What Is Postpartum Psychosis?
Newborn baby holding mother’s hand.
This story was originally reported by Brooke Migdon of The 19th. Meet Brooke and read more of their reporting on gender, politics and policy.
Attorneys for Lindsay Clancy, the Massachusetts woman on trial for strangling her three young children in 2023, argued before a jury Tuesday that Clancy should not be held criminally responsible for their deaths. The 35-year-old former labor and delivery nurse, they said, had been experiencing postpartum psychosis, a rare and dangerous medical condition that alters a person’s perception of reality after childbirth.
At the time of the killings, Clancy had recently given birth to her third child. She reported intense feelings of anxiety and depression and sought psychiatric care. On Tuesday, her lawyer said Clancy had been diagnosed with bipolar disorder, and her husband, Patrick Clancy, said his wife had begun describing intrusive thoughts of harming herself and the children roughly a month before their deaths.
In a lawsuit filed last year, Patrick Clancy said Lindsay Clancy’s doctors had failed “to attend to her worsening psychiatric condition.”
Here’s what to know about postpartum psychosis.
What Causes Postpartum Psychosis?
About a third of people diagnosed with postpartum psychosis have also been diagnosed with another mental health condition, most commonly bipolar I disorder, according to experts at the Cleveland Clinic. Researchers believe the condition may also have a genetic link: Those who have experienced postpartum psychosis often report having had family members with a history of the disorder or a related mental health condition, such as schizophrenia or major depressive disorder.
While extremely rare, postpartum psychosis most commonly presents in people who have just given birth to their first child. For individuals with a history of postpartum psychosis, however, the chances of experiencing it again after future childbirths are between 30 and 50 percent, according to the Cleveland Clinic. Researchers have speculated that sleep and autoimmune disorders and a person’s sensitivity to postpartum hormonal changes may also play a role.
What Are The Symptoms Of Postpartum Psychosis?
Symptoms of postpartum psychosis can vary widely and are typically grouped into three subtypes: depressive, manic and mixed, according to the Cleveland Clinic. The depressive subtype is the most common, accounting for roughly 41 percent of reported cases. It’s also the most dangerous, with depressive symptoms almost always present in cases involving self-harm or harm to a child.
Manic symptoms, including irritability, aggression and delusions of grandeur, make up roughly 34 percent of cases, according to the Cleveland Clinic, and mixed symptoms, including disorganized speaking, confusion and hallucinations, appear in about 25 percent of cases.
How Is Postpartum Psychosis Different From Postpartum Depression?
Postpartum psychosis is a severe and dangerous medical emergency that involves an altered experience of reality. It is extremely rare, affecting roughly 1 or 2 women out of every 1,000.
Postpartum depression can also be dangerous, but it is much more common, affecting up to 1 in 7 people who have recently given birth, according to the Cleveland Clinic. People with postpartum depression report feelings of hopelessness and anxiety and trouble bonding with their newborns. They do not, however, experience a break from reality.
How Can Postpartum Psychosis Be Treated?
Treating postpartum psychosis requires immediate medical intervention, most commonly psychiatric hospitalization and antipsychotic and mood-stabilizing medications. Because the condition disrupts a person’s sense of reality, inpatient mental health care is almost always involuntary, according to the Cleveland Clinic.
The Cleveland Clinic’s guidance notes that electroconvulsive therapy, a procedure sending a small electric current through the brain to induce a small, controlled seizure, may be appropriate in some cases.
With the right treatment, most people will fully recover from postpartum psychosis, according to Action on Postpartum Psychosis, a United Kingdom-based charity. Recovery can take anywhere from six months to a year, and often includes bouts of depression, anxiety and low social confidence as those affected come to terms with their experience.
Have There Been Other Postpartum Psychosis Cases Like Clancy’s?
Clancy’s case echoes that of Andrea Yates, who drowned her five children in the bathtub of her Texas home in 2001. Yates’ legal team argued at the time that she had suffered from postpartum psychosis and that religious delusions had driven her to kill her children.
A Texas appeals court in 2006 overturned Yates’ murder conviction, finding her not guilty by reason of insanity and committing her to a state mental hospital.
