Roughly one to two out of every 1,000 birth mothers experiences postpartum psychosis, a medical emergency that develops within days or weeks after delivery. Broadly speaking, that translates into something between hundreds of cases a year in the US to as many as 9,400. <\/p>\n
Unlike the \u201cbaby blues\u201d or postpartum depression, the illness can cause delusions, hallucinations, paranoia, profound confusion, and a break from reality. People with the condition fall into depressive or manic subtypes, or a third that presents as a mix of both. Patients with depressive symptoms account for 41 percent of all postpartum psychosis patients, and it is the most serious form of the illness, according to the Cleveland Clinic<\/a>. <\/p>\n Some experts argue it\u2019s a type of bipolar disorder<\/a> that is triggered by hormonal and immune changes that occur after childbirth. Left untreated, it carries risks of suicide and, in rare cases, harm to an infant or others. <\/p>\n Women with mental health issues before pregnancy are at higher risk of developing postpartum psychosis, experts have said.<\/p>\n Paranoia, confusion, and irritability are \u201cpink flags,\u201d early warning signs of postpartum psychosis, Haider said.<\/p>\n The condition doesn\u2019t always present initially with \u201cfull-blown auditory or visual hallucinations,\u201d she said, but symptoms can turn more severe very quickly.<\/p>\n In courtroom testimony and in separate civil suits brought against her mental health providers, Clancy and her ex-husband, Patrick Clancy, described her descent into illness. Lindsay Clancy initially experienced manic behavior after the birth of Callan in May 2022, including extensive exercising and even running a five-mile race five weeks after delivery, according to a lawsuit she filed against her clinicians. About three months after giving birth, though, her condition shifted dramatically, to anxiety and depression and she had insomnia for months. <\/p>\n In her suit, Clancy states her clinicians failed to properly diagnose her with bipolar disorder and gave her a course of medication that worsened her condition until she suffered a psychotic break.<\/p>\n She received 30 prescriptions for 13 drugs<\/a> from at least six providers between September 2022 and the death of her children, according to evidence presented in court. She wasn\u2019t given lithium but was prescribed antidepressants, which can worsen symptoms<\/a> of postpartum psychosis. <\/p>\n The prosecution has questioned the severity of Clancy\u2019s mental illness and suggested she didn\u2019t take every medication as prescribed, which can make it substantially more difficult to determine whether the treatment was effective. <\/p>\n In testimony Friday, Clancy\u2019s initial provider, Dr. Jennifer Tufts, a psychiatrist, described seeing her from September 2022 to just days before the deaths of the Clancy children. Tufts described Clancy as \u201cdeteriorating\u201d over that time, increasingly consumed by depression, insomnia, and anxiety, but said she did not see signs of psychosis. She raised the possibility of bipolar disorder at an appointment in November, but said Clancy didn\u2019t meet the criteria for the condition, including fast talking, grandiosity, and risk-taking behavior.<\/p>\n Dr. Alia Goodheart, a psychiatrist at McLean Hospital, testified that she, too, did not see signs of psychosis when Clancy was a patient at the facility from Dec. 31, 2022 to Jan. 4, 2023.<\/p>\n Specialists in perinatal psychiatry are trained to distinguish postpartum psychosis from other conditions. But there\u2019s a gap in knowledge among generalists, Haider said, particularly among the three professions that she described as frontline workers for new mothers: pediatricians, doulas, and therapists.<\/p>\n \u201cThey are our earliest warning systems, and we need to equip them more and provide them with more education on specifically what to do in the postpartum phase,\u201d Haider said.<\/p>\n Families, too, should receive more information about postpartum mental illness during the perinatal period, the time immediately before, during, and after birth, she said.<\/p>\n Adding to the diagnostic challenges, some patients with postpartum psychosis don\u2019t share their true thoughts due to fear of stigmatization, or because of their delusions.<\/p>\n Dr. Veerle Bergink<\/a>, director of the Women\u2019s Mental Health Center<\/a> at the Icahn School of Medicine at Mount Sinai in New York City believes the treatment Clancy received reflected a lack of awareness about postpartum psychosis. <\/p>\n \u201cIn the case of Lindsay Clancy, it\u2019s really clear people missed the diagnosis, and not one health provider, but multiple,\u201d she said. <\/p>\n Treatment for postpartum psychosis almost always involves a period of inpatient hospitalization, Haider said. Depending on a patient\u2019s condition, they may receive antipsychotic medication, a mood stabilizer, and a benzodiazepine and are closely monitored. Lithium, used to treat bipolar disorder, may also be prescribed, experts said. <\/p>\n For patients who are severely ill, refusing food, or in a state of catatonia, or not responding quickly enough, electroconvulsive therapy<\/a>, or ECT, has some of the strongest evidence for improvement and is considered a safe treatment during the postpartum period. Seven studies conducted from 2004 to 2024 showed 100 percent of patients showed improvement, according to an article in European Psychiatry<\/a>, and most fully recovered. <\/p>\n Clancy did receive inpatient care; she was admitted at McLean Hospital for about five days. An admitting physician evaluating Clancy reported evidence of post-partum anxiety and depression, but a \u201clow suspicion\u201d of bipolar disorder, according to Clancy\u2019s suit.<\/p>\n McLean declined to comment, with a spokesperson saying the hospital cannot discuss the care of specific patients.<\/p>\n There is a push underway to include postpartum psychosis in the Diagnostic and Statistical Manual of Mental Disorders, psychiatry\u2019s central diagnostic text, which would help increase awareness of the condition. <\/p>\n Meghan Cliffel, a mindfulness teacher and writer who has written extensively about her experience with postpartum psychosis, was treated successfully for the condition after the birth of her second child 11 years ago. <\/p>\n She said she experienced a paranoid delusion in which she was surrounded by people in a malevolent cult, including her own husband. <\/p>\n \u201cThe weird thing about psychosis is that often the things that you think are happening are happening. Every detail is just a little off,\u201d Cliffel wrote in a 2024 article for the Journal of the American Academy of Psychiatry and the Law. \u201cYour brain is working, applying logic and thinking, but weaving it into an alternate reality.\u201d<\/p>\n Cliffel said it took less than two days for delusions to emerge and develop to the point that she needed inpatient hospitalization. <\/p>\n \u201cIt\u2019s hard to believe if you haven\u2019t experienced it,\u201d Cliffel said in an interview. She did not have any history of mental illness before giving birth to her second child. <\/p>\n About 4 percent of women with the most serious type of postpartum psychosis are estimated to kill their children, according to the Cleveland Clinic<\/a>. About 5 percent commit suicide. <\/p>\n For Cliffel, who lived in New York City at the time, recovery involved 12 days of inpatient care. After being discharged, she underwent six weeks of intensive therapy with both a therapist and psychiatrist. She followed that with therapy and a year-long prescription of lithium. <\/p>\n Recovering, she said, took more than conventional psychiatric care; meditation, mindfulness, yoga, soothing music, and journaling all played a part. <\/p>\n Women with a history of postpartum psychosis have a 30 to 50 percent higher risk of experiencing the condition again after another birth without treatment, Haider said. Despite the risks, Cliffel and her husband, Colin, decided to have a third child about seven years ago. <\/p>\n She called it, \u201cthe scariest thing we\u2019ve ever done.\u201d<\/p>\n Cliffel arranged a comprehensive plan for her mental health care and well-being before giving birth and stayed well throughout the postpartum period, she said. <\/p>\n \u201cThe overwhelming narrative was \u2018you\u2019re a shameful mess,\u2019\u201d Cliffel said. \u201cTo make the turn to, \u2018you\u2019re not a shameful mess, you were sick,\u2019 is really important.\u201d<\/p>\n Sarah Rahal can be reached at sarah.rahal@globe.com<\/a>. Follow her on X @SarahRahal_<\/a> or Instagram @sarah.rahal<\/a>. Jason Laughlin can be reached at jason.laughlin@globe.com<\/a>. Follow him @jasmlaughlin<\/a>.<\/p>\n![\"Lindsay](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/08\/D5OAFJKOZKWE4ED6FFMUBBQ7M4.jpg\")
Lindsay Clancy’s defense attorney Kevin Reddington looked over a book titled “Good Moms Have Scary Thoughts,” marked as an exhibit during the trial at Plymouth Superior Court in Plymouth on Aug. 5.David L. Ryan\/Globe Staff<\/p>\n