A key question in the Massachusetts murder trial of Lindsay Clancy is whether postpartum psychosis drove her to kill her three children.
On Monday, a jury heard opening statements in the trial of the former labor and delivery nurse at Massachusetts General Hospital. Both sides agree she strangled her children aged 5 and younger in 2023. But they disagree over whether she should be held criminally responsible.
Clancy and her ex-husband, Patrick Clancy, filed lawsuits accusing her medical providers of failing to properly diagnose and treat her condition.
Here’s what to know about the disorder.
Postpartum psychosis is rare and dangerous
It’s estimated to afflict only 1 to 2 per 1,000 women after delivery. Experts at the Cleveland Clinic describe it as a mental health emergency affecting someone’s sense of reality.
It can happen to anyone after giving birth, but the chances are higher for people with certain mental health conditions. In a journal article on the subject in 2023, researchers at the Medical University of Lublin in Poland said about half of people with postpartum psychosis have a previous history of psychiatric problems and the most common risk factor associated with the condition is bipolar affective disorder, which causes extreme mood swings.
“So what is the difference here? What happens is, it can be this waxing and waning. When I say waxing and waning, it means at one moment, the woman can look completely like herself. At the next moment, she’s very, very ill,” Dr. Julia Riddle, a reproductive psychiatrist and clinical researcher at the University of North Carolina School of Medicine, told CBS News. “It’s very, very hard to diagnose.”
Though most people with postpartum psychosis don’t harm their children, mothers with severe cases may try to do so, and also may try to harm themselves.
Signs of postpartum psychosis
Experts say it’s important to seek immediate help if you or your partner or family member show signs of postpartum psychosis.
Postpartum psychosis usually happens within several days of giving birth but can occur up to six weeks afterward.
Symptoms may include hallucinations, delusions, paranoia or other behavior changes.
“When women are experiencing postpartum psychosis, very, very often they are terrified or suspicious to tell anyone what they’re thinking,” Riddle told CBS News.
A woman may also have mood changes, such as mania or depression, disorganized thinking or behavior, insomnia, irritability or agitation.
Riddle told CBS News that recognizing and diagnosing postpartum psychosis requires advanced training.
“You have to be trained in seeing these things to know when you’re seeing it, and you have to catch a woman during the moment when she is expressing these things,” Riddle said.
It’s not the same as postpartum depression or baby blues
Postpartum depression is a mood disorder that can also be dangerous but is much more common. One 2024 study found that U.S. rates reached 19% in 2021. Baby blues is a lot milder and affects about 8 in 10 new moms shortly after delivery.
With baby blues, crying jags and feelings of sadness aren’t enough to interfere with normal life and moms should still be able to care for themselves and their babies.
If sadness lingers for more than two weeks, that can be a sign of postpartum depression. Other signs include intense feelings of despair, anxiety, loss of interest, feelings of guilt and worthlessness, low energy and decreased concentration and appetite. Moms may worry constantly about their babies, be unable to sleep, or stop showering for days. They may even have thoughts of harming themselves.
Postpartum psychosis is the most severe postpartum psychiatric illness.
Treatment for postpartum psychosis
Moms with the condition need inpatient mental healthcare, which can include involuntary hospitalization. Treatments include medications or electroconvulsive therapy, a procedure done under anesthesia in which small electric currents pass through the brain, intentionally causing a brief seizure.
Experts say getting help early increases the odds of a good outcome.
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