The University Record, February 07, 2000

Health Notes

From Health System Public Relations

This winter, don’t be in the dark about SAD

It isn’t “all in your head”—Seasonal Affective Disorder (SAD) is more than the “winter blues” or a post-holiday letdown.

SAD is a physically and emotionally debilitating condition that affects approximately 6 percent of the population, mostly women. For some individuals, the seasonal decrease of sunlight and the long dark nights take a very real toll on their quality of life.

SAD sufferers experience low energy levels, sleep disruption, changes in appetite, apathy, ennui and, in extreme cases, suicidal tendencies. These individuals tend to avoid social interaction and would “hibernate” if they were able to.

SAD is triggered when the production of mood-influencing brain chemicals decreases along with the amount of sunshine during the fall and winter months. Reductions of two major neurochemicals—melatonin and serotonin—may bring on SAD. Melatonin is the body’s timekeeper, regulating sleep cycles and the body’s “internal clock.” When serotonin production falls, it may affect sleep, appetite, mood and concentration.

“Most of us are aware of the really cheerful, the elevating effect of a bright sunny day on our mood,” says Sheila Marcus, clinical assistant professor and director of the Division of Outpatient Psychiatry, “and of the converse—the negative impact of a gray, gloomy day.”

If left untreated, SAD may lead to problems on the job, difficulty with relationships, and strains on marriage and relationships with children and other family members, Marcus says. In the extreme, but rare case, suicide is the end result.

So what can SAD sufferers do?

  • Walk or run on a bright sunny day.

  • Try a sunbox or light box. Essentially, these “grow lights for humans” compensate for the lack of sunlight.

  • Invest in a dawn simulator, which can be set to gradually lighten a room within minutes or hours. Many of these devices can be found in natural food stores, vitamin/health companies, mail order, or via the Internet.

  • Ask your doctor about anti-depressant drug therapy.

    Copper-lowering drug stabilizes advanced cancer in trial

    By depriving cancer tumors of the copper supply they need to form new blood vessels, U-M researchers report they have stopped for more than a year the growth and spread of the disease in a small group of patients with advanced cancer.

    Five of six patients whose copper levels were kept at one-fifth of normal for more than 90 days had no growth of existing tumors or formation of new ones, according to a paper published in the January issue of Clinical Cancer Research. The sixth had progression of only one tumor; all other tumors within her body remained stable. Twelve other patients did not achieve the target copper level, or could not stay at the target level for 90 days, because of disease progression.

    The surprising finding is the first evidence in humans that physicians might be able to fight multiple types of cancer by targeting copper as a “common denominator” of angiogenesis—the process by which tumors grow the blood vessels that allow them to expand beyond a tiny cluster of cells.

    The U-M trial used oral doses of an inexpensive compound called tetrathiomolybdate, or TM, to lower the patients’ copper levels. TM originally was developed for clinical use by George J. Brewer, the Morton S. and Henrietta K. Sellner Professor of Human Genetics, to treat people with Wilson’s disease, a rare genetic disorder caused by excess copper. His work has shown TM to be the world’s most potent anti-copper agent, and has also demonstrated that it is safe to use.

    “What began as a scientific hunch now appears to have potential as a simple but effective general anti-angiogenesis strategy,” Brewer says. “We are proceeding with a clinical trial aimed at accelerating TM-induced copper reduction and assessing its effect on advanced-stage cancer. Later this year, we hope to test this approach in 100 patients with five types of less advanced cancer.”

    Neither trial is currently accepting patients.

    Big problems, little ears

    More children could be spared the traumatizing problems of speech and learning delays if more parents knew the risk factors and signs of early hearing loss, says Paul Kileny, professor of otorhinolaryngology and director of speech and audiology.

    “Hearing is the door that needs to be opened up in order for language and speech development to occur,” Kileny explains. “And we all know that those functions are very closely related to the thought process, academic function and overall development. If hearing loss is not diagnosed early enough, some of the milestones associated with normal development just do not occur.”

    National statistics show that many problems are going undiagnosed until children are as old as age 3. They must play catch-up with others their age, through special educational and therapeutic efforts.

    Parents and physicians should be especially vigilant with children whose family or medical history puts them at special risk for deafness, Kileny stresses. A family history of hearing loss, especially in the childhood years, is an obvious risk factor, but even a difficult birth in which the baby is deprived of oxygen briefly can increase the risk of hearing loss during the first few months of life. Infectious diseases, low birth weight and respiratory problems during infancy can hurt tiny ears, too.

    In all, Kileny says, as many as 4 percent to 6 percent of babies with one or more of these risk factors may have full or partial deafness. Even for otherwise healthy children, he explains, “the overall incidence of hearing loss in infancy is between one and two per 1,000.”

    Babies with normal hearing typically will:

  • Birth to 3 months: Respond to the voice of a parent, especially the one they spend the most time with. They might also smile in response to a specific parental voice or startle in response to loud sounds.

  • Three to 6 months: Begin to vocalize, or babble, more often. At this age, this activity depends more and more on the babies hearing themselves and realizing that they are the ones making noise.

  • Six to 12 months: Begin to build vocabulary.

  • 7 to 10 months: Be saying a few familiar words. They should be able to respond when others call them by name, and should turn or look in the direction of the person speaking.

  • 12 months and older: Have an increasing vocabulary, and speak fairly intelligibly and consistently.

    Kileny advises parents who are concerned about a child’s hearing to make an appointment with the child’s primary physician immediately.

    “The parents and grandparents, and others who are close to the baby and are with the baby most of the time, are really the best reporters of what the baby’s hearing status is,” Kileny says.