Postpartum Psychosis: Killings Of 3 MA Children Spotlight Condition

Lindsay Clancy, the 32-year-old Duxbury mother facing charges in the deaths of her three children, said a man’s voice told her to kill her three children in a moment of psychosis, according to allegations made in court by Plymouth County District Attorney Jennifer Sprague.

The admission came in a phone call to her husband, Patrick Clancy, who said it was the first time his wife had mentioned hearing voices or used the word psychosis, Sprague alleged. The D.A. went on to detail Lindsay Clancy’s actions that day, including routine things like taking one of her children to the doctor and playing with the others. The children were killed when her husband was not at home, a situation Sprague said Lindsay Clancy created and did not merely take advantage of.

The horrors came in to focus around 6 p.m. Jan. 24, when police said they found two children, ages 5 and 3, dead and an 8-month-old seriously injured in the Duxbury home after Patrick Clancy called 911 to report that his wife had attempted suicide by jumping out a window. Within days, the third child was also dead, and Lindsay Clancy was in custody having been charged with her childrens' murders.

What went wrong?

“Ideations She Could Not Control”

Clancy’s husband and lawyer have each given statements alluding to her recent, escalating struggles with mental health. Calling Clancy an "incredible mother,” Clancy's lawyer, Kevin Reddington, told The Boston Herald that she had "some homicidal and suicidal ideations that she could not control." Her husband wrote that she had been portrayed "largely by people who have never met her and never knew who the real Lindsay was,"adding that his marriage was "wonderful and diametrically grew stronger as her condition rapidly worsened."

In court on Tuesday, where a not-guilty plea was entered on Clancy’s behalf on charges of murder, assault and battery and strangulation, Reddington told the court she had been prescribed a variety of medications in the months before the killings, including Prozac, Benadryl and other mood stabilizers. He argued that Clancy did not plan the killings as Sprague alleged.

The Boston Globe reported that around the time of the killings, Clancy was experiencing postpartum anxiety – which the Cleveland Clinic defines as excessive worrying that occurs after childbirth or adoption – claims which were reiterated in court Tuesday.

It’s unknown what specific conditions she suffered from but her defense has said she was mentally ill.

Patch spoke with three experts who explained how a condition like postpartum psychosis may present itself. None of the experts treated Clancy.

What Is Postpartum Psychosis?

Speaking with Patch, Dr. Meghan Downey, a licensed clinical psychologist, explained that postpartum anxiety is a common condition that occurs in one in every eight to 10 deliveries. However, in rare cases, women can develop a condition called postpartum psychosis, which the Cleveland Clinic describes as altering a person’s perception of reality following the birth of their child.

Postpartum psychosis is not nearly as common a condition as postpartum depression or postpartum anxiety, though when it occurs, it is an emergency, Downey told Patch. Occurring in every 1,000-2,000 deliveries, the condition can cause hallucinations and delusions, paranoia, disorganization, dysregulated mood, irritability or agitation and insomnia, Downey explains.

"Whether psychosis is organic, substance-induced, or occurs postpartum, it can significantly distort or alter an individual's reality," Downey said, adding that delusions can make an individual have full conviction that their false beliefs are true.

Pathway To Violence

Downey emphasized that intense false beliefs "can certainly contribute to violence."

When faced with auditory hallucinations, for example, "an individual may hear the voice of someone they know, someone they don't know, or even a voice who they perceive to be God or the devil instructing them to do something," Downey explains. "These voices can be so powerful and convincing. Combined with delusions, again, there is certainly a potential for violence."

Symptoms of postpartum psychosis typically develop within one to four weeks of childbirth, Downey said, adding that prompt treatment is crucial because symptoms, which can begin with extreme confusion, loss of touch with reality and a disorganized thought process, often develop rapidly.

"The biggest concern with postpartum psychosis is that an individual may feel driven to harm themselves or their children," Downey said.

While Clancy "never indicated she was hallucinating, delusional, or had disordered thoughts or speech" in journal entries leading up to the killings, she did write in an October entry about resenting her two older children, and she had committed herself into a mental health facility in early January, according to statements made by Sprague in court Tuesday.

Not Like In The Movies

Sprague outlined multiple interactions Clancy had with her husband, her daughter’s doctor and a store manager on the day of the killings, purporting that she had "clarity" and "focus" and that no one reported that any of the encounters were out of the ordinary.

Dr. Amanda Itzkoff, an assistant professor at the Department of Psychiatry at Mount Sinai Hospital, said that doesn’t necessarily mean Clancy was not suffering from psychosis.

"Someone can be delusional and not appear obviously psychotic unless they tell you about their delusions," Itzkoff told Patch. "There are not necessarily outward signs of delusions because they are just beliefs."

Itzkoff added that though psychosis is often portrayed differently in the movies, “people who have a delusional form of psychosis do not necessarily hear or see things that aren’t there, and they don’t always respond outwardly to internal stimuli.”

"It does not surprise me that she seemed okay," Itzkoff said.

Paige Bellenbaum, the founding director of The Motherhood Center of New York, echoed Itzkoff’s assertion that to the untrained eye or ear, a person suffering with delusions might not appear unwell.

"Psychosis does something called waxing and waning," Bellenbaum told Patch. "Somebody can go from being totally lucid, appearing to be organized, making sense, and then at the drop of a dime, they can become actively psychotic."

Bellenbaum emphasized that suffering with delusions doesn’t preclude one’s ability to carry out a plan.

"Remember, the whole premise of psychosis is fixed false belief, and it comes and goes," she said.

Treatment Is Both Difficult And Helpful

"Most individuals who experience psychosis have tremendous shame, which can make them more reluctant to share some of the difficult thoughts or symptoms they may be experiencing," Downey said. "Any time anyone is suffering a mental health crisis, treatment may often feel both difficult and helpful."

Itzkoff said that postpartum psychosis is “very treatable” if health care providers act immediately once symptoms appear and continue to follow up.

Treatment may consist of both therapeutic and pharmaceutical options like mood stabilizers and antipsychotics.

Bellenbaum said she saw no red flags relating to Lindsay Clancy’s medication use, saying it’s not uncommon for someone to be on a variety of medications at once or over a time period of several months as doctors try to figure out the right medication and dosage.

No Mother In Her Right Mind

Bellenbaum hoped for leniency for Clancy.

Even without the potential for a lifelong prison sentence, Clancy would have a long and challenging road ahead, she said.

"She will have to live with this forever," Bellenbaum said. "And if that isn’t being imprisoned, I don’t know what is."

If you are having suicidal thoughts, dial 988 for the National Suicide and Crisis Lifeline.