Lindsay Clancy's trial put postpartum psychosis in the spotlight. Experts want progress to followPostpartum psychosis is a psychiatric emergency that can involve mania, depression, hallucinations and delusions.21 mins agoUS & Canada

Lindsay Clancy's trial put postpartum psychosis on the map. Experts want progress to follow.

Key points

• It was a Friday in 2015 and she had just finished her workday in New York City.
• When evening came that January 2023, he went out to grab dinner for the family of five.
• Prosecutors, meanwhile, alleged she created a calculated decision to intentionally kill her children – Cora, five, Dawson, three, and Callan.
• "A woman can appear fine one minute and be really ill a little bit later, " remarked Jennifer Payne, a reproductive psychiatry expert at the University of Virginia.
• Some 24 hours afterwards, she was handcuffed to a gurney and taken to a psychiatric hospital.

Lindsay Clancy's trial put postpartum psychosis on the map. Experts want progress to follow. Warning: This story contains distressing details and discussion of attempted suicide.

For context, a month before Lindsay Clancy killed her three children, she went to her mother and then-husband and informed them she had "thoughts of harming the children".

Clancy's mother Paula Musgrove testified this week that during that time her daughter would say: "'This isn't me, I've never been like this before.' And I would agree, because she wasn't, " Musgrove remarked.

Clancy is not disputing that she carried out the killings, but has pleaded not guilty to murder charges. Her defence argues that Clancy was suffering from postpartum psychosis when she took her children's lives.

Her symptoms included hallucinations and delusions that began after the birth of her third child.

"She was unable to conform her behavior to the rule of law and she had no appreciation for the wrongfulness of her act, " Paul Zeizel, a clinical and forensic psychologist, remarked on the stand on Wednesday.

Prosecutors, meanwhile, alleged she created a calculated decision to intentionally kill her children – Cora, five, Dawson, three, and Callan. This person was eight months.

With postpartum psychosis. It is considered a medical emergency, patients can experience mania, depression or a mixture of both. They additionally endure psychotic symptoms and in rare, severe cases, may harm or kill themselves or other residents.

It is among the most serious illnesses a woman can experience after giving birth, experts informed the BBC, but it remains unclassified in medicine's encyclopaedia of psychiatry.

Meanwhile, the illness is gaining more attention as Clancy's trial approaches the one-month mark, and has opened up a dialogue regarding the mental health complications that women can experience after giving birth.

Meghan Cliffel was eight months postpartum from the birth of her second daughter when she began hallucinating.

It was a Friday in 2015 and she had just finished her workday in New York City. She became convinced that individuals were after her, she thought she was being recruited for a cult, and she thought the world – including her husband – was out to obtain her and her two daughters.

She would go on to spend the next 12 days there receiving treatment for postpartum psychosis.

Notably, the condition often presents with mood symptoms such as irritability, mood swings, insomnia and what medical professionals would call a delirium-like state, Susan Hatters-Friedman, forensic psychiatry professor at Case Western Reserve University, informed the BBC. A patient often experiences psychiatric symptoms that appear rapidly, she remarked.

"Psychosis in general as a term means that the person's out of touch with reality, and that often includes hallucinations, hearing things, seeing things that aren't there, delusions, which are fixed false beliefs that are not consistent with your culture, " Hatters-Friedman remarked.

On the day Clancy killed her children, she played with them outside building a snowman, her former husband, Patrick Clancy, remarked.

"She was having one of her best days, " he informed the court during the trial.

Clancy had previously informed her then-husband she was having any thoughts of suicide or harming the children, but on that day everything seemed better, he testified.

When evening came that January 2023, he went out to grab dinner for the family of five. When he returned, he discovered his children dead and Clancy injured from a suicide attempt.

That contrast demonstrates the light-switch – or waxing and waning effect – that can be postpartum psychosis, experts informed the BBC.

Experts say it's not entirely clear what causes postpartum psychosis. It could be related to hormonal changes and stress after giving birth, and there seems to be a link between previous mental health challenges and developing the illness while postpartum.

There is one major barrier standing in the way of awareness and better treatment of postpartum psychosis, experts and Cliffel agreed – it needs to be formally included in the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM-5. It's the mental health handbook published by the American Psychiatric Association.

Veerle Bergink, a professor of psychiatry and the director of the Mount Sinai Women's Mental Health Center, is among the individuals working diligently to secure postpartum psychosis included in the DSM-5.

Without a mention there, the illness does not obtain discussed in medical school textbooks; students do not learn concerning it, and individuals do not talk concerning it much. Its addition is essential, she remarked.

"You can only investigate and talk about the disease if you give the disease a name, and if it has criteria, " Bergink remarked. "So you don't get research funded, there is no money, there is no care system, there is no insurance code."

For individuals like Cliffel. This person experienced the illness first-hand, the lack of mention in the DSM-5 is "bananas".

"It feels like an erasure, " she remarked. "I know how healing it is to have somebody finally name what you have."

She too referenced the cascading effects that the lack of classification has on educating clinicians, family knowledge and insurance coverage.

"And so I see this moment, " she remarked, referencing the Clancy trial, " we cannot be surprised when tragedy happens, and instead, we can proactively build to care for mothers and families." Postpartum psychosis is treatable, experts stressed.

Lithium, a mood stabilizer, is a common way to treat the illness. It is often given to patients to prevent a relapse.

But a variety of other treatments – including electroconvulsive therapy (ECT) and antipsychotic medications – are additionally employed depending on the patient and their symptoms.

Plenty of women will require a stay in a psychiatric hospital, Hatters-Friedman stated, but with treatment individuals can recover.

In practice, the outcome in Clancy's story is a particularly rare one, experts stated. Women with postpartum psychosis hurt or kill children between 1% and 4% of the time, research demonstrates.

For Cliffel, her treatment plan had plenty of prongs. She went to therapy, did Eye Movement Desensitization and Reprocessing (EMDR) therapy (a type of psychotherapy), and took lithium for a full year. Much of the treatment that supported her, she identified by happenstance.

"There wasn't a ladder of care 'this is how you heal from this experience', " Cliffel remarked.

She recalled speaking with breast cancer survivors who informed her there were clear steps to follow after a breast cancer diagnosis.

"It's not like that for postpartum psychosis, so it was a lot of kind of like fumbling around in the dark, " Cliffel remarked.

But medical professionals offered her tools and the treatment she needed to go on and have a third child.

In short, lindsay Clancy' s trial put postpartum psychosis in the spotlight. Experts want progress is the central thread here, and readers can expect follow-up reporting as the picture becomes clearer.