Lindsay Clancy's trial put postpartum psychosis in the spotlight - experts want progress to follow

A month prior to Lindsay Clancy's murder of her three children, she disclosed to her mother and ex-husband her thoughts of harming the children. Clancy's mother, Paula Musgrove, recounted that Lindsay would tell her, "This isn't me, I've never been like this before," which was untrue. Clancy was found guilty of the killings but pleaded not guilty by reason of insanity, claiming she suffered from postpartum psychosis.

This condition brought her hallucinations and delusions following the birth of her third child. During her trial, Paul Zeizel, a clinical and forensic psychologist, testified that Clancy was incapable of conforming her actions to the law and had no understanding of her actions' wrongfulness.

Following Clancy's trial, prosecutors argued she intentionally killed her children - Cora, five, Dawson, three, and Callan, eight months old. Postpartum psychosis is a rare medical emergency that can lead to mania, depression, or a combination of both. Patients may also experience psychotic symptoms, such as hallucinations or homicidal thoughts.

Experts noted that it is a serious illness often overlooked in medical literature, as it remains unclassified in the DSM-5, the standard manual for diagnosing psychiatric disorders.

The condition gained more attention due to Clancy's trial, sparking conversations about the mental health struggles women face after childbirth. Postpartum psychosis often presents with mood symptoms like irritability, mood swings, insomnia, and a delirium-like state. Susan Hatters-Friedman, a forensic psychiatry professor at Case Western Reserve University, explained that psychosis means a person is out of touch with reality, which can include hallucinations, hearing things, seeing things that aren't there, and fixed false beliefs.

The onset of symptoms in postpartum psychosis can occur rapidly, making early treatment crucial. Some women, like Meghan Cliffel, experienced sudden and severe symptoms after giving birth. Cliffel lost touch with reality about eight months after her second daughter's birth and spent 12 days in a psychiatric hospital receiving treatment.

Clancy appeared perfectly fine with her children one day, playing outside building a snowman, before returning home on another day to find her children dead and herself injured from a suicide attempt.

Experts suggest that postpartum psychosis may stem from hormonal changes and stress following childbirth and have a potential link to pre-existing mental health issues. However, there is still much uncertainty surrounding its causes. The primary obstacle in increasing awareness and improving treatment for postpartum psychosis is the absence of its inclusion in the DSM-5, the diagnostic handbook published by the American Psychiatric Association.

Without a formal recognition and criteria in the DSM-5, the illness remains under-discussed, leading to a lack of research funding, care systems, and insurance codes.

Veerle Bergink, a professor of psychiatry and director of the Mount Sinai Women's Mental Health Center, is actively advocating for the inclusion of postpartum psychosis in the DSM-5. She emphasized that without a mention in the manual, there can be no research, educational material, or support for patients and clinicians. Clancy's trial serves as a reminder that tragedy can be prevented by proactively addressing mental health complications in mothers and families. Postpartum psychosis is treatable, and early intervention is essential for recovery.