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Clancy’s defense team argues she killed her three children under the condition, and should not be convicted of murder
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Wellness — Sarah Sloat
Postpartum psychosis, a rare and severe mental health illness, is central to the trial of Lindsay Clancy, who has pleaded not guilty to three counts of first-degree murder. Her defense team argues that she killed her three children while experiencing the condition, which can cause hallucinations, delusions and rapid mood changes.
While the outcome of the trial may hinge on a determination of Clancy’s mental state, women who have experienced postpartum psychosis say the attention surrounding the case could help raise awareness about the need for better support, including more research and improved medical training.
Despite its severity, postpartum psychosis is not entirely understood, with gaps in research, diagnosis and treatment.
“Each case I have been part of treating has shown just how incredibly devastating postpartum psychosis can be,” says Crystal Schiller, a clinical psychologist and director of the University of North Carolina at Chapel Hill Center for Women’s Mood Disorders.
“Women deserve better access to care, and they deserve experts who really understand what’s going on and who can provide answers on how to treat and prevent this illness.”
To understand why postpartum psychosis can have such tragic consequences, it’s important to understand the illness itself.
What is postpartum psychosis and what are the symptoms?
Postpartum psychosis is a mood disorder with psychotic features, says Dr Soudabeh Givrad, a clinical associate professor of psychiatry and behavioral sciences at Stanford Medicine.
Most individuals with postpartum psychosis experience severe mood symptoms. These can include hallucinations, delusions, confusion, depression, insomnia and a mixture of low and manic moods. Postpartum psychosis is associated with a high risk of suicide and infanticide.
These symptoms can start within two weeks after giving birth. It’s rarer for symptoms to emerge several weeks after birth, but it is possible, according to the UK’s National Health Service. Symptoms can also come and go, which can make it difficult to identify in the limited window a patient has with a care provider, says Givrad.
Overall, the illness is rare , affecting about one to two out of every 1,000 women after childbirth. It is considered a psychiatric emergency.
There is a spectrum of perinatal mental health conditions, or conditions that affect a person during pregnancy and after childbirth, says Bonnie Kerker, a professor of population health and child and adolescent psychiatry at the NYU Grossman School of Medicine. Postpartum psychosis is at the far end of this spectrum, she says.
Yet, overall, “when it comes to perinatal mental health, there are still a lot of myths out there where women tend to think that pregnancy and the postpartum period are supposed to be the happiest time of their life”, Kerker says. This can lead to ignoring symptoms and refusing help.
What causes postpartum psychosis and who is at risk?
While we don’t know exactly what causes postpartum psychosis, its emergence is likely the result of multiple colliding factors, says Givrad.
Its onset possibly stems from an interaction between an underlying biological vulnerability and triggering factors like the profound changes to hormones, lack of sleep and the immune system that happen during pregnancy.
An underlying biological vulnerability could be a family history of postpartum psychosis or bipolar disorder. A 2026 paper published in Biological Psychiatry suggests postpartum psychosis is a “distinct mental illness within the bipolar spectrum”. There is a crossover in treatments for bipolar disorder and postpartum psychosis. Subsequently, women with bipolar disorder are at a higher risk of developing postpartum psychosis.
However, “in about 40% of cases, there are no known risk factors that we can identify”, says Schiller.
How postpartum psychosis is treated and when to get help
Postpartum psychosis is a medical emergency that can get worse rapidly. The start may be accompanied by factors like sleep deprivation, irritability and racing thoughts, and can quickly turn to beliefs detached from reality and hallucinations, says Givrad.
Because the illness can escalate swiftly, it’s important for both the patient and her family to pay attention to the signs. While speaking with a care provider about any changing symptoms is critical, Givrad explains that immediate help may also be necessary. This can look like calling a crisis line or going to the emergency room.
Treatments for postpartum psychosis vary and may be delivered alone or in combination. These include medications, like antipsychotics, antidepressants and mood stabilizers like lithium. Patients may also be treated with electroconvulsive therapy.
“In the majority of cases, it can be very treatable,” says Givrad. “We have lots of women who have postpartum psychosis and then go on to live normal lives.”
But more research is needed on what causes the illness in the first place, which would pave the way for better research on which treatments work best and for whom, says Schiller. Research on postpartum psychosis is deficient for several reasons, she says, including historic underfunding in women’s health generally, and the use of what limited funds there are on more common illnesses, like postpartum depression .
As individuals recover, they may also be recommended for cognitive behavioral therapy. Recovery times differ across the patient population. Severe symptoms may last two to 12 weeks .
In the United States, it’s common for mothers who need to be hospitalized to receive treatment while separated from their babies (depending on the case, they will have scheduled visiting hours). This is less common elsewhere – for example, in the United Kingdom, treatment can occur in this type of specialist psychiatric unit, known as a mother-and-baby unit. These units prevent the trauma of separation and support bonding, and in turn improve mental health overall.
Inpatient programs designed to treat the perinatal population specifically are ideal, but these are also rare in the US, says Schiller: UNC has a five-bed unit , sought after by patients from across the country. Infants are encouraged to visit with extended hours but cannot stay overnight.
“I hope that increased awareness of this [postpartum psychosis] will allow other specialty programs like ours to grow and blossom,” says Schiller. “It’s so important that women have access to high-quality care in this kind of emergency situation.”
Recovery can vary. Some women fully recover and never experience psychosis again; some have episodic bipolar illness, while others have “more of a chronic situation, though that category is relatively rare”, says Schiller. People who receive good treatment quickly are most likely to fully recover.
According to a 2021 study on 106 women with postpartum psychosis, more than two-thirds of this sample group did not experience any major psychiatric episodes outside of the postpartum period. The majority of the remaining group transitioned to a bipolar disorder diagnosis.
“It’s been shocking to me to see the difference between when our patients are admitted to our inpatient unit for postpartum psychosis and once they’ve received adequate treatment,” says Schiller. “It’s like a switch gets flipped and they are back to their usual self.”
People at a higher risk of developing postpartum psychosis should speak with their healthcare providers before, during and after pregnancy, says Schiller. The clinics she works with offer preconception counseling for women who have a history of bipolar disorder or postpartum psychosis, so they can be set up with preventative treatments.
“The key is working closely with a trusted clinician proactively,” she says. “There are medications that can help prevent the onset of psychosis after giving birth.” Some providers will have their patients begin antipsychotics or mood stabilizers late in the third trimester, or at delivery, and provide counseling on how to balance taking medications with lactation concerns.
But stigma, fear and systemic barriers like access to healthcare providers can make it difficult for women to come forward with their symptoms, says Schiller.
“Many women are afraid they’ll be referred to law enforcement or their children will be taken away if they disclose anything,” she says.
While pregnant women may be evaluated for depression before and after labor, a similar screening tool for postpartum psychosis doesn’t exist. Schiller says it can be up to the healthcare provider or a family member to notice the signs and symptoms in new mothers. Though mothers can and should bring up symptoms, by nature of the illness it can be difficult for an individual to realize they are experiencing postpartum psychosis.
Beyond the specifics of postpartum psychosis, other factors have been shown to support new mothers’ mental health generally, says Kerker, including health insurance and paid maternity leave.
She also emphasizes that because different cultures view mental health and self-care differently, it’s critical to ensure the services offered match how people think about these things; otherwise, some communities will not utilize services.
How can care for postpartum psychosis be improved?
Lived experiences and research suggest it can be very difficult for families to find and obtain help for postpartum psychosis.
This reality stems, in part, from how new mothers receive care. After giving birth, a postpartum checkup happens about six weeks later. But those first six weeks are “the period of highest risk for postpartum psychosis”, says Schiller. Because a baby’s first pediatrician appointment happens in the early days after birth, it can fall to pediatricians to notice whether a new mother’s mental health is suffering.
Ideally, women would be checked on weekly after labor, says Schiller. But even if this system existed, nurses and doctors are often untrained in speaking to patients about postpartum psychosis.
“It’s only in a relationship of trust that patients feel comfortable talking about these very distressing and highly stigmatized symptoms,” says Schiller.
For now, postpartum psychosis does not have a distinct classification in the Diagnostic and Statistical Manual of Mental Disorders (DMS), the guide used by care providers to diagnose and classify mental health conditions.
Experts argue that inclusion in the DSM can improve detection and treatment. Inclusion means established diagnostic criteria are used to identify which patients have the condition and which patients should be studied.
Funding is more accessible with a DSM listing, says Schiller. Insurance companies also use the DSM to decide which mental health treatments they will cover.
“As a field, we’re really hoping it will be recognized as a distinctive illness, because it has distinctive timing,” says Givrad. “Inclusion in the DSM means it’s easier to develop how to make sure postpartum individuals don’t fall through the cracks.”
While the outcome of the trial may hinge on a determination of Clancy’s mental state, women who have experienced postpartum psychosis say the attention surrounding the case could help raise awareness about the need for better support, including more research and improved medical training.
This report is published with credit to theguardian.com. Full available text from the wire is above. Read on theguardian.com →
Source: theguardian.com · Sarah Sloat. Published 27 Aug 2026, 12:00 pm.
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