists, one from the U.S. and one from France.

The Oregon team put a little cool twist on this technique. They took the sperm from the man with a known mutation that causes heart failure, they added the sperm to donor eggs. After injecting the sperm into the egg, they added a molecule created in the lab to specifically cut out this abnormal gene from the sperm DNA. And the really cool part, the egg with the normal gene had natural gene repair mechanism that replaced the gene from the sperm that been cut out, with a copy of the normal gene from the egg. They even in the paper called it not "gene editing" but "gene repair."

The zygotes that were created with this technology were then tested and the majority of them were normal by genetic testing. Now, this was a very special kind of genetic problem. It came from the man and was carried in the sperm. The cutting and pasting happened very early after the sperm was added to the egg, waiting later after fertilization doesn't work as well. And other research teams using this technique in already fertilized eggs didn't find it worked as well. We don't know if this would work if the egg was carrying the mutation and that would be much harder to do as eggs are hard to get.

So why would a couple use this technique when it's perfected rather than other options we've already mentioned? Some people have philosophical or religious concerns about discarding embryos. This new technique isn't perfect and some abnormal embryos will still be created, so discarding embryos will still happen.

Should we do this just because we can? Maybe. Pre-implantation genetic diagnosis, the technique we can do now to replace only normal embryos is complicated but it works very well. You do need a bunch of embryos to make sure you have enough for some to be normal. Gene editing might allow for greater chance of getting normal embryos, if you don't make very many eggs.

Of course many people worry about a slippery slope of creating people with specific genes for certain traits, height, smarts, eye color. But the same kinds of arguments were put forth when any genetic testing of fetuses or embryos was first attempted. So this technology is not ready for general clinical use at this time. It's amazing that they could cut out the abnormal gene from the sperm and the eggs' DNA repair could create a new healthy gene. If the technology gets better, and it will, it'll be available somewhere in the world and some people will use it. So stay tuned and thanks for joining us on The Scope.

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Interviewer: Ten percent of people living in Utah are at a higher risk for seasonal affective disorder. We're talking today with Dr. Jason Hunziker. First of all, why are we, living in Utah, at a higher risk?

Dr. Hunziker: There are a lot of theories as to why people who live in the northern latitudes are at higher risk of this type of depression. One of those theories is the fact that there just is not as much daylight in the north as there is closer to the Equator. So the further we get away from the Equator, the shorter the days become, the darker it becomes, and so people get more depressed.

Interviewer: And so, then it's true that sunlight actually makes you happy.

Dr. Hunziker: That's correct. People who live closer to the Equator have less chance of this type of depression.

Interviewer: Are there other risks then, being in Utah, besides not enough sun?

Dr. Hunziker: There are, and people who are at risk that live in Utah are people who are young, they're a lot more at risk. Women tend to be at a higher risk than men, at an almost ten times more likely to get this type of depression than men.

The other thing that occurs in Utah, that doesn't occur in other places, is our inversion. So time away from the sun, even on a bright day, we don't get that because the inversion's there to block the sun. People who live around tall buildings that block the sun tend to get more depressed. If your job is indoors, in the basement with no windows, during the winter you're really at risk.

Interviewer: And especially since we have Daylight Savings here in America, you get out of work at 5:00 and it's already dark.

Dr. Hunziker: That's right.

Interviewer: And so you don't really ever . . .

Dr. Hunziker: That's right.

Interviewer: And then you wake up at, you know, 6:00, 7:00 and it's still dark, and so you never really see the sun.

Dr. Hunziker: That's correct, and it can't just be the light in your office that makes the difference, it has to be the same wavelength as the sun to make a difference, which is why people use light boxes because that does help with most people who have this type of seasonal disorder.

Interviewer: So knowing that people in Utah are at higher risk for depression, tell me from a doctor's perspective exactly how dangerous that is.

Dr. Hunziker: Yeah. So depression can be extremely dangerous, and suicides rates, particularly in Utah, are quite high. And if depression of any type goes unchecked, it can lead to people thinking about ending their life, which is extremely important. So any time you're experiencing a depressed mood, it should be evaluated, at least by your primary care doctor to see if something else needs to be done.

Interviewer: So with depression being so serious, does it often get confused for somebody just being moody, then, because people get moody and they get upset, but when does that become depression? When does it become dangerous?

Dr. Hunziker: The way you can tell is if this lasts every day for at least two weeks, where you're feeling so terrible that you don't want to get out of bed, where you feel like you have to sleep all of the time. You have absolutely no energy, or interest, or desire to do anything with anyone. You notice that you're eating a ton, particularly carbohydrates. With this population that gets seasonal affective disorder, carbohydrates tend to be the big thing that they do. And then, of course, if you start having any thoughts about hurting yourself at any time, that's when it really needs to be addressed.

So in summary, I think that for those of us living in Utah, we are at higher risk, so we need to pay attention to those signs of depression. Particularly women, particularly young people, particularly people who work in environments where they're not around sunlight need to pay attention to this. If you notice that you're having any changes in your mood, please seek help.

updated: December 16, 2022
originally published: December 16, 2015

Dr. Jones: About 10% of US adults experience mental illness such as depression or anxiety every year. How to overcome that stigma? This is Kyle Bradford Jones, family physician at University of Utah, coming up next on The Scope.

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Dr. Jones: So lots of people, particularly adults in the US, suffer from depression or anxiety but have difficulty overcoming the stigma of having that. A lot of people think, "Hey, am I crazy if I'm depressed? I can buck up. I can do this on my own." The culture in the United States tends to revolve around being the cowboy, "I am independent. I can do this on my own. I do not need your help," but depression and anxiety is more than that. This is something that is a real illness that you cannot simply overcome on your own.

There are a couple of things to keep in mind. This is more than just being sad. That's kind of the first thought that most people have. Depression can be an emotion, it can be a symptom of something else, or it can be a diagnosis. The emotion is feeling sad. It is having a bad hair day. It's going through something tough. That's completely normal. It can also be a symptom of something else, such as thyroid disease or something like that.

But the diagnosis of depression, you feel a little bit more sad, you feel guilt, you have trouble concentrating, you have less energy. You no longer take pleasure in things that are normally fun and entertaining for you, and it leads to decreased function. And so having that thought of, "Hey, I can overcome this on my own," is actually going to be detrimental if you have the diagnosis of clinical depression.

So what things can you do? First of all, go see your physician. This is something I can start with your primary care physician. Talk to them about what you are experiencing. They can give you some guidance on how severe it is, if it is the diagnosis versus if it's an emotion, a symptom, they can offer some different things for you.

A lot of people think that therapy is just talking to someone and that's it. But that's not the purpose of it. So certainly that helps a little bit, but there are therapeutic methods that have been proven to give you better coping skills, to help you better deal with the things that you're experiencing.

Now, the best way to deal with depression is a combination of therapy and medication. A lot of people are worried, "Hey, if I go on medication, I'm going to be on this for the rest of my life. It shows that I am crazy and I'm going to feel like a zombie. It's going to completely take away my ability to feel." It's actually the opposite on all those accounts.

The vast majority of people who are on medication for depression or anxiety take it for about 6 to 12 months, and then they're okay without it after that. It's actually not something that's going to make you feel like a zombie and keep you from feeling. It actually quiets the depression and anxiety so that you can get back to your normal self, to your normal feelings, your normal activities. Less than 50% of adult men get treatment for their depression or anxiety. Obviously, that's a big deal.

Now, how do we get rid of this stigma? The first step is understanding it, understanding that this is a medical condition. It's caused by a decrease of chemicals in your brain. This is not a moral weakness. Oftentimes this can be brought on by a stressful life event and it can just be a short-term thing. Like we said, you don't need to have treatment long-term for most people. Also, understanding that as a society we just need to talk about it more. It's okay.

There are actually a significant amount of people that struggle with this from time to time and that's okay. Treatment helps because if you don't get it treated, it actually worsens your relationships, it worsens other health problems that you have and overall can simply make things worse. So seeking treatment and seeking the appropriate diagnosis can really make a big difference.

In summary, if you feel like you may be suffering from depression or anxiety, you are not crazy. Seek therapy. Go see your physician. Don't be afraid of it, because denying it only further ruins everything else going on in your life.

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Interviewer: People with eating disorders experience severe disturbance in their eating patterns. It's important to remember that eating disorders are mental illnesses and the physical effects are the symptoms. That's coming up next on The Scope.

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Interviewer: Three percent of Americans suffer from binge eating disorder. We're talking with Dr. Jason Hunziker, a psychiatrist at the University of Utah. Dr. Hunziker, what mental conditions can cause an eating disorder?

Dr. Jason Hunziker: There are lots of mental illnesses that are associated with eating disruption or eating disorder for different reasons. An example would be somebody with schizophrenia gets very paranoid often, so they won't eat their food because they're afraid it's been poisoned. We have other people who are so anxious about allergies in food that they just won't eat, so they have a specific phobia about certain foods. Some recent studies have shown that people with bipolar disorder and/or depression also struggle with eating disorder of a different type in which they binge eat.

Interviewer: First of all, what is binge eating?

Dr. Jason Hunziker: Binge eating is when you're going along fine and you eat normal foods, then you have an episode in which you just can't get enough food. You binge on whatever's in front of you. Most often it's not stuff that's good for you.

Interviewer: Always.

Dr. Jason Hunziker: You eat lots of it. Then, you eat to the point that you almost feel like you're going to burst. That leads to some people then going in and purging and getting rid of the food that they just ate.

Interviewer: So, it's different than, say, on a Saturday night I'm in front of a movie and I'm eating everything that's in my kitchen. That's different. It's those people that do that but then feel guilty, and then they throw up afterwards. Is that correct?

Dr. Jason Hunziker: That's correct. Usually, with binge eating there is a number of times you need to participate in that event before it even gets classified as a binge eating disorder. That has to be several times a week or month. Then, you qualify for a binge eating disorder.

Interviewer: What exactly causes someone mentally to think okay, I need to throw up? Because when I eat too much and I'm full I just wait for the food to settle down.

Dr. Jason Hunziker: Not everybody does throw up when they have the binge eating. What they'll do, though, is they use that food as some way to help comfort them for whatever's going on in their life. Often, as I said, it is associated with depression. When people are sad and they're down they...

Interviewer: They eat.

Dr. Jason Hunziker: ...feel like eating. And, the same with bipolar disorder - when you're sad and you're down, you eat. That somehow gives them some comfort, while at the same time it induces shame, and guilt, and other aspects of well, now I'm gaining weight, and now I'm not thin. It's a vicious cycle for them.

Interviewer: We obviously know that we classify binge eating as an eating disorder which is a mental illness. What other physical health conditions can it cause?

Dr. Jason Hunziker: It depends on how long this goes. Clearly, binge eating is going to increase your weight. As your weight increases we know that affects all aspects of your body including your lungs, and your heart, and then the cardiovascular system and other physiologic effects that it can bring on. Type-2 diabetes in this country now is really expanding because of the obesity problem, and this would be another way to contribute to that problem.

Interviewer: That's interesting. There are all these sorts of more severe diseases that can come from just binge eating.

Dr. Jason Hunziker: That's correct.

Interviewer: Obviously, you know that's going to happen. You want to treat it. Is it something that you physically and emotionally are maybe aware of, or do you need somebody to tell you I think there's a problem you need to go see a specialist?

Dr. Jason Hunziker: I think that some people are aware and some aren't. I think if it's associated with your mood disorder that would be a time to get into your doctor and get on some medication for your depression, which often will help take care of those binge eating episodes. Sometimes the medication itself will help take care of that compulsion or drive to eat which some people just have. They just feel compelled to do it and they can't feel good unless they do it. Then, they feel bad after they do it. It's a really vicious cycle. The medicine often will help with that.
There are good therapies that can help with eating disorder as well. It's really important to understand the underlying cause, and if it's caused by another illness to make sure that you treat that illness so that you can then treat the binge eating.

Interviewer: Any final thoughts on binge eating?

Dr. Jason Hunziker: I think that the important thing to do is for the patients and/or their families to recognize that the binge eating is a disruption to them, and that they get into talk to their doctor as soon as possible about what could be done to help them...

Interviewer: Because it can be treated.

Dr. Jason Hunziker: ...because it can be treated.

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