Postpartum Depression, Postpartum Psychosis, and What the Lindsay Clancy Case Reveals
New motherhood is supposed to be joyful, but for a significant number of women it’s also a period of serious psychiatric risk. Postpartum depression (PPD) is the condition most people have heard of, but it exists on a spectrum with rarer, more severe illnesses — including postpartum psychosis, the diagnosis at the center of one of the most closely watched criminal trials in the country right now: the case of Massachusetts mother Lindsay Clancy.
What postpartum depression actually is
PPD affects roughly 1 in 7 to 1 in 8 women after childbirth. It typically involves persistent sadness, exhaustion beyond normal new-parent fatigue, feelings of worthlessness or guilt, difficulty bonding with the baby, appetite and sleep changes, and in some cases intrusive, frightening thoughts. It can begin anytime in the first year postpartum and, importantly, is highly treatable with therapy, medication, and support — most women recover fully.
PPD is not a violent condition. The overwhelming majority of women with postpartum depression are never a danger to themselves or anyone else. Where PPD becomes dangerous is when it goes unrecognized or untreated and depression symptoms include suicidal thinking, which requires urgent care.
Postpartum psychosis is a different, much rarer illness
Postpartum psychosis is a distinct and far less common condition, affecting roughly 1 to 2 women per 1,000 births. It’s considered a psychiatric emergency. Symptoms can include delusions, hallucinations, extreme confusion, rapid mood swings, paranoia, and loss of touch with reality — often emerging suddenly within the first days to weeks after birth. It’s this condition, not ordinary postpartum depression, that carries a recognized (though still rare in absolute terms) risk of harm to the mother or infant, generally when psychotic symptoms go unrecognized and untreated.
The Lindsay Clancy case
Lindsay Clancy, a Massachusetts labor and delivery nurse, is on trial for the 2023 killings of her three children — Cora, 5, Dawson, 3, and Callan, 8 months — after which she attempted suicide by jumping from a second-story window and is now paralyzed from the waist down. She has not disputed causing her children’s deaths; the trial centers entirely on her mental state at the time.
Her defense argues she was not criminally responsible because she was experiencing postpartum psychosis at the time of the killings. A forensic psychiatrist called by the defense testified that Clancy was clearly psychotic that day and reported hearing a voice commanding her to kill her children, and that she showed evidence consistent with both severe depression and bipolar disorder. Her attorney has also argued that being prescribed as many as 12 different medications following her third child’s birth contributed to her deterioration.
Prosecutors dispute this account. A prosecution psychiatrist testified that Clancy retained the capacity required for criminal responsibility, characterizing her actions that day as methodical rather than the product of a break from reality. Prosecutors have pointed to details of the killings as evidence of premeditation rather than psychosis.
Her husband, Patrick Clancy, has publicly supported her, telling a reporter that he wasn’t married to a monster but to someone who got sick.
As of this week, the case remains unresolved. The jury began deliberating in late August and, after multiple days without a unanimous decision, told the judge it was deadlocked; the judge sent them back to continue deliberating. No verdict has been reached as of this writing.
Why the distinction matters
Cases like this one tend to get flattened in public conversation into “postpartum depression made her do it” — but that conflates two very different conditions. PPD, the common and highly treatable condition, is not what’s being argued here; the legal question turns specifically on postpartum psychosis, a rare and severe illness that most people with any postpartum mood disorder will never experience. Blurring that line can do real harm: it can make women with ordinary postpartum depression afraid to seek help, out of fear of being seen as dangerous, when in reality the far greater risk they face is to their own life through untreated depression and suicidal thinking, not to anyone else’s.
Getting help
Postpartum psychosis is a medical emergency — sudden confusion, hallucinations, delusions, or thoughts of harming the baby require immediate care, including calling 911 or going to an emergency room. For postpartum depression and anxiety, Postpartum Support International (1-800-944-4773) offers a free helpline and connects families to local specialists.
*This is a sensitive topic. If you’re personally experiencing symptoms of depression, anxiety, or intrusive thoughts after childbirth, I’m glad to help you find the right resources or just talk through what you’re going through.*