Miss America 2020 reveals battle against anxiety and depression symptoms

Growing up, Camille Schrier experienced anxiety and depression. When she was a teenager, she didn’t always recognize what she was and, as she got older, her mental health worsened. When she was in college, she experienced obsessive-compulsive thoughts and disordered eating, also. In the middle of her sophomore year of college, she became overwhelmed by her uncontrolled mental health conditions and she dropped out to attend the college closest to her home.

camille schrier
For years, Camille Schrier struggled with various mental health conditions. In college, she found out what she was experiencing and began treatment.

“I sought out mental health treatment for the first time,” Schrier, 27, a Miss America 2020, from Richmond, Virginia, told TODAY. “That’s probably not the right way to put it. My parents forcibly took me into mental health treatment for the first time in my life.” Schrier was diagnosed with major depressive disorder, generalized anxiety disorder, and eating disorderand visited a psychiatrist to obtain medication to treat his conditions. It often seemed difficult to adjust the dosage of medications. That is until recently. She had a pharmacogenetic test, which she said helped her doctor find the right medications for her.

“My doctor says, ‘I have a pharmacogenomics test that I just had. I think you should do it. They look at how you’re going to metabolize painkillers and all these antidepressants, anxiolytics,’” he explained. “(The test) said that (the drug I had been taking since 2014) might not be the best drug for me.”

Contests and the pandemic

Growing up, Schrier competed in pageants and enjoyed it. As she got older, she considered competing for Miss America, but she worried that being in the swimsuit competition would worsen her anxiety, depression, and eating disorders.

“As someone who has recovered, or maybe not even fully recovered … with an eating disorder, the last thing I wanted to do was put myself in a situation where I was judged directly by my body,” Schrier said. “But (the swimsuit competition) went away in 2018, so I thought, ‘Maybe I could do this.'”

Schrier first competed, and won, locally to enter the Virginia state meet, which he also won. Eight weeks later, she became Miss America 2020 after her talent show wowed audiences and judges when she performed science experiments, showing her love for science, technology, engineering, and math ( STEM).

“I was absolutely thrilled, but in the same way, I had an underlying fear that it was going to compromise all the progress I had made in the mental health part of my life,” she said. “There is such a microscope in you. Criticism, people tear you apart in a way that I’ve never experienced.”

Three months after winning Miss America, the COVID-19 pandemic began and her public engagements ceased.

“I really enjoyed being in the experience, meeting people and seeing kids and getting these looks that I could do the real work…talk about STEM and do science demonstrations. And then I couldn’t do any of it,” she said. “It was just me and my house with the internet.”

camille schrier
Camille Schrier loves science and when one of her doctors suggested she try pharacogenomic testing to determine which drugs might work best for her, she wanted to try it to find out more.Courtesy of Camille Schrier

That’s when the anxiety kicked in again. Even opening social media could dampen her mood. She approached her doctor and he gave her a higher dose of antidepressants. But that surge might have happened too quickly.

“You have to taper (antidepressants) in a very specific way, and I don’t think we’ve done it appropriately, and I ended up having these brain shocks,” Schrier said. “Now I am changing the dose of this medication and I feel like my brain is speeding up.”

Her doctor lowered the dose before she returned to Virginia for graduate school. At the same time, she experienced a flare-up of another condition she lives with: Ehlers Danlos syndrome, a rare disorder that affects the skin, joints, and blood vessels. That’s when another of his doctors suggested a pharmacogenomics test to assess how he metabolizes medication.

“The medication that I have been taking for a long time might not necessarily have been the best for me,” he said. “How funny it is that my neurosurgeon was literally able to help me figure this out.”

Pharmacogenetic testing and antidepressants

Pharmacogenetics examines how a person’s genes affect how they metabolize drugs. People take a blood test or submit a saliva sample to see if they have genes that influence how they process drugs.

Dr. David Oslin, a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania, recently conducted a study of pharmacogenomic testing for antidepressants.

“The tests that we have now don’t really tell us anything about the disease … and they don’t tell us about your particular response to a particular drug. What everyone would love to have is proof that says, ‘This drug is going to be the best,’” Oslin, chief of behavioral health at Michael J. Crescenz VA Corporal Medical Center in Philadelphia, told TODAY. “What they really tell us is the individual differences in the metabolism of these drugs, which would allow me, as a provider, to administer different doses.”

camille schrier
Camille Schrier, Miss America 2020, loved meeting people to talk about STEM. When the pandemic stopped her commitments, she felt isolated and alone and she noticed that her mental health worsened.Photo courtesy of EmmiClaire

Oslin, who has not treated Schrier, was the principal investigator on a recent study that looked at how the results of pharmacogenomics tests can help patients and doctors decide on an antidepressant and its dosage. The clinical trial included 1,944 veterans, with some receiving pharmacogenomics testing and some not. The results were published in JAMA in early July.

“The science behind these tests is pretty solid,” Oslin said. “The tests are looking at the ways that people metabolize different drugs, and that basic science has mapped out pretty well.”

The researchers worked with providers treating veterans with depression at 22 Veterans Affairs sites across the country. Some patients and providers got pharmacogenomic test results, while others did not.

“The test did not help most patients. what do I want to say with that? Most patients don’t have a gene that predicts a change in the metabolism of the drugs they take,” Oslin said.

“In the four-fifths of patients who didn’t have a gene that predicted changes in metabolism, it’s reassuring to know that,” he added. “(But) it doesn’t convince you in terms of choosing a different drug.”

For the quarter of patients whose results indicated a difference in how they metabolize a drug, providers changed prescribing practices, Oslin noted. Some providers avoided the drug altogether, while others used a different dosage, but it’s not clear whether patients on different dosages had better outcomes, Oslin added.

For some patients, these tests are helpful: “If I know in advance that the patient is really a fast metabolizer (of drug X), I know … that if I use that drug, I will have a lot more trouble finding the right dose,” he explained. Oslin.

Life as a graduate student

Schrier is pursuing a Doctor of Pharmacy at Virginia Commonwealth University and has two more years until he completes his program. Since she started her new medication regimen, she has noticed a slight difference.

“My energy levels have increased so much that I feel like I can do more things, and it has helped me feel a little more balanced,” she said. I feel good about it.”

Camille Schrier as a child.
As a teenager, Camille Schrier experienced anxiety and depression, but she didn’t know what it was until she was older. She wanted to share her experience with mental health to help others.Courtesy of Camille Schrier

Schrier said it was important to tell her story so that other people with mental health problems would feel less alone.

“For a while, I felt like the shell of a human being,” he said. “It took me a while to be able to talk about it because I had always tried to put on this ‘I’m fine’ facade. If I can help by sharing information about the journey I’ve been through, then maybe someone can look at me and identify that what’s going on might not be what needs to happen.”

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