It’s not an overstatement to say Jennifer Payne, MD, ‘lives and breathes’ mental illness. She’s devoted her career to treating psychiatric illnesses that are so common during and after pregnancy. Her daughter fell ill with schizoaffective disorder at age 15. In both her professional and personal life, Payne has seen firsthand the stigma of mental health.
She's now made a startling discovery. Her research into depression and pregnancy, she hopes, could help end the stigma of mental health once and for all.
One Day, a Blood Test for Mental Illness
Postpartum depression (PPD) is the most common complication of pregnancy. When missed and left untreated, PPD not only threatens the mother’s life and well-being but can significantly impair a child’s development.
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Payne's research is laying the groundwork for a time when we could use a blood test to detect PPD, severe depression after giving birth. Doctors now use blood tests for gestational diabetes. This test would work the same way.
Payne’s discovery isn’t just a professional achievement. It’s important to her as a mom.
Payne shares, “What is totally exciting as a psychiatrist and the mother of a child with mental illness is what this research does to the stigma associated with mental health. If we have a blood test for psychiatric illness that we can then prevent, that turns a lot of people on their heads. It dispels the false idea that you just need to pull up your socks and it’s not real.”
For Now, Speaking Out to Fight Mental Health Stigma
As a leading researcher in her field, Payne has published many articles in academic journals. But she’s so passionate about shedding light on mental illness as a common and treatable medical condition that she wrote a very personal account of her experience with mental illness in Psychiatric Times.
When Payne's daughter was hospitalized, people told her she was brave. She writes: "Nobody would have called me brave if my daughter had a brain tumor.”
She continues, “Apparently, it takes courage to reveal to your colleagues, even to your psychiatric colleagues, that your child is mentally ill — as if a serious mental illness in a child or relative is something to be hidden, not discussed."
Payne says she even lost friends during the worst of her daughter’s illness. They were, she says, "uncomfortable with the fact that I had a mentally ill child. Some family members hid what was happening from others, I think out of a sense of shame and embarrassment.”
Why Don’t We See Mental Illnesses as Real, Treatable Conditions?
Mental illnesses are common and treatable medical conditions. That’s a fact. Yet, so many people don’t get the treatment they need. This is partly to blame on mental health stigma. This bias has many root causes, Payne says, including:
- We don’t entirely understand what causes mental illness.
- Mental illness sometimes causes people to behave in baffling or even dangerous ways.
- Many people don’t understand the gravity of mental illness — believing patients with depression, for example, just need to get on with life.
- Humans tend to marginalize anyone who looks, acts, or thinks differently.
When Mental Illness Stigma Hurts Your Health
When we don’t take mental illness seriously and treat it, the consequences are dire and widespread, Payne says.
Every week, she sees pregnant patients whose doctors tell them to come off their psychiatric medications. “This is troubling,” she writes, “as these doctors don’t take into account the severity of the patient’s illness or the impact of untreated psychiatric illness on the developing child.”
She adds, “I have patients and families who ask whether they should have children in the first place, as if someone with a mental illness cannot also be a nurturing and loving parent.”
Depression is the most common complication of childbirth — affecting 1 in 10 women. We’ve known this for a long time. But it wasn’t until 2016 that the U.S. Preventative Taskforce recommended depression screening for pregnant and postpartum women, Payne notes.
An easy survey exists that can identify PPD risk. But many doctors still don’t screen women for depression.
Research To Change How We View Mental Health
Payne directs the UVA School of Medicine Reproductive Psychiatry Research Program. Her most important discovery was so startling that even she didn’t believe the findings. She didn’t talk about them for a year and a half. “Then we replicated our findings in somebody else’s samples. I felt like I tripped over something,” she shares, with excitement.
What did she and her collaborator, a basic science epigenetics researcher, find? Biomarkers that can predict with 80% accuracy whether a pregnant person will go on to develop clinical depression requiring treatment.
More is yet to come. She can’t share details yet, but she and her collaborator have made other discoveries. If this research is developed into a blood or saliva test, doctors could predict with 100% accuracy clinical depression after pregnancy.
Good Things Happen When Mental Illness Gets Treated
As for her daughter’s journey with a mental illness, Payne proudly shares what can happen when someone gets treatment. Her daughter has graduated from a highly competitive college, gotten married, and writes amazing poetry and fiction.
She continues, “My daughter still has delusions, but quietly so, and has developed a clear understanding of her illness and the necessity of mood stabilizers, though she still refuses antipsychotics. Why am I revealing the facts of my daughter’s illness in a public forum? In a word, stigma.”
Listen to Jennifer and Amanda Payne's podcast on the stigma of mental health.