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Birth of a Notion
Jennifer Payne, M.D.
“Unlike the typical postpartum mood problems we see, some women become deeply depressed literally hours after they deliver a baby, especially if they’ve been depressed before,” Jennifer Payne explains. “They tell me it’s like a curtain falling.”
Since seeing them as a medical resident, psychiatrist Payne has felt compelled to help women whose moods slip out of control at hormones’ bidding: those with premenstrual, pregnancy, postpartum or perimenopausal difficulties. “Mood disorders in women are understudied, to put it mildly,” she says.
Payne aims to remedy that. First, she and colleague Karen Swartz created the Women’s Mood Disorders Center, a much-needed consultation clinic within Hopkins’ broader mood center.
Payne also cites the desperate need for research. Clinical trials, for example, tell how best to use available therapies—What about lithium during pregnancy? Do you taper it during labor? More descriptive studies shed light on the biology.
Because the mood disorders she sees predictably come and go, women can serve as their own experimental controls. “It’s a unique chance to tell what’s broken in major depression and bipolar disorder.”
Payne begins by collecting data: Following at-risk women through pregnancy and after delivery, for example, yields DNA for gene studies, information on stress levels and chemistry, on sleep and hormone levels. “I’m hoping to say something like, look, if you have elevated IL6—an immune protein—you’re at greater risk for postpartum depression.” IL6, then, could predict disease. And when, at last, patient-testing of a potential therapy comes around, IL6 might tell, early on, if it’s working.
“Trials,” she adds, “make sense of what we do.”