Why Are We So Ashamed of Mental Illness? This Psychiatrist Is Determined to End the Stigma

In both her professional and personal life, Dr. Jennifer Payne has seen firsthand the stigma of mental illness.

A professor in the University of Virginia School of Medicine’s psychiatry department, Payne has devoted her career to treating a psychiatric illness that is common during and after pregnancy.

Additionally, her daughter, Amanda, fell ill with schizoaffective disorder at age 15.

Now Payne has made a startling discovery. Her research into depression and pregnancy, she hopes, could help remove the stigma of mental illness once and for all.

A Blood Test for Mental Illness?

Postpartum depression, severe depression after giving birth, is the most common complication of pregnancy. When missed and left untreated, PPD not only threatens the mother’s life and wellbeing, but can significantly impair a child’s development.

Payne’s research is laying the groundwork for a time when a blood test could be used to detect PPD. 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 mother.

“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 psychiatric illness,” she said. “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.”

Speaking Out to Fight 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 the journal Psychiatric Times.

When her daughter was hospitalized, people told Payne she was “brave.” She writes: “Nobody would have called me brave if my daughter had a brain tumor.

“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 in her account that she even lost friends during the worst of her daughter’s illness. They were “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 Illness as a Real, Treatable Condition?

Mental illnesses are common and treatable medical conditions. Yet, experts say, so many people don’t get the treatment they need, a fact partly to blame on mental illness stigma. This bias has many root causes, Payne said, including:

• A lack of full understanding of what causes mental illness.
• Mental illness sometimes causes people to behave in baffling or even dangerous ways.
• Many don’t understand the gravity of mental illness – believing patients with depression, for example, just need to “get on with life.”
• Many people tend to marginalize those who look, act or think differently.

When Mental Illness Stigma Hurts Your Health

When mental illness isn’t taken seriously and treated, the consequences can be dire and widespread, Payne said.

Every week, she sees pregnant patients whose doctors have instructed them to quit taking 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 one in 10 women. Though the statistic has been known for a long time, Payne said, the U.S. Preventative Services Taskforce didn’t recommend depression screening for pregnant and postpartum women until 2016. The task force is an independent panel of experts in disease prevention and evidence-based medicine that makes recommendations about clinical preventive services.

An easy survey exists that can identify PPD risk, Payne said, but many doctors still don’t screen women for depression.

Research That Could Change How We View Mental Illness

Payne directs the 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 said 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.

Payne said if this research is developed into a blood or saliva test, doctors could potentially predict with 100% accuracy clinical depression after pregnancy.

Good Things Happen When Mental Illness Gets Treated

As for her daughter’s experience 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 poetry and fiction.

“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,” Payne said. “Why am I revealing the facts of my daughter’s illness in a public forum? In a word, ‘stigma.’”

This article originally appeared on Healthy Balance, the blog from UVA Health.