Lindsay Clancy is currently on trial in Massachusetts. The former nurse is accused of strangling her three young children—aged five, three, and eight months—in 2023. She tried to take her own life after. Her defense team is pleading not guilty by reason of insanity. They argue that Clancy suffered from a severe mental health disorder.
That disorder is postpartum psychosis.
During an episode, lawyers say voices convinced her to kill her family and herself. The prosecution says it was premeditated murder. The case has dragged the topic into the national spotlight. But experts say the condition is complex. It is understudied. It is also treatable.
What is postpartum psychosis and how common is it?
Postpartum psychosis is rare. It hits about one or two of every 1,00 live births. This is far rarer than postpartum depression. The latter affects up to 20% of new mothers. The former is a medical emergency.
Khatiya Moon, a psychiatry professor at Hofstra/Northwell, says symptoms vary wildly. Patients might experience:
- Delusions
- Paranoia
- Hallucinations (hearing voices or seeing things that aren’t there)
- Repetitive, purposeless behavior
Physical symptoms are common too. Insomnia is standard. Poor hygiene happens because patients are too consumed by delusions to care.
There is also a loss of insight. Doctors call this “insight.” It means patients don’t realize they are sick. They know something is off. But they can’t name it. They can’t connect it to a need for help.
Why does postpartum psychosis happen?
No one knows for sure. There is no single cause. Veerle Bergink, who runs the Women’s Mental Health Center at Mount Sinai, says this is typical for psychiatric disorders.
Theories point to the body’s response to birth. The “hormonal roller-coaster” might be the culprit. Changes in the immune system after delivery are also a suspect.
Studying this is hard. It’s rare. It’s not formally classified as a disease. That makes funding difficult. When an episode starts, it’s chaotic. You can’t easily run blood tests. Or get an MRI. Or measure hormone levels. The patient is often too unstable. Symptoms also shift daily. By the time you diagnose it, it might have changed.
Who is at risk for postpartum psychosis?
It can happen to anyone. But some groups face higher odds. People with bipolar disorder are at the highest risk. Estimates say one in six women with bipolar will experience it during pregnancy or postpartum.
Moon talks to every bipolar patient about this before they conceive. She doesn’t sugarcoat the risk.
How is postpart psychosis treated?
The FDA hasn’t approved specific drugs for this. Doctors use what works for other psychoses. Options include:
- Antipsychotic medications
- Benzodiazepines (for sleep and anxiety)
- Lithium (common for bipolar)
- Electroconvulsive therapy (ECT) in severe cases
Early recognition saves lives. Suicide is a far more common outcome than infanticide. Bergink notes that while infanticide gets the headlines, it’s extremely rare. Suicide is the real danger.
Recovery is possible. Bergink says it is a treatable condition. Some women have one severe episode. Then they never have it again.
The Clancy case is a tragedy. It highlights a blind spot in maternal health. We focus on the headlines. We ignore the nuance. The science is still catching up to the symptoms.
But the takeaway is clear. It happens. It is dangerous. But it can be stopped if we watch for the signs.
