The trial of Lindsay Clancy, a former labour and delivery nurse accused of murdering her three young children before attempting to take her own life, has drawn intense global attention. The case has also sparked widespread discussion about how mental health services support women after childbirth, placing postpartum psychosis firmly in the spotlight.
Clancy, 36, from Massachusetts, does not deny killing her children. Her defence argues that she was suffering from postpartum psychosis, as well as bipolar disorder, insomnia, anxiety and postpartum depression, and that she should not be held criminally responsible for their deaths. Prosecutors allege that Clancy made a calculated decision to intentionally kill her children - Cora, five, Dawson, three, and Callan, who was eight months.
What is postpartum psychosis?
Postpartum psychosis is a serious mental health illness that can develop after a woman gives birth. It is sometimes known as puerperal or postnatal psychosis. It is very different from the "baby blues" or postpartum depression and is deemed a medical emergency by the NHS.
Dr Julie Hammond, an NHS GP and specialist in women's health, told the Mirror: "What people sometimes struggle to understand is that when someone is experiencing psychosis, what they are seeing, hearing, or believing feels very real to them." She added that postpartum psychosis is highly treatable with the right support, and almost all mothers recover fully after an episode.
How common is it and what causes it?
Postpartum psychosis affects one in every 1,000 mothers in the UK. In comparison, postnatal depression affects between 10 percent and 15 percent of UK mothers within the first year of giving birth - around 1 in 8 to 1 in 10.
According to the mental health charity Mind, there is no single clear factor that causes postpartum psychosis. The condition is often linked to the stress, sleep deprivation and hormonal changes after birth. Some women who develop it have no previous history of mental illness, but the charity Action on Postpartum Psychosis (APP) says that a history of bipolar disorder raises the risk. Other factors, such as a traumatic birth or a family history of mental health problems like bipolar disorder or schizophrenia, can also increase the chance of developing the illness.
Symptoms, first signs and recovery
Postpartum psychosis can come on suddenly and be very distressing. According to APP, it is most common for it to begin in the first two weeks after birth, often in the first few days. Symptoms can also start later, several weeks postpartum, but this is more rare. The main signs are delusions, hallucinations, mania and confusion.
According to Mind, women may feel excited or elated (manic), restless, severely depressed, anxious or irritable, like their thoughts are racing, paranoid or suspicious of other people, like their mood is changing rapidly, or confused or disorientated. Dr Hammond explained: "Feeling like you don't need sleep is one of the key things that we advise people to monitor, because we know that a lack of sleep can also exacerbate underlying mental health illness." She noted that a person may speak much faster, have racing thoughts, or speak in a disconnected way about random things that are hard to follow. They may be agitated, energetic, confused, paranoid, or say things that are out of character.
Because of the detachment from reality, the patient may not recognise that they are ill, so loved ones are usually the ones who spot that something is wrong. Postpartum psychosis is a temporary illness, with the most severe symptoms typically lasting between two to 12 weeks. A full recovery can take 6 to 12 months or longer. APP says that getting the correct treatment as soon as possible can reduce illness severity and recovery time.
The charity added: "Postpartum psychosis is often followed by a period of depression, anxiety and low social confidence. It can take time to come to terms with what has happened to you. It's normal to feel some sadness at missing out on early motherhood. It can take time to rebuild confidence in relationships and friendships. But most women do get back to feeling like their usual selves again."
