Postpartum Psychosis and the Lindsay Clancy Case: What the Media Gets Wrong
The Lindsay Clancy case is heartbreaking.
Three children are dead. A family has been devastated. And a mother is at the center of a trial that has captured national attention because of one incredibly difficult question: What happens when a person experiencing a severe psychiatric illness commits an unimaginable act?
As a therapist who specializes in women's trauma, postpartum mental health, and life transitions, I've been following the conversation around this case closely. And I'll be honest: I have struggled with some of the way postpartum psychosis has been discussed. Not because I believe the deaths of these children should be minimized. They shouldn't. Not because I believe mental illness automatically excuses someone's actions. It doesn't. And not because I believe I can diagnose Lindsay Clancy from media coverage. I can't.
What I do believe is that we cannot understand a case involving alleged postpartum psychosis if we don't understand what postpartum psychosis actually is.
And too much of the public conversation seems to interpret Lindsay's actions through the lens of a person who was thinking rationally, understood reality, and was making decisions from the same psychological state she would have had when well.
That assumption is exactly what deserves to be questioned.
Why the Lindsay Clancy Case Has Put Postpartum Psychosis in the Spotlight
Lindsay Clancy is currently on trial for the deaths of her three children in Massachusetts in 2023. Her defense is arguing that she was experiencing severe mental illness, including postpartum psychosis, and that her psychiatric treatment in the months leading up to the tragedy failed to recognize or adequately address what was happening. The prosecution disputes the defense's interpretation of her mental state.
The trial is ongoing, and testimony from psychiatric providers has focused on her symptoms, medications, treatment, and changes in her mental health before the deaths.
That distinction matters because there are really two separate questions being discussed.
One is legal:
Was Lindsay Clancy criminally responsible for what happened?
The other is clinical:
What was happening psychologically and neurologically that may have influenced her perception, judgment, and behavior?
Those questions overlap, but they are not the same question.
And as a therapist, the second question is where I think we have an enormous opportunity to learn something about postpartum mental health.
What Is Postpartum Psychosis?
Postpartum psychosis is a serious psychiatric emergency that can develop after childbirth.
It affects approximately 1–2 out of every 1,000 births, with ACOG currently citing an estimated range of 1–3 per 1,000 births.
That may sound like a small number, but behind every statistic is a mother and a family who may suddenly find themselves dealing with a psychiatric crisis they never anticipated.
Postpartum psychosis can involve:
Delusions
Hallucinations
Paranoia
Severe confusion
Disorganized thinking or behavior
Dramatic mood changes
Agitation
Severe insomnia
Significant changes in judgment
A loss of contact with reality
ACOG notes that people experiencing postpartum psychosis may have poor insight into their symptoms, which is one reason it can become particularly dangerous and requires immediate psychiatric care.
This is important:
A person experiencing psychosis may not know that they are psychotic.
They aren't necessarily thinking, “Something is wrong with my perception of reality.” They may genuinely believe what they are experiencing is true. That distinction is at the heart of understanding postpartum psychosis.
What Does Postpartum Psychosis Actually Look Like?
We often imagine psychosis as something dramatic and unmistakable. Someone is completely incoherent. Someone is visibly disconnected from reality. Someone is behaving in a way that immediately makes everyone around them realize something is seriously wrong. But psychiatric symptoms don't always present that neatly.
A person experiencing postpartum psychosis may still have moments of lucidity. They may be able to have conversations. They may appear loving toward their baby. They may continue performing everyday tasks. ACOG specifically notes that postpartum psychosis can involve mood fluctuations, confusion, cognitive impairment, bizarre behavior, insomnia, hallucinations, paranoia, and delusions—and that someone may have moments of lucidity.
That matters because someone can look relatively functional from the outside while experiencing something profoundly disturbing internally. They may believe someone is trying to harm them. They may believe their baby is in danger. They may believe they have received a special message or instruction. They may hear voices. They may develop a belief that is completely disconnected from reality but feels absolutely real to them.
From the outside, the belief may look irrational. From inside the psychotic experience, it may feel like reality.
That is the piece that is so difficult to understand if you've never experienced psychosis.
Postpartum Psychosis Is Not the Same as Postpartum Depression
This distinction is incredibly important.
Postpartum depression can involve sadness, hopelessness, guilt, emotional numbness, irritability, anxiety, loss of pleasure, difficulty bonding with the baby, and thoughts of self-harm.
Postpartum anxiety can involve racing thoughts, excessive worry, hypervigilance, physical tension, and persistent fears that something terrible will happen.
These conditions can be profoundly distressing.
But postpartum psychosis involves something different:
A disruption in a person's ability to accurately perceive reality.
That doesn't mean postpartum depression and anxiety can't occur alongside psychosis. They can. It also doesn't mean someone with postpartum depression cannot experience thoughts about death or harm. In fact, this brings us to one of the most important distinctions I wish more people understood.
Postpartum Psychosis vs. Intrusive Thoughts
Many postpartum women experience intrusive thoughts. These can be incredibly frightening. A mother may suddenly imagine dropping her baby down the stairs. She may picture accidentally hurting her child. She may think, “What if I lose control?” She may become terrified by the thought itself.
And then she may think:
“What kind of mother thinks this?”
This is where shame can take over. But having an intrusive thought does not mean you want the thought to happen. Often, the distress comes precisely because the thought is so inconsistent with the person's values and desires.
There is an important difference between:
“I am terrified that this could happen, and I don't want it to.”
and
“I believe this is happening, or I believe I need to do something because of a distorted belief.”
With intrusive thoughts, the person generally recognizes the thought as unwanted or frightening. With psychosis, insight can become severely impaired. The person may genuinely believe a delusion, hallucination, or distorted perception is real. This distinction is one reason I don't want postpartum women reading about the Lindsay Clancy case and immediately becoming terrified of their own thoughts.
A scary thought does not automatically mean you're psychotic.
But a significant change in your relationship with reality deserves immediate attention.
Why I Don't Think We Can Understand the Lindsay Clancy Case Without Understanding Psychosis
I want to be very intentional here. I did not evaluate Lindsay Clancy. I don't know exactly what was happening inside her mind in the moments leading up to the deaths of her children. And I don't think anyone who wasn't involved in her care can responsibly diagnose her based solely on media reports.
But I also don't believe we can look at her alleged actions and automatically assume they came from the mind of a healthy, rational person making ordinary decisions.
That is the discrepancy I see in much of the public conversation.
There seems to be an assumption that if someone did something horrific, they must have understood the situation in the same way we understand it from the outside.
Psychosis challenges that assumption.
When someone is experiencing a severe psychotic episode, their perception of reality can become profoundly distorted.
Their beliefs may be driven by delusions. Their behavior may be influenced by hallucinations. Their judgment may be impaired. They may be terrified. They may believe they are protecting themselves or someone else. They may believe something catastrophic is happening. And they may not have the insight necessary to recognize that their experience is a symptom of illness.
That doesn't make the outcome less devastating. It doesn't erase the children who died. It doesn't eliminate the grief experienced by their family.
It changes the clinical context in which we have to understand what happened.
Understanding is not the same as excusing.
A Loving Mother Can Experience Postpartum Psychosis
This is perhaps one of the most uncomfortable truths about postpartum psychosis.
We have a cultural image of motherhood that says:
A mother would never hurt her baby.
But psychiatric illness doesn't operate according to that rule.
A person can love their children deeply and still experience a psychiatric crisis that radically changes their perception of reality.
Psychosis does not mean someone didn't love their baby.
It means their brain and mind may have become severely impaired in their ability to interpret what was happening around them.
Postpartum Support International emphasizes that most people who experience postpartum psychosis do not harm themselves or anyone else, while also emphasizing that psychosis involves delusional thinking and impaired judgment and therefore requires immediate intervention.
This distinction matters.
We should neither sensationalize postpartum psychosis nor minimize the potential danger.
We should understand it well enough to recognize it.
Sleep Deprivation Is More Than “Just Part of Having a Newborn”
There is another part of postpartum mental health that deserves much more attention:
Sleep.
New parents are expected to be exhausted.
We joke about it.
We normalize it.
We tell people to sleep when the baby sleeps—even though anyone who has actually had a newborn knows that isn't always realistic.
But there is a difference between being tired and experiencing severe sleep disruption alongside escalating psychiatric symptoms.
ACOG identifies significant sleep deprivation as an important concern in postpartum psychosis and recommends careful attention when someone has gone without adequate sleep.
If a postpartum woman is barely sleeping, becoming increasingly agitated, confused, paranoid, unusually energized, or disconnected from reality, that isn't something to simply chalk up to new motherhood.
It deserves immediate attention.
What the Lindsay Clancy Case Can Teach Us About Postpartum Mental Health
For me, the biggest takeaway isn't simply about one woman. It's about what we miss. How many women are afraid to tell someone that they're having frightening thoughts? How many mothers believe that admitting they're struggling means they're failing? How many providers hear “I'm not sleeping” and assume it's normal? How many women have symptoms that don't fit neatly into postpartum depression but aren't recognized as something more serious? And how many mothers are terrified that if they tell the truth about what's happening in their minds, someone will decide they're an unfit mother?
These are important questions.
Because shame doesn't make postpartum mental illness disappear.
It makes people hide it.
And hidden symptoms are harder to treat.
When Postpartum Psychosis Requires Immediate Help
If you or someone you love has recently given birth and is experiencing:
Hallucinations
Delusions
Severe paranoia
Confusion or disorientation
Significant disorganization
Extreme agitation
Dramatic changes in behavior or mood
Little or no sleep combined with concerning psychiatric symptoms
A loss of contact with reality
Thoughts or beliefs involving harm to themselves or their baby
please take it seriously.
Postpartum psychosis is a psychiatric emergency and requires immediate medical and psychiatric evaluation. Hospitalization is often necessary, and treatment may include psychiatric medication and intensive support.
This is not the time to wait for a routine therapy appointment. It is not the time to see whether things improve tomorrow. And it is not a reflection of whether someone is a good mother.
It is a medical emergency.
You Don't Have to Be Experiencing Psychosis to Need Postpartum Support
There is another message I want women to hear. You don't have to be in a psychiatric crisis to deserve help. Maybe you're not experiencing hallucinations or delusions. Maybe you're simply overwhelmed. Maybe motherhood has brought up trauma you thought you had already worked through. Maybe you're anxious all the time. Maybe you're struggling to trust yourself. Maybe you feel disconnected from your body. Maybe you're grieving the person you were before becoming a mother. Maybe everyone keeps telling you that you should be happy, but you don't feel like yourself.
Those experiences matter, too.
Becoming a mother is not just a physical transition. It can change your identity, relationships, routines, expectations, sense of safety, and relationship with your own body. And sometimes a major life transition brings old wounds to the surface.
That's where therapy can be helpful.
In my work with women navigating postpartum experiences, trauma, and life transitions, I use a trauma-informed, somatic approach alongside CBT and DBT-informed strategies. We can work on understanding what is happening in your body and nervous system while also looking at the thoughts, patterns, relationships, and experiences shaping how you're moving through this transition.
You don't have to wait until everything falls apart before asking for support.
Postpartum Therapy for Women in Westlake Village, CA
If you're a woman in Westlake Village or the surrounding communities navigating postpartum changes, trauma, anxiety, identity shifts, or a major life transition, therapy can give you a place to slow down and make sense of what you're experiencing.
My work focuses on women's trauma and life transitions, including the complicated emotional experiences that can come with pregnancy, postpartum, motherhood, relationships, and becoming someone new while still trying to recognize yourself.
You don't have to have the perfect words. You don't have to know exactly what's wrong. And you don't have to prove that things are “bad enough” to deserve support.
Sometimes the first step is simply being able to say:
“I don't feel like myself anymore, and I want help finding my way back.”
If that's where you are, I invite you to reach out and learn more about postpartum therapy and women's trauma therapy in Westlake Village, CA.
5 FAQs
1. What is postpartum psychosis?
Postpartum psychosis is a serious psychiatric emergency that can occur after childbirth and may involve delusions, hallucinations, paranoia, confusion, disorganized thinking, severe insomnia, and loss of contact with reality. It requires immediate psychiatric evaluation.
2. What are the warning signs of postpartum psychosis?
Warning signs can include hallucinations, delusions, paranoia, severe confusion, unusual or bizarre behavior, extreme agitation, dramatic mood changes, significant insomnia, and difficulty distinguishing what is real from what isn't.
3. How is postpartum psychosis different from postpartum depression?
Postpartum depression primarily affects mood, motivation, energy, and functioning. Postpartum psychosis involves a disruption in reality testing, such as hallucinations, delusions, or severe paranoia. The two can occur together, but psychosis requires immediate psychiatric attention.
4. Are intrusive thoughts a sign of postpartum psychosis?
Not necessarily. Intrusive thoughts can occur with postpartum anxiety and other conditions. A person experiencing intrusive thoughts typically recognizes them as unwanted and distressing. Psychosis can involve a loss of insight in which delusions or hallucinations are experienced as real.
5. Did Lindsay Clancy have postpartum psychosis?
The public cannot make a clinical diagnosis based on media coverage. Lindsay Clancy's ongoing trial is addressing questions about her mental state and criminal responsibility, with the defense arguing that she experienced severe mental illness including postpartum psychosis. The prosecution disputes that interpretation.
